Information for People Exposed to Birds or Other Animals Infected with Avian Influenza Viruses

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Public Health Monitoring Plan for USDA/APHIS Responders to Detections of Avian Influenza Virus in Poultry [325 KB, 17 pages]

This document provides guidance to local, state, and federal public health authorities on monitoring of persons potentially exposed to avian influenza A viruses during official United States Department of Agriculture Animal and Plant Health Inspection Service (APHIS) response activities in the United States.

The following information and guidance apply to include not only wild birds, poultry, and backyard captive birds but also other animals, wild terrestrial and marine mammals, domesticated animals such as dogs and cats, farmed animals such as mink, and livestock such as goats and cattle.

You are being given this information and these instructions, because you were recently around poultry, wild birds, or other animals, found to be infected with avian influenza viruses (“bird flu” viruses). Viruses like these have caused rare, sporadic infections in people, resulting in human illness ranging from mild (e.g., eye infections, cough, sore throat) to severe (e.g., pneumonia, shortness of breath, difficulty breathing). These viruses have the potential to cause human illness in people who have been exposed to infected birds or other animals.

Infected birds shed avian influenza viruses in their saliva, mucous, and feces. Other animals infected with avian influenza viruses might have viruses in respiratory secretions, blood, and other fluids including animal milk, and organ tissues such as the brain. Therefore, animals infected with avian influenza viruses can contaminate the environment they are living in with avian influenza viruses. Human infections with avian influenza viruses are rare, but they can happen when virus gets into a person’s eyes, nose, or mouth, or is inhaled. This can happen when viruses are in the air (in droplets or small particles, and possibly dust) and are deposited in the eyes or breathed in by a person, or possibly when a person touches something contaminated by avian influenza viruses and then touches their mouth, eyes, or nose. Most often these infections have occurred after unprotected contact with infected birds but can occur after exposure to other animals known or suspected to be infected with avian influenza viruses.

Because human infections with these avian influenza viruses are possible, all people with direct or close exposure to well-appearing, sick, or dead birds, poultry or backyard flocks, other animals that are known or suspected to be infected with avian influenza viruses, or their contaminated environment (e.g., living areas, animal bedding) including surfaces should be monitored for illness for 10 days after their last exposure. More information on exposure criteria for human infections with HPAI A(H5N1) virus is available at Highly Pathogenic Avian Influenza A(H5N1) Virus in Animals: Interim Recommendations for Prevention, Monitoring, and Public Health Investigations | Avian Influenza (Flu) (cdc.gov). State and local health departments are helping to monitor people’s health and you should contact your health department if you get any of the symptoms listed on this fact sheet during the 10 days after your last exposure. By following the instructions below, you can help ensure that you receive prompt medical evaluation, testing, and appropriate treatment if you become ill with signs and symptoms that could be due to bird flu.

Please follow these instructions carefully:

Monitor your health for symptoms of avian influenza virus infection.
During and then immediately after your last exposure to known or suspected infected birds, other infected animals, or areas and surfaces contaminated by infected birds and other animals, monitor yourself daily for any of these signs and symptoms for 10 days:

Fever (Temperature of 100°F [37.8°C] or greater) or feeling feverish/chills*
Cough
Sore throat
Difficulty breathing/Shortness of breath
Eye tearing, redness, or irritation
Headaches
Runny or stuffy nose
Muscle or body aches
Diarrhea
*Fever may not always be present

You should observe your health daily even if you carefully followed all guidelines and instructions for properly putting on and taking off personal protective equipment (PPE) and maintaining biosecurity precautions.

Re-start your 10-day monitoring period from Day 1 if you are around infected birds, or other known or suspected infected animals, or contaminated environments again.

Your local/state health department should contact you regarding your exposure. Please follow all additional instructions that are given to you regarding monitoring for symptoms. They may, for example, ask you to respond to a daily phone call, email, or text message with a report on your health status.

Call your state/local health department immediately if you develop any illness signs or symptoms during the 10-day observation period. Your health department will help you determine what to do next.

Remember:

Most of the signs and symptoms of bird flu overlap with those of other respiratory illnesses (like seasonal flu or COVID-19). Fever may not always be present.
If you develop any of the signs or symptoms listed on this fact sheet, immediately call the health department of the state you are in at the time. Your health department wants to hear from you, even if it turns out to be a ‘false alarm.’ Your health department will give you further instructions and might ask you to get tested for avian influenza virus infection.
If you have symptoms, stay home and limit contact with others as much as possible until the results of your test are known. Your health department might have additional instructions for you as well.
To test for avian influenza virus, a doctor or nurse will collect a sample from you by swabbing your nose and/or throat and possibly your eyes if you have eye redness or discomfort.
If you become sick while you are observing your health, a doctor might prescribe an antiviral medication for you that is used for treatment of seasonal flu. These drugs can also treat avian influenza virus infection. It is important to start antiviral treatment as soon as possible and to follow the directions for taking all of the medication that is prescribed. (CDC recommends that clinicians prescribe antiviral medications for treatment of ill persons who had exposure to avian influenza viruses and are suspected to be infected with avian influenza viruses.)

Here’s an example of a log you can keep as a reminder to check your health each day for illness signs and symptoms.
Day	Date	Temperature	Signs and Symptoms Write ‘None’ if you aren’t experiencing any of the signs and symptoms.
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10

Additional Resources

Where to Find More Information:

Call 1-800-CDC-INFO (1-800-232-4636); TTY: 888-232-6348

Avian influenza (bird flu) virus infections in humans are of public health concern, not only because of the illness they may cause but because of their pandemic potential if they were to change to spread easily from person to person. Avian influenza (bird flu) virus infections can cause a wide range of illness, from mild to severe. Some avian influenza (bird flu) viruses have been associated with greater numbers of human infections and more serious illnesses in people and therefore may pose a greater public health risk. More Information on Bird Flu Infections in People.