While the world adapts to the ongoing presence of COVID-19 and its hazards, other potential pandemic diseases continue to cause concerns. One example is avian influenza, also known as bird flu. In the US, the Centers for Disease Control and Prevention (CDC) and Occupational Safety and Health Administration (OSHA) note that avian influenza H5N1 was first seen in the U.S. in migratory birds in 2015, and in agricultural poultry stock beginning in 2022. Since then, a few mammal infections have been confirmed, and in April 2024, a dairy farm worker tested positive for avian influenza A (H5N1). This history confirms a slow expansion of pathways to infection, and at-risk species extending to include humans. There have not yet been confirmed human-to-human transmissions, which could trigger the next pandemic if they began to proliferate (just as COVID-19 did a few years ago). As these concerns rise, in August 2024 OSHA gathered and updated safety information about Bird Flu, which I summarize below.
How does bird flu manifest in humans?
OSHA’s latest Fact Sheet summarizes bird flu infections and symptoms as they have appeared so far in humans:
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Symptoms of avian flu in humans
Symptoms in humans can range from asymptomatic or mild illness (e.g., conjunctivitis (eye redness), mild flu-like upper respiratory symptoms) to severe illness (e.g., pneumonia) requiring hospitalization. Signs and symptoms may include fever, cough, sore throat, runny or stuffy nose, muscle or body aches, headaches, fatigue, and shortness of breath or difficulty breathing. Less common symptoms include diarrhea, nausea, vomiting, or seizures. Fever does not always occur in humans infected with avian influenza.
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How people become infected
Avian influenza infections in humans are the result of contact with infected poultry (e.g., domesticated chickens, ducks, and turkeys) or dairy cattle, including when a person touches a contaminated surface, object, or material and then touches the mouth, nose, or eyes, as well as inhalation of avian influenza virus. Examples of employees subject to these exposures include
− Workers handling or contacting sick birds, livestock, or other animals including poultry, dairy and slaughterhouse workers; non-agricultural animal handlers (e.g., animal control, zookeepers, veterinarians)
− Laboratory employees who handle influenza viruses
− Healthcare workers treating patients with known or suspected avian influenza viruses
What does OSHA recommend for employees at risk of exposure?
Employees subject to the sources of infection should do the following:
− Avoid unprotected contact with birds and animals suspected or known to be infected
− Use proper hand hygiene practices
− Get the seasonal flu vaccine
− If sick, stay at home except to get medical attention
− Contact state or local health department for additional guidance, especially if symptoms begin after potential exposure
OSHA identifies appropriate personal protective equipment (PPE) to minimize exposures, including:
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Protective clothing
− Long-sleeved fluid-resistant coveralls that can be cleaned and disinfected or disposed of
− Properly fitted, unvented or indirectly vented safety goggles or a face shield
− Impermeable (fluid-resistant) gloves
− Rubber boots or rubber boot covers with sealed seams
− Head or hair cover
- NIOSH Approved filtering facepiece respirator (FFR) or elastomeric half mask respirator with minimum of N95 filters (OSHA’s Respiratory Protection Standard requires written respiratory protection program, medical evaluations, fit testing, and training)
The Fact sheet also reminds that PPE must be properly donned, worn/used and doffed, including training as necessary. PPE may cause heat issues, which must be addressed when present. Finally, the Fact sheet summarizes workers’ rights under the OSH Act.
What’s next?
There is not yet evidence of sustained human-to-human transmission of bird flu, so recommendations from OSHA, CDC and others are advisory. However, organizations with activities that expose workers to birds – and even mammals – should consider the sources and potential effects of exposures, and the use of PPE and procedures to minimize exposures.
Self-Assessment Checklist
Does the organization conduct activities where employees may be exposed to sick birds or other animals?
If so, has the organization evaluated these activities, investigating possible exposures and ways to manage them?
If so, does the organization have policies and procedures to manage such exposures in order to minimize the risk of infection by possible animal-to-human transmission of animal-borne diseases including bird flu?
Does the organization provide information/training about the hazards of exposures to sick animals, ways to recognize symptoms from animal-to-human transmission, and appropriate responses?
Where can I go for more information?
- OSHA
- Avian Influenza (Bird Flu) Fact Sheet (rev. 8/24)
- Hazard Alert, H5N1 (Avian Influenza) in Dairy Cattle (7/24)
About the Author
Jon Elliott is President of Touchstone Environmental and has been a major contributor to STP’s product range for over 30 years.
Mr. Elliott has a diverse educational background. In addition to his Juris Doctor (University of California, Boalt Hall School of Law, 1981), he holds a Master of Public Policy (Goldman School of Public Policy [GSPP], UC Berkeley, 1980), and a Bachelor of Science in Mechanical Engineering (Princeton University, 1977).
Mr. Elliott is active in professional and community organizations. In addition, he is a past chairman of the Board of Directors of the GSPP Alumni Association, and past member of the Executive Committee of the State Bar of California's Environmental Law Section (including past chair of its Legislative Committee).
You may contact Mr. Elliott directly at: tei@ix.netcom.com