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Highly Pathogenic Avian Influenza (H5N1) Virus Infected a Turkey Farm in Suffolk, England

On Saturday, 3 February 2007, the Department for the Environment Food and Rural Affairs (Defra) reported that turkeys on a large farm near Lowestoft in north Suffolk had been confirmed by the Veterinary Laboratories Agency (VLA) to have been infected with H5N1 avian influenza virus [1]. Later that day, the VLA confirmed that the influenza virus identified in the poultry was of the highly pathogenic Asian lineage and similar to the virus found in Hungary in January 2007 [2].

From 3 February 2007, the State Veterinary Service (SVS) has enforced a Protection Zone, with a radius of three kilometres, and a Surveillance Zone, with a radius of 10 kilometres, around the premises, where poultry must be isolated from wild birds [1]. The farm itself has been under restrictions since Thursday evening (1 February 2007) when a health problem in turkeys on the farm was first noted. In consultation with ornithologists, a wider Restricted Zone, of approximately 2090 square km, was also introduced in which the isolation of poultry from wild birds is required and all bird movements must be licensed [3].

Humane culling of turkeys at the infected farm began on Saturday 3 February and was completed by the evening of 5 February 2007 [4]. Among the total of 159,000 turkeys on the farm, 2,500 were reported to have died [5] and the rest were culled.

The level of risk to the general public from H5N1 infection as a result of this incident is assessed to be extremely low. The UK Food Standards Agency and the World Health Organization have advised that there is no risk in eating properly cooked poultry, including turkey and eggs [6,7].

Nonetheless, any possibility of human exposure is taken very seriously and the Health Protection Agency (HPA) has continued to work closely with Defra and local NHS partners to ensure that all the necessary actions have been taken to protect those people who may have been exposed to the virus, particularly those who have been in close contact with the infected poultry or their immediate environment. The measures include the use of personal protective equipment, the offering of antiviral drugs and seasonal influenza vaccine, provision of information and follow-up for any sign of illness.

To facilitate the response to the incident, the HPA has produced new guidance (a) on the management of personnel, involved in the response to the occurrence of confirmed highly pathogenic avian influenza (H5N1) in poultry in the UK, presenting with febrile respiratory illness, and (b) guidance on post-exposure prophylaxis (PEP) for farm workers/residents, SVS staff, and cullers involved in confirmed or suspected outbreaks of highly pathogenic avian influenza suspected or known to be due to H5N1 in poultry in the UK [8].

References:

1. H5N1 avian influenza confirmed in poultry (News release) London: Defra, 3 February 2007. Available at <http://www.defra.gov.uk/news/2007/070203a.htm>.

2. H5N1 in poultry in Suffolk confirmed as Asian strain of avian influenza (News release). London: Defra, 3 February 2007. Available at <http://www.defra.gov.uk/news/2007/070203b.htm>.

3. Additional restrictions imposed following confirmation of Highly Pathogenic H5N1 (News release). London: Defra, 3 February 2007. Available at <http://www.defra.gov.uk/news/2007/070203c.htm>.

4. Suffolk bird flu outbreak: cull now complete. Defra website [online]. 6 February 2006. [Accessed 8 February 2007]. Avaulable at
<http://www.defra.gov.uk/news/latest/2007/animal-0203.htm>.

5. World Organisation for Animal Health. Immediate notification report OIE:4719. Available at <http://www.oie.int/wahid-prod/reports/en_imm_0000004719_20070205_100632.pdf>.

6. Bird flu advice: 3 February 2007 . Food Standards Agency website [online]. 3 February 2007 [accessed 8 February 2007]. Available at <http://www.food.gov.uk/news/newsarchive/2007/feb/avianflu>.

7. Avian influenza - situation in Nigeria – update. Geneva: World Health Organization 2007. Available at <http://www.who.int/csr/don/2007_02_03/en/index.html>.

8. Guidance relating to suspected human cases of avian influenza returning to the UK.
HPA Website [online] 6 February 2007. [Accessed 8 February 2007]. Available at <http://www.hpa.org.uk/infections/topics_az/influenza/avian/guidelines.htm>.

Use of antiviral drugs for influenza

On 8 February 2007 the UK Department of Health issued a letter to all general practitioners in England to inform them that the use of antiviral drugs for the treatment or prophylaxis of influenza was now recommended, in line with the NICE guidance (http://www.nice.org.uk) [1]. The most recent influenza surveillance data for England show that the overall rate for influenza has exceeded the threshold at which the use of antivirals is triggered. The overall GP consultation rate for influenza-like illness in England and Wales based on RCGP data, has increased from 16.8 per 100,000 in week 04/2007 to 30.2 per 100,000 in week 05/2007. The rise in the consultation rate is most evident in those aged 15 to 44 years and 45 to 64 years.

References
1. Influenza Season 2006/07 – Use of antivirals Department of Health Gateway Reference Number 7824. London: Depatment of Health, February 2007. Available at <http://www.info.doh.gov.uk/doh/embroadcast.nsf>.