Scott McPherson's Web Presence

In conclusion, our study suggests that human-to-human transmission of HPAI A/H7N7 can occur within household contacts in the absence of contact with infected poultry. Monitoring of clinical symptoms alone in household contacts of confirmed A/H7N7 cases underestimates the extent of human-to-human spread. In addition, our results suggest that cloth handkerchiefs, having indoor pet birds at home or having at least two toilets at home could be risk factors for household transmission A/H7N7 .

Taking all the results together, we recommend that during an outbreak of avian influenza: 1) Household members should be encouraged to use paper handkerchiefs instead of cloth handkerchiefs; 2) Household members of poultry workers exposed to A/H7N7 should be advised on enhanced general hygiene measures; 3) In the case that oseltamivir prophylaxis is offered to exposed poultry workers in future A/H7N7 epizootics, this should also be considered for household members of A/H7N7 cases; 4) Indoor pet birds of poultry workers should be screened and monitored during future outbreaks of avian influenza, in order to determine the role of indoor birds in household transmission of the virus; and 5) Further seroprevalence studies among contacts of asymptomatic persons with positive H7 serology should be conducted in order to assess the risk of person to person transmission, and consequently the potential for a new pandemic strain, in the absence of symptoms.

Don't forget that the H7N7 outbreak in the Netherlands also killed a veterinarian.

The Canadians have some prior experience in handling avian influenza cases in poultry.  In fact, in what some would consider as foreshadowing, a report released at the very end of last year was highly critical of the Canadian government's handling of a 2004 outbreak of H7 in poultry.  The CBC article can be found at: http://www.cbc.ca/health/story/2007/01/01/birdflu.html .

Poultry workers did not comply with public health recommendations requiring them to wear protective goggles during British Columbia's avian flu outbreak in 2004, a new study suggests.

The H7N3 form of bird flu infected 1.3 million birds that year in the province and led to economic losses that were estimated at more than $300 million.

Dr. Danuta Skowronski of the BC Centre for Disease Control and her colleagues surveyed 167 people in the spring of 2004 to look at both cases of illness and compliance with recommended protective measures.

The only two human infections in the province occurred after direct contact with the eyes, which highlights the importance of wearing goggles, the team said. They found that the H7N3 strain of the disease caused mild eye infections.

"Recommended protective measures should be provided and readily accessible to any potentially exposed person during future outbreaks of avian influenza," the researchers concluded in Tuesday's issue of the Canadian Medical Association Journal.

"These precautions should be simple and feasible and should enable safe and unobstructed work; evaluation of compliance, effectiveness and impact should be undertaken."

When participants were asked about their biosafety concerns, eye protection was cited the most often. However, they said the goggles they used fit poorly over regular glasses, fogged up frequently or generally interfered with vision.

During the outbreak, the Canadian Food Inspection Agency provided protective gear to its workers but they were unable to give it to farmers, a difference that may be reflected in the results of the study, the researchers said.

Unlike a vaccine or antiviral medication, the protective gear has to be repeatedly donned and doffed, and compliance may be harder to recall, the study found.

The fear:  A highly pathogenic H7N3 avian influenza mixes with seasonal flu in the lungs of a poultry worker, or a health care worker, a constable, or anyone else within miles of the outbreak.  Remember that the epidemic of seasonal flu in the Southern Hemisphere that is going on as we speak is the worst in twenty years.  And it is headed our way.  If a nasty H3N2 or H1N1 variant reassorts with a high-path H7N3, we could wind up with a wholly new avian virus that loves a species jump to people.  This is why it is so vitally important that the Saskatchewan authorities move decisively to contain this outbreak in poultry.

The story about the current Canadian outbreak is available at http://news.yahoo.com/s/afp/20070927/hl_afp/canadaanimalhealthbirdflu2 .