Abstract
BackgroundIn Germany, the first outbreak of highly pathogenic avian influenza A/H5N1 occurred among wild birds on the island of Ruegen between February and April 2006. The aim of this study was to investigate the use of recommended protective measures and to measure H5N1-seroprevalence among personnel tasked with bird collection.MethodsInclusion criteria of our study were participation in collecting wild birds on Ruegen between February and March 2006. Study participants were asked to complete a questionnaire, and to provide blood samples. For evaluation of the use of protective measures, we developed a personal protective equipment (PPE)-score ranging between 0 and 9, where 9 corresponds to a consistent and complete use of PPE. Sera were tested by plaque neutralization (PN) and microneutralization (MN) assays. Reactive sera were reanalysed in the World Health Organization-Collaborating Centre (WHO-CC) using MN assay.ResultsOf the eligible personnel, consisting of firemen, government workers and veterinarians, 61% (97/154) participated in the study. Of those, 13% reported having always worn all PPE-devices during bird collection (PPE-score: 9). Adherence differed between firemen (mean PPE-score: 6.6) and government workers (mean PPE-score: 4.5; p = 0.006). The proportion of personnel always adherent to wearing PPE was lowest for masks (19%). Of the participants, 18% had received seasonal influenza vaccination prior to the outbreak. There were no reports of influenza-like illness. Five sera initially H5-reactive by PN assay were negative by WHO-CC confirmatory testing.ConclusionGaps and variability in adherence demonstrate the risk of exposure to avian influenza under conditions of wild bird collection, and justify serological testing and regular training of task personnel.
Highlights
In Germany, the first outbreak of highly pathogenic avian influenza A/H5N1 occurred among wild birds on the island of Ruegen between February and April 2006
Gaps and variability in adherence demonstrate the risk of exposure to avian influenza under conditions of wild bird collection, and justify serological testing and regular training of task personnel
Based on the protective equipment (PPE) score, our study showed that PPE adherence differed between occupational groups as well, and was highest in firemen who probably similar to cullers had more previous experience in the use of PPE owing to their occupation
Summary
In Germany, the first outbreak of highly pathogenic avian influenza A/H5N1 occurred among wild birds on the island of Ruegen between February and April 2006. Severe human A/H5N1 infections were first observed during outbreaks of highly pathogenic avian influenza (HPAI) A/H5N1 among poultry in Hong Kong in 1997 [1]. In Germany, the first outbreak of HPAI A/H5N1 occurred among wild birds on the island of Ruegen in the federal state Mecklenburg-Western Pomerania, in northeastern Germany between 8th February and 6th April 2006. Soldiers of the German Federal Defence Force, professional firemen from Mecklenburg-Western Pomerania, firemen of the local auxiliary fire brigade and local government workers (administrative staff) participated in collection of wild birds on Ruegen during the outbreak. Local veterinarians collected and transported wild birds to laboratory for testing
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