Public Health's Role in Response to an Outbreak of Highly Pathogenic Avian Influenza (HPAI) H5N2—Minnesota, 2015

Abstract

Background. On March 3, 2015, the Minnesota Department of Health (MDH) was alerted to an outbreak of HPAI H5N2 in a commercial turkey flock in Pope County. During March 3–June 5, 104 infected flocks were identified. Although the risk of bird to human transmission with this strain was perceived to be low, transmission of other HPAI H5 strains from poultry to humans has been previously documented. Methods. Poultry farm personnel working with infected flocks were interviewed about exposures and contacted once daily for 10 days to monitor for eye infections or respiratory symptoms: cough, fever, sore throat, and runny nose. Antiviral medication was recommended for those with direct contact with HPAI H5N2 infected flocks without proper use of recommended personal protective equipment (PPE). MDH coordinated testing for those reporting symptoms. Nasopharyngeal and conjunctival swabs were collected and tested at MDH – PHL for avian influenza using the CDC Influenza A/H5 RT-PCR assay. Results. During March 3–June 16, MDH attempted to contact 439 people associated with 104 flocks. Of those, 379 (86%) were interviewed, evaluated for exposure, and monitored for symptoms and 60 (14%) were lost to follow up or refused monitoring. Of the 379 evaluated for exposure, 194 (51%) reported direct contact without appropriate PPE and were advised to take antiviral medications as a precaution; 138 (71%) agreed. Lack of appropriate PPE ranged from using no PPE to missing a single PPE component. The most commonly missing PPE component was goggles (162, 84%). Fifteen (4%) of the 379 monitored personnel had symptoms and were tested at the MDH-PHL within 15 days of symptom onset. Influenza A/H5 was not detected in any of the samples. Conclusions. Although multiple opportunities for viral transmission existed, no human infections were documented with this outbreak. Interviews with poultry farm personnel allowed MDH to identify gaps in PPE use, educate workers on the importance of rigorous PPE use, and offer antiviral medication. Monitoring of personnel exposed to avian influenza allows public health to quickly identify transmission events from poultry to exposed workers so risk of infection can be understood and appropriate public health measures implemented. Disclosures. All authors: No reported disclosures.