2. 2
▪ 2006. Nine cases of poultry infected by H5N1
▪ 2008. Outbreak of poultry infected by H5N1 in Binyamina
▪ 2010. Outbreaks in Ein Gedi and Ein Shemer
▪ 2011. Outbreak in Rosh Zurim.
▪ 2015. Identification of H5N1 in turkeys in Hedera
▪ In addition, in 2015, was identified the same Avian Influenza type
in the Palestinian Authority
Background
Until yesterday, 26th of January 2015 no human cases were found.
3. 4
Avian Flu and its connection with humans
Person to person transmission
has not been documented
Because of the high
morbidity and mortality, the
best prevention is to
administrate prophylaxis to
persons exposed to infected
birds.
5. 6
Clinical signs and symptoms
▪ Can vary from mild to
severe illness:
▪ Cough, rhinorrhea
▪ Sore throat
▪ Respiratory insufficiency
▪ Gastrointestinal symptoms:
vomiting, abdominal pain,
diarrhea
▪ Death
6. 7
Ministry of Health enacted the avian flu preparedness plan,
which has been updated following the world’s lessons since
2006
7. 8
Avian flu preparedness plan: Case definition
Clinical symptoms: Acute respiratory syndrome without other
obvious causal explanation and fever > 38*C
Epidemiological criteria: (one or more in the 7 days before initiating the symptoms):
- Exposure to wild birds or poultry in an area of suspected or confirmed
presence of H5N1 in the last month
- Direct contact with a patient suspected or confirmed as infected with
Avian Flu
- Direct contact with animals diagnosed as infected with Avian Flu
- Contact with the samples suspected of being infected with Avian Flu
+
Suspected Cases
Confirmed: Suspected + Lab confirmation
8. 9
Avian flu preparedness plan: Case definition (cont….)
Suspected Cases
▪ All the suspected cases will be treated in the hospital
▪ If a patient is identified in the community, he/she will be transfer to the
hospital ER with simultaneous notification to the health district officer
▪ The laboratory samples will be transfer to the Central Virology Reference
Laboratory – Shiba Hospital in coordination with the health district officer
▪ Oseltamir will be given at 75 mg twice a day x 5 days
▪ If the lab test rules out the suspected case, the treatment will be discontinued
9. 10
Guidelines for Contacts of suspected cases:
▪ The health district does active surveillance
▪ All the healthy contacts will have a :
▪ 7 days follow up (fever & respiratory symptoms)
Guidelines for prevention of infection for the general public
Avian flu preparedness plan: Guidelines for…..
Guidelines for prevention of infection of healthcare workers
10. 11
Avian flu Preparedness Plan: Exposed population
Exposed population - prophylaxis
▪ Persons who have been in close contact with infected poultry (H5N1)
▪ Workers who handled infected birds
▪ People engaged in containment, culling, removal and burial of poultry
▪ Laboratory workers handling lab samples, chicken carcasses or any other
material containing H5N1 virus
11. 12
Prophylaxis treatment:
Adults (including pregnant women):
• One-time exposure: Oseltamir 75 mg x day x 7 days from the last day exposure
• Continuous exposure: Oseltamir 75 mg x day no more than 6 weeks of continuous administration
If fever appears during the treatment, send the patient to the ER for further evaluation
Children:
≤ 15 kg3mg/kg/day
≤ 15 kg30 mg X1
15 - 23 kg45 mg X1
23 - 40kg60 mg X1
>40kg75 mg X1(
)
Avian flu Preparedness Plan: Exposed population
