WHO interim recommendations for the protection of persons involved in the mass slaughtering of animals potentially infected with highly pathogenic avian influenza viruses.

Avian influenza is a highly contagious disease of birds which is currently epidemic amongst poultry in Asia. Exposure to infected poultry and their feces or dust/soil contaminated with feces) can result in human infection. These recommendations have been developed because human infections have been identified in association with the current poultry epidemic. They will be updated as more information becomes available.

• Cullers and transporters should be provided with appropriate personal protective equipment:
  protective clothing, preferably coveralls plus an impermeable apron or surgical gowns with long cuffed sleeves plus an impermeable apron; disposable examination gloves; masks: the minimum requirement is well-fitted surgical masks, where N951 masks are available their use is recommended; 2 goggles; boots or protective foot covers that can be disinfected.

• All persons who have been in close contact with the infected animals should wash their hands frequently. Cullers and transporters should disinfect their hands after the operation.

• Environmental clean up should be carried out in areas of culling, using the same protective measures as above.

• All persons exposed to infected chickens or to farms under suspicion should be under close monitoring by local health authorities. It is recommended that persons at specific risk of inhaling possible infected material (e.g. cullers and farmers involved in mass culling at commercial farms) receive prophylaxis with antivirals3. They should also be vaccinated with the current WHO recommended influenza vaccine to avoid simultaneous infection by human influenza and avian influenza and to minimize the possibility of a re-assortment of the virus's genes4.
  Additonal health monitoring of chicken cullers, others involved in the process and their family members should be carried out. These individuals should report any relevant health problems (respiratory complaints, flu-like illnesses or eye infections) to a health care facility. Persons at high risk for severe complications of influenza (e.g. immunocompromised, over 60 years old, or with known chronic heart or lung disease) should avoid working with affected chickens.

• Serological surveillance of exposed animal workers and veterinarians is encouraged.

• In liaison with designated laboratories, full blood and post mortem specimens (intestinal contents, anal and oro-nasal swabs, trachea, lung, intestine, spleen, kidney, brain, liver and heart) of animals (including pigs) should be collected for investigation of new viral isolates.