Di Lorenzo L, Soleo L
Dipartimento di Medicina Interna e Medicina Pubblica, Sezione di Medicina del Lavoro "E.C. Vigliani", Università degli Studi di Bari.
Med Lav. 2006 Jan-Feb;97(1):63-9.
Avian influenza caused by H5N1 virus can be transmitted to exposed workers from contact with infected poultry, and is thus, like other zoonoses, the responsibility of occupational physicians (OP). The high pathogenicity of H5N1 virus has caused a 30-75% mortality among infected humans. Most of those subjects were occupationally exposed in different areas of poultry raising in Asian countries. At the moment, person-to-person transmission, even though possible, is unable to start a new human influenza pandemic due to the current genetic characteristics of H5N1 virus. However, its spontaneous tendency to mutate must alert the international community to the need of eradicating avian influenza in poultry as well as preventing transmission to humans.
In Italy competent OPs are required to take part in prevention of H5N1 avian influenza infection of potentially exposed workers, such as poultry sector workers, workers engaged in poultry culling, litter management, carcass disposal, zoo and nature reserve workers, gamekeepers, veterinarians, biologists, laboratory technicians, and health workers caring for possible instances of human infection.
According to Italian legislations, OPs must offer the national community their long-standing experience in the fields of workplace environmental monitoring, health surveillance, choice of personal protection equipment (PPE) and training and information of workers potentially exposed to H5N1 virus about occupational risks and correct use of PPE. They must also cooperate with other involved professionals to programme antiviral and vaccine prophylaxis.
Occupational physicians can have an important role in contributing to the prevention of and scientific research on H5N1 avian influenza virus.
H5N1病毒引起的禽流感可通过接触受感染家禽传播给接触者,因此与其他动物源性疾病一样,属于职业医生(OP)的职责范围。H5N1病毒的高致病性导致感染人类的死亡率达到30%至75%。这些感染者大多在亚洲国家的不同家禽养殖领域有职业暴露。目前,尽管H5N1病毒存在人际传播的可能性,但由于其当前的基因特征,还无法引发新的人类流感大流行。然而,其自发突变的倾向必须引起国际社会对根除家禽禽流感以及防止传播给人类的必要性的警觉。
在意大利,要求主管职业医生参与预防H5N1禽流感感染可能暴露的工人,如家禽行业工人、从事家禽扑杀、垫料管理、尸体处理的工人、动物园和自然保护区工作人员、猎场看守人、兽医、生物学家、实验室技术人员以及照顾可能的人类感染病例的医护人员。
根据意大利法律,职业医生必须向全国提供他们在工作场所环境监测、健康监测、个人防护设备(PPE)选择以及对可能接触H5N1病毒的工人进行职业风险培训和信息告知以及正确使用PPE方面的长期经验。他们还必须与其他相关专业人员合作,制定抗病毒和疫苗预防计划。
职业医生在预防H5N1禽流感病毒和相关科学研究方面可发挥重要作用。