Krueger Anna, Myles Devin J F, Rice Carrie P, Taylor Tegwin K, Hurwitz Carolyn, Morris Jesse, Robinson Sara
Maine Center for Disease Control and Prevention, Augusta, Maine, United States.
MCD Global Health, Hallowell, Maine, United States.
Zoonoses Public Health. 2024 May;71(3):331-335. doi: 10.1111/zph.13097. Epub 2023 Nov 27.
The risk of infection with avian influenza A viruses currently circulating in wild and domestic birds in the Americas is considered low for the general public; however, detections in humans have been reported and warning signs of increased zoonotic potential have been identified. In December 2022, two Canada geese residing on the grounds of an urban hospital in Maine tested positive for influenza A H5N1 clade 2.3.4.4b.
Given the opportunity for exposure to staff and hospital visitors through potentially infected faeces on the property, public health authorities determined mitigation efforts were needed to prevent the spread of disease. The ensuing response relied on collaboration between the public health and animal health agencies to guide the hospital through efforts in preventing possible zoonotic transmission to humans.
Mitigation efforts included staff communication and education, environmental cleaning and disinfection, enhanced illness surveillance among staff and patients, and exposure and source reduction.
No human H5N1 cases were identified, and no additional detections in birds on the property occurred. Hospital staff identified barriers to preparedness resulting from a lack of understanding of avian influenza A viruses and transmission prevention methods, including avian influenza risk in resident wild bird populations and proper wildlife management methods.
As this virus continues to circulate at the animal-human interface, this event and resulting response highlights the need for influenza A H5N1 risk awareness and guidance for facilities and groups not traditionally involved in avian influenza responses.
美洲野生和家养鸟类中目前传播的甲型禽流感病毒感染公众的风险被认为较低;然而,已有人类感染的报告,并且已发现人畜共患病潜力增加的警示信号。2022年12月,缅因州一家城市医院场地内的两只加拿大鹅甲型H5N1 2.3.4.4b分支检测呈阳性。
鉴于该场地内潜在受感染粪便可能使工作人员和医院访客接触到病毒,公共卫生当局决定需要采取缓解措施以防止疾病传播。随后的应对措施依赖于公共卫生机构和动物卫生机构之间的合作,以指导医院努力预防可能的人畜共患病传播给人类。
缓解措施包括工作人员沟通与教育、环境清洁与消毒、加强工作人员和患者的疾病监测以及减少接触和源头控制。
未发现人类H5N1病例,该场地内的鸟类也未出现额外检测阳性情况。医院工作人员指出,由于对甲型禽流感病毒及传播预防方法缺乏了解,包括对野生鸟类种群中的禽流感风险和适当的野生动物管理方法缺乏了解,导致在准备工作中存在障碍。
随着这种病毒继续在动物与人类的界面传播,这一事件及后续应对措施凸显了对甲型H5N1流感风险提高认识以及为传统上未参与禽流感应对工作的设施和群体提供指导的必要性。