Exposure alert: Avian flu at Butterfield Acres

Avian influenza (likely H5N1) has been identified among birds at Butterfield Acres petting farm, and members of the public were exposed between Oct. 6 and Oct. 12.

Patients presenting with respiratory or flu-like symptoms are strongly recommended to complete NP and throat swab testing (and conjunctival swabs in the presence of conjunctivitis) if they:

• Visited Butterfield Acres between Oct. 6 and Oct. 12
• Developed symptoms within 10 days of exposure

No human cases have been identified thus far.

Symptomatic individuals should isolate at home and reach out to Health Link at 811 for a Virtual MD assessment.

Avian influenza is an influenza virus which is commonly found in birds across the globe and causes outbreaks in poultry, wild fowl, and some other animals (e.g. cattle).

The incubation period for avian influenza (H5N1) is up to 10 days, but it is most commonly less than seven days.

Avian influenza can cause severe disease in humans, though many cases can also be mild.

Risk of transmission from animals to humans is generally low, but it is higher under outbreak scenarios when people have close contact with infected animals, or when people handling sick animals or working in their environment, do not wear PPE.

Recommendations

Use of PPE for suspected avian influenza:

• Follow local guidance

Symptomatic individuals assessed virtually:

• Patients who are symptomatic and developed symptoms no more than 10 days after exposure between Oct. 6 and Oct. 12 are being asked to isolate at home and call Health Link at 811.
• When calling 811, callers should select option No. 2 and then option No. 1.
• Callers who developed symptoms within the indicated timeframe will be referred for assessment by Virtual MD and sent for testing at Richmond Road Diagnostic and Treatment Centre in Calgary.

Symptomatic patients presenting for care:

• Should a patient present to their physician or the emergency department, proper PPE should be used, and a thorough assessment should be conducted.
• Testing:
  • Follow testing guidance from APL: H5N1 Avian Influenza Laboratory Testing
  • Testing should always include NP swab and throat swab.
  • Testing may include conjunctival swab (if conjunctivitis is present only).
  • Please include the exposure investigation number (EI # 2025-1066).
  • Please ensure all samples are labelled with 2 unique patient identifiers, including the patient’s full name and health care number if available.
• Mild symptoms:
  • Empiric antiviral therapy:
    • Consider empiric oseltamivir (pending testing) if client has risk factors for severe disease:
    • Do not offer empiric oseltamivir if the client does not have risk factors for severe disease.
    • Pediatric risk factors: <2 years of age, immunocompromised, underlying significant respiratory disease (asthma with history of ED visits, CF, home O2), congenital heart disease, neurologic conditions, hemoglobinopathy, children under 18 years of age on long duration ASA, BMI >30
    • Adult risk factors: Risk factors include pregnancy, cardiac or pulmonary disorders, diabetes mellitus or metabolic disease, cancer, immunosuppression, renal disease, anemia, hemoglobinopathy, neurological or developmental conditions, morbid obesity (BMI 40-plus or 35-plus with obesity-related health conditions), adults 65 years or older, and vulnerable populations
• Severe symptoms:
  • Assess necessary level of care
  • Consider consulting infectious diseases
  • Antiviral drugs such as oseltamivir, zamanavir, and/or peramivir should be administered as soon as a diagnosis of avian influenza is considered; do not delay treatment while waiting for specimen collection
  • Supportive care (e.g., ventilation, dialysis) may also be required

Asymptomatic individuals:

• Do not require clinical assessment
• Should self-monitor for symptoms for 10 days following exposure and call 811 if they become symptomatic