Primary prevention

The primary means of containing highly pathogenic avian influenza (HPAI) H5N1 virus in communities and decreasing the risk to human health is through H5N1 poultry immunization or prompt culling of poultry suspected of HPAI H5N1 virus infection with disinfection of the contaminated environment. The most effective way to prevent HPAI H5N1 virus infection is to minimize exposure by avoiding direct or close contact with sick or dead poultry in HPAI H5N1 virus-affected countries.

The World Health Organization (WHO) and national public health organizations do not recommend travel restrictions to HPAI H5N1-affected countries. It is recommended, however, that people avoid contact with poultry suspected of HPAI H5N1 virus infection, animals in live food markets in HPAI H5N1-affected countries, and any surfaces that may be contaminated by feces from poultry or other animals suspected of HPAI H5N1 virus infection.[17]

Influenza A (H5N1) vaccines have been found to be safe and immunogenic.[70][71][72] Various vaccines are licensed around the world, including the US and Europe, for use in children and adults in pandemic situations. The US contains a national stockpile that could be used if the virus begins transmitting easily from person to person.[73] Development and availability status of candidate vaccines is available from the WHO.

WHO: candidate vaccine viruses and potency testing reagents for influenza A (H5N1)

Healthcare workers in HPAI H5N1 virus endemic countries are recommended to receive annual seasonal influenza vaccine to decrease the risk of nosocomial transmission of seasonal influenza viruses in the healthcare setting. Preventing seasonal influenza among people exposed to HPAI H5N1 virus may also decrease the theoretical risk of human coinfection with seasonal influenza A and HPAI H5N1 viruses and of viral reassortment (an event that could lead to the emergence of a potential pandemic virus strain).

Most public health organizations consider the use of oral oseltamivir or inhaled zanamivir antiviral chemoprophylaxis for primary prevention to be unnecessary if appropriate personal protective equipment and infection control precautions are followed.

Standard personal protective measures (e.g., home isolation, respiratory etiquette, hand hygiene) are recommended to slow the spread of infection; however, additional measures may also be recommended during pandemics, including:[74]

  • Voluntary home quarantine

  • Use of face masks by people who are ill (or who are well)

  • School, university, or childcare facility closures

  • Social distancing measures (e.g., workplaces, mass gatherings)

  • Environmental surface cleaning measures.

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