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INTERIM GUIDANCE FOR THE CO-OPERATION OF THE FIRE SERVICE WITH THE DEPARTMENT OF AGRICULTURE AND FOOD

IN THE WHOLE HOUSE GASSING OF POULTRY IN RESPONSE TO AN OUTBREAK OF AVIAN INFLUENZA

The Information in this document may change in the light of experience in Ireland and internationally and if new information emerges. Please ensure that you have the most up to date version of this document.

Document Title:

Interim Guidance for the Co-operation of the Fire Service with the Department of Agriculture and Food in the Whole House Gassing of Poultry in Response to an Outbreak of Avian Influenza

08 January 2007

Interim Guidance 8th January 2007 1.

CONTENTS Page 1.0 INTRODUCTION 3

1.1 Avian Influenza 3 2.0 HAZARDS 5

2.1 Carbon Dioxide 5 2.2 Controlling the Risks from Carbon Dioxide 5 2.3 Avian Influenza 5 2.4 Controlling the Risks from Avian Influenza 5

2.4.1 Limiting the Exposure 5 2.4.2 Personal Protective Equipment 5 2.4.3 Hygiene 6 2.4.4 Anti-viral Prophylactic agents 6 2.4.5 Human influenza vaccination 6

3.0 RESPONSE GUIDANCE 8 4.0 RESPONSE ACTIONS 10 5.0 DECONTAMINATION 13 6.0 HEALTH MONITORING 14 Appendix 1 Approved Disinfectants 16 Appendix 2 Suggested Equipment for Fire Service 17

Response Vehicle Appendix 3 Site Layout 18 Appendix 4 Commonly Used Abbreviations 19 Appendix 5 Generic Risk Assessment for Avian 20 Influenza Response Appendix 6 Categorisation of workers 21 Appendix 7 Hand washing protocol 23 Appendix 8 Donning and Doffing personal protective equipment 24


1.0 INTRODUCTION 1.0.1 This interim guidance has been developed in co-operation with representatives from local

authority fire services and in conjunction with the Department of Agriculture and Food (DAF). The guidance is based on the best available current knowledge and it will be updated as required. Trials of the gassing procedure were carried out by DAF in Monaghan in November 2005, and in Limerick in May 2006. Feedback from both trials, together with the participation of Monaghan County Fire Service in the Monaghan trial aided the development of this protocol.

1.1 AVIAN INFLUENZA (AI) 1.1.1 Avian influenza is a contagious viral infection of wild birds and it is particularly prevalent in

waterfowl. It may occur as a mild infection that may not cause clinical disease. This is called Low pathogenic Avian Influenza (LPAI). The less common High Pathogenic Avian Influenza (HPAI), which is occasionally seen, may cause outbreaks leading to large numbers of deaths in domestic poultry, and in wildfowl. This strain includes the H5N1 strain currently circulating in Asia since late 2003. Other strains of HPAI have also caused outbreaks.

1.1.2 People are rarely affected with avian influenza. Where human infection has occurred it has

normally been due to close contact with live infected birds or their droppings. To date Avian H5N1 can be characterised as follows: • Influenza virus type A/H5N1 is a group of avian viruses that are highly pathogenic and

very infectious for a number of bird species including most poultry species kept domestically by humans;

• As an influenza virus, H5N1, to date, is poorly adapted to the human species; • For those few people that do become infected, the virus can be highly pathogenic,

causing high mortality • Reflecting its poor adaptation to humans, H5N1viruses generally do not transmit easily

from one infected person to another human. Though human-to-human transmission has occurred, it is as yet inefficient.

Source: European Centre for Disease Prevention and Control

1.1.3 When human infection does occur, it usually presents with influenza-like symptoms and sometimes as an eye infection (conjunctivitis). In exceptional cases the illness can be more serious and can cause respiratory symptoms and death.

1.1.4 Influenza viruses are by their nature very changeable. This means that the virus can change

(mutate) suddenly and cause a more serious illness, even if it caused only a mild illness in the first instance. H5N1 viruses are mutating and evolving constantly. Like all influenza viruses they can also change abruptly by recombination – exchanging genetic material with other influenza viruses. There remains the possibility that they can change, and suddenly, for example transmit more efficiently among humans, or becoming less pathogenic for humans or birds. Thus H5N1 viruses have pandemic potential although when and if they will ever show this is imponderable. Source: European Centre for Disease Prevention and Control


1.1.5 The Department of Agriculture and Food has an emergency plan designed to contain outbreaks of H5N1 avian influenza in poultry should the disease arrive in this country. In line with Government policy, all public bodies will be required to co-operate with the management of this national emergency in accordance with their competencies. Should avian influenza be detected in poultry houses in this country, the Department of Agriculture and Food will commence a culling to contain the disease. In large commercial holdings this will be by way of a whole house gassing procedure, using CO2. Where the whole house gassing method has been used, it will be necessary to check the CO2 gas levels to ensure that it is safe for relevant personnel to enter the poultry houses to deal with the bird carcasses. Because of their competencies in the wearing of breathing apparatus and in the response to, and management of, hazardous materials incidents the local authority fire service will carry out this check and provide the information to Department of Agriculture and Food staff.

1.1.6 It is the purpose of this document to outline additional procedures to be used in conjunction

with standard fire service training to ensure the health and safety of Fire Service personnel should they be called upon to engage in this essential task. This document relates only to the response to avian influenza incidents; nothing in this document affects the standard response and crewing arrangements for any other type of incident.


2.0 HAZARDS 2.1 Carbon Dioxide

At ambient temperatures carbon dioxide (CO2) is a colourless, odourless non-explosive gas. Carbon dioxide is naturally present in the atmosphere at levels of approximately 0.035%. Higher concentration can affect respiratory function and cause excitation followed by depression of the central nervous system.

2.2 Controlling the risks from Carbon Dioxide

In the Dangerous Goods Emergency Action Code, 2005 the Emergency Action Code for CO2 is 2T therefore the PPE required is BA and Fire Kit. Breathing Apparatus should therefore be worn to provide respiratory protection from the effects of CO2. In the circumstances of this pre-planned response under this protocol alone, Fire Kit is to be replaced by the disposable clothing supplied by the Department of Agriculture and Food. The following points were considered when making this decision:

• There is no fire risk – CO2 is an extinguishing agent • Although refrigerated CO2 is used, the time lapse from the introduction of the gas to • the poultry house to the arrival of the fire service is such that there is no cryogenic

risk; and • Fire Kit is not disposable or easily decontaminated.

2.3 Avian Influenza

Birds that are infected with influenza can shed virus in saliva, nasal secretions and faeces. Transmission from sick or dead birds can occur via these routes, to other birds or to humans. Faeces contain high concentrations of virus and are an important factor in spreading the disease. The viruses can survive in the environment for up to 3 months in cool and moist conditions. The following are the most likely routes of infection:

(a) Breathing-in the virus from the faeces or infected discharges of the birds or breathing in dust contaminated with faeces and/or respiratory discharges

(b) Nose, eye or mouth contact with airborne virus, infected faeces, or contaminated objects, e.g., through hand to mouth contact with contaminated objects

(c) Rubbing eyes with hands/gloves after handling infected material.

2.4 Controlling the risks from Avian Influenza There are a number of measures that can be taken to control the risks from Avian Influenza. These measures include:

2.4.1 Limiting the Exposure • Minimising the number of people on site • Minimising the number of people in-house • The World Health Organisation (WHO) has determined that a human must be within 1metre

of a live infected bird to have any risk of virus transmission • Transmission through contaminated organic matter particularly faecal matter is the primary

concern when the birds are dead.

2.4.2 Personal Protective Equipment Depending on the category of work been carried out (see Appendix 6: categorisation document): DAF and Non-DAF staff will wear different levels of personal protective equipment (PPE)*. For staff in engaged in activity on an infected premises (I.P) with only a short contact time with infected birds/ litter (category 2 workers) the following PPE will be worn:


• Disposable suits with integral hood and elasticated wrist and ankle cuffs • Disposable gloves and boot covers • Goggles • Negative pressure respirators *Non-DAF staff will be expected to conform to the same, or a higher standard of PPE

If DAF staff are required to have extended contact time with infected poultry (category 1 workers) Positive Pressure Respirators will be worn instead of negative pressure respirators.

Fire Service staff will wear the following protection provided by the On-Site Disease Control

or Local Biosecurity Centre depending on circumstances (see Appendix 8- Donning and Doffing PPE). • Disposable suits with integral hood and elasticated wrist and ankle cuffs • Disposable gloves, and boot covers • Negative pressure respirators (when on site but not wearing BA) • Goggles • When entering the poultry house -

o Coverall suit1 with integral gloves and boots2 o Breathing Apparatus

(Note: A standard hard hat should be worn under the coverall suit to compensate for the absence of the fire helmet and ensure the correct positioning of the vision panel.) The purpose of the coverall suit in this case is to protect the B.A. set thus removing the need to decontaminate the set. It also provides a layer of protection above any required standard.

2.4.3 Hygiene

a. Correct hand hygiene is the most important measure in preventing the spread of infection after contact with infected or exposed poultry, contact with contaminated surfaces or after removing gloves. Hands should be washed with soap and water for 20-30 seconds; alternatively an alcohol based hand rub/wipes can be used. Wipes must be disposed of appropriately (see Appendix 7-Hand washing protocol).

b. There should be no eating, drinking, smoking or the putting on/taking off of contact lenses in high-risk areas.

c. All cuts or open wounds should be covered with appropriate waterproof dressings.

2.4.4 Anti-viral Prophylactic agents Members of the response team must receive screening for suitability to take antiviral agents such as oseltamivir (tamiflu). Tamiflu (75mg tablets) are taken prophylactically on a daily basis for the duration of time during which contact with infected poultry, or contaminated surfaces, occurs. This should be continued for 7 days following last exposure – subject to a maximum of six weeks. Should the exposure period exceed this then plans for rotating workers should be implemented.

2.4.5 Human influenza vaccination

All members of the Fire Service that may be involved in an Avian Influenza response must receive the human influenza vaccination prior to any response. This is a precaution against the possibility of somebody being infected with avian influenza and human influenza at the same time. As slightly different variants of the influenza virus circulating each season vaccination should occur annually. It takes two weeks for the vaccine to produce the

1 Coverall suits should ideally be coverall splash suits; where fire authorities do not have coverall splash suits coverall gas tight suits may be used.

2 Where suits do not comprise integral boots rubber boots should be supplied in place of leather fire fighting boots


required antibodies to protect against infection. Further information about human influenza can be viewed on the Health Protection Surveillance Centre website.

http://www.ndsc.ie/A-Z/Respiratory/Influenza/Factsheet/index.html

2.4.6 Recommendations by Influenza experts are, that only personnel that have been vaccinated will be permitted to participate in outbreak control activities.


http://www.ndsc.ie/A-Z/Respiratory/Influenza/Factsheet/index.html

3.0 RESPONSE GUIDANCE 3.0.1 A response crew of five personnel comprising two, two-person B.A. teams and one officer

in charge (OIC) has been assessed to be the optimum number of responders to an Avian Influenza infected site. This number allows B.A. protocols to be adhered to while minimising personnel exposure.

3.0.2 All members of response teams that will be required to deploy to the site of an infected

poultry house must have received the human influenza vaccination. The fire service Occupation Health Professional will administer this vaccination. Vaccination is required annually as the influenza virus is subject to minor changes in its structure and this gives rise to slightly different variants circulating each season.

3.0.3 Only personnel from the fire service response team who have been screened for suitability

for receiving antiviral agents (such as tamiflu), and who have been vaccinated for seasonal human flu, shall be allowed on a cull site.

3.0.4 Periodic health monitoring should occur as a precautionary measure during the culling

period. A Public Health Doctor will be located at the Local Disease Control Centre, or another nominated location for the purpose of this monitoring. DAF will notify the location to the on site Infected Premises (I.P.) officer.

3.0.5 Members of the fire service who work with/in the poultry industry should either:

(a) not be included as part of response teams, or (b) not work with poultry for the duration of their involvement in the response and for three full

days post the last response. 3.0.6 On being requested to respond, personnel should deploy to the agreed rendezvous point at a

time determined by the Rostered Senior Fire Officer (RSFO), and in accordance with the local fire authority response plans.

3.0.7 If Avian Influenza is detected in poultry, DAF will implement their plans, and develop their

response structures. Two components of the DAF response structure that should be understood by the fire service are: the Local Disease Control Centre (LDCC) and the Local Biosecurity Centre (LBC).

3.0.8 The Local Disease Control Centre is an administrative centre run by DAF to direct and

implement the control strategy. It is at this location that the Public Health Doctor may be possibly based. Although the fire service will not have any administrative functions the response team should attend the LDCC once during each response (either before the response or after the response) to make contact with the Public Health Doctor.

3.0.9 The Local Biosecurity Centre is a building designated and staffed by DAF for the purposes

of ensuring that proper biosecurity measures are taken by all personnel. This building may typically be a local GAA centre/ community centre. Once established, every fire service must report to this centre before and after each response.

3.0.10 In the early stages of an outbreak the above structures may not have been established and the

Department of Agriculture and Food Liaison Officer may nominate alternative interim arrangements.


3.0.11 Fire authorities should ensure that adequate fire cover is maintained during avian flu responses. In areas where there are high densities of commercial poultry houses fire authorities should consider mutual aid arrangements with neighbouring authorities.

3.0.12 Map 1 below is a density map of poultry locations, the majority of commercial units are

located in Monaghan/ Cavan and in Limerick/Cork/Waterford (note generalised distribution of backyard flocks throughout the country)

Map 1. Density Map of Poultry Locations


4.0 RESPONSE ACTION 4.0.1 A DAF representative from the local District Veterinary Office (DVO)/ Local disease

Control Centre (LDCC) will contact the On-Call Rostered Senior Fire Officer (RSFO) through the relevant Fire Control Centre.

4.0.2 The RSFO should obtain all relevant information from the Department of Agriculture

and Food (DAF) staff and activate response personnel according to local protocols. The following is the minimum information required by the RSFO in order that he or she can plan the required resources: • Location of the cull site(s) and the number of sites to be checked on a particular day • Number of poultry houses on each site that will require checking • Location of the relevant Local Biosecurity Centre (if established) • Estimated time when assistance will be required

4.0.3 Response personnel (OIC and 4 firefighters) should deploy to the relevant Local

Biosecurity Centre in a suitable Fire Service Vehicle3. As this is not a time-critical operation a blue light response is not warranted. The Fire Service Vehicle should carry only the minimum equipment to deal with the incident (see Appendix 2).

4.0.4 Response personnel should only used the designated vehicle to respond to the poultry

site. On arrival at the site the response vehicle should if possible, remain in a clean area (see Appendix 3-Site layout. If the response vehicle to be used for transportation to the site enters the cull site rather than remains in the clean area, appropriate plastic coverings should be attached to the seats by DAF personnel.

4.0.5 When the crew arrive at the poultry house site they should report immediately to the

Gate officer (DAF) and don disposable protective over-clothing. The OIC should then report to the Infected Premises (I.P.) officer

4.0.6 The fire service OIC should carry out an appropriate Dynamic Risk Assessment and in

consultation with the I.P. Officer determine the most appropriate location for the establishment of B.A. Entry Control. DAF will have established Decontamination Zones in accordance with Appendix 3.

4.0.7 Two fire service personnel should deploy in B.A. and coverall suits4 and carrying a CO2

monitor (provided by DAF) into the poultry house to check the gas levels. A radio link should be maintained between the BA team and the OIC/ECO so that gas levels at different points in the house can be communicated. Once established the gas levels will be relayed to the I.P. Officer. Crews should be aware that CO2 is heavier then air and readings at the level of the bird carcasses are of particular relevance.

4.0.8 A second team should be on standby wearing full P.P.E., B.A. and coverall suit in the

clean area (ideally the public road) to deploy in the event of an extended duration operation or an incident/accident.

3 This vehicle can be a jeep, van or class B appliance. If a class B is being used it should only have the equipment outlined in Appendix 2, empty lockers and the pump bay shutters should be kept in the closed position for ease of disinfection.

4 Where suits do not comprise integral rubber boots rubber boots should be supplied in place of leather fire fighting boots


4.0.9 Decontamination of all personnel who entered the poultry house should be undertaken in accordance with the attached advice.

4.0.10 All protective over-clothing worn on site should be disposed of under the direction of

I.P. officer before proceeding to the next site.

4.0.11 Once all sites have been checked response personnel should return to the Local Biosecurity Centre to shower.

4.0.12 Coverall suits should be inflation tested at the end of each day’s operations.


DAF-operated Local Biosecurity Centre Before

• Protection for response vehicle After

• Showering

DAF operated On-Site Disease Control (I.P. Officer)

Before • Fire service personnel report here

on arrival and don protective over clothing

After • Fire service personnel exit site by

reporting back to this point and disposing of protective over clothing

Fire Service Operations

• Establishment of Entry Control • Robing and Disrobing • Decontamination

POULTRY HOUSE

RSFO activates local response protocol

DAF Liaison Officer contacts relevant Fire Control Centre

Interim Guidance 8th January 2007

Response personnel deploy at pre-arranged time to Local Biosecurity Centre

12.

5.0 DECONTAMINATION 5.1 On-site decontamination (See diagram in Appendix 3) 5.1.1 All organic matter should be washed off the coverall splash suits with a scrub brush and low

volume water flow to prevent widespread dispersal of potentially infective material. 5.1.2 Suits should then be sprayed with an appropriate disinfectant at the correct concentration

using a knapsack sprayer. Effective decontamination is achieved through a combination of disinfectant and contact time. A list of DAF approved disinfectants is contained in Appendix I. The necessary contact time is dependant on the disinfectant (typically 10 minutes) and reference should be made to the manufacturers contact sheets for this information. Advice can be sought from the local district veterinary office where necessary. All disinfectants should be properly stored, used when in date and in accordance with the manufacturers instructions.

5.1.3 Once the disinfectant has been applied to all parts of the suits they can be removed in

accordance with fire service training. Any contact with the suits should be with gloved (latex/nitrile) hands. The suit should be zipped closed once removed and the disinfectant should remain on the suit and allowed to air dry to ensure the required contact time is achieved

5.1.4 DAF will provide water supplies at the site.

Summary of order of removal of protective attire/equipment 1. Remove organic matter from coverall suit

2. Disinfect outside of coverall suit

3. Remove suit using gloved hands (latex/nitrile gloves supplied by on site disease control)

4. Remove disposable suit

5. Remove gloves

6. Wash /decontaminate hands

5.1.5 Having regard to the underlying principle of minimising the number of people exposed it

should be possible, with some additional training, for the two firefighters that entered the poultry house in BA and coverall suits to decontaminate each other before doffing. The remaining 2 firefighters should remain on standby in the Clean Area.

5.1.6 Staff who are not familiar with removing latex/nitrile gloves should be instructed in the

technique that avoids touching the outside surface of the gloves with bare hands (see Appendix 8- Donning and Doffing PPE).

5.1.7 Correct hand hygiene is the most important measure in preventing the spread of infection

after contact with infected or exposed poultry, contact with contaminated surfaces or after removing gloves. Hands should be washed with soap and water for 20-30 seconds alternatively an alcohol based hand rub/wipes can be used. Wipes must be disposed of appropriately.

5.1.8 All clothing issued on site by DAF should be disposed of on site.

5.1.9 Response crews should shower at the Local Biosecurity Centre at the end of each response.


6.0 HEALTH MONITORING 6.0.1 Birds that are infected with influenza can shed virus in saliva, nasal secretions and faeces.

Transmission from sick or dead birds can occur via these routes to other birds or to humans. Faeces containing high concentrations of virus are an important factor in spreading the disease. The viruses can survive in the environment for up to three months in cool and moist conditions.

6.0.2 Infection with Avian Influenza in humans can cause influenza-like symptoms. It can also

cause conjunctivitis, i.e. watery itching painful eyes, with a purulent discharge. It may cause serious respiratory complications and death.

6.0.3 Public Health Doctors from the HSE will undertake human health monitoring. They will be

stationed in the Local Disease Control Centre throughout the outbreak and they will be responsible for the official health monitoring and for giving advice as necessary. The Public Health Doctor will provide response crews with a contact telephone number in the unlikely event that they develop symptoms that concern them.

6.0.4 Members of response teams should be asked to report any relevant health problems when

undertaking outbreak control and eradication activities, and for one week following their last exposure to avian-influenza-infected birds or contaminated environmental surfaces.

6.0.5 All staff exposed to infected birds, or contaminated material, will be monitored while they

are engaged in the cull activities and for 7 days afterwards to ensure that they do not develop any signs, or symptoms, suggestive of infection with the avian influenza virus. They will be required to check their own temperature twice daily with disposable thermometers provided and report any fever or influenza-like symptoms to the designated public health, or occupational health, doctor assigned to them at the commencement of their activity.

6.0.6 Fever is a temperature of 380C/ 100.40F, or higher. Influenza-like symptoms include –

• Cough, shortness of breath

• Temperature

• Runny nose

• Sore throat, myalgia/arthralgia (painful muscles or joints), or headache

• Watery diarrhoea – This is often present in the early stages of illness and may precede respiratory symptoms by up to one week

• Abdominal pain and vomiting

• Headache

6.0.7 If staff have to visit their GP, or a hospital Accident and Emergency department, with any of the above symptoms they must inform the health professionals in the health facility that they might have been exposed to avian influenza so that they can receive the appropriated tests and treatment without delay.

6.0.8 All staff exposed to infected birds, or contaminated material, are recommended to have a

blood sample taken for base line serology within the first few days of engaging in control


activities and a second blood sample taken four weeks later to check if there is any serological response indicating that they have been exposed to the avian influenza virus.

6.0.9 Persons at high risk for severe complications of influenza (e.g. immunocompromised) those

over 60 years old, with chronic heart or lung disease or those for whom oseltamivir is contraindicated should not form part of response teams. Those on medications such as steroids should seek medical advice prior to taking part in response activities.

Further information can be obtained from the address below: http://www.ndsc.ie/hpsc/A-Z/Respiratory/AvianInfluenza/Guidance/


APPENDIX 1 APPROVED DISINFECTANTS

Diseases of Animals (Disinfectants) Order, 1975 (Amendment) Order, 1978 LIST OF APPROVED DISINFECTANTS FOR USE AGAINST POULTRY DISEASES APRIL2006

(Extracted from List of Approved Disinfectants April 2006)

DISINFECTANT DISINFECTANT

PRODUCT Fowl Pest (Newcastle Disease, Fowl Plague)

PRODUCT Fowl Pest (Newcastle Disease, Fowl Plague)

Agrisept MC Tabs* (see note) 271* Novagen FP 80

Antec Ambicide --- Omnicide 325 125

Antec Hyperox 375 Opticide 200 125

Antec Virkon S 280 Osmodex 150

Bio Dine 145 Purogene 20

Bio Guard 80 Septrivet* (see note) 449

Bio Kill 365 Septrivet 17 700

Bi-OO-Cyst 125 Sorgene 5 100

Bio Phen 190 Spectocide 2000 150

Bio Phen Plus 210 Supercide 200

Bio Shield 155 Superdine 125

Bio VX 285 Superkill 100

Chlorasol 200 SWC Bacto Detsan ---

Citrox 0.66 SWC Maxikleen 100

Clinidine 140 Tego 2000 ---

Clinidine 28 170 Tegodor FARM 51

Deosan Iodel FD 130 Trigene II ---

Dermicidal Extra 125 V26 200

Envirocare A 99 Vandox 300

Enviroguard 150 Vesphene D39 50

Equisept --- Verucidal Extra 300

FAM (New Formulation) 150 Viktor 280

FAM 30 125 Virex 300

GPC 8 (New Formulation) 190 Virchlor 271

Iodosure Bio 110 Virophen 210

Iosan Farm Disinfectant 80 Virophen Plus 240

Jentabs 449 Virophor 2.8% 185

Jeyes Fluid 30 Viroshield 165

Kick Start 2 145 Zal Perax II 145 * Dilution rate is expressed as one part of the preparation to the number of parts of water in the appropriate column.

Note: The volume of mls of water above relate to 1g of the product - Agrisept MC Tabs weigh 5g, Septrivet tablet weigh 17g NOTE: READ CAREFULLY THE MANUFACTURER’S INSTRUCTIONS BEFORE USAGE

PARTICULARLY IN RELATION TO SPECIFIED PRECAUTIONS Note: Dilution rates for disinfectants for use against Foot and Mouth Disease and/or Swine Vesicular Disease relate to effectiveness when applied to a clean surface. (a) thoroughly washed or sprayed with an approved disinfectant; (b) thoroughly cleansed, ensuring that dung, litter, etc. is removed and disposed of so that there is no risk of contact with livestock; and (c) (the clean area) washed or sprayed with an approved disinfectant used at the approved dilution.

Fowl Plague is the same as Avian Influenza on the list of disinfectants. In outbreaks the supply of disinfectant may become an issue and it may be necessary to use different products. Reference should always be made to the Manufacturers instructions and the appropriate contact times.


APPENDIX 2 SUGGESTED EQUIPMENT FOR

FIRE SERVICE RESPONSE VEHICLE 4 no. BA sets 4 no. Splash suits 4 no. Hand Portable Radios Spare BA cylinders Several Traffic Cones and Barrier tape 1st Aid Kit/First Responder Kit and box of disposable latex/nitrile gloves BA Entry Control equipment Disposable soft bristle scrubbing brushes DAF recommended disinfectant 4 hard hats Drinking Water (note: There should be no eating or drinking in high-risk areas. Drinking water should not be brought onto the poultry site.)


APPENDIX 3 SITE LAYOUT

POULTRY HOUSE

Distance determined by DAF (40m approx.)

DAF CORDON

Disrobe Area Remove coverall

suit and allow it to air dry

Disinfect Area Appropriate disinfectant applied with

knapsack sprayer

Wash Down Area

all organic matter to be removed

Interim Guidanc

Disposable PPE

Hand Washing

FIRE SERVICE CORDON

Emergency team on standby

Clean Area i.e. Public Road

e 8th January 2007 18.

APPENDIX 4 COMMONLY USED ABBREVIATIONS

CVO Chief Veterinary Officer DCVO Deputy Chief Veterinary Officer DVO District Veterinary Officer IP Infected Premises LAVI Local Authority Veterinary Inspector LBC Local Biosecurity Centre LDCC Local Disease Control Centre OIC Officer in Charge (station Officer or Sub-Officer) OV Official Veterinarian PPE Personal Protective Equipment PVP Private Veterinary Practitioner RSFO Rostered Senior Fire Officer SVI Regional Senior Superintending Veterinary Inspector R/SVI Regional Superintending Veterinary Inspector (Public Health) SAO Supervising Agricultural Officer SSVI Senior Superintending Veterinary Inspector SVI Superintending Veterinary Inspector TAO Technical Agricultural Officer TVI Temporary Veterinary Inspector VI Veterinary Inspector VS Veterinary Surgeon


APPENDIX 5 Generic Risk Assessment for Avian Flu Response

Task Hazard Consequence Severity Likelihood Level ofRisk

Control Measure Responsible Person

Occupational Health

Reaction to medications: -Flu Vaccination -Tamiflu

Ill health 4 2 Low Health professionals to assess suitability of personnel to take medication

Occupation Health Provider

Working on site Slips, trips and falls. Injury from manual handling

Physical injury

3 3 Low Dynamic risk assessment by OIC. Manual handling procedures to be adhered to

OIC and Crew

Monitoring CO2 in poultry house

CO2 Asphyxiation 6 4 High Breathing Apparatus to be worn in poultry house

OIC and Crew


Contamination with Avian Flu virus

Ill Health 5 4 High Breathing Apparatus, and PPE as detailed in protocol to be worn. Decontamination as per protocol and in conjunction with fire service training Restrict numbers entering poultry house Tamiflu to be taken as directed

OIC and Crew


Slips, trips and falls

Physical injury

3 4 Med Pre-incident familiarisationBA procedures to be adhered to Building will be illuminated and doors open BA Comms in place Emergency response team on standby outside Restrict number of people entering the poultry house

OIC and Crew

Decontamination on exiting poultry house

Exposure to avian flu virus

Ill Health 5 3 High Protocol to be applied in conjunction with fire service training Particular attention to be paid to hand washing Tamiflu to be taken as directed

OIC and Crew


APPENDIX 6 a Categorisation Document

Exposure category, protection and training required

Worker Category

Exposure Protection

Training on PPE, respirator fit & SOPs

1 • Exposure to infected, or highly suspect (HS), live birds in confined space for prolonged period

Flu vac (in season) Tamiflu PPE Positive Pressure Respirator (P3)

Yes

2 • Exposure to infected, or HS, live birds in confined space for brief period

• Exposure to infected, or HS, live birds in open space

• Exposure to infected, or HS, dead birds in confined or open space

• Exposure to contaminated or potentially contaminated material (specimens, litter, faeces, feed, equipment, environment)

Flu vac (in season) Tamiflu PPE Disposable P3 negative pressure respirator* goggles

Yes

3 • Engaged in active surveillance in contiguous flocks & contact flocks

Flu vac (in season) PPE Disposable P3 negative pressure respirator* Goggles Tamiflu if birds test positive

Yes

4 a) Exposure to injured, sick or dead wild birds in restricted zone when H5N1 on Island of Ireland

b) Exposure in investigation large die off in wild birds

Flu vac (in season) Tamiflu PPE Disposable P3 negative pressure respirator* Goggles

Yes

5 a) Exposure to isolated injured, sick or dead wild birds outside restricted zone when H5N1 on Island of Ireland

b) Exposure to isolated injured, sick or dead wild birds when H5N1 not on Island of Ireland

Disposable gloves Tamiflu if birds test positive

Information

6 • Assisting in outbreak control not exposed to hazardous material

Information

* Staff with beards, or moustaches, should shave or use a positive pressure respirator. There are several models of disposable P3 negative pressure respirator and those staff whose face shape doesn’t allow a good fit with the standard model will be offered an alternative. Post exposure health monitoring and serology will be required for all staff according to the Guidelines of the Avian Influenza Subcommittee of Pandemic Influenza Expert Group (Annex 1)


APPENDIX 6 b Individual categorisation assisting in the control of an outbreak in a flock*

Infected premises Individuals Potentially Exposed Category

Farm staff, manager, owner

DAF veterinary Inspector/TAO on site

Sealing crew: (1 vet, 2 AOs) o Inside house o Outside house

Gas delivery driver

Fire brigade staff : o 2 to go inside, o 2 outside

o 1 supervisor on periphery/outside house

(If not gassing) Catching and slaughter crew

Collection team (s) for dead birds

Driver of waste transport vehicle

Staff in intake area of Rendering Plant receiving waste

Dealing with litter, feed and water

1 or 2

2

1 2

2

2 2

6 or 2

1

2

2

2

2

Staff involved in erecting and operating: • Porto cabins for office, rest rooms etc

• Canteen on site • Porto loos on site

Personnel removing PPEs (already bagged & binned)

Engineers/environmental technicians assessing

burial composting sites

TAO/Garda security at periphery of infected premises

6 6 6

6

6

6

STAFF WORKING OFF SITE:

Active surveillance in contiguous flocks

Operating road checks

3

6


APPENDIX 7 Correct Hand-washing protocol

1st step: Palm to palm Attention: including wrists (30 sec).

5thRotrighpalm

Interim Guidance

2nd step:Palm of right hand over back of left hand and palm of left hand over back of right hand(30 sec).

step: ational rubbing of t thumb clasped in left and vice versa (30 sec).

17th October 2006

3rd step: Palm to palm with fingers Interlaced(30 sec).

6th step: Rotational rubbing, backwards and forwards with clasped fingers of right hand in left palm and vice versa (30 sec).

4th step: Back of fingers to opposing palms with fingers interlocked(30 sec).

23.

APPENDIX 8

Donning Personnel protective equipment

Interim Guidance 17th October 2006 24.

APPENDIX 8 Doffing Personnel protective equipment

Interim Guidance 17th October 2006 25.

Documents

AIMMS Tutorial for Professionals - Absentee and Planning Overviews