H5N1 Avian Influenza (Bird Flu) Protocols

• Activated an internal workgroup composed of experts in epidemiology, infectious disease, medicine, laboratory services, emergency response planning and dairy for preparation of a detailed response plan should the virus be found in an Illinois dairy herd.
• Daily communications and information sharing with the Illinois Department of Agriculture, USDA, FDA and CDC along with continuous monitoring of the evolving situation across the US and engagement with other states regarding their preparedness activities.
  
• Active collaborations with external stakeholders to build a multifaceted, response and unified messaging through partners including the Dept. of Agriculture, the Dept. of Natural Resources, Illinois Farm Bureau, Illinois Milk Producers Association, Local Health Departments (LHDs), Illinois Migrant Council, large animal veterinarians and the University of Illinois. These collaborations have included:
  
  1. Establishment of an open channel of communication with the IL Farm Bureau to achieve effective messaging with dairy farmers.
  2. Partnership with the Farm Bureau to establish a method to reach out to dairy farms in Illinois for the purpose of information distribution and requests for PPE. Each county has a local FB office that is has working relationships with the farms.
     
  3. Discussion of H5N1 concerns regarding farm workers with the board of the Illinois Milk Producers Association for direct producer buy in along with offer of PPE via the FB.
     
  4. Face to face contact with available farmers and employees during routine farm inspections. Answering questions, providing guidance to current information available through IDOA, USDA, CDC and FDA.
     
  5. Working with DNR to monitor bird die-offs and processes to minimize exposures from waterfowl
• Through a partnership with the Illinois Farm Bureau, dairy farms have been provided information on H5N1 and the use of PPE along with the ability to request PPE supplies which will be filled and delivered by the LHDs.IDPH has launched and analyzed results from a survey of LHDs for their capabilities and needs if H5N1 is found within their counties. This included information on the ability to isolate an exposed symptomatic worker, delivery of PPE to affected dairy farm(s), farm employee surveillance and specimen collection for laboratory testing and their ability to prescribe prophylactics or treatment to those who may need them.
  
• IDPH has the Illinois stockpile of Personal Protective Equipment (PPE) as well as antiviral medications for exposure treatment and prophylaxis along with development of ordering and distribution process for LHDs to request PPE supplies for affected dairy farms, materials for sample collection of exposed workers.
  
• IDPH has provided educational sessions to local health department, health advisories to clinicians and lab professionals as well as press releases to the general public on this issue.
  
• Active engagement with academic partners that do wastewater surveillance for influenza A across the state. IDPH and LHDs are responding to any wastewater signals for H5 (H5N1 is subvariant of this category) However, to date, there have been no consistent high level detects for more than one week in a row suggesting that the spikes in Flu A in waste water are transient and don’t suggest a significant or sustained outbreak of Flu A, thus far. No human cases or sick animals on farms have been identified as a result of these elevated levels in the waste water, thus far. IDPH monitors each event closely and conducts the following actions in response to each high level flu A detection:
  
  1. Analysis of ER visits in that jurisdiction for influenza like activity (ILI), suggestive symptoms of H5N1 as well as Flu A detections to identify any spike in human infections or human outbreaks
  2. Analysis of any influenza A testing surveillance sites in that jurisdiction, if any active sites are present to evaluate for Flu A
     
  3. Communication with local health departments to provide the information in order to raise awareness locally as well as receive feedback on any findings from local farms, local healthcare providers or high-risk events in that jurisdiction.
     
  4. Communication with the Dept. of Agriculture on these findings

Further, IDPH is prepared to launch additional actions if we identify any persistent presence of high Flu A levels in the waste water, outside of the Flu season, or any suspected/documented infections in cattle farms, animals or humans.

• IDPH has allocated resources to and initiated a process for H5N1 testing of felines from farms who test negative for rabies.
• IDPH will conduct a tabletop exercise in July, 2024 that will involve IDPH, Illinois Department of Agriculture, Illinois Department of Natural Resources and LHDs to test the response plan.