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How to use this guide Health officials who are alerted to a location where poultry (chicken, ducks and other farmed birds) have been found to be dying of bird flu or avian influenza (H5N1 virus) will need to take immediate steps to ensure that the disease does not spread. With a good plan, one that includes effective communication measures, the spread of bird flu can be successfully arrested. This simple guide provides key messages and information to achieve this goal.

The first objective is to identify the people and communities that are most at risk. This would constitute the primary audience.

The Food and Agriculture Organization estimates that 70% of poultry is raised in backyard farms. It is critical, therefore, that health authorities provide basic information on prevention and control of avian influenza to these people as they are at greatest risk of being exposed to the disease. It is also advisable that this information could be disseminated through other communication channels such as the media, community leaders, nongovernmental organizations and policy-makers. This would constitute the secondary audience.

The second objective is to adopt and adapt these key messages and information for local dissemination and use.
The third objective is to provide additional local information that will enable or reinforce positive or desired actions and behaviours of the target audience. Hotlines, referral numbers and names of key people who could provide help can be added by health officials to this guide.

Key steps to ensure the effective use of this guide:
• Identify audiences.
• Adopt, adapt and translate if necessary before dissemination.
• Add relevant information on local contact persons, hot lines, help centres, etc.

KEY MESSAGES AND ADVICE
The spread of bird flu in affected areas can normally be prevented.• People should avoid contact with chickens, ducks or other poultry unless absolutely necessary. This is the best way to prevent infection with the bird flu virus.
• Children are at high risk because they may play where poultry are found. Teach your children the following basic
guidelines:
o Avoid contact with any birds, their feathers, faeces and other waste.
o Do not keep birds as pets.
o Wash hands with soap and water after any contact.
o Not to sleep near poultry.
• Do not transport live or dead chickens, ducks or other poultry from one place to another even if you think your birds are healthy.
• Handling of poultry in affected areas should be done within the area without transporting them to other areas.
• Do not prepare poultry from affected areas as food for your family or animals. The slaughter and preparation of such birds for food is dangerous.
• If you unintentionally come into contact with poultry in an affected area, such as touching the bird's body, touching its faeces or other animal dirt, or walking on soil contaminated with poultry faeces:
o wash your hands well with soap and water after each contact;
o remove your shoes outside the house and clean them of all dirt; and
o check your temperature for 7 days at least once daily. If you develop a high temperature (>37.5°C), visit a
doctor or the nearest health care facility immediately.

Proper handling of poultry that are ill, suspected of having bird flu or dead is an important control measure to
prevent the spread of the disease.• Make sure to keep children away from dead or sick poultry.
• If you need to handle dead or sick poultry, make sure you are protected. Wear protective clothing such as a mask,
goggles, gown, rubber boots and gloves. If these are not available, cover your mouth with a piece of cloth, wear
glasses, use plastic bags to cover hands and shoes and fix these tightly around wrists and ankles with a rubber band or string. Wear overalls that can be washed.
• If you encounter sick and dead poultry for the first time and are unsure of the situation, inform the authorities
immediately and leave the handling of the poultry to experienced personnel (cullers, clean-up personnel, etc.).

Decontamination of the yard or chicken pen will help control the spread of the disease.• If possible, ask experienced personnel to help you decontaminate the yard or chicken pen.
• If this is not possible and you have to do it yourself, wear protective gear to protect your eyes, hands, feet and other exposed parts of your body as described above.
• Dead birds should be buried safely (see next section).
• Effective cleaning results in no visible feathers or faeces remaining in the shed.
• Influenza viruses can survive for some time in organic material, so thorough cleaning with detergents is an important step in decontamination. All organic matter must be removed from poultry houses as much as possible.
• As outdoor areas used by poultry can be difficult to clean or disinfect, poultry should be excluded from these areas for a minimum of 42 days to allow natural ultraviolet radiation to destroy any residual virus. The period of exclusion should be longer in cold weather.
• Spraying of disinfectants on vegetated outdoor areas or soil is of limited value due to the inactivation of these
chemicals by organic material. Removal of surface soil is not normally recommended unless it is heavily contaminated with faeces.

Dead birds and their faeces should be buried.• As much as possible, seek assistance from your local agriculture authority on how to bury dead animals safely.
• When burying dead birds or their faeces, try to avoid generating dust. Spraying or sprinkle water to dampen the area first. Bury bird carcass and faeces at a depth of at least 1 metre.
• When the dead birds and their faeces have been properly disposed, clean all areas very well with detergent and water. Influenza viruses are relatively susceptible to a variety of detergents and disinfectants.

Contaminated protective clothing should be properly handled or disposed.
• After the area has been cleaned, remove all the protective materials and wash your hands with soap and water.
• Wash clothes in hot or warm soapy water. Hang them in the sun to dry.
• Put used gloves and any other disposable materials in a plastic bag for safe disposal.
• Clean all reusable items such as rubber boots and glasses/goggles with water and detergent, but always remember to wash your hands after handling these items.
• Items that cannot be cleaned properly should be destroyed.
• Shower/wash body using soap and water. Wash your hair.
• Take care not to re-contaminate yourself or the cleaned area by avoiding contact with dirty, contaminated clothes and items.
• Most importantly, wash your hands every time after handling any contaminated items.

Footwear should also be decontaminated.• After walking around areas that may be contaminated (such as farms, markets or backyards with poultry), clean your shoes as carefully as possible with soap and water.
• When cleaning shoes, make sure that you do not flick any particles into your face or on your clothes. Wear a plastic bag over your hands, shield your eyes by wearing glasses or goggles, and cover your mouth and nose with a cloth.
• Leave dirty boots and shoes outside the home until they have been thoroughly cleaned.

People who have flu-like illness should take additional precautions.
• WHO believes it is very important to prevent human influenza from spreading in areas affected by bird flu. Where the avian influenza viruses and human influenza viruses come in contact with each other, there is a risk that genetic
material will be exchanged and a new virus could emerge.
• Anyone with flu-like illnesses should therefore be careful with secretions from the nose and mouth when around other people, especially small children, in order not to spread human influenza viruses.
• Cover your nose and mouth when coughing or sneezing. Use a tissue and throw it away once used. Teach children to do this as well.
• Always wash your hands with soap and water after any contact with secretions from nose or mouth as these can carry a virus.
• Children are especially prone to touching their face, eyes and mouth with unwashed hands. Teach children the
importance of hand washing after coughing, sneezing and touching dirty items.
• Inform the health authorities immediately and seek medical advice from a health professional if you develop signs of illness, such as fever and/or flu-like symptoms.

Precautions can be taken when visiting friends or relatives in health-care facilities.• If you visit a patient who has bird flu, follow the advice from the hospital staff to wear protective clothing, including a mask, gown, gloves and goggles.
• Such special protective clothing is required when you have direct contact with the patient and/or the patient's
environment.
• It is important that the protective mask fits properly. If it doesn't, seek advice from the hospital staff.
• When you leave the patient's room you must remove these items and wash your hands with soap and water.

In affected areas where the presence of bird flu has been confirmed, do not eat poultry meat that comes from
dead or sick animals.• In affected areas it is advisable not to use dead and sick chicken or other poultry for preparing food for humans and/or animals. Even healthy-looking poultry of any kind from a bird-flu affected area should not be used for food.

In neighbouring areas (next to the bird-flu affected area) some precautions need to be taken.• In general, only apparently healthy poultry should be prepared for food.
• For killing, use a method that does not contaminate you or the environment of your household with blood, dust, faeces and other animal dirt. Seek advice from the agriculture authority about the proper procedure.
• For plucking, use a method that does not contaminate you or the environment of your household with dust, faeces and other animal dirt. It is best to put poultry in boiling water before plucking feathers.
• For degutting, use a method that does not contaminate you or the environment of your household with blood, dust,
faeces and other animal dirt.
• Do not touch other items or your face (e.g. rubbing your eyes) during the procedure, unless you have washed your hands with soap and water.

Take all precautionary measures to ensure that poultry and poultry products are properly prepared and safe to eat.• Chicken prepared hygienically and cooked thoroughly, i.e. no pink juices should be observed, can be considered safe to eat. However, remember, if the bird has a transmittable disease, such as bird flu, the person preparing the food is at risk of becoming infected and the environment may become contaminated.
• Eggs, too, may carry pathogens, such as the bird-flu virus inside or on their shells. Care must be taken in handling
raw eggs and shells. Wash shells in soapy water and wash hands afterwards. Eggs, cooked thoroughly (hard boiled, 5 minutes, 70oC) will not infect the consumer with bird flu.
• In general, all food should be thoroughly cooked to an internal temperature of 70°C or above.