HPAI Protocol

Effective 10/21/2025 – date prone to change to accommodate changing status of HPAI.

Purpose/ Applicability: 

Please see below the reinstated protocol for high-risk HPAI avian species to help mitigate the risk to the VTH students and staff, effective immediately.

Scope: H5N1 Influenza – Bird Flu

Definition(s): highly pathogenic avian influenza (HPAI) that affects birds and dairy cattle. Current outbreaks among poultry and backyard bird flocks.

Equipment:

Procedure:

1. Response for High-Risk Species:

• For any case with moderate to high suspicion of HPAI, isolation protocols must be implemented immediately (similar to those for Canine Parvovirus or Distemper).
• Students, aside from those that are paid staff and have been fit-tested for N95's, will NOT be involved with any sick poultry/waterfowl/falconry cases.
• Any cases with moderate to high suspicion of HPAI including all poultry, waterfowl, and falconry species will be examined in the MRO ward, even during normal business hours. No patients should be examined in VMSC.

1. VMSC faculty/house officers will come to SAC for cases with moderate to high suspicion of HPAI.

• Zoomed will receive all sick poultry primarily, including through ER (house officer on-call will come in and not involve any ER staff, doctors, or students). 
• Zoomed will also be the primary contact for triaging these cases before they come to the hospital.

1. Zoo Med will only accept backyard poultry Monday - Friday between the hours of 8am-4pm and will come in as needed on ER basis Saturday and Sunday between the hours of 8am-12pm.  
2. Customer Service Representatives (CSRs) will need to gather key information at the outset, including the number of birds affected and any clinical signs and relay information to Zoomed on call Team, this will help facilitate appropriate decision-making and testing.

1. Anything that call after those hours a CSR will let owners know we are only accepting backyard poultry during normal business hours due to the HPAI outbreak, but a phone triage team will be calling them back shortly after they take down the following information:

1. Name, Best contact phone number, Species of birds, Number in flock, Clinical signs present, Number of sick birds, Number of dead birds.

2. Zoo Med Phone triage team will then contact owner and determine if coming the next day is the best option or if the client needs to contact the state veterinarian.
3. On the weekends, the Zoo Med Triage team will determine if the animals need to be seen or if the client needs to contact the state veterinarian.  If they should be seen the triage team will let owner know the fees of approximately $450 to be seen over the weekend and that doesn’t include any diagnostics or treatment. Additionally, we do not have the capacity to hospitalize a high-risk species unless they have a negative HPAI test back.
4. The goal is the triage team can determine if animals need to come in and then will plan a time for them to come in so adequate staffing is available. 
5. If a client arrives at the hospital with backyard poultry without first calling, they should be instructed to wait in the car and CSR should follow same protocol as above and gather important information and let client know the triage team will be calling them shortly.
6. If client wants euthanasia after hours for backyard poultry, it will be at the On-call triage team discretion based on the circumstance, but after-hours fees need to be charged for these instances.   

2. Testing and Additional Measures:

• HPAI PCR testing (Influenza A Matrix RT-PCR) is recommended for patients with neuro or respiratory signs, and in cases of potential human exposure. The client’s cost for this test will be approximately $100.
• Special synthetic or polyester swabs are being ordered for HPAI testing and will be available through the storeroom.

3. The Illinois Department of Public Health recognizes that we are 1.) highly trained and 2.) at risk for exposure. They have requested that frequently exposed individuals self-monitor for signs and symptoms of H5N1 infection. Please see both symptom monitoring attachments. (Exposure with no symptoms and Symptoms after exposure).

Update: If people are wearing full PPE (Tyvek, hood, goggles, N95 that's been fit-tested, gloves), when working with a known or suspected positive, that is NOT considered exposure per CUPHD new guidelines.

• People who are exposed but not symptomatic do not have to report it to CUPHD, unless they later become symptomatic.
• Most importantly -> if anyone develops relevant symptoms (document 2 above) during a (formal or informal) monitoring period, we ask that they reach out first thing to Champaign-Urbana Public Health District (CUPHD) so that they may arrange any assessment, treatment, or testing they may require. They do not want someone potentially infectious with H5N1 to show up un-announced at a medical facility and potentially infect others. Furthermore, H5N1-specific testing requires approvals that must be arranged by the public health system so contacting the CUPHD first will help expedite matters. Given that the H5N1 human incubation period is thought to range from 2-10 days, staff should not be concerned for H5N1 infection unless they have had known or potential contact with an H5N1 positive animal, specimen, or byproduct within the previous 2-10 days prior to the onset of their symptoms. CUHD or IDPH staff should be reachable in under an hour at any time day or night – please reach out first thing if there is a significant concern for human H5N1 infection.
• Contact information:

1. Champaign-Urbana Health District: 217-531-4253. After hours you may call 217-352-7961 to reach the health district’s answering service.

For additional resources: https://www.cdc.gov/bird-flu/

Thank you for your continued cooperation as we navigate HPAI and these protocols.