A joint advisory issued on May 25 by the National Centre for Disease Control (NCDC) and Department of Animal Husbandry and Dairying stated that in 2024, four states -- Andhra Pradesh (Nellore), Maharashtra (Nagpur), Kerala (Alappuzha, Kottayam, and Pathanamthitta districts), and Jharkhand (Ranchi) -- have already reported outbreaks of Avian influenza in poultry.

"Given that Avian Influenza (H5N1) infection is highly pathogenic and has the potential to be transmitted to humans, it is imperative to take all necessary measures to minimize and prevent the spread of this infection," the joint advisory said.

The Avian Influenza virus (bird flu virus) is normally maintained in circulation in nature among mainly migratory birds and is known to cause outbreaks among domesticated poultry birds probably due to spill over events when migratory birds come in contact with poultry, it said.

The H5N1 is the main Avian influenza virus that has caused multiple outbreaks among poultry globally. Both types of viruses (HPAI and LPAI) may occasionally affect other mammalian species, including humans.

Human infections are primarily acquired through direct contact with infected poultry or contaminated environments, the joint advisory said.

Although there have been sporadic reports in humans and outbreaks among domestic and wild birds, since March 2024, there is a global concern over Avian influenza outbreaks in cattle from multiple states in the US that have resulted in one reported human case of H5N1, the joint advisory stated.

Avian influenza outbreaks from India in poultry have been reported since 2006 and have been jointly investigated by the Animal Husbandry and Health Departments (IDSP, NCDC).

The states and Union Territories have been advised to orient all the health care workers/private practitioners on case definitions, signs and symptoms of Avian influenza.

"Be vigilant for any unusual deaths amongst the domestic birds/poultry in your state, and if observed, please share the information immediately with the Department of Animal Husbandry so that public health action can be initiated as per the national action plan for Avian Influenza," the joint advisory said.

The states have been advised to strengthen biosecurity measures in all poultry establishments, zoos, poultry markets, etc. after conducting a thorough assessment.

"Comprehensive biosecurity assessments on all poultry farms are recommended. Access to farms should be restricted and stringent hygiene protocols, including the use of disinfectant footbaths and protective clothing, should be enforced. Measures to prevent contact between wild birds and domestic poultry should be implemented," it stated.

The states have been asked to enhance information, education and communication tools among the general public regarding preventive measures such as minimizing the handling of dead or sick birds with bare hands and without adequate respiratory protection and following food safety measures while consuming products of animal origin.

Besides, they have been asked to be prepared for all preventive measures like stockpiling of an adequate number of antiviral drugs (Oseltamivir), PPE, masks etc.

Isolation wards/beds at dedicated hospitals may be required to handle any suspect case of Avian Influenza if confirmation among birds occurs in your state, the joint advisory stated.

It also called for enhanced surveillance (in wet markets, abattoirs, poultry farm workers etc.) as well as expanded surveillance (in sewage samples, water bodies, crows etc.) for Avian Influenza in collaboration with National Centre for Disease Control (NCDC), Indian Council of Medical Research (ICMR) and Department of Animal husbandry and Dairying (DAHD).

It emphasised on timely sharing of information besides underlined the need for strict compliance with the SARI surveillance guidelines of the Ministry of Health and Family Welfare by all states and its monitoring at senior level.

For the states where there is an active outbreak of Avian Influenza, the joint advisory advised some additional measures.

They have been asked to collect samples from cullers and surveillance workers (considered as 'at-risk' groups) on the 5th and 10th days following sanitization operations for H5N1 testing.

The joint advisory has stressed on conducting surveillance for suspected human cases and providing health check-ups for cullers and poultry workers, with a duration of 10 days and stated that recommended measures for chemoprophylaxis, management, and use of personal protective equipment (PPE) should be implemented.

It also advised following the SOPs for collecting and transporting samples from suspected cases to designated laboratories.

"A coordinated response involving experts from veterinary services, health departments, wildlife and forest departments, local authorities and other relevant stakeholders is required in all Avian Influenza outbreaks. Regular meetings should be conducted to share information, assess the situation and adjust strategies accordingly," the joint advisory said.