Managing Cats and Captive Wild Animals Exposed to Bird Flu (H5N1)

Information for veterinarians, veterinary staff, and other animal caretakers
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Key points

  • Veterinarians and veterinary staff, in field and clinical settings, who are working in close contact with cats who are suspected or confirmed-positive for HPAI A(H5N1) virus infection should take precautions to prevent potential unprotected exposures.
  • Veterinarians, veterinary staff, and other animal caretakers, in field, clinical, and other animal care settings should take precautions to prevent potential unprotected exposures when working in close contact with animals suspected or confirmed with HPAI A(H5N1) virus infection.
Influenza A viruses are found in many animals including cats.

Purpose

Provide information and resources on preventing potential HPAI A(H5N1) exposures when working in close contact with domestic cats or captive wild animals with suspected or confirmed HPAI A(H5N1) infection.

Veterinarians and Animal Caretakers Who May be at Higher Risk

Veterinarians, veterinary staff, and other animal caretakers who work in close contact with animals suspected or confirmed with HPAI A(H5N1) virus infection, including those who sample animals for HPAI A(H5N1) viruses, should take precautions.

Highly Pathogenic Avian Influenza (HPAI) A(H5N1) virus infections have been reported in domestic cats and captive wild animals (e.g., tigers, mountain lions, red foxes, seals, birds of prey, flamingos) in the United States. Regular updates on HPAI A(H5N1) detections in animals can be found on the USDA APHIS H5N1 landing page.

Animal care settings may include:

  • Veterinary clinical and field settings
  • Animal sanctuaries including wildlife sanctuaries
  • Zoos/aquaria
  • Animal shelters
  • Animal care and control facilities

Clinical Signs of HPAI in Animals

Possible clinical signs of HPAI A(H5N1) in animals range from a mild illness to severe neurologic disease and rapid death. Signs of infection in cats are better known than in other species. Clinical signs in domestic cats or captive wild animals may include the following:

  • Decreased energy and appetite
  • Neurologic signs (e.g., ataxia, circling, tremors, seizures, or blindness)
  • Respiratory signs (e.g., nasal discharge, tachypnea or breathing quickly, dyspnea or trouble breathing, sneezing, or coughing) may or may not be present
  • Death with no obvious signs of illness

Risk Factors for Animals

  • Feeding animals raw (unpasteurized) milk or dairy products from infected animals
  • Feeding animals raw or undercooked meat from infected animals
  • Feeding animals commercially produced raw pet foods containing infectious virus
  • Animal contact with wild birds, poultry, or other infected animals
  • Animal contact with objects (e.g., clothing, shoes, or equipment) contaminated with infectious virus

Protecting People From HPAI A(H5N1) in Animal Care Settings

Recommendations to reduce exposure to avian influenza A viruses for veterinarians, veterinary staff, and other animal caretakers who work with cats or other animals with suspected or confirmed HPAI A(H5N1) virus infection:

Implement ventilation and engineering controls

  • Implement engineering controls with ventilation systems and administrative controls with testing and monitoring plans

Additional information on implementing environmental infection control can be found in CDC's Interim Guidance for Infection Control Within Healthcare Settings When Caring for Confirmed Cases, Probable Cases, and Cases Under Investigation for Infection with Novel Influenza A Viruses Associated with Severe Disease | Bird Flu | CDC

Use appropriate Personal Protective Equipment (PPE)

  • When handling or interacting with animals that might be infected with or exposed to HPAI A(H5N1) viruses, veterinarians, veterinary staff, and other caretakes should wear PPE including:
    • NIOSH Approved® particulate respirator
    • Fluid-resistant coveralls
    • Safety goggles
    • Boot covers or boots
    • Head cover or hair cover
    • Disposable gloves
      • Optional PPE items:
        • Waterproof apron over the top of coveralls to protect the coveralls and allow for easy removal of gross contamination during PPE removal
        • Face shield over the top of goggles and respirator to protect against large amount of liquid splashing onto the filtering facepiece respirator
        • Outer work gloves to protect the disposable gloves (for example, gloves for cold protection, manual shoveling, handling live poultry)
          • If thicker reusable gloves are required, rubber gloves should be waterproof and not have linings. Thicker gloves should be able to be cleaned and disinfected after each use.

® N95 and NIOSH Approved are certification marks of the U.S. Department of Health and Human Services registered in the United States and several international jurisdictions.

Workers should receive training on and demonstrate an understanding of: when to use PPE; what PPE is necessary; what it looks like when PPE is properly fitted; how to properly put on, use, take off, dispose of, and maintain PPE; and the limitations of PPE.

Pay special attention to aerosol-generating procedures

Use particular care during aerosol-generating procedures (e.g., endotracheal intubation and extubating, open suctioning of airways, cardiopulmonary resuscitation).

Additional recommendations to reduce exposure can be found in: Reducing Exposure for Workers to Avian Influenza A Viruses | Bird Flu | CDC

Resource

Epidemiological criteria for exposure are described in: Recommendations for Monitoring and Testing of Individuals Exposed to A(H5N1) Viruses | Bird Flu | CDC

Testing Animals for HPAI A(H5N1)

Testing should be considered in animals with both compatible clinical signs (see above) and either known or potential exposure to HPAI A(H5N1) (see Risk Factors for Animal Exposure to HPAI A(H5N1)). Veterinarians should contact their state public health veterinarian or their state animal health official for more information on testing options.

Testing for certain types of diseases in animals, including highly pathogenic avian influenza, must be performed at either USDA APHIS' National Veterinary Services Laboratories (NVSL) or other APHIS-approved facilities. Some testing is performed only by laboratories in the National Animal Health Laboratory Network (NAHLN). List of APHIS-Approved Testing Laboratories.

Managing Cats and Other Animals With HPAI A(H5N1)

Animals with HPAI A(H5N1) virus infections should be isolated from people and other animals until a negative rRT-PCR test result following resolution of clinical signs or until two weeks after the resolution of clinical signs. Contact with affected animals in isolation should be kept to a minimum, even while wearing appropriate PPE, when providing care like food, water, and cleaning and disinfecting isolation areas.

The decision to isolate companion animals at home or at a veterinary clinic should be made by the owner and the attending veterinarian. The state animal health official or the state public health veterinarian or designated public health contact can be consulted when determining isolation protocols. The decision may be based on access to proper isolation facilities or the ability to keep infected animals away from people and other animals, accessibility of appropriate PPE for the household members, availability of trained personnel and knowledge of biosecurity procedures when caring for both infected and non-infected animals, and severity of illness in the animal, among other factors.

Veterinarians, veterinary staff, and others caring for infected animals should wear PPE. Ideally, one designated person should be assigned to care for isolated animals with HPAI A(H5N1) virus infections. When selecting a primary caretaker for isolated animals, keep in mind that some people (e.g., children younger than 5 years, people 65 years and older, pregnant women, and people with certain chronic medical conditions) are at higher risk of developing serious influenza complications and should limit contact with infected animals. Where possible, people with an increased risk of severe illness should avoid caring for animals with HPAI A(N5N1) virus infection.

Information for People Exposed to HPAI A(H5N1)

Follow the HPAI A(H5N1) exposure guidance for people exposed to cats or other animals that are suspected or confirmed to have infection with HPAI A(H5N1) viruses:

People exposed to HPAI A(H5N1) virus-infected cats or other animals including people wearing recommended PPE should be monitored for new respiratory illness symptoms, and/or conjunctivitis (eye redness) beginning after their first exposure and for 10 days after their last exposure.

Persons who develop any symptoms of illness after exposure to HPAI A(H5N1) virus infected cats or other animals should seek prompt medical evaluation for possible influenza testing and antiviral treatment by their clinician or public health department.

Communication Guidance

Veterinarians might consider the following communications for cat owners:

  • Inform cat owners about a potential risk of exposure
  • Provide recommendations to keep domestic cats inside and discourage feeding of raw food diets, including raw (unpasteurized) milk, raw meats, and commercially produced raw pet foods
  • Provide recommendations for handling cats and other animals at higher risk for HPAI A(H5N1) infections

Keep in mind

For recommendations on monitoring and testing people exposed to HPAI A(H5N1) infected animals, health departments should refer to CDC's Recommendations for Monitoring and Testing of Individuals Exposed to A(H5N1) Viruses | Bird Flu | CDC


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