See also: 23 May 2003, 16 May 2003, 9 May 2003, 2 May 2003, 25 April 2003, 18 April 2003, 11 April 2003, 4 April 2003, 28 March 2003, 14 March 2003, 7 March 2003, 7 March 2003

Information received on 18 March 2003 from Dr Frederik H. Pluimers, Chief Veterinary Officer, Ministry of Agriculture, Nature Management and Fisheries, The Hague:

End of previous report period: 10 March 2003 (see Disease Information, 16 [11], 63, dated 14 March 2003).

End of this report period: 18 March 2003.

New outbreaks:

Location	No. of new outbreaks
Province of Gelderland	20
Province of Utrecht	7

Description of affected population in the new outbreaks: 20 flocks of layer hens, 3 flocks of broiler parents, 2 flocks of turkeys and 2 small backyard flocks.

Total number of animals in the new outbreaks:

species	susceptible	cases	deaths	destroyed	slaughtered
avi	673,041	...	...	673,041	0

Diagnosis: see follow-up report No. 2.

Epidemiology:

A. Source of agent / origin of infection: the type of strain isolated on one of the infected holdings and the fact that many of the holdings had free-housing facilities strongly suggests introduction via waterfowl.

B. Mode of spread: contiguous or possibly through indirect contact with wildlife (waterfowl). Contiguous contact (spatial spread) is possible between holdings that are located within an area of 1 km of an infected flock. Thirty-two of the 54 outbreaks to date have occurred within a radius of 1 km of another infected holding. All confirmed outbreaks are located in “de Gelderse Vallei” (see map), an area with a very dense poultry population.

Control measures during reporting period: see follow-up report No. 2.

Additional information received on 19 and 20 March 2003 from Dr Frederik H. Pluimers, Chief Veterinary Officer, Ministry of Agriculture, Nature Management and Fisheries, The Hague:

Report date: 20 March 2003.

Several people working on the eradication of avian influenza have been infected with the highly pathogenic avian influenza (HPAI) virus and have developed conjunctivitis. About 132 human cases of conjunctivitis have been detected, of which 32 have been confirmed to be related to the HPAI virus. In one case, transmission of the virus from one person with conjunctivitis to another person has been diagnosed. This was the daughter of a person involved in the culling of an infected poultry farm.

After consultation of experts, the following measures were taken by the Ministry of Public Health:

- Hygienic measures: protective clothing, masks and spectacles for personnel working at the culling of infected and suspect farms. Washing of hands as a precaution against eye infection.

- Vaccination against human influenza of people working with poultry in the protection zones. This vaccination protects against human influenza and helps to prevent simultaneous infection with human and avian influenza.

- Antiviral treatment for persons with conjunctivitis who were in close contact with infected poultry.

- Antiviral prophylactic treatment of all persons who are working in close contact with infected poultry. This includes the persons working on eradication as well as the owners and workers of infected and suspected farms.

Antiviral treatment of eradication personnel started on 15 March.

The local Public Health Authorities have started their campaign for vaccination and treatment of other persons in the protection zones.

Source: OFFICE INTERNATIONAL DES EPIZOOTIES - 21st March 2003