Respiratory Protection and Avian Influenza Viruses Frequently Asked Questions

What is avian influenza or flu?

Influenza viruses that infect birds, such as the H5N1 virus, are called “avian influenza viruses.” Avian influenza viruses do not usually infect humans; however, influenza viruses are constantly changing, and several instances of human infections have been reported since 1997.

What are the symptoms of avian influenza?

Symptoms of bird flu in humans have ranged from typical flu-like symptoms (fever, cough, sore throat and muscle aches) to eye infections, pneumonia, severe respiratory diseases (such as acute respiratory distress), and other severe and life-threatening complications.

How is avian influenza transmitted?

Birds that are infected with avian influenza viruses can shed virus in saliva, nasal secretions, and feces. It is believed that most cases of avian influenza infection in humans have resulted from contact with infected poultry or contaminated surfaces. In such situations, people should avoid contact with infected birds or contaminated surfaces, and should be careful when handling and cooking poultry. Strict hand hygiene must also be performed. Other means of transmission are possible, such as the virus becoming aerosolized and landing on exposed surfaces of the mouth, nose, eyes, or being inhaled.

Can avian influenza be transmitted from person to person?

To date the CDC and WHO have reported that although there is evidence of limited person-to-person spread of infection, sustained human-to-human transmission has not occurred.

How long can the avian influenza virus survive in the environment?

The duration that these viruses can survive in the environment depends on temperature and humidity conditions, but they may survive up to weeks in cooler and moister conditions.

What type of personal protective equipment (PPE) is recommended for those who are involved with disease control and eradication activities?

According to CDC and WHO, US NIOSH certified N-95, European CE certified EN143 P2 / EN149 FFP2, or comparable national/regional particulate respirators should be worn by workers who eradicate infected poultry. Higher level particulate respirators may also be used. Disposable gloves, protective clothing, shoe covers or boots, and safety goggles should also be worn by eradication workers. Disposable PPE should be properly discarded, and non-disposable PPE should be cleaned and disinfected. Hand hygiene measures should be performed after removal of PPE.

What type of personal protective equipment (PPE) is recommended for health care workers who are exposed to patients with known or suspected avian influenza?

According to CDC and WHO, because of the uncertainty in transmission and risk of serious disease, isolation precautions identical to caring for patients with severe acute respiratory syndrome (SARS) should be used. These include gloves, gown, eye protection and US NIOSH certified N-95, European CE certified EN143P2 / EN149 FFP2, or comparable national/regional particulate respirators. Higher level particulate respirators may also be used. Disposable PPE should be properly discarded, and non-disposable PPE should be cleaned and disinfected. Hand hygiene measures should be performed after removal of PPE.

Should avian influenza patients wear a surgical mask?

Persons suspected of having avian influenza should be separated from others and asked to wear a surgical mask. If a surgical mask is not available, tissues should be provided and patients should be asked to cover their mouth and nose when coughing.

How do I clean my respirator after use?

Disposable respirators should not be cleaned; dispose of the respirator immediately after use according to facility policy. Reusable respirators may be disinfected using a mild bleach and water solution (0.1% sodium hypochlorite).

Can disposable respirators be shared between people?

No. Disposable respirators should never be shared.

Can respirators protect you from biological agents such as Bacteria or Viruses?

Respirators are designed to reduce exposures of the wearer to airborne hazards. Biological agents, such as viruses, are particles and can be filtered by particulate filters with the same efficiency as non-biological particles having the same physical characteristics (size, shape, etc.). However, unlike most industrial particles there are no exposure limits established for biological agents. Therefore, while respirators will help reduce exposure to avian influenza viruses, there is no guarantee that the user will not contract avian flu. Respirators may help reduce exposures to airborne biological contaminants, but they don't eliminate the risk of exposure, infection, illness, or death.

What is the difference between a government-certified respirator and a surgical mask?

Respirators are designed to help reduce the wearer’s exposure to airborne particles. The primary purpose of a surgical facemask is to help prevent biological particles from being expelled by the wearer into the environment. Some surgical masks are also designed to be fluid resistant to splash and splatter of blood and other infectious materials. Surgical facemasks are not necessarily designed to seal tightly to the face and therefore air leakage around the edges is likely. However, some respirators are designed to have the characteristics of both an approved respirator and a surgical mask.

How important is respirator fit?

Fit is very important. If a respirator does not seal properly to the face, airborne hazards can penetrate or enter underneath the face piece seal and into the breathing zone. It is very important to always follow the donning instructions and do a user seal-check or fit-check before entering the contaminated environment. Some countries, such as the US and UK, also require fit testing. A good fit can only be obtained if the face is clean-shaven in the area where the respirator seals against the face. Beards, long mustaches, and stubble may interfere with a good seal and cause leaks into the respirator. Many medical facemasks, not approved as respirators, do not seal tightly to the face allowing airborne hazards to enter the breathing zone. Even those medical facemasks that appear to seal tightly to the face have not been designed to protect the wearer from airborne hazards. Therefore, they should not be considered an equivalent substitute for government-approved respirators.

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