Veterinary Professionals

HDOA HPAI Guidance for Veterinary Clinics

Submitted by Raquel Wong, DVM, Hawaii Dept of Ag Animal Industry Division

Avian clients should not be turned away simply because HPAI is in the environment. Clinics and mobile veterinarians are encouraged to continue treating birds with extra attention focused on biosecurity and the signs of HPAI should they need to report suspected cases to animal health officials.

What are the signs of HPAI?

Decreased water consumption
Extreme depression
Very quiet
Difficulty breathing
Decrease in feed or water intake
Swelling or purple discoloration of head, eyelids, comb, wattle, and hocks
Decrease in egg production
Sudden unexplained death

What if a client calls with sick birds?

Veterinary clinics should develop a set of questions for their clients to determine the HPAI risk of the pet bird and then develop their own procedures appropriate to the risk. Some starter questions to consider:

Is the avian species a wild bird?
- Veterinarians should not let wild waterfowl, gulls or other susceptible HPAI wild species into their facility.
Are all birds sick or just one? What is the overall health of the flock?
- If one bird is sick or dead and all the others appear healthy it may not be HPAI. However, if a flock is experiencing daily mortality or there are a number of dead birds it should be reported to the Animal Industry Division, Hawaii Department of Agriculture at 808-483-7100 (Monday – Friday 7:45 AM – 4:30 PM). After hours or weekends to 808-837-8092. Or email HDOAIC@hawaii.gov.
Does the bird have access to the outside in a free ranging type of situation (vs. being in a contained/controlled housing away from environmental elements)
- If yes, how long does the bird spend time outside? Is the time spent outside supervised?
Does the client live by a body of water or agricultural field?
Does the client feed wild birds or wild animals?
Does the client engage in sport hunting of wild birds?
Does the client work or volunteer with any avian species?

Answering yes to any of these questions should prompt additional precautionary procedures to be utilized and have AI on your list of differential diagnoses.

How should clinics handle routine avian appointments?

Avian patient physical contact should be limited, and staff should always wear the appropriate PPE and wash their hands before and after handling birds. Additional biosecurity guidance includes:

Make an exam room at the clinic for avian appointments only.
See avian appointments at the end of the day.
Limit staff contact with avian species, especially those that have pet birds at home.
Emergency surgeries only for avian species.
Hospitalized avian species should be kept away from routine avian appointments.
All medical equipment and laundry used for avian appointments should be washed and disinfected appropriately.
Disinfect exam rooms following label directions on preparation and contact time to ensure it kills potential HPAI virus. Look for a disinfectant with an EPA registered product with label claim for Avian Influenza
Proper PPE should be used including gowns, foot coverings, masks, gloves, and eye protection.
Educate staff and clients about how HPAI is spread and how to reduce the spread of the disease.

How should mobile veterinarians handle client visits?

Wear clean clothing and boots.
If possible, limit ambulatory visits to facilities with poultry to one site per day.
Wash your vehicle immediately prior to and when leaving a site with poultry.
Use disposable coveralls, boots, and gloves, +/- masks. If possible and agreeable to the client, leave them at the client’s site.

Considerations for clinic staff biosecurity

Does the facility have a written biosecurity plan and procedures?
Do employees and volunteers receive biosecurity training?
Do employees and volunteers change into dedicated work clothing onsite? Is work-provided clothing laundered onsite, or is it taken home with employees?
What personal protective equipment (such as boots, gloves, coveralls, and masks) do you provide?
Are staff allowed to keep poultry or pet birds at home? Do staff engage in sport hunting of wild birds?
If the attending veterinarian is an offsite contractor, do they treat birds at other locations? What precautions do they take when visiting your facility?
Are there protocols (such as showering, changing clothes, or avoiding bird contact for 72 hours) for people who visit captive wild bird facilities or poultry premises?

What if you suspect a bird in your care has HPAI?

Call the Animal Industry Division, Hawaii Department of Agriculture at 808-483-7100 (Monday – Friday 7:45 AM – 4:30 PM). After hours or weekends to 808-837-8092. Or email HDOAIC@hawaii.gov.