How to Control Avian Influenza (H5N1) in Your Facility with Hydrogen Peroxide (HP)

What is Avian Influenza (H5N1)?

Avian influenza, commonly known as bird flu (H5N1), is a highly pathogenic virus that causes influenza in birds and other animals and leads to high mortality rates.

First discovered in Italy in 1878 when reports of a contagious disease with a high mortality rate in poultry arose, it was coined with the name “fowl plague” and was thought to be a more severe strain of fowl cholera. In 1880, studies showed it to be a different disease altogether. By 1955, fowl plague became widely known as highly pathogenic avian influenza (HPAI). The term “highly pathogenic” refers to the impacts of the disease on birds specifically. The strain of HPAI which causes the most infection and has the highest mortality rate is H5N1. The first outbreak of H5N1 happened in 1996 in China and the first human cases were recorded in 1997 in Hong Kong.

Although avian influenza is extremely dangerous to birds, infections in humans remain sporadic. The main route of transmission from animal to human of H5N1 was identified to be via feces or bodily fluids such as saliva. The mortality rate is nearly 100% for birds and approximately 56% for humans. Recent outbreaks of the disease have shown that it affects more domesticated animals than just poultry. In March 2024, H5N1 was first identified in juvenile goats in the United States and dairy cows in Kansas and Texas. On April 1st, 2024, the first human contraction of avian influenza from dairy cows was recorded. By May 2024, the CDC reported two more people had contracted the disease by exposure to dairy cows in Michigan. These findings indicate that this may be the beginning of an avian influenza outbreak.

How Avian Influenza Affects Facilities

Avian influenza is found in public health facilities, more specifically labs that test and process samples; vaccine testing and developing centers; pharmaceutical research labs; and poultry/dairy farms. However, it is most commonly found in in vitro experimentation labs specifically, BSL-3 and BSL-4 research laboratories worldwide where it is manipulated and studied. Cross-contamination can contribute to elevated risks. For example, in 2014, an instance was reported where a harmless sample of avian flu (H9N2) from one laboratory was given to another laboratory where the sample became cross-contaminated with a sample of H5N1, a highly pathogenic strain of avian flu.

How to Control the Spread of Avian Influenza

Taking precautionary and protective measures, such as those below, can help mitigate the spread and acquisition of animal-related infections and viruses:

wearing gloves
thoroughly washing your hands before touching your face
wearing hair/head covers
wearing protective chemical-resistant or chemical-impermeable clothing (PPE)
wearing protective shoes
utilizing respirators or well-fitting masks
using eye protection such as goggles

CURIS Advantage in Combatting H5N1

Many other decontamination systems use chemicals such as formaldehyde, sodium hypochlorite (bleach), or chlorine dioxide. While these chemicals are highly effective decontaminators, they pose dangers to the staff as they have been linked to possible causes of cancer and severe respiratory issues. Additionally, these chemicals also lead to the degradation and corrosion of lab equipment and leave behind sticky residues which, combined with the cold temperatures of research labs, create the perfect breeding environment for harmful pathogens such as H5N1.

CURIS^® bypasses the issues created by these toxic chemicals by using 7% hydrogen peroxide solution and Hybrid Hydrogen Peroxide™ (HHP™) technology. HHP™ decontamination is a combination of vapor and micro aerosols which have extremely small particle sizes that allow it to stay in the air, ensuring that it fulfills the contact time requirement. The small particle sizes also allow for the solution to be identified as a dry applicant when it is being used and prevent the droplets from agglomerating to form large areas of moisture, which double as breeding grounds for pathogens.

CURIS' patented Pulse™ technology replenishes any decomposed hydrogen peroxide during the contact time to maintain efficacy and efficiency, simultaneously conserving resources. To further streamline the process, devices are pre-calibrated meaning they don’t have to be calibrated before every use of the device and they auto-calculate the amount of solution needed to ensure maximum efficiency.

According to the Spaulding Classification System (see graph below), Avian influenza is classified as a “virus with lipid envelopes."

All CURIS^® decontamination devices have a 6-log reduction (99.9999%) of “bacterial spores,” which are 6 levels above “viruses with lipid envelopes” according to the Spaulding Classification system. In fact, they've proven a 10-log reduction (99.9999999%) of adenovirus and an 8-log reduction (99.999999%) of norovirus, which are both members of the “viruses without envelopes family” on the chart, 4 levels above “viruses with lipid envelopes.” These high reduction rates provide CURIS^® with a distinct advantage in killing pathogens such as avian influenza.

Could Avian Influenza become the next Disease X?

Disease X is a hypothetical concept that represents a potential pandemic-causing pathogen. It has been around since 2018 and its purpose is to usher people to begin thinking about possible pandemics that may arise. With recent advancements in artificial intelligence (AI), vaccine generation and pathogen prediction have become more efficient. The 2020 outbreak of COVID-19 classified COVID-19 as the first Disease X. In order to be classified as a Disease X, there are some criteria that it needs to fulfill. For example, the pathogen must spread through respiration as it is the most efficient transmission route. Avian influenza is transmitted through feces and bodily fluids of animals; however, its route to transmission for human-to-human infection changes to respiration. It is not certain if avian influenza will become the next Disease X, but it is causing a great deal of concern and observation.

Information on, and guidance for, Avian Influenza can be found on your state and local health department websites such as below and will often offer specific guidance for farm workers:

https://garretthealth.org/avian-flu/

https://www.cdc.gov/flu/avianflu/influenza-a-virus-subtypes.htm#highly-pathogenic

Lupiani, B., & Reddy, S. M. (2009). The history of avian influenza. Comparative Immunology, Microbiology and Infectious Diseases, 32(4), 311–323. doi:10.1016/j.cimid.2008.01.004 

https://www.cdc.gov/flu/avianflu/timeline/avian-timeline-2020s.htm

https://www.fda.gov/food/alerts-advisories-safety-information/updates-highly-pathogenic-avian-influenza-hpai

https://www.who.int/docs/default-source/wpro---documents/emergency/surveillance/avian-influenza/ai_20230203.pdf

https://netec.org/2023/01/30/situation-report-highly-pathogenic-avian-influenza-ah5n1/#:~:text=H5N1%20is%20highly%20contagious%20among,with%20smaller%20flocks%20at%20home.

https://www.yalemedicine.org/news/h5n1-bird-flu-what-to-know#:~:text=The%20CDC%20says%20the%20public,caused%20sporadic%20outbreaks%20among%20poultry.

https://www.osha.gov/avian-flu/control-prevention

https://publichealth.jhu.edu/2024/what-is-disease-x

https://cepi.net/disease-x-what-it-and-what-it-not