Bird flu in Quebec: risk to humans, symptoms and when to seek care

Sick birds on a farm, animals found dead by the water, and the same question keeps coming up: is this dangerous for us? The bird flu affects birds first, and the Public Health Agency of Canada assesses the risk as low for most people in the country. That risk does vary with exposure, however: people who work with infected animals are more exposed than the general population. Here is what you need to know about transmission to humans, the symptoms to watch for, when to call Info-Santé 811 or 911, and what to do around a sick or dead bird.

On this page

• What is bird flu?
• What is the risk to humans?
• Symptoms in humans
• To remember
• When should you seek care or call?
• How is the illness treated?
• Can you eat chicken and eggs?
• What should you do about a sick or dead bird?
• Is there a vaccine?
• Myths and misconceptions
• Frequently asked questions
• Sources

What is bird flu?

The bird flu, also called avian influenza, is a viral infection that mainly affects wild birds and poultry. The strain public health authorities are monitoring closely is the A(H5N1) virus. It can also reach other animals, which is why official guidance refers to potentially infected animals and not just birds.

How the virus reaches humans

Human infection is rare. It occurs when the virus enters through the mouth, nose or eyes, in one of these ways:

• by breathing in particles suspended in a contaminated environment;
• through direct contact with contaminated material, such as feathers, droppings, raw milk or other secretions;
• by touching a contaminated surface, then your face.

And from person to person?

Public health authorities have not observed any sustained transmission between people. Close contact with an infected person is still an exposure to take seriously. That is why a sick person must follow the instructions they receive to avoid passing on the virus.

What is the risk to humans?

The risk to the general public is considered low by the Public Health Agency of Canada, which considers it higher for people with high exposure. When the illness does occur, it can range from mild to severe and is sometimes fatal. As with other viruses that make the headlines, such as Ebola or hantavirus, it is important to separate how serious an infection can be from how likely you are to catch it.

Who is most exposed?

• People who work with or handle potentially infected wild or domestic animals.
• In Quebec, mainly workers in close contact with infected poultry.
• People who work in environments heavily contaminated by feathers, droppings, raw milk or other secretions.
• People who visit livestock farms or live animal markets.
• People in close contact with an infected person.
• People who handle or eat raw or undercooked poultry, meat, eggs or milk.

Where do human cases stand?

In Canada, one severe locally acquired human case has been reported in a teenager. In Quebec, according to the latest public data consulted, no human cases have been detected. This may change: the pages of the Public Health Agency of Canada and the Institut national de santé publique du Québec remain the references to consult.

Bird flu symptoms in humans

The symptoms often resemble those of seasonal flu. That is why recent contact with sick animals is important information to share. Some infected people have no symptoms.

Most commonly described symptoms

• Cough
• Shortness of breath
• Fever
• Muscle aches
• Headaches

Other possible symptoms

• Red eyes or conjunctivitis
• Runny nose and sore throat
• Fatigue
• Diarrhea and, more rarely, nausea or vomiting
• Bleeding gums

Québec.ca mainly mentions conjunctivitis and signs similar to those of seasonal flu. Red eyes have several possible causes, as explained in our article on conjunctivitis. It is the exposure context that changes what you should do.

Time to onset

According to the Public Health Agency of Canada, symptoms generally appear 1 to 5 days after exposure, sometimes later. Québec.ca, for its part, gives an incubation period of 2 to 14 days.

Signs of severe illness

• Difficulty breathing
• Pneumonia, acute respiratory distress or fluid in the lungs
• Altered mental state
• Seizures
• Failure of organs such as the kidneys, liver or heart

Any of these signs requires immediate medical help.

To remember

• The risk is assessed as low for most people in Canada.
• People exposed to infected animals, especially at work, face a higher risk.
• No sustained person-to-person transmission has been observed.
• Symptoms can resemble those of the flu, sometimes with red eyes.
• After contact with sick or dead birds, monitor your health for 10 days.
• If symptoms develop after such contact, call Info-Santé 811 and mention the contact.

When should you seek care or call?

The steps to take depend mainly on two things: recent contact with potentially infected animals and how severe the symptoms are. The following table summarizes the guidance from public health authorities.

Situation	What to Do
Contact with sick or dead birds, no symptoms	Watch for symptoms for 10 days after the last exposure.
Symptoms after contact with sick or dead birds	Call Info-Santé 811 and mention this contact.
Going to a care setting after a possible exposure	Report the exposure before you arrive and follow the instructions you receive.
Difficulty breathing, severe or worsening symptoms	Call 911 and report the possible exposure.
Respiratory symptoms with no exposure to animals	Call Info-Santé 811 if needed or consult a health professional.

What is useful to mention

• The type of animal and the circumstances of the contact.
• When the last exposure occurred.
• Your symptoms and when they started.
• Your job, if it brings you into contact with animals.

While waiting for a professional’s advice

The Public Health Agency of Canada recommends that a sick person stay home, wear a well-fitted mask around others, ventilate the space, wash their hands, cover their cough and disinfect surfaces. They should also avoid all contact with birds and other animals.

For a child with a fever who has had no contact with sick animals, our article on teleconsultation for a sick child offers further guidance.

Do you have respiratory symptoms without having been in contact with sick birds or animals? You can book an appointment at one of our service points in Quebec or choose a teleconsultation. After contact with sick or dead birds, call Info-Santé 811 first and mention this contact before coming in. Employers whose staff work with animals can consult our occupational health services.

How is bird flu treated?

The treatment is a matter for a health professional, who assesses each situation. Antivirals may be used. According to the Public Health Agency of Canada, they work best when started early, ideally within 48 hours of symptom onset.

Why report an exposure quickly

Antivirals can ease symptoms, shorten the illness and reduce the risk of serious complications. An early call therefore allows a professional to determine whether testing or treatment is indicated. Severe cases may require hospitalization.

Can you eat chicken and eggs?

This question comes up with every outbreak. According to current data, properly cooked poultry and eggs do not transmit the virus. The same goes for properly cooked meat, game and offal, and for pasteurized milk. The sale of unpasteurized milk is also illegal in Canada.

Internal cooking temperatures

Health Canada recommends the following internal temperatures, to be checked with a food thermometer.

Food	Internal temperature
Whole poultry	82 °C
Poultry pieces	74 °C
Ground poultry	74 °C
Egg dishes	74 °C

Precautions at home

• Do not drink raw milk or give it to other people or to your pets.
• Do not give your pets raw meat or offal from hunting.
• Wash your hands after handling raw poultry or eggs.

What should you do about a sick or dead bird?

The right reflex is simple: do not touch, feed or handle an animal that may be infected. If contact is unavoidable, wear gloves and a mask or respirator, then wash your hands with warm water and soap or with an alcohol-based hand sanitizer.

Wild bird found dead or sick

1. Avoid approaching or handling the animal while you wait for instructions.
2. Report it to the line designated by the Government of Quebec, at 1 877 346-6763.
3. In a public place, the municipality takes care of the carcass.
4. On your property, if the carcass is not collected, never touch it with your bare hands. Put it in a bag and throw it out with your household garbage.
5. Then wash your hands thoroughly.

If you have a small flock

• Promptly isolate sick birds and contact a veterinarian.
• If no veterinarian is available, contact the Canadian Food Inspection Agency’s animal health office. Outside business hours, the number is 1 866 806-4115.
• For any unusual deaths, contact the Ministère de l’Agriculture, des Pêcheries et de l’Alimentation du Québec at 1 844 ANIMAUX (264-6289).
• Avoid gatherings of birds, such as fairs, exhibitions and auctions.
• Avoid all contact between your birds and wild birds.

Is there a bird flu vaccine?

It is important to distinguish between two vaccines. The seasonal flu vaccine does not protect against the H5N1 virus. The Public Health Agency of Canada still recommends it every year for everyone aged 6 months and older, because it prevents severe cases of seasonal flu. Québec.ca also recommends it for exposed workers. Our article on recommended vaccines for adults gives the overall picture.

The H5N1 vaccine

This vaccine is not offered to the general public. In Quebec, it is subject to a shared medical decision for certain workers at high risk of exposure, including:

• staff who work with the live virus;
• veterinarians, technicians and people who perform necropsies on potentially infected animals;
• workers who repeatedly manage cases on several farms;
• wildlife rehabilitation staff.

The Institut national de santé publique du Québec states that, for now, there is no need to launch a program broadly targeting farm workers or hunters.

Myths and misconceptions

“Bird flu spreads easily between people”

False. No sustained person-to-person transmission has been observed. Authorities continue, however, to monitor how the virus evolves.

“Eating chicken or eggs can give you bird flu”

False when they are properly cooked. According to current data, properly cooked poultry and eggs do not transmit the virus. Raw or undercooked foods are another story.

“My flu shot also protects me against bird flu”

False. The seasonal vaccine does not protect against the H5N1 virus. It is still recommended to prevent severe cases of seasonal flu.

“If I do not work on a farm, I have no risk”

Nuanced. The risk is low for most people, but it is not zero. Handling a sick or dead bird without protection is a possible exposure, whatever your job.

“You should mention contact with birds before coming to a clinic”

True. Reporting a possible exposure before you arrive lets you receive the appropriate instructions and avoid passing on the virus.

Frequently asked questions

Is bird flu dangerous to humans?

Infection is rare in humans and the risk is considered low for most people in Canada. When it does occur, however, the illness can be mild or severe, and sometimes fatal. The risk is higher for people exposed to infected animals.

What are the symptoms of bird flu in humans?

Reported symptoms include cough, shortness of breath, fever, muscle aches, headaches and red eyes. Some people have no symptoms. Difficulty breathing or worsening symptoms mean you should call 911.

How do humans catch bird flu?

The virus enters through the mouth, nose or eyes, after breathing in particles, direct contact with contaminated material, or touching a contaminated surface and then the face.

What should I do if I find a dead bird?

Avoid handling it and report it at 1 877 346-6763, the line designated by the Government of Quebec. In a public place, the municipality takes care of it. Never touch a carcass with your bare hands.

I touched a dead bird and I have symptoms. What should I do?

Call Info-Santé 811 and mention this contact, then follow the instructions you receive before going to a care setting. If you have difficulty breathing, severe symptoms or worsening symptoms, call 911.

Is there a bird flu vaccine in Quebec?

An H5N1 vaccine exists for certain workers at high risk of exposure, through a shared medical decision approach. It is not offered to the general public. The seasonal flu vaccine does not protect against this virus.

Sources

1. Public Health Agency of Canada, Avian influenza A(H5N1)
2. Public Health Agency of Canada, Avian influenza A(H5N1): Spread, prevention and risks
3. Government of Quebec, Avian influenza
4. Government of Quebec, Surveillance and control of avian influenza
5. Institut national de santé publique du Québec, Influenza aviaire (in French)
6. Institut national de santé publique du Québec, Stratégie d’utilisation des doses de vaccin contre l’influenza A(H5N1) au Québec (in French)
7. Health Canada, Safe internal cooking temperatures