AVIAN INFLUENZA COMMODITIES TRAINING GUIDE MODULE 2 - DECONTAMINATION PARTICIPANT HANDOUTS

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1 AVIAN INFLUENZA COMMODITIES TRAINING GUIDE MODULE 2 - DECONTAMINATION PARTICIPANT HANDOUTS MARCH 2007

2 MODULE 2 PARTICIPANT HANDOUTS Participant Handouts Participant Handout #1 Decontamination Facts Participant Handout #2 Survival of the Avian Influenza Virus Participant Handout #3 Disinfectants Used for Decontamination Participant Handout #4 Decontamination Kit Contents List Participant Handout #5 General Concepts to Keep in Mind When Decontaminating Potentially Infected Areas Participant Handout #6 General Decontamination Procedures During Outbreak Situations Participant Handout #7 Routine Biosecurity Participant Handout #8 Decontamination Procedures for Live Bird Markets Participant Handout #9 Virkon Disinfectant Information Sheet Participant Handout #10 Illustration of Farmyard

4 MODULE 2 Handout #1 Decontamination Facts What is decontamination? Decontamination is a method used to get rid of germs and viruses as quickly and efficiently as possible. Getting rid of germs and viruses means they can no longer transmit disease. Why we decontaminate There are three important reasons to decontaminate during an avian influenza outbreak: 1. Decontamination prevents contamination of people and the environment. 2. Decontamination prevents further spread of the virus during an outbreak. 3. Decontamination allows safe repopulation of flocks after a proper quarantine period.

6 MODULE 2 Handout #2 Survival of the Avian Influenza Virus After an outbreak of avian influenza, the virus can survive for: At least 35 days at 4 C in poultry droppings (feces). Even small amounts of contaminated droppings can contain enough virus to infect large numbers of birds. Several days in carcasses at air or room temperature. Up to 23 days in carcasses if refrigerated Up to four days at 22o C and more than 30 days at 0o C in water In general, warmer temperatures kill the virus more quickly, while colder temperatures help it live longer. This is important to know in locations where there are cold winters, where avian influenza can survive potentially longer in the environment. Scientists in the field have also reported that: Hands/skin, clothing or shoes can become contaminated with avian influenza virus, either from poultry directly or from contaminated feces, bedding, cages and other equipment that may have come in contact with infected birds. The virus can be carried on shoes, clothing, tires, and equipment to uninfected farms, thus spreading the virus to new areas. Avian influenza can be spread directly through contaminated feed, water and equipment. Therefore cleaning and decontamination of areas where birds are kept are some of the most important steps that can be taken to eliminate the spread of virus to clean flocks. Poultry manure and bedding from flocks infected with avian influenza virus can contaminate dust and soil, causing infection in people when the contaminated dust is inhaled or enters their eyes, nose or mouth. Live bird markets are known as a major source of avian influenza transmission. Because avian influenza virus is spread to uninfected birds through infected feces, saliva, mucous or other animal fluids, it is important to practice strict sanitary procedures while at the market. This includes decontamination of feed, water, cages and equipment before and after being at the market.

8 MODULE 2 Handout #3 Disinfectants Used for Decontamination Groups of chemicals that disinfect Oxidizing agents Alcohols Halogens Common names for chemicals Hydrogen Virkon peroxide Rubbing alcohol used at the health clinic Chlorine-based chemicals like bleach Phenolics Quaternary ammoniums Quats Lysol BenzaRid

10 MODULE 2 Handout #4 Decontamination Kit Contents List Personal Protective Equipment Coverall (Enviroguard with hood and boots) N-95 respirator Outer Gloves (Nitrile, Size 10, 11-mil) Inner Gloves (Vinyl, 4 mil) Goggles (Chemical Splash) Shoe Covers (DuPont Proshield III) Apron (Plastic, in a pouch) Respirator Fit Test Kit (Bitrex solution) Disinfectants Virkon Disinfectant (5-kg Drum) Sani Cloth Disinfectant Wipes (160-count canister of PDI HB Sani Cloth) Cleaning/Decontamination Supplies Scrub Brush Bar of Soap (4 per kit) for washing hands Inflatable Basin to be used for foot baths Bucket (approximately 19 liter) Biohazard control materials PDI HB Sani Cloth virucidal wipe (one large, individual wipe) Alcohol Pads, 70% Generally used to wash hands after removing PPE. Bag for Infectious Waste Sprayer nozzle Sprayer container (8.52 liters) used to dispense Virkon or other disinfectant

12 MODULE 2 Handout #5 General Concepts to Keep in Mind When Decontaminating Potentially Infected Areas Bird feces are the biggest danger for spreading the avian influenza virus. The avian influenza virus likes moist, dirty conditions such as where feces are present, so it is essential to thoroughly disinfect items that have been in contact with bird feces - cages, shoes, clothes - before working with poultry or entering a place where poultry are kept. Organic material such as feces or dirt can absorb some chemical disinfectants and make them less effective. The presence of feces or layers of dirt makes it much more difficult to destroy the virus. Therefore, organic material such as dirt and feces must first be removed by scrubbing or brushing with soap and water or a disinfectant before disinfection by any method can be effective. The virus survives well in water. Simple washing or spraying with water will not kill the virus, and may even assist the virus to enter into areas where it can be picked up by birds. Therefore, any washing to remove contamination should always be with detergents (or soapy water) or specific disinfectants such as the Virkon contained in your kit. Rinsing with only water is not enough. Transmission of the virus has been strongly linked to transporting live birds, contaminated dead birds, or litter in vehicles. It is very important to remember to decontaminate any equipment used to move live, sick or dead birds. This includes cages, crates, boxes/bins, baskets and vehicles. To avoid infecting an area again, it is important to remove birds from the premises before decontamination and to make sure that any vehicles or equipment brought into an area after decontamination are also decontaminated. Avian influenza virus can be killed by most disinfectants. Avian influenza virus is sensitive to detergents which destroy the fat-containing outer layer of the virus. The virus needs this layer to enter cells of animals, so if the layer is eliminated, the virus becomes ineffective. It is important to determine the proper concentration and quantity of disinfectants for them to be effective.

13 For the Virkon in your Decontamination Kits, you should mix each 10 grams of powder with a liter of water. For the disinfectant to be effective, it must be in contact with the infected material or surface for an amount of time that is based on how contaminated it is. The more contaminated something is, the longer you have to keep the disinfectant on it. The manufacturer of Virkon recommends that Virkon remain in contact with heavily infected (dirty) areas for 24 hours without being washed off. Always consider factors such as the weather (temperature) and how the disinfectants might interact with other materials in the area being decontaminated. Disinfectants might have dangerous reactions with other chemicals in the area such as Virkon, which generally should not be used near lye. It is best to check the label of the disinfectant you are using to make sure that there are no other dangerous materials you should avoid.

14 MODULE 2 Handout #6 General Decontamination Procedures During Outbreak Situations A. Pre-activities Donning PPE and preparing Virkon Before starting any decontamination procedures all personnel must be provided with and wear personal protective equipment (PPE) comprised of: N-95 Respirator, including a fit test kit Goggles Coveralls Gloves 2 pairs Shoe covers or boots Virkon has been selected by the FAO as the disinfectant of choice and is provided by USAID in the Decontamination Kits. It is important to remember that you will need your PPE when mixing it and using it because it can irritate your skin or eyes. Virkon has been reported to have low toxicity but has not been approved for use on skin. Virkon comes in a powdered form that can be mixed with water at the site of an avian influenza outbreak. It can be sprinkled in powdered form over wet or boggy areas, but the concentration of disinfectant achieved by that kind of application cannot be accurately controlled. There are a number of recommended decontamination programs/procedures for avian influenza outbreak situations. The following is the procedure recommended by the manufacturer of Virkon (Dupont - Avian Influenza Decontamination Procedures for the Cleaning and Disinfection of Farm Premises) and is being used as an example. Resource site: B. First Disinfection Phase Thoroughly disinfect all bird carcasses with a disinfectant or soapy water, and remove them for burning or burying. Spray a disinfectant or soapy water on all areas where birds have had direct or indirect contact, such as buildings, cages, and runs. Thoroughly soak all nesting, litter and fecal material with a disinfectant or soapy water.

15 Spray all interior walls and roof spaces where birds are housed with a disinfectant or soapy water. External walls need only be disinfected when they face an area where infected birds have been kept or have passed by during the decontamination process. Let disinfectant soak and penetrate into all surfaces for 24 hours do not wash off. Disinfect farm/village roads, barnyards, footpaths thoroughly, ensuring that watercourses are protected from contamination by the disinfectants or virus. If possible, only disinfect areas that are far from ditches or drains, or try to direct disinfectant run-off to grassy areas where the disinfectant will be unlikely to flow into water sources. When disposing of disinfectant, you can pour it into a slurry or manure store. If this is not possible, small amounts of disinfectant can be poured onto an area of grass that is not near water, drains or septic tanks. Straw that has been soaked in disinfectant should be composted or bagged and taken to a landfill for burial or to an incineration site for burning. Because the avian influenza virus can be spread on the feet of rodents, it is also important to have an effective rodent control program (or integrated pest control program) to keep as many rodents away as possible. Resource site: C. Second Disinfection Phase It is important to wait at least 24 hours between First and Second Disinfection Phases Remove all organic matter (litter and dirt) from the buildings. The litter should be buried on the premises, or placed in bags and taken to a designated landfill or incinerator. Clean ventilation systems, if they are present, and then disinfect the ventilation systems using a cloth soaked in Virkon. If the systems cannot be cleaned in place, remove them to clean area and disinfect them before replacing. If you have a pressure washer, fill it with detergent and water and use it (on a low-pressure setting) to thoroughly soak the floors, walls, ceilings, roof spaces, nest boxes and feeders in all of the buildings that have been in direct contact with infected birds. If you do not have a pressure washer, you can use the sprayer/ container to do this. Scrub with brushes provided in the Decontamination Kit in areas that are accessible.

16 Allow at least 10 minutes for the detergent to penetrate and loosen the dirt from all surfaces before rinsing with clean water. Ensure that all equipment is then thoroughly disinfected with Virkon (or any other disinfectant that you may be using). Spray all areas (farm buildings, loading bays, paths, backyard runs) with the disinfectant and allow the disinfectant to soak in for at least 30 minutes. Rinse with water if possible. After seven (7) days have passed, repeat the complete Second Disinfection Phase procedure. Returning uninfected birds to formerly infected (now disinfected area) should not occur until the avian influenza virus has been declared eradicated by animal health officials. You should wait for an additional 21 days (3 weeks) before bringing in new birds. You may have to use sentinel birds to test the area before bringing in new poultry. Sentinel birds are unvaccinated birds that are susceptible to the avian influenza virus and would become infected/die if virus was still present or reintroduced.

18 MODULE 2 Handout #7 Routine Biosecurity Routine biosecurity is important in farmyards, commercial poultry farms, and anywhere else that live birds are kept. Decontamination procedures for routine biosecurity focus on clothing, footwear, vehicles and equipment. For clothing, all visitors to the farm or poultry facility are required to wear coveralls or other protective clothing. This clothing should be cleaned with soap and water (or detergent) after each use, unless it is disposable. If you are wearing disposable coveralls, aprons or other garments, you should dispose of them in a biohazard bag, and ensure that they are properly burned or buried. For footwear, visitors should wear farm-supplied footwear when visiting clean farms if they are available. If no footwear is available, you should first scrub off all debris from the shoes you are wearing, and then wash them with soap and water. Finally, clean them with a disinfectant. Ideally, foot baths containing disinfectant should be placed at the entrance of poultry houses to clean footwear when entering and exiting the poultry house. You should first scrub or brush off debris from your footwear before stepping into the footbath. Typically, the bath is 6 centimeters high and needs to cover the entire bottom of the shoe. Disinfecting vehicles is important because transmission of avian influenza virus has been strongly linked to transporting live birds, contaminated dead birds or bedding in vehicles. All vehicle undercarriages, tires and beds should be disinfected before vehicles enter a clean farm using a standard pump sprayer containing disinfectant. When disinfecting, stand about 30 centimeters away from the vehicle if you are using a hand sprayer. For power sprayers, you should stand about 1 meter away from the vehicle, and ensure that all surfaces of the vehicle that are being disinfected are wet and dripping. All equipment brought onto an uninfected farm should first be cleaned and disinfected. This means cages, crates, farming tools, brooms, shovels, vehicles and their tires. They should first be brushed or scrubbed so that debris is removed, and then washed with detergent or soapy water, followed by disinfectant. All equipment on the farm should be cleaned and disinfected on a regular basis. For example, vehicles should be cleaned every time they enter the farmyard from another location.

20 MODULE 2 Handout #8 Decontamination Procedures for Live Bird Markets The decontamination procedures for live bird markets are important. These procedures include the following: The marketplace should be cleaned and disinfected after every day of sale. This means that every surface that comes in direct or secondary contact with birds or bird feces needs to be cleaned and then either wiped or sprayed with disinfectant. All equipment and surfaces that are in direct or secondary contact with birds or bird feces should also be cleaned and disinfected including chicken crates, holding cages and feeding/watering equipment, scales, counters and floors. All equipment and crates should be cleaned and disinfected before they are returned to the farm or household. When cleaning vehicles or equipment, it is recommended that each item be taken apart so you can reach all areas where virus may have gone. First wash equipment with soap and water, rinse, and then spray or wipe with a disinfectant such as Virkon. Remember, transmission of avian influenza virus has been strongly linked to transporting live birds, contaminated dead birds, or litter in vehicles. Thus, it is important to decontaminate any vehicles including their tires, wheel wells and undercarriage that come into the gates or boundaries of the market or delivery areas. Vehicles should generally be parked at least 30 meters away from poultry houses.

22 MODULE 2 Handout #9 Virkon Disinfectant Information Sheet Virkon is most often a pink/grey/yellow/orange-colored powder that is mixed with water to form a 1% or 2% solution (i.e., 10g or 20g per liter). The color is useful because the color fades as the disinfectant is used, indicating to people that the disinfectant solution needs to be replaced. In general, the powder (when added to water) makes a solution that is stable for 7 days. Resource link: Mixing procedures Use latex gloves when mixing and handling the powder and solution. Wear an N-95 respirator to avoid inhalation of fine dust when mixing. A mask and eye protection (goggles) should be used when working with these fine sprays or mists. Dosing Virkon should be dosed at 1% w/v (i.e., 10 gms/liter of water) 10 minutes contact time will allow for high level disinfection for all known viruses Virkon solution is usable for up to 7 days or until the color, which is from an in-built dye indicator, fades. Virkon powder absorbs liquid, decontaminating it and making it easy to dispose of without fear of infecting anything else. Safety issues when using Virkon Virkon is non-toxic but avoid contact with skin and eyes. (Virkon has the standard pesticide label, but studies have shown that it is non-irritating to both skin and eyes). When using Virkon on food preparation surfaces, it is important to rinse the area well with water after air-drying.

24 MODULE 2 Handout #10

25 Prepared by the Academy for Educational Development (AED) and Development Alternatives, Inc. (DAI) for the USAID Avian Influenza Program.

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