[mou] West Nile Virus and bird banders

[Jim Williams]

forward from  BIRDNET at
http://www.nmnh.si.edu/BIRDNET/WNV.html
as sent by
Ellen Paul
Executive Director
The Ornithological Council
"Providing Scientific Information about Birds"

Jim Williams

---
 =20
West Nile Virus: what ornithologists and bird banders should know

Introduction

West Nile Virus (WNV) was first isolated in 1937 in Uganda. There have been
outbreaks in Israel (1951-1954), France (1962, 2000), and South Africa
(1974). It appeared in Western Europe in the mid-1990s and traveled to the
United States in 1999, where researchers =AD and their universities,
government research agencies, and other research organizations =AD became
concerned about the risk to field biologists, students, and others. Perhaps
out of an abundance of caution and spurred by constant media attention to
WNV, one university cancelled field research and field biology classes that
involved bird banding. The Ornithological Council =AD a consortium of 11
scientific ornithological societies in the Western Hemisphere =AD consulted
with a number of experts to compile this fact sheet about the risks of WNV
to ornithologists and bird banders and to=A0 provide the most up-to-date
public health recommendations for those handling live birds, carcasses, or
tissue that is potentially infected with WNV.

Understand the risk

All research involves risk. Know the risks and take reasonable precautions.
West Nile Virus should be no more of a deterrent to ornithological research
and education than any other risk encountered in scientific research.

According to the Centers for Disease Control (as of 11 April 2003; see
http://www.cdc.gov/ncidod/dvbid/westnile/qa/symptoms.htm):

*    Most mosquitoes bites will not lead to a WNV infection
*    Most people who are infected with WNV do not develop any type of
illness
*    It is estimated that 20% of the people who become infected will develo=
p
West Nile fever: mild symptoms, including fever, headache, and body aches,
occasionally with a skin rash on the trunk of the body and swollen lymph
glands.
*    About 1 of each 150 infected persons becomes seriously ill with centra=
l
nervous system infection (encephalitis &/or meningitis)
*    About 6.6% of the 4,161 cases of the laboratory-positive 2002 WNV case=
s
in the United States were fatal.

For young/healthy researchers who are not immunocompromised, West Nile Viru=
s
is unlikely to cause much more than a mild illness =AD typically =B3flu-like
symptoms.=B2 A more serious case of West Nile Virus in humans results in
fever, disorientation, muscle weakness, neck stiffness, headache, nausea.
Persons over 50 years of age are at increased risk of severe disease. An
analysis of attack rates per million persons during the 1999 New York City
outbreak showed that compared with persons 0 to 19 years of age, the
incidence of severe neurologic disease was 10 times higher in persons 50 to
59 years of age and 43 times higher in those at least 80 years of age
However, although older persons are at greater risk for West Nile
Meningoencephalitis or death, persons of any age might develop severe
neurologic disease (Nash et al. 2001). CDC recommends that persons with
severe or unusual headaches seek medical attention as soon as possible.

In the lab

As of February 2003, there have been only two documented cases of=A0
researchers contracting West Nile Virus in the course of conducting
research. Both cases involved microbiologists. One was infected from an
accidental needle puncture in the finger while working with live virus whil=
e
the other was infected through an accidental scalpel cut while performing a
necropsy on a dead Blue Jay (CDC Morbidity and Mortality Weekly Review, 20
December 2002).=20

It is best to assume that any specimen could be infectious and to take
proper precautions at all times. Specifically:

*    Neither refrigeration nor freezing will kill the virus. Ornithologists
working with thawed tissue or specimens=A0 should assume that this material
contains live virus.
*    Ornithologists preparing specimens or working with tissue from fresh
(never frozen) birds should be aware that the virus will remain viable in
dead birds for several days.
*    Ornithologists preparing specimens should take care to avoid scalpel
cuts and punctures. If they occur, cleanse the area promptly and thoroughly=
,
apply antiseptic, and report the incident to a supervisor. If signs of
illness occur within two weeks of exposure, prompt medical evaluation and
consultation with public health authorities should be sought.
*    Standard measures to minimize exposure to fluids or tissues during
handling of potentially infected tissue comprise standard droplet and
contact precautions. These include barrier protections such as gloves,
masks, and eyewear; proper use and disposal of needles, scalpels, and other
sharp instruments; and minimizing the generation of aerosols (such as
vigorous spraying of water on carcasses or work surfaces). While wearing
gloves, be careful not to handle anything but the materials involved in the
procedure. Touching equipment, phones, wastebaskets or other surfaces may
cause contamination. Be aware of touching the face, hair, and clothing as
well. Researchers who use gloves must learn the proper way to remove and
dispose of gloves and must avoid touching unprotected skin with the gloved
hand. Consult your safety officer or safety manual. Typical instructions sa=
y
to remove the first glove by grasping the cuff =AD being careful to avoid
touching the bare skin of the wrist or arm =AD and peeling the glove off the
hand so that the glove is inside out. Repeat this process with the second
hand, touching the inside of the glove cuff, rather than the outside. Wash
hands immediately with soap and water.
*    Although WNV is classified as a Biosafety Level 3 agent, it is
considered acceptable practice to work with most specimens in a Biosafety
Level 2 laboratory under Level 3 conditions. See Biosafety in
Microbiological and Biomedical Laboratories 4th ed. [http://bmbl.od.nih.gov=
]
for details.=20
In the field

Although there are no documented cases of ornithologists or bird banders
contracting WNV from handling living or dead birds, it is also the case tha=
t
there has been no surveillance of ornithologists or bird banders to
determine the presence/absence or prevalence of the disease. Even if such
surveillance were to be implemented, it would be difficult to know if the
disease had been contracted through contact with bird feces or saliva or if
it had been contracted from an insect bite =AD at the research site or
elsewhere.

It has been confirmed that WNV may be shed from the cloacal and oral
cavities. (Komar et al. 2002). Therefore,=A0 contact with droppings,
dropping-contaminated feathers, or the cloaca may result in exposure to WNV=
.

*    Be sure to have antiseptic (not antibacterial or antimicrobial)
available for handwashing and first aid for cuts or punctures sustained
while handling birds.
*    Reasonable precautions include the use of antiseptic wipes. This will
protect both the researcher and the birds subsequently handled by the
researcher.=20
*    Avoid contact with bird feces.
*    If bitten by a bird, wash hands (when possible) or use antiseptic (not
antibacterial or antimicrobial) wipes or even a small amount of fresh
bleach.=20
*    Since ornithologists often use needles to take blood samples, extra
care should be taken to avoid needle sticks.
*    Public health officials consider gloves to be an appropriate precautio=
n
but ornithologists rarely wear gloves when handling birds, particularly in
the field. If gloves are worn, they should be changed or decontaminated wit=
h
70% ethanol or other appropriate substance after handling each bird to avoi=
d
transmission from one bird to another. Again, be familiar with proper glove
removal and disposal. Other barrier protections such as goggles and masks
are standard precautions against inadvertent exposure to droplets and
fluids.=20
*    Ornithologists and bird banders should take the same reasonable
precautions to minimize risks =AD of various diseases - posed by mosquito
bites. Reasonable measures include protective clothing (long sleeves, long
pants, socks),=A0 and the use of DEET or other insect repellants =AD with
repeated applications over time. For detailed information about the proper
use of DEET and summary of a recent assessment of the efficacy and safety o=
f
DEET, see the appendix).
Precautions against transmission to birds and other wildlife

*    Ornithologists and bird banders should not re-use contaminated bags,
boxes or other holding/carrying devices and other devices used to restrain
birds during processing. The North American Banding Council manual states,
=B3Launder bird bags frequently, as they must be kept clean,=B2 and =B3If a
diseased bird is caught, it is extremely important to put that bag aside
until it has been washed and disinfected.=B2 However, as it is not possible t=
o
determine if a bird is shedding virus, the better practice would be to carr=
y
an ample supply of bags or other holding/carrying devices so that no bag or
other holding device is used more than once before laundering.
*    When preparing specimens in the field, place waste material in a
biosafety bag, seal it, and burn it, or carry it out with you.
*    Never re-use needles or scalpel blades unless decontaminated with a
fresh 10% bleach solution.

REFERENCES

Centers for Disease Control Morbidity and Mortality Weekly Review, 20
December 2002. [http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5150a2.htm].

Komar, Nicholas, Robert Lanciotti, Richard Bowen, Stanley Langevin, and
Michel Bunning. 2002. Detection of West Nile Virus in Oral and Cloacal Swab=
s
Collected from Bird Carcasses. Emerging Infectious Diseases 8: 741-742.

Nash D, Mostashari F, Fine A, Miller J, O'Leary D, Murray K, et al. 2001.
The outbreak of West Nile virus infection in the New York City area in 1999=
.
New England Journal of=A0Medicine=A0344:1807- 1814.

This publication was reviewed by scientific experts=A0 under the auspices of
the Ornithological Council.=A0 You may contact the Council for further
information.=20
The Ornithological Council thanks the following individuals for sharing
their time and expertise:

Nick Komar, ScD.=20
Arbovirus Diseases Branch
Centers for Disease Control and Prevention

Robert G. McLean, Ph.D.
Program Manager Wildlife Diseases, National
Wildlife Research Center (Wildlife Services, Animal and Plant Health
Inspection Service,
U.S. Department of Agriculture)

Sarah A. Lister, DVM, MPH, Dipl. ACVPM
Director of Public Health Preparedness
Association of Public Health Laboratories

Brenda J. Nordenstam, Ph.D.
Associate Professor
College of Environmental Science and Forestry
State University of New York at Syracuse

Citation: Ornithological Council (2003). West Nile Virus: what
ornithologists and bird banders should know.

Back to Top=20

The Ornithological Council (OC) was founded in 1992 as a non-profit
organization by the American Ornithologists' Union, Association of Field
Ornithologists, Cooper Ornithological Society, Pacific Seabird Group, Rapto=
r
Research Foundation, Waterbird Society, and Wilson Ornithological Society.=A0
The Society for the Conservation and Study of Caribbean Birds,=A0 Secc=EDon
Mexicana del Consejo Internacional para la Preservac=EDon de las Aves
(CIPAMEX), the Society of Canadian Ornithologists/Soci=E9t=E9 des
Ornithologistes du Canada, and the Neotropical Ornithological Society have
joined the OC in recent years.

The Ornithological Council represents ornithologists to the government
agencies that make rules and regulations and issue permits that affect the
practice of ornithology.=A0 The Council has been particularly effective on
these issues and new, major changes of benefit to the ornithological
community are being implemented.

The Ornithological Council has been representing scientific ornithology on =
a
wide variety of public issues concerning the science of ornithology, birds,
and bird habitat. The Council gives ornithologists a means to provide timel=
y
and relevant information from ornithological science to legislators,
managers, conservation organizations, and private industry.=A0 The Council
also keeps ornithologists informed about policy issues affecting birds.

The member societies of the Ornithological Council provide approximately on=
e
half of the Council's annual budget.=A0 Contributions of individual
ornithologists are needed if the Council is to continue providing its
excellent services.
How to contact the Ornithological Council:
Ellen Paul, Executive Director=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0 David E.
Blockstein, Ph.D., Chairman of the Board
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Council for Science and the Environment
Chevy Chase, MD 20815=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0 1707 H St., N.W.,
Suite 200=20
Phone: (301) 986-8568=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0 Washington, D.C.
20006=20
Fax: (301) 986-5205=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0 Phone: (202)
207-0004=20
e-mail: epaul@concentric.net=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0 Fax: (202) 628-431=
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E-mail: oc@cnie.org

For information about the Ornithological Council, please visit our website
at http://www.nmnh.si.edu/BIRDNET.

Back to Top=20

APPENDIX: THE PROPER USE OF DEET AND AN ASSESSMENT OF THE RISKS OF THE USE
OF DEET=20

To determine the relative efficacy of DEET versus other insect repellants,
Fradin and Day (2002) tested the relative efficacy of seven botanical insec=
t
repellents; four products containing N,N-diethyl-m-toluamide, now called
N,N-diethyl-3-methylbenzamide (DEET); a repellent containing IR3535 (ethyl
butylacetylaminopropionate); three repellent-impregnated wristbands; and a
moisturizer that is commonly claimed to have repellent effects. These
products were tested in a controlled laboratory environment in which the
species of the mosquitoes, their age, their degree of hunger, the humidity,
the temperature, and the light=ADdark cycle were all kept constant.

They found that DEET-based products provided complete protection for the
longest duration. Higher concentrations of DEET provided longer-lasting
protection. A formulation containing 23.8 percent DEET had a mean
complete-protection time of 301.5 minutes. A soybean-oil=ADbased repellent
protected against mosquito bites for an average of 94.6 minutes. The
IR3535-based repellent protected for an average of 22.9 minutes. All other
botanical repellents they tested provided protection for a mean duration of
less than 20 minutes. Repellent-impregnated wristbands offered no
protection.=20

Fradin and Day concluded that currently available non-DEET repellents do no=
t
provide protection for durations similar to those of DEET-based repellents
and cannot be relied on to provide prolonged protection in environments
where mosquito-borne diseases are a substantial threat.

Depending on the time in the field, the temperature, exposure to water,
perspiration, or concentration of DEET in the product, you may need to
re-apply. This study found that a product containing 23.8% DEET provided an
average of 5 hours of protection against mosquito bites. A product
containing 20% DEET provided almost 4 hours of protection, and a product
with 6.65% DEET provided almost 2 hours of protection. DEET may be washed
off by perspiration or rain, and its efficacy decreases dramatically with
rising outdoor temperatures.

Much has been said about the safety of DEET usage. The Fradin and Day paper
addressed this issue:

Despite the substantial attention paid by the lay press every year to the
safety of DEET, this repellent has been subjected to more scientific and
toxicologic scrutiny than any other repellent substance. The extensive
accumulated toxicologic data on DEET have been reviewed elsewhere. DEET has
a remarkable safety profile after 40 years of use and nearly 8 billion huma=
n
applications. Fewer than 50 cases of serious toxic effects have been
documented in the medical literature since 1960, and three quarters of them
resolved without sequelae. Many of these cases of toxic effects involved
long-term, heavy, frequent, or whole-body application of DEET. No
correlation has been found between the concentration of DEET used and the
risk of toxic effects. As part of the Reregistration Eligibility Decision o=
n
DEET, released in 1998, the Environmental Protection Agency reviewed the
accumulated data on the toxicity of DEET and concluded that "normal use of
DEET does not present a health concern to the general U.S. population." Whe=
n
applied with common sense, DEET-based repellents can be expected to provide
a safe as well as a long-lasting repellent effect. Until a better repellent
becomes available, DEET-based repellents remain the gold standard of
protection under circumstances in which it is crucial to be protected
against arthropod bites that might transmit disease.



Fradin, M.D., Mark S. and John F. Day, Ph.D. 2002. Comparative Efficacy of
Insect Repellents Against Mosquito Bites. New England Journal of Medicine
347: 13-18; available online at
<http://content.nejm.org/cgi/content/full/347/1/13>.

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