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[The role of the occupational physician in the prevention of the spreading of H5N1 virus avian influenza in exposed workers].

BACKGROUND
Avian influenza caused by H5N1 virus can be transmitted to exposed workers from contact with infected poultry, and is thus, like other zoonoses, the responsibility of occupational physicians (OP). The high pathogenicity of H5N1 virus has caused a 30-75% mortality among infected humans. Most of those subjects were occupationally exposed in different areas of poultry raising in Asian countries. At the moment, person-to-person transmission, even though possible, is unable to start a new human influenza pandemic due to the current genetic characteristics of H5N1 virus. However, its spontaneous tendency to mutate must alert the international community to the need of eradicating avian influenza in poultry as well as preventing transmission to humans.


OBJECTIVE
In Italy competent OPs are required to take part in prevention of H5N1 avian influenza infection of potentially exposed workers, such as poultry sector workers, workers engaged in poultry culling, litter management, carcass disposal, zoo and nature reserve workers, gamekeepers, veterinarians, biologists, laboratory technicians, and health workers caring for possible instances of human infection.


METHODS
According to Italian legislations, OPs must offer the national community their long-standing experience in the fields of workplace environmental monitoring, health surveillance, choice of personal protection equipment (PPE) and training and information of workers potentially exposed to H5N1 virus about occupational risks and correct use of PPE. They must also cooperate with other involved professionals to programme antiviral and vaccine prophylaxis.


RESULTS AND CONCLUSIONS
Occupational physicians can have an important role in contributing to the prevention of and scientific research on H5N1 avian influenza virus.