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# Monkeypox: information & prevention
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3. Monkeypox: information & prevention
## Monkeypox : the current situation
Since the start of the monkeypox outbreak in 2022, based on CDC data issued on 02 Sep 2022, more than 53 027 outbreaks worldwide have been reported on September 2nd 2022 – many of them in non-endemic countries in Europe and North America.
* More than 16.750 confirmed cases from 29 EU/EEA countries
* 19.961 from the US
!
## General information
## Fact & Figures
## Prevention
## Monkeypox – General Information
Monkeypox is a viral zoonosis, i.e. an infectious disease of humans which is transmitted to humans from animals. The virus is a double-stranded DNA enveloped virus, and the hosts include a range of rodents and non-human primates. Transmission can take place:
* **from animal-to-human**: through direct contact with blood, bodily fluids, or with wounds of the skin or the mucous membrane of infected animals
* **human-to-human:** through direct contact to skin lesions or a close contact with an infected person over respiratory secretions (meaning a long face-to-face contact).  At this time, data suggest that some sexual relationships make up the majority of cases in the current monkeypox outbreak. However, anyone, regardless of sexual orientation or gender identity, who has been in close, personal contact with someone who has monkeypox is at risk.
* **via touching contaminated surfaces** that have been used by someone with monkeypox**:** objects**,** equipment, material, fabrics (clothing, bedding, or towels) etc. in touch with an infected person.
Historically occurring in tropical rainforest areas of Central and West Africa, some cases of Monkeypox were reported outside of Africa since 2003. Two distinct clades of the monkeypox virus exist – the Central African clade (Congo Basin), causing more severe disease and expected to be transmitted easier, and the West African clade.
Lately, more cases of monkeypox were identified worldwide in several non-endemic countries. Extra investigations are running to get further information on sources of infection and transmission and the epidemiology.
### FACT & FIGURES ON MONKEYPOX
**Basic background information:**
* **Incubation period**: Usually between 6 to 13 days but can range from 5 to 21 days from infection to first symptoms. A person is not contagious during this period.
* **Human-to-human Transmission**: Only by symptomatic individuals through direct or indirect contact. A person with monkeypox can spread it to others from the time symptoms start until the rash has fully healed and a fresh layer of skin has formed.
* **Symptoms**: can be divided into 2 periods
  + ***the invasion period*** (lasts 0–5 days): characterized by fever, intense headache, swollen lymph nodes, back pain, muscle aches and lack of energy.
  + ***the skin eruption*** (1–3 days after the start of the fever): rash on the face and extremities, oral mucous membranes, genitalia, conjunctivae, and the cornea. The rash develops from macules to papules, vesicles, pustules and crusts which dry up and finally fall off.
* **Duration:** self-limited disease, symptoms lasting from 2 to 4 weeks
* **Fatality Rate**: around 3-6% in recent times
* **Smallpox vs Monkeypox:** In 1980 WHO declared smallpox eradicated – making it the only human disease to be eradicated. Nowadays routine smallpox vaccination is no longer performed on the general public. Even though the clinical presentation of Monkeypox resembles that of smallpox, a related orthopoxvirus infection, Monkeypox is less contagious than smallpox and causes less severe illness.
* **Vaccination:** Smallpox vaccins also provide protection against monkeypox (85%). Nonetheless, the younger generations (< 40-50 years, depending on country) are no longer vaccinated against smallpox. Newer vaccines approved for prevention of monkeypox exist.
* **Medication:** Treatment is mainly symptomatic and supportive to avoid a secondary bacterial infection. Antivirals, such as tecovirimat (TPOXX) which has been approved by EMA (European Medicines Agency) in 2022 – even though not yet widely available.
### Monkeypox – Prevention
The main measurements to control Monkeypox and the prevention of the spread of the disease is the education of the people. Increased attention and awareness to early signs – since only symptomatic individuals transmit the disease – lead to a rapid detection and to a potential stop the transmission.
**When traveling in areas of higher risk of Monkeypox, make sure**
* to watch out for early signs and avoid close contact with people having a rash or other related symptoms
* to follow standard personal hygiene procedures such as hand washing and hand disinfection with a virucidal hand disinfectant
* avoid contact to sick and dead animals
* only eat thoroughly cooked meat
**When a person in your surrounding is expected to face a monkeypox infection, it is essential to isolate the person as much as possible and to follow strict hygiene procedures:**
* to wear personal protective equipment (PPE) such as face masks and disposable gloves whenever being in contact with materials and equipment in contact with the infected person
* thoroughly and frequently clean and disinfect the surfaces of equipment (medical, food preparation, glasses, etc.) and the surrounding (handles, railings, light switches, door handles) – make sure to only use appropriate virucidal disinfectants with a confirmed efficacy against enveloped viruses and to apply them properly as explained on the label or product information.
* People in charge of hygiene measures (cleaning and waste management) should always wear a disposable water-resistant gown, disposable gloves, respiratory protection (FFP2 masks), eye splash protection (goggles or visor) and footwear that can be disinfected with appropriate disinfectants
On a farm there are many ways of contamination – external and internal sources might be responsible for an outbreak of a disease. It is essential to check your premises, your work flow structures and your biosecurity program to detect weak spots and adjust accordingly
Strict biosecurity measures and good hygiene practices are essential in protecting against a disease outbreaks and a spreading of this contagious disease.
#### ***References:***
*More detailed information can be found on the website of the*
* *WHO (World Health Organization):* 
* *ECDC (European Centre for Disease Prevention and Control):* 
* *Centre of Disease and Prevention* 
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# Avian Influenza: information & prevention
3. Avian Influenza: information & prevention
## About Avian Influenza Disease
Avian Influenza is a highly contagious viral disease affecting several species of food-producing birds (chickens, turkeys, quails, etc.) pet birds and wild birds. Occasionally, mammals including humans may contract avian influenza. (e.g. H5N1 & H7N9 sometimes cause fatal infections in people).
In this context, Kersia is committed to supporting poultry farms through offering complete, comprehensive, tested biosecurity products and solutions, through our “Cleaning, Disinfection and Protection” programs.
## Sources of contamination
## Avoidance program
## Active management
## Products
## Avian Influenza – General Information
**Avian Influenza (AI)** is a highly contagious viral disease affecting several species of food-producing birds (chickens, turkeys, quails, etc.) pet birds and wild birds.  Occasionally mammals, including humans, may contract avian influenza. Even though most AI viruses do not infect humans, some such as H5N1 and H7N9 had caused fatal infections at people.
There are many AI virus strains, which are usually classified into two categories according to the severity of the disease in poultry:
* **low pathogenic (LPAI) strains → cause few or no clinical signs in poultry**
* **highly pathogenic (HPAI) strains can cause severe clinical signs and potentially high mortality rates among poultry**
To date, naturally occurring highly pathogenic avian influenza A viruses that produce acute clinical disease in poultry have been associated with only the **H5 and H7 subtypes** (e.g. A variety of subtypes including H5N1, H5N2, H5N5, H5N6, H5N8, and H7N9).
Any detection of **highly pathogenic avian influenza viruses**, or avian influenza viruses of the H5 and H7 subtype (due to their potential for mutation) in poultry holdings during regular surveillance **need to be notified and precautionary measures applied to prevent potential avian to human infection**.
### FACT & FIGURES ON AVIAN INFLUENZA
#### **AI Virus – High stability in the environment,  highly contagious!**
#### **Influenza A viruses can survive:**
* Over 30 days at 0°C (32.0°F) (over one month at freezing temperature)
* 6 days at 37°C (98.6°F) (one week at human body temperature)
* decades in permanently frozen lakes
* on hard non porous surface such as plastic or stainless steel for 24 to 48 hours
* on clothes, paper and tissues for 8 to 12 hours
* AI is not transmissible by eating properly prepared poultry and eggs:
  + cook thoroughly (cooking at 70°C inactivate H5N1 virus)
  + prevent cross-contamination between raw and cooked food.
NOTE: viruses cannot multiply without a “host”, unlike bacteria
#### **Inactivato of the virus occurs under the following conditions:**
* 30 minutes @ 60 C (140.0 F)
* Acidic pH conditions
* Presence of specific oxidizing agents such as sodium dodecyl sulphate, lipid solvents, and B propiolactone
* Exposure to specific disinfectants
### Avian Influenza – Sources of Contamination
### Direct contact
On a farm there are many ways of contamination
### Contaminated feed
### Contaminated fomites
(such as shoes, clothes, vehicles, equipment etc.)
## Avoidance Program – Essential Measures
**Kersia** is committed to supporting **poultry farms** through offering complete and comprehensive and tested biosecurity products and solutions, through our ‘**‘Cleaning, Disinfection and Protection**’’ **Programs**.
CLEANING
Effective cleaning of surfaces and equipment ensures the best possible condition for disinfection.
DISINFECTION
Successful disinfection is the elimination of micro-organisms through the selection of a proven disinfectant, applied at the correct dilution rate with adequate contact time.
PROTECTION
Comprehensive Biosecurity measures are required to prevent micro-organisms from re-entering and contaminating clean buildings and equipment.
### **Avoidance is better than cure!**
#### **General biosecurity measures**
**Preventive cleaning, disinfection and protection measures**
On farms, ensure the protection of the animals with regards to all the external sources and entrants:
* Control of access to buildings (visitors, staff…): use of personal protective equipment to access livestock buildings – Cleaning and Disinfection procedures.
* Limiting the arrival of external vehicles on site including those used for the transport of animals. Apply Cleaning and Disinfection procedures for vehicles in any case.
* Improvement of building maintenance, pest control, rodent control…
* Improvement of Cleaning and Disinfection procedures on all surfaces of buildings and equipment and the environment in general.
* Monitoring of entrants (food, water…),
* Monitoring animal health (abnormal signs or symptoms…)
#### **If the disease is reported**
**Confinement – Isolation – Crisis Management**
If a case is proven, establishment of a management procedure for hazardous areas including
* Elimination of animals: slaughter of all animals in the premises concerned.
* Isolation and securing of the site: rigorous and controlled confinement and isolation procedures.
* Cleaning and disinfection of premises in collaboration with the competent authorities and selected service providers
## Avian Influenza **–** **Active Management**
### Cleaning, disinfection & protection – Step-by-Step
#### 1. Cleaning
* Product selection, concentration and application is key to successful cleaning.
* Effective cleaning of surfaces and equipment ensures the best possible condition for disinfection.
#### 2. Disinfection
* Product selection, concentration and application is key to successful disinfection.
* Successful disinfection is the elimination of micro-organisms through the selection of a proven disinfectant, applied at the correct dilution rate with adequate contact time.
#### 3. Protection - by means of hygiene management
* Product selection, concentration and application is key to successful protection.
* Offer possibilities and make it obligatory to disinfect boots, wheels, vehicles, hands and equipment prior to and after entering the premises or different areas of the premises.
* Cleaning and disinfection of the water system & water disinfection
#### 4. Protection - by means of structural management
Implement additional measures to prevent Avian Influenza Virus entering your building:
* Protection against uncontrolled movement and entering (people, vehicles, wild animals) – i.e. keep wild birds outside and your poultry flock inside, fences are intact, lockable gates, etc.
* Limitation of passenger and vehicle traffic to the necessary minimum, keeping a visitor’s book
* Consistent implementation of the “CLEAN and DIRTY zones” principle:
  + Enter the premises only with company clothing and prior showering
* + Street clothing and stable protective clothing are kept separate from each other before and after entering the production areas
  + Division of the business premises into “CLEAN” (animals, feed, bedding etc.) and “DIRTY” (manure, carcasses etc.) areas
  + Avoid crossing paths, from “DIRTY” and “CLEAN” areas
  + Storage of the carcass in a closed container or similar construction, which is secured against unauthorized access and the entry of vermin, rodents, wild animals and the leakage of liquids and which is easy to clean and disinfect
  + Relocation of carcasses as close to the road as possible on paved ground that is easy to clean and disinfect, so that the vehicle of the processing plant for animal by-products does not have to drive on the premises
Feed and litter deliveries as well as loading or unloading of animals only take place on the traffic areas (no traffic and access by outside persons in the production areas)
* Feed, bedding & other resources are stored safely protected from wild birds
* Special employee training on the Avian Influenza transmission risks
* Continuous Pest control including documentation
* Continuous animal health monitoring (abnormal signs or symptoms…)
### **Proven Avian Influenza case**
**If an Avian Influenza case is proven, a management procedure for hazardous areas include**
## Kersia Solutions Against Avian Influenza
#### Virex, Fumagri Effisafe, Force 7, Hypred Force 7, Viroshield +, Viroshield, HPPA, Virobacter, Kilcox Extra, AGAKOK 2.5, Fumagri OPP and Fumagri HA were all successfully tested against Avian Influenza Virus.
#### 
## Kersia Expert Opinion Document
#### Download the PDF version
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### Contact Kersia Experts
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