Dr. Richard Webby of Saint Jude Childrens’ Research Hospital and Director of the International Influenza Reference Laboratory considers that the emergence of bovine influenza-H5N1 justifies preventive vaccination of workers coming into contact with cattle.  He noted, “If we look at the exposure levels of some of these farmers are getting, it’s high.”  Notwithstanding this opinion and taking into account the relatively low level of surveillance, only three cases of infection have been recorded.  All three presented with conjunctivitis and with the third patient showing mild upper respiratory symptoms.

Dr. Ron Fouchier of the Erasmus Medical Center in Rotterdam, in the Netherlands is closely monitoring for genetic changes in isolates that might predict a strain that would be infectious to humans with the possibility of human-to-human transmission representing potentially pandemic strain.

Authorities in the E.U. are planning to import vaccine from the U.S. stockpile produced by CSL Seqirus currently preparing five million doses.

Dr. Nirav Shah, Principal Deputy Director of the U.S. Centers for Disease Control and Prevention stated that, “any decision on deployment of vaccine will depend on evidence of pathogenicity to humans, emergence of cases in individuals not in direct contact with cattle and other epidemiologic criteria.

At the very least, all who come into contact with poultry flocks and dairy herds should receive the annual multivalent seasonal influenza vaccine each fall to avert a possible recombinant event.  Should changes occur in the currently circulating H5N1 virus, all contacts with poultry flocks, processing and packing plant workers and their immediate families and cohabitants should be protected with an approved H5 vaccine as available.