H5N1 avian influenza in cats. ABCD guidelines on prevention and management

OVERVIEW: Avian influenza is a disease of birds, caused by a type A influenza virus. The subtype H5N1 avian influenza occurs primarily in birds and infection varies from mild disease with little or no mortality to a highly fatal, rapidly spreading epidemic (highly pathogenic avian influenza). It is extremely rare for cats to be infected and there are only very few confirmed reports of the disease in cats in Europe. INFECTION: Cats can be infected via the respiratory and oral routes (eg, by eating infected birds). The key precondition for infection is that the cat lives in an area where H5N1 virus infection has been confirmed in birds. Additionally, the cat should have had outdoor access to an environment where waterfowl is present, or contact with poultry or uncooked poultry meat, or close contact with an H5N1-infected, sick cat during the first week of infection. CLINICAL SUSPICION: Clinical signs in cats may include fever, lethargy, dyspnoea, conjunctivitis and rapid death. Neurological signs (circling, ataxia) have also been recorded. DIAGNOSIS: The veterinary authorities should be notified. Oropharyngeal, nasal and/or rectal swabs or faecal samples of suspected cases should be submitted for PCR and/or virus isolation. Post-mortem samples of lung and mediastinal lymph nodes should be obtained. Particular care should be taken when handling the cat and/or samples. DISEASE MANAGEMENT: The virus is sensitive to all standard medical disinfectants. Cats with suspected H5N1 infection should be kept in strict isolation. Owners should be advised to confine the cat to a separate room prior to bringing it to the veterinary clinic. VACCINATION AND DISEASE PREVENTION: No H5N1 vaccines are commercially available for cats. In the event of confirmed cases of H5N1 avian influenza in birds in the area, owners should keep their cats indoors until further information is available, and follow official regulations.