WHO recommendations relating to travellers coming from and going to countries experiencing outbreaks of highly pathogenic H5N1 avian influenza

November 2005

These recommendations are in line with phase 3 in the WHO 6-phase scale of pandemic alert: human infections with a novel influenza virus subtype are occurring, but the virus does not spread efficiently and sustainably among humans. These recommendations may change according to the change in the epidemiological situation and related risk assessments.

WHO guidance for the application of measures before and during different phases of an influenza pandemic are summarized in the WHO global influenza preparedness plan issued in 2005.

Advice to countries

WHO does not recommend any restrictions on travel to any areas affected by H5N1 avian influenza

WHO does not recommend travel restrictions to areas experiencing outbreaks of highly pathogenic H5N1 avian influenza in birds, including countries which have reported associated cases of human infection.

WHO does not recommend screening of travellers coming from H5N1 affected areas

WHO does not, at present, recommend the routine screening of travellers coming from affected areas. Local authorities may, however, usefully provide information to travellers on risks, risk avoidance, symptoms, and when and where to report should these symptoms develop.

Advice to travellers

WHO advises travellers to avoid contact with high-risk environments in affected countries

Travellers to areas affected by avian influenza in birds are not considered to be at elevated risk of infection unless direct and un-protected exposure to infected birds (including feathers, faeces and under-cooked meat and egg products) occurs.

WHO continues to recommend that travellers to affected areas should avoid contact with live animal markets and poultry farms, and any free-ranging or caged poultry. Large amounts of the virus are known to be excreted in the droppings from infected birds. Populations in affected countries are advised to avoid contact with dead migratory birds or wild birds showing signs of disease.

Direct contact with infected poultry, or surfaces and objects contaminated by their droppings, is considered the main route of human infection. Exposure risk is considered highest during slaughter, defeathering, butchering, and preparation of poultry for cooking. There is no evidence that properly cooked poultry or poultry products can be a source of infection.

Travellers should contact their local health providers or national health authorities for supplementary information.