[Avian influenza and oseltamivir; a retrospective view].

The outbreak of avian influenza A due to an H7N7 virus in Dutch poultry farms turned out to have public-health effects for those who were involved in the management of the epidemic and who were thus extensively exposed to contaminated excreta and dust. An outbreak-management team (OMT) of experts in virology, infectious diseases and public health advised the Dutch government with respect to the potential health effects on humans. Strict hygiene measures were advised. Moreover, vaccination against human influenza was advised to prevent emergence of a new pandemic virus in humans. Since the human influenza virus H3N2 circulated at the same time, a double infection and emergence of a new human virus was the main fear on which prevention was focused. Conjunctivitis was observed in about 10% of the people involved. The conjunctivitis was sometimes accompanied by mild flu-like symptoms and incidental transmission between humans occurred as well. Because of the unexpected high incidence of symptomatic infections, proven to be caused by the H7N7 strain, oseltamivir was advised as an additional control measure, both for the treatment of symptoms and prophylactically for those with prolonged occupational exposure. After the unfortunate death of a veterinarian due to pneumonia caused by the avian virus, the preventive policy was further extended to people with short and incidental exposure to infected flocks. It is concluded that the policy was adequate, in spite of the unforeseen victim.