Biosecurity uptake and perceived risk of avian influenza among people in contact with birds in the UK

Recent intercontinental spread of highly pathogenic avian influenza (HPAI) A(H5N1) among kept and wild birds and transmission to mammalian hosts, including cattle and humans has heightened the need to review public health risk assessments. Biosecurity is essential for limiting disease spread, but how widely practices are implemented is not fully known. Here, we report on the uptake of biosecurity measures using questionnaire data collected in 2024 from people in contact with birds in the UK (Avian Contact Study). Almost half of the sample were poultry farmers (104/225). We found hand washing after contact with birds was the most common biosecurity measure implemented (89%, 196/218), followed by using disinfecting footwear dips (78%, 170/218). Individuals in contact with a higher number of birds were more likely to use at least one PPE measure for the face or body (χ2 (1, n=217) = 32.452, p<0.001) or at least one footwear-related PPE measure (Df=1, n=217, p<0.001), indicating the increasing number of birds as a likely proxy for farming practice, given the skewed poultry farmer sample. The perceived risk of avian influenza to the health of birds was generally high for individuals in contact with large flocks (≥1001 birds) and was associated with uptake of at least one footwear-related PPE measure (χ2 (1, n=185)= 9.171, p=0.002). The risk to human health was not associated with any biosecurity measure. These results suggest that routinely used biosecurity measures are implemented to limit disease spread among birds, but not with the primary view to limit zoonotic transmission from birds to humans. Future work should investigate attitudes towards avian influenza and biosecurity in larger sample sizes across varying populations to guide zoonotic influenza policy and inform targeted interventions.