🔍💡 HPAI and “One Health”: an operational guide to articulate biosecurity, human and animal surveillance, and crisis management on the ground. #AvianFlu
🦆🧑⚕️ From wildlife to farms and caregivers: this report details the roles, protocols, and tools to limit the risk of HPAI in France. #OneHealth #Zoonoses
🔍➕ This document is directly usable for veterinary health professionals, DDecPP agents, ARS, and public health professionals who need to quickly understand “who does what” and with what tools in HPAI within a One Health framework.
It is also useful for occupational health structures, MSA, prevention services, and grassroots associations working with farmers, hunters, naturalists, or wildlife rehabilitation centres to adapt their messages, procedures, and training.
Finally, it provides local policy coordinators (departmental councils, local authorities, associative networks) with a structured view of the national systems on which to base coherent territorial actions.
Source: 📒 The management of animal diseases under a “One Health” approach – The case of highly pathogenic avian influenza (HPAI) in questions and answers
📜🔗LINK
- article -https://sante.gouv.fr/grands-dossiers/article/one-health-l-approche-globale-une-seule-sante
- report in French -https://sante.gouv.fr/IMG/pdf/rapport_une_seule_sante_iahp_france.pdf
- report in English - https://sante.gouv.fr/IMG/pdf/report_one_health_hpai_france-eng.pdf
Estimated reading time: 1 hour 30 to 2 hours
1. Analytical summary
Context of AIHP and One Health issues
The document responds to the questionnaire from the European Commission (mission of June 2025) aimed at analysing the management of AIHP in France within a 'One Health' approach, covering ecosystem health, public health, animal health, and intersectoral cooperation. It describes a context of H5N1 panzootic with major health, psychological, social, and economic impacts on the poultry sector and biodiversity, with repeated outbreaks and strong international pressure. The main audiences are national and European health authorities, but the responses highlight the articulation between veterinary services, ARS, SpF, Anses, OFB, MSA, CNR/LNR, surveillance networks (SAGIR, RESAVIP, SAGA), and field actors. The central issue is to show how France structures monitoring, risk assessment, biosecurity, vaccination, outbreak management, and communication, including in a pre-pandemic situation. The text also highlights the One Health governance (Interministerial Task Force, PNSE4, SNB 2030) and its limitations, particularly the lack of a dedicated financial mechanism.
Operational contributions for the field
The report provides, in a question-and-answer format, a precise mapping of responsibilities (ecosystems, human health, animal health) and procedures: passive and active surveillance, SAGA protocol, case definitions, screening methods, measures in the event of symptomatic or asymptomatic human cases, ORSEC/PNISU command chain. It describes concrete tools: IAHP brochures for breeders, SpF leaflets for the general public and health professionals, COREB sheets on 'Zoonotic Influenza Vigilance', DGAL technical instructions on biosecurity, vaccination, health visits, and wildlife surveillance. Stakeholders can find normative references (decrees, instructions, national plans, diagnostic guides) to adapt their protocols, training plans, and communication materials. The work details CNR/LNR cooperation, sequencing capabilities, notification circuits (EWRS, Epipulse, WHO), and methods for updating risk assessments, useful for surveillance, ESR, ARS, or monitoring platform managers.
2. Key points of the document
The European mission and the 'One Health' framework (pp. 2–3)
The report is built around a questionnaire from the European Commission aimed at identifying best practices and gaps in the management of IAHP under the 'One Health' approach, following several waves of epizootics with significant socio-economic impact. It presents the French responses in full, structuring the information into four sections: ecosystem health, public health, animal health, and intersectoral cooperation.
Organisation of ecosystem and wildlife surveillance (pp. 9–13)
The health of ecosystems relies on the DEB, the OFB, hunting federations, wildlife rehabilitation centres, and the SAGIR network for detecting abnormal mortalities, complemented by the Pelagis observatory for marine mammals. The text details the authorisation procedures for rehabilitation centres, international monitoring, examples of managing IAHP episodes in seabirds and mammals (Sept-Îles, Île aux Moutons, TAAF), and the event-based monitoring of terrestrial and marine mammals.
Public health system: prevention, surveillance and SAGA protocol (pp. 15–29, 21–22 for SAGA)
The document lists all the tools mobilised for health professionals and exposed populations: HCSP opinions, HAS recommendations, COREB fact sheets and webinars, SpF leaflets, DGS-Urgent messages, press conferences, thematic file on avian influenza, and seasonal flu vaccination for at-risk workers. It describes the SAGA protocol for active surveillance of individuals exposed to IAHP outbreaks, the pilots conducted in 2023–24 and 2024–25, the results (no human infections detected) and the planned deployment in 2025–26 across the entire territory.
Biosecurity measures, vaccination and surveillance in animal health (pp. 31–35)
The measures in farms and for captive birds are based on national decrees (biosecurity, transport, IAHP vaccination) and technical instructions detailing application conditions, controls, health visits, inspection campaigns and surveillance in domestic (RESAVIP) and wild mammals. The text recalls the definition of suspected and confirmed cases, awareness messages for reporting (IAHP press releases, 'health tripod' slogans biosecurity-surveillance-vaccination, practical veterinary guides) and support for small bird holders.
Governance One Health and coordination of national plans (pp. 37–41)
Intersectoral cooperation relies on the animal health epidemiological surveillance platform, Public Health France, Anses, DGS, DGAL, OFB, ARS, SpF CRs, and CNR/LNR, coordinated through regular committees (zoonoses coordination committee, health security meeting, regional RSS). The report describes the interministerial Task Force "One Health" created in 2023, action 20 of PNSE4, PRSE, and the National Biodiversity Strategy 2030, while highlighting the lack of a dedicated financial mechanism for One Health.
3. Action points for local stakeholders
Establish a local reporting circuit for IAHP involving all field actors (pp. 9–13, 32–35, 37–39)
Local authorities, ARS, DDecPP, OFB, hunting federations, and care centres can formalise a shared circuit for reporting wild or domestic bird mortalities, based on the procedures described for the SAGIR network, DDecPP, and instructions to municipalities (collection, PPE, use of rendering services). This circuit can be integrated into departmental ORSEC systems and PRSE to ensure responsiveness in the event of IAHP outbreaks, providing communication materials suitable for the general public and poultry keepers.
Adapt professional training based on national materials (pp. 15–19, 34–35)
Training structures (IFSI, ENV, agricultural schools, continuing education for doctors and veterinarians, MSA, associations) can integrate COREB sheets, SpF and MSA leaflets, as well as biosecurity guides and manuals for diagnosing epizootics into their modules to enhance early detection capacity and management of exposures. One strategy is to co-construct short training sequences with the ARS, DDecPP, and MSA around concrete cases (IAHP outbreak, occupational exposure, management of a suspected case) based on the SAGA procedures and the recommended actions described.
Strengthening prevention and occupational health in the poultry and pig sectors (p. 18, 28–30)
Agricultural occupational health services, MSA, and professional organisations can use recommendations on seasonal flu vaccination for exposed workers, key biosecurity messages, as well as MSA flyers and campaigns to systematically integrate the IAHP risk into professional risk assessments. These tools can be supplemented by collective or individual interviews with farmers, abattoirs, hunters, and ringers, including psychosocial dimensions and support in the event of an epizootic crisis.
Integrating One Health into territorial plans (PRSE, local zoonoses plans) (p. 37–41)
The ARS, DREAL, DRAAF, and local authorities can rely on action 20 of the PNSE4 and the SNB 2030 to incorporate IAHP/zoonoses objectives into the PRSE, with concrete actions for monitoring terrestrial and wild fauna, coordinating networks, and health strategies for parks, hunting enclosures, and protected areas. At the local level, this can translate into regional One Health monitoring groups, involving decentralised services, health agencies, naturalist associations, veterinarians, and medico-social structures.
Prepare healthcare and medico-social structures for a case of zoonotic influenza (pp. 15–17, 26–29)
Health establishments, SSR, EHPAD, and medico-social structures can integrate the necessary actions (isolation, contact tracing, antiviral prescription, coordination with COREB, CNR VIR, ARS) into their white plans and REB procedures, in connection with DGS-Urgent messages. Teams can organise internal exercises based on the described scenarios (symptomatic or asymptomatic cases, exposure in farming or wildlife) to identify points of fragility (literacy, equipment, external coordination).
4. Additional references
🔍➕ For more information, see the articles referenced by "Pratiques en Santé" on the topic of one health ➡️🔗https://pratiquesensante.odoo.com/2-5-one-health-une-seul-sante
WHO – "Public health resource pack for countries experiencing outbreaks of influenza in animals: revised guidance"https://www.who.int/publications/i/item/9789240076884
This resource complements the report by detailing the components of public health preparedness and response in the event of the circulation of animal-origin influenza viruses.
ECDC – "Targeted surveillance to identify human infections with avian influenza virus during the influenza season 2023/24, EU/EEA" (2023)
https://www.ecdc.europa.eu/en/publications-data/avian-influenza-infections-surveillance-eu-eea
This document delves into the methodology of targeted surveillance, in line with the SAGA protocol mentioned in the report.
ANSES – "Avian Influenza: Current Health Risks for Animals and Humans" (updated after 2022)
This page provides an updated overview of the AIHP risks, circulating strains, and recommendations for field actors.
5. Cross-sectional analysis — Values of Health Practices
Literacy: The document remains technical but refers to simplified materials (SpF leaflets, MSA brochures, DGAL guides) tailored to various audiences, provided there is local educational support.
Empowerment: Final beneficiaries (farmers, workers, general public) are not much involved in co-construction, but they are provided with tools for self-surveillance, vaccination, and actions to take in case of symptoms.
Participation: Participation is mainly institutional (agencies, ministries, surveillance networks, PNSE4, monitoring groups), with little detail on citizen or community participation.
Community health: The collective dimension is present through surveillance networks, national plans, PRSE, and public communications, but local community approaches are not at the core of the text.
Ethics: The issues of social or territorial biases are not explicitly addressed, but the consideration of occupational risks, population protection, and biodiversity reflects an attention to differentiated impacts.
Human rights: Equity and inclusion are not explicitly addressed, but the free seasonal vaccination for at-risk workers and the broad information targeted suggest a desire for universal access.
Intersectorality: The report details the partnerships between Health, Agriculture, Environment, Research, civil security, and the links between PNSE4, SNB 2030, Task Force One Health.
Partnership: Collaboration models are formalised through committees (RSS, zoonoses committee), platforms (PESA, SAGA), networks (SAGIR, RESAVIP) and plans (PNISU, pandemic plan).
Combating discrimination: Discrimination is not directly addressed; the document rather emphasises the non-exposure of the general public to unnecessary risks, the protection of workers, and the consideration of wildlife.
6. Assessment of the reliability of the resource
Scientific relevance
The document is based on European and national regulations, HCSP and HAS opinions, joint risk assessments by SpF–Anses–CNR, surveillance systems (SAGA, SAGIR, RESAVIP) and collaborations with ECDC, WHO, FAO, OIE and GISRS, which ensures a solid and up-to-date scientific basis (references until December 2024–January 2026). The methodology relies on a detailed description of the systems rather than on quantitative analyses, but it is consistent with international One Health standards.
Operational relevance
The resource is highly operational for institutional actors and health professionals, veterinarians, prevention and surveillance, thanks to the systematic presentation of procedures, responsibilities, communication materials and links to regulatory texts. For field workers unfamiliar with administrative language, mediation or simplified summaries remain necessary for quick appropriation.
7. MCQ — 5 questions
Part 1 — MCQ without answers
Question 1 (pp. 2–3, 37):
What was the purpose of the European Commission's mission to France in June 2025 regarding HPAI?
a) To assess only the economic impact of HPAI on the poultry sector
b) To identify best practices and gaps in HPAI policies within a 'One Health' approach
c) To establish a new European regulation on poultry products
d) To replace national health authorities with a European agency
Question 2 (pp. 21–22):
What is the main objective of the SAGA protocol described in the document?
a) To organise the vaccination of poultry against HPAI
b) To actively monitor individuals exposed to HPAI outbreaks to detect human infections
c) To control biosecurity in poultry slaughterhouses
d) To manage crisis communication with the media
Question 3 (pp. 31–33):
According to the document, which statement correctly describes a confirmed case of HPAI in animals?
a) Any mortality of wild birds exceeding 10 individuals
b) Any unexplained fever in a poultry farm
c) An infection by H5 or H7 with highly pathogenic characteristics demonstrated by a reference or approved laboratory
d) The presence of anti-influenza antibodies in vaccinated poultry
Question 4 (pp. 37–39):
Which actor coordinates the preparation and response to the HPAI risk from a human health perspective at the national level?
a) The Directorate General for Food (DGAL)
b) The French Office for Biodiversity (OFB)
c) The General Directorate of Health (DGS)
d) The Agricultural Social Mutuality (MSA)
Question 5 (pp. 39–41):
The interministerial Task Force 'One Health' (TFIOH) created in 2023 has the main mission to:
a) Directly finance all local One Health projects
b) Ensure health control of abattoirs
c) Cross ministerial perspectives to strengthen coordination and embed the 'One Health' approach in public policies
d) Manage the communication of government social media
Part 2 — Commented correction
Question 1:
✅ Correct answer: b) Identify good practices and gaps in AIHP policies within a 'One Health' approach
📝 Explanation: The European mission of June 2025 is presented as an information study aimed at identifying good practices and gaps in AIHP policies within a 'One Health' approach, taking into account risks to animals, the environment, and humans. Source: pp. 2–3.
Question 2:
✅ Correct answer: b) Actively monitor individuals exposed to AIHP outbreaks to detect human infections
📝 Explanation: The SAGA protocol (Active Surveillance of Avian Influenza) aims to monitor, through sampling and virological testing, asymptomatic individuals exposed to AIHP outbreaks in farming to detect potential human infections and adapt surveillance. Source: pp. 21–22.
Question 3:
✅ Correct answer: c) An infection by H5 or H7 with highly pathogenic characteristics demonstrated by a reference or approved laboratory.
📝 Explanation: The text specifies that a confirmed case of HPAI requires the detection of an infection by an H5 or H7 virus and the demonstration of highly pathogenic characteristics through direct HPAI diagnosis carried out by the National Reference Laboratory or an approved laboratory. Source: p. 31–32.
Question 4:
✅ Correct answer: c) The Directorate General of Health (DGS)
📝 Explanation: The DGS coordinates the anticipation, preparation, and response to risks to human health, informs healthcare professionals, engages expert bodies, and leads the weekly health security meeting. Source: p. 37–39.
Question 5:
✅ Correct answer: c) To align ministerial perspectives to strengthen coordination and embed the 'One Health' approach in public policies.
📝 Explanation: The interministerial 'One Health' Task Force brings together the ministries of Health, Agriculture, Environment, and Research to better coordinate intersectoral actions and sustainably integrate One Health into public policies, without having a dedicated budget. Source: p. 39–41.
8. Frequently Asked Questions (FAQ)
Who coordinates the surveillance of HPAI in wildlife in France? (p. 9–13, 39)
Surveillance relies on the OFB and the Hunting Federations via the SAGIR network for terrestrial wildlife, and on the Pelagis observatory for marine mammals, in connection with the DEB and DGAL.
What tools are available to inform healthcare professionals about zoonotic influenza? (p. 15–19)
The main tools are the opinions of the HCSP, SpF leaflets, COREB technical sheets on 'Zoonotic influenza vigilance', COREB webinars, DGS-Urgent messages, and HAS vaccination recommendations.
How are individuals exposed to an AIHP outbreak in farming monitored? (p. 21–22, 24–29)
They can be included in the SAGA protocol: identification of exposed individuals, proposal for RT-PCR testing, clinical follow-up, and if necessary, sequencing and contact tracing coordinated by SpF, ARS, and CNR VIR.
What are the main biosecurity obligations for poultry farms? (p. 31–33)
The obligations arise from national decrees (biosecurity, transport, vaccination) and DGAL technical instructions, and concern the sheltering of poultry, flow control, cleaning and disinfection, carcass management, staff equipment, and mandatory health visits.
How is the response organised in the event of detecting a human case of zoonotic influenza? (p. 26–29)
The protocol includes isolation, epidemiological and virological investigation, antiviral prescription, contact tracing, monitoring of co-exposed individuals for 10 days, and the mobilisation of COREB, CNR VIR, SpF, and ARS according to REB procedures.
What role does the 'One Health' approach play in national policies? (p. 37–41)
It is integrated into the PNSE4 (action 20), the PRSE, the National Biodiversity Strategy 2030, and the interministerial One Health Task Force, with strengthened intersectoral governance but without a dedicated financial mechanism to date.
Where can the reference texts for managing an AIHP crisis be found? (p. 34–35, 40–41)
The main texts are the PNISU, the ORSEC plan, the government pandemic plan, the biosecurity and vaccination IAHP orders, the DGAL technical instructions, and the SGDSN circulars on the organisation of major crisis management.
9. Rewriting in Easy-to-Read Language
Easy-to-Read Title
“Avian Influenza: How France Protects Animals, Nature, and Humans”
Easy-to-Read Summary
Context and Issues
Avian influenza affects many birds in France.
It can also affect some mammals and sometimes humans.
France wants to protect animals, nature, and people at the same time.
Several state services work together for this.
This joint work is called “One Health.”
Contributions for the Field
The document explains who does what in the case of avian influenza.
It describes the rules for farms and wildlife.
It provides the steps to follow if a person is exposed or ill.
It explains how to monitor the disease in animals and humans.
It shows how the services communicate and make decisions.
Key Points in Easy-to-Read Language
Observe and protect wild animals
Teams monitor dead or sick wild birds and mammals.
They send animals for analysis in laboratories.
This helps to see if avian influenza is circulating in nature.
Inform caregivers and the public
Simple leaflets explain avian influenza and the right actions.
Special fact sheets help doctors and nurses to react quickly.
Official messages inform professionals when the situation changes.
Protect poultry farms
There are rules to prevent the entry of the virus into farms.
Farmers must protect their animals and monitor for signs of illness.
The vaccination of poultry is organised according to a precise plan.
Monitor people exposed to the virus
People close to an avian influenza outbreak may be tested.
This monitoring is called SAGA and involves nasal swabs and tests.
If a person tests positive, follow-up and treatment are offered.
Working together with 'One Health'
Human, animal, and environmental health services often meet.
They share information to decide on actions to take.
They also prepare plans in case of a major epidemic.