What is the treatment for a lung illness contracted from chickens or peacocks?

Treatment of Psittacosis (Lung Illness from Chickens or Peacocks)

Initiate doxycycline immediately for any patient with respiratory symptoms and bird exposure—this is the drug of choice and should be started even before laboratory confirmation. 1

Immediate Antibiotic Treatment

Doxycycline is the definitive treatment for psittacosis and should be started as soon as the diagnosis is suspected based on clinical presentation and exposure history. 1, 2 The CDC explicitly recommends prompt treatment with tetracycline antibiotics, with doxycycline being the specific agent of choice. 1

Key Clinical Points:

• Do not wait for laboratory confirmation to initiate treatment—early therapy is critical for preventing progression to severe disease. 1
• Psittacosis presents with influenza-like symptoms and community-acquired pneumonia after exposure to birds including chickens, peacocks, parrots, and other avian species. 3
• The incubation period ranges from 3 days to several weeks, though active disease can appear years after exposure. 4

Diagnostic Approach

While treatment should begin immediately, obtain diagnostic confirmation through:

• Paired sera testing for Chlamydia antibodies by complement-fixation test (≥4-fold rise to ≥32). 2
• Chlamydia psittaci IgM detection by indirect immunofluorescence assay. 3
• Metagenomic next-generation sequencing (mNGS) can improve diagnostic accuracy in challenging cases. 5

Infection Control and Prevention

Persons exposed to infected birds must wear N95 respirators or higher-rated protection—standard surgical masks are not effective against C. psittaci transmission. 1, 2 This is a critical pitfall, as inadequate respiratory protection leads to continued exposure and potential transmission.

Additional protective measures include:

• Wear protective clothing, gloves, and disposable surgical cap when handling infected birds or cleaning contaminated areas. 1
• Wet carcasses with detergent and water before necropsy to prevent aerosolization of infectious particles. 4
• Work under biological safety cabinet when performing procedures on potentially infected birds. 4

Environmental Decontamination

Thoroughly clean and disinfect all contaminated environments using appropriate agents effective against C. psittaci:

• 1:1,000 dilution of quaternary ammonium compounds (Roccal® or Zephiran®). 1
• 70% isopropyl alcohol. 1
• 1% Lysol®. 1
• 1:100 dilution of household bleach (2.5 tablespoons per gallon). 1

Critical cleaning protocol:

• Wet-mop floors frequently with disinfectants—never use vacuum cleaners as they aerosolize infectious particles. 4
• Moisten waste material before removal and double-bag for disposal or burn. 4
• Allow at least 5 minutes of contact time with disinfectant before rinsing. 4

Reporting Requirements

Physicians must report cases of psittacosis to state or local health authorities—this is required in most states and helps identify infection sources and prevent further transmission. 1 Timely reporting enables epidemiologic investigations and implementation of additional disease control measures. 4

Management of Infected Birds

All birds with confirmed or probable avian chlamydiosis should be:

• Isolated immediately and treated under veterinary supervision. 1
• Treated with medicated feed containing chlortetracycline for 45 days, or doxycycline (25-50 mg/kg body weight once daily). 1
• Monitored daily with weight checks every 3-7 days. 4

Avoid calcium supplementation during treatment as high dietary concentrations of calcium and other divalent cations inhibit tetracycline absorption—remove oyster shell, mineral blocks, and cuttlebone. 4

Important Caveats

• Human-to-human transmission is documented—psittacosis can spread not only from infected patients to close contacts but also to secondary contacts. 5
• Clinical manifestations range from mild flu-like symptoms to severe acute respiratory syndrome and systemic disease. 5
• The organism is resistant to drying and can remain infectious for several months in the environment. 4
• Infected birds may appear healthy and shed the organism intermittently, with stress factors activating shedding. 4