What is Bird Flu

8/6/2019 What is Bird Flu

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WHAT IS BIRD FLU ?

Avian influenza is flu infection in birds. The disease is of concern to humans, who

have no immunity against it. The virus that causes this infection in birds can

mutate (change) to easily infect humans. Such mutation can start a deadly

worldwide epidemic.

What Is The Avian Influenza A (H5N1) Virus That Has Been Reported In

Africa, Asia, Europe, And The Near East?

Influenza A (H5N1) virusalso called "H5N1 virus"is an influenza A virus

subtype that occurs mainly in birds, is highly contagious among birds, and can be

deadly to them.

Outbreaks of avian influenza H5N1 occurred among poultry in eight countries in

Asia (Cambodia, China, Indonesia, Japan, Laos, South Korea, Thailand, and

Vietnam) during late 2003 and early 2004. At that time, more than 100 million

birds in the affected countries either died from the disease or were killed in order

to try to control the outbreaks. By March 2004, the outbreak was reported to be

under control.

Beginning in June 2004, however, new outbreaks of influenza H5N1 among

poultry and wild birds were reported in Asia. Since that time, the virus has spread

geographically. Reports of H5N1 infection in wild birds in Europe began in mid-

2005. In early 2006, influenza A H5N1 infection in wild birds and poultry were

reported in Africa and the Near East.

Human cases of influenza A (H5N1) infection have been reported in Azerbaijan,

Cambodia, China, Djibouti, Egypt, Indonesia, Iraq, Kuwait, Lao People's

Democratic Republic, Nigeria, Thailand, Turkey, and Vietnam.
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Causes, incidence, and risk factors

Historically, avian influenza viruses infected pigs and mixed with pig influenza

viruses. The viruses exchanged genetic information, which led to the formation of

a new virus. This new virus could then infect humans and easily spread from

person to person. Previous flu pandemics (worldwide epidemics) have started

this way.

The first avian influenza virus to infect humans directly occurred in Hong Kong in

1997, during an avian flu epidemic on the island. This outbreak was linked to

chickens and classified as avian influenza A (H5N1).

Since the Hong Kong outbreak, the bird flu virus has spread across Asia, and in

October 2005 was discovered in poultry in Turkey and Romania. So far,

hundreds of people have been infected by H5N1. Many people have died.

The wider the area over which the avian flu virus spreads, the greater the

chances of a worldwide outbreak. There is tremendous concern that H5N1 poses

an enormous pandemic threat.

Farmers and other people working with poultry, as well as travelers visiting

affected countries, have a higher risk for getting the bird flu. Handling an infected

bird can cause infection. People who eat raw or undercooked poultry meat are

also at an increased risk for avian influenza. Highly infective avian flu viruses,

such as H5N1, have been shown to survive in the environment for long periods

of time, and infection may be spread simply by touching contaminated surfaces.

Birds who recover from the flu can continue to shed the virus in their feces andsaliva for as long as 10 days.

Health care workers and household contacts of patients with avian influenza may

also be at an increased risk of the bird flu.


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Can I get avian influenza from eating or preparing poultry or

eggs?

You cannot get avian influenza from properly handled and cooked poultry and

eggs.

There currently is no scientific evidence that people have been infected with bird

flu by eating safely handled and properly cooked poultry or eggs.

Most cases of avian influenza infection in humans have resulted from direct or

close contact with infected poultry or surfaces contaminated with secretions and

excretions from infected birds. Even if poultry and eggs were to be contaminated

with the virus, proper cooking would kill it. In fact, recent studies have shown that

the cooking methods that are already recommended by the U.S. Department of

Agriculture (USDA) and the Food and Drug Administration (FDA) for poultry and

eggs to prevent other infections will destroy influenza viruses as well.

So to stay safe, the advice is the same for protecting against any infection from

poultry:

Wash your hands with soap and warm water for at least 20 seconds before and after

handling raw poultry and eggs.

Clean cutting boards and other utensils with soap and hot water to keep raw poultry from

contaminating other foods.

Use a food thermometer to make sure you cook poultry to a temperature of at least 165

degrees Fahrenheit Consumers may wish to cook poultry to a higher temperature for

personal preference.

Cook eggs until whites and yolks are firm.


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What are the Symptoms of Bird Flu?

The incubation period of H5N1 Bird Flu virus varies from 2 to 10 days. That

is, symptoms appear 2 to 10 days after the virus has first entered a body. A

person can be contagious without showing symptoms. An adult is still contagious

until 7 days after fever stops and must remain isolated. Children 12 and under

are still very contagious for 21 days from the beginning of illness. Keep the

patient quarantined during this time.

Symptoms of Bird Flu

eople infected with Bird Flu may have some or all of the:ollowing symptoms

Mild cold, sore throat, cough and shortness of breath.

Fever greater than 38 degrees Celsius

Diarrhea, vomiting and abdominal pain.

Mild to severe respiratory distress. needing ventilation within days.

In very severe cases large amounts of mucous accumulate in the lungs

limiting breathing. Patients can drown in their own mucous within 10 to 20

days. This may also involve secondary bacterial infection.

Laboratory tests have shown an early onset of lymphopenia, which is an

abnormally low number of lymphocytes in the blood.

Complications also included renal failure and multi organ failure.

Other symptoms have also occurred through H5N1 bird flu infection

leading to many incorrectly diagnosed patients including encephalitis,

dengue, gastrointestinal disorders and cholera.

A very common symptom of the 1918 Spanish flu was the cytokine storm


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?ow is avian influenza detected in humansAvian influenza cannot be diagnosed by symptoms alone, so a laboratory test is

required. Avian influenza is usually diagnosed by collecting a swab from the nose

or throat during the first few days of illness. This swab is then sent to a

laboratory, where they will either look for avian influenza virus using a molecular

test, or they will try to grow the virus. Growing avian influenza viruses should only

be done in laboratories with high levels of protection. If it is late in the illness, it

may be difficult to find an avian influenza virus directly using these methods. If

this is the case, it may still be possible to diagnose avian influenza by looking for

evidence of the body's response to the virus. This is not always an option

because it requires two blood specimens (one taken during the first few days of

illness and another taken some weeks later), and it can take several weeks to

verify the results.

What are the implications of avian influenza to human health?

Two main risks for human health from avian influenza are 1) the risk of direct

infection when the virus passes from the infected bird to humans, sometimes

resulting in severe disease; and 2) the risk that the virusif given enough

opportunitieswill change into a form that is highly infectious for humans and

spreads easily from person to person.


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Transmission and host range

Influenza A virus, the virus that causes Avian flu. Transmission electron

micrograph of negatively stained virus particles in late passage. (Source: Dr. Erskine

Palmer, Centers for Disease Control and Prevention Public Health Image Library)

Infected birds transmit H5N1 through their saliva, nasal secretions, feces and

blood. Other animals may become infected with the virus through direct contact

with these bodily fluids or through contact with surfaces contaminated with them.

H5N1 remains infectious after over 30 days at 0 C ( 32.0 F) (over one month at

freezing temperature) or 6 days at 37 C ( 98.6 F) (one week at human body

temperature) so at ordinary temperatures it lasts in the environment for weeks. In

Arctic temperatures, it doesn't degrade at all.

Because migratory birds are among the carriers of the highly pathogenic H5N1

virus, it is spreading to all parts of the world. H5N1 is different from all previously

known highly pathogenic avian flu viruses in its ability to be spread by animals

other than poultry.

In October 2004, researchers discovered that H5N1 is far more dangerous than

was previously believed. Waterfowl were revealed to be directly spreading the

highly pathogenic strain of H5N1 to chickens, crows, pigeons, and other birds,
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and the virus was increasing its ability to infect mammals as well. From this point

on, avian flu experts increasingly referred to containment as a strategy that can

delay, but not ultimately prevent, a future avian flu pandemic.

"Since 1997, studies of influenza A (H5N1) indicate that these viruses continue to

evolve, with changes in antigen city and internal gene constellations; an

expanded host range in avian species and the ability to infect felids; enhanced

pathogen city in experimentally infected mice and ferrets, in which they cause

systemic infections; and increased environmental stability."

The New York Times, in an article on transmission of H5N1 through smuggled

birds, reports Wade Hagemeijer of Wetlands International stating, "We believe it

is spread by both bird migration and trade, but that trade, particularly illegal trade,

is more important".

On August 22, 2007, a 28-year-old Indonesian chicken trader was the 2nd

person to die of bird flu on the island of Bali, after 4 days of hospitalization,

raising the death toll due to the disease in Indonesia to 84. Tests in 2 local

laboratories were positive for the H5N1 strain of the disease. 194 people the

majority of them in Indonesia -- have died since 2003, according to the WorldHealth Organization.

The H5N1 bird flu virus can also pass through a pregnant woman's placenta to

infect the fetus, researchers reported on Thursday 27 Sep 2007. They also found

evidence of what doctors had long suspected -- that the virus not only affects the

lungs, but also passes throughout the body into the gastrointestinal tract, the

brain, liver, and blood cells.


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SYMPTOMS TO THE ANIMAL

Wild fowl act as natural asymptomatic carriers of Influenza A viruses. Prior to the

current H5N1 epizootic, strains of Influenza A virus had been demonstrated to be

transmitted from wild fowl to only birds, pigs, horses, seals, whales and humans;

and only between humans and pigs and between humans and domestic fowl;

and not other pathways such as domestic fowl to horse.

Wild aquatic birds are the natural hosts for a large variety of influenza A viruses.Occasionally viruses are transmitted from these birds to other species and may

then cause devastating outbreaks in domestic poultry or give rise to human

influenza pandemics.

H5N1 has been shown to be transmitted to tigers, leopards, and domestic cats

that were fed uncooked domestic fowl (chickens) with the virus. H3N8 viruses

from horses have crossed over and caused outbreaks in dogs. Laboratory mice

have been infected successfully with a variety of avian flu genotypes.

Influenza A viruses spread in the air and in manure and survives longer in cold

weather. It can also be transmitted by contaminated feed, water, equipment and

clothing; however, there is no evidence that the virus can survive in well-cooked

meat. Symptoms in animals vary, but virulent strains can cause death within a

few days.
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Effect on human society

Main article: Social impact of H5N1

H5N1 has had a huge effect on humansociety, especially the financial, political,

social, and personal responses to both actual and predicted deaths in birds,

humans, and otheranimals.

Billions ofU.S. dollars are being raised and spent to research H5N1 and prepare

for a potential avian influenza pandemic. Over ten billion dollars have been lost

and over two hundred million birds have been killed to try to contain H5N1.

People have reacted by buying less chicken causing poultry sales and prices to

fall. Many individuals have stockpiled supplies for a possible flu pandemic. One

of the best known experts on H5N1, Dr. Robert Webster, told ABC News he had

a three month supply of food and water in his house as he prepared for what he

considered a reasonably likely occurrence of a major pandemic.

International health officials and other experts have pointed out that many

unknown questions still hover around the disease

Dr. David Nabarro, Chief Avian Flu Coordinator for the United Nations, and

former Chief of Crisis Response for the World Health Organization has described

himself as "quite scared" about the potential of H5N1's potential impact on

humans. Nabarro has been accused of being alarmist before and on his first day

in his role for the United Nations he proclaimed the avian flu could kill 150 million

people. In an interview with the International Herald Tribune, Nabarro compares

avian flu to AIDS in Africa, warning that underestimations led to innappropriate

focus for research and intervention.
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However it has been pointed out that media often focuses on "worst case" and

"what if?" scenarios, which often promotes a climate of fear and "a fertile ground

for speculation and rumours". Availability of reliable information is tanatamount

according to WHO public health official Robert Brown. Brown downplays the

significance of bird flu compared to other global public health issues:

In terms of death statistics so far, human avian influenza is not a huge public

health issue. As Brown put it, there are 40 million people living with HIV around

the world. More people die of traffic accidents in Vietnam than of avian flu. But a

mix of fear, disaster and the unknown makes avian flu a topic of concern. Other

factors add to this -- that avian flu marks the arrival of a new emerging infection

has a large impact on the poultry industry, a high mortality rate, and the potentialto cross national boundaries.


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Treatment and prevention for humans

Flu

Treatment

Different types of avian flu virus may cause different symptoms. Therefore,

treatment may vary.

In general, treatment with the antiviral medication oseltamivir (Tamiflu) or

zanamivir (Relenza) may make the disease less severe -- if you start taking the

medicine within 48 hours after your symptoms start.

Oseltamivir may also be prescribed for persons who live in the same house as

those diagnosed with avian flu.

The virus that causes human avian flu appears to be resistant to the antiviral

medicines amantadine and rimantadine. Therefore these medications cannot be

used if an H5N1 outbreak occurs.

People with severe infection may need to be placed on a breathing machine.

Experts recommend that persons diagnosed with avian flu be put in isolation.

Doctors recommend that people get an influenza (flu) shot to reduce the chance

of an avian flu virus mixing with a human flu virus, which would create a new

virus that may easily spread.
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The U.S. Food and Drug Administration has approved a vaccine to protect

humans from the avian flu. Experts say the vaccine could be used if the current

H5N1 virus starts spreading between people.

Prevention

Flu-like Symptoms With a Few Differences:


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In general, bird flu symptoms in humans are similar to regular flu symptoms. High

fever, muscle aches, cough, and sore throat are common. Humans ill with avian

flu subtype H5N1 rarely have conjunctivitis, a common symptom in people

infected with other subtypes of avian flu.

Most people have suffered respiratory distress, but a couple of young children

did not show any signs of respiratory distress, but had diarrhea and symptoms of

encephalitis.

Surveillance:Keeping track of where bird flu cases break out in poultry, other

animals and in humans is mostly the role of country governments. The World

Health Organization provides surveillance support. The WHO seeks to confirmbird flu cases and deaths and may use computer mapping (Geographic

Information Systems) to help local officials plan containment strategies. The

pitfalls of surveillance lie in unreliable data or untimely reporting of diseases.

Laboratory Competence: Bird flu symptoms alone are not enough to

determine if an illness can be attributed to bird flu. Rapid antigen tests are not as

sensitive in detecting influenza as laboratory tests that isolate the genetic

material of the virus (RNA) for identification. Prevention of bird flu measures

involve proper identification of the disease-causing agent. A weakness in

laboratory readiness in many countries is that tests may be too expensive to

perform regularly.

Participation and Communication: Individual Pandemic Preparation

Planning should help slow or prevent the spread of a pandemic flu. The fewer

human cases there are, the less likely it is that a new avian flu virus in humans

will emerge and become very contagious. Pandemic stockpilingfor 12 weeks has

been recommended. Community participation in planning and decision making is
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necessary for the success of emergency measures, such as the culling of

animals. Ignorance, mistrust and poverty can lead to breakdowns in

communication and participation. See why backyard chickens in a developed

country are not likely to cause avian flu in humans.

Government Policies: Government policies affect important prevention

measures such as: timely reporting of diseases, solid surveillance programs,

laboratory preparation, community participation, the ability to plan for

emergencies and enforce emergency measures, the ability to stockpile poultry

vaccines, antibiotics, and antiviral drugs and deliver them, and the level of

access to healthcare.

Personal Hygiene and Healthcare: Frequently wash hands with soap and

water and avoid contact with sick animals and people. Maintain general health by

updating routine vaccinations, getting a seasonal flu shot, eating right and

exercising. Receive medical care if bird flu symptoms are detected. Treatment

with antiviral drugs can reduce the severity of the flu if taken within 24-48 hours

of the onset of symptoms. Nevertheless, antiviral drugs, such as Tami flu, have

not been very successful in preventing death from avian flu so far. More studies

are needed to determine the effectiveness of antiviral drugs in treating avian flu.

Food Safety: Follow the tips to cooking poultry safely. Well cooked poultry and

eggs are perfectly safe to eat. Avoid cross contamination of raw meat with

cooked meat. Always disinfect cutting boards with 4 teaspoons of chlorine bleach

to one gallon of water before re-using them. Do not eat uncooked blood from

poultry.

It's not clear how people could become infected with the H5N1 avian flu virus via

the gastrointestinal tract, but it does seem some people contracted the virus in

Vietnam after drinking blood from poultry. Blood from infected animals contains

high levels of avian flu virus.
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Follow Best Practices for Poultry Farmers: Poultry farmers should

cooperate with their country's governments in the effort to contain bird flu. In the

US, farmers should be familiar with Insecurity for the Birds to protect poultry from

diseases introduced from outside the farm and participate in the voluntary USDA

reporting program. Learn how to spot bird flu among your flock. Report

suspicious deaths to the USDA. Protect those who must be in direct contact with

poultry. Wear gloves, rubber boots, and properly fitted face masks.

Rapid Response to Human Outbreaks: Rapid response to human outbreaks

of bird flu will reduce human deaths and the possibility of human-to-human

transmission. The outcome of rapid response will also reduce the possibility that

the bird flu virus will mutate or result in resentment to create a very contagious

novel virus in humans. The correct use of antiviral drugs and seasonal flu

vaccines play a role in the response to human outbreaks of bird flu

Preparations for pandemic

Cumulate Human Cases of and Deaths from H5N1

As ofApril 11, 2007
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Notes:

Source WHOConfirmed Human Cases of H5N1

"The incidence of human cases peaked, in each of the three years in

which cases have occurred, during the period roughly corresponding to

winter and spring in the northern hemisphere. If this pattern continues, an

upsurge in cases could be anticipated starting in late 2006 or early 2007."Avian influenza epidemiology of human H5N1 cases reported to WHO

The regression curve for deaths is y= a + ek x, and is shown extended

through the end of April, 2007.

"The United States is collaborating closely with eight international organizations,

including the World Health Organization (WHO), the Food and Agriculture

Organization of the United Nations (FAO), the World Organization for Animal

Health (OIE), and 88 foreign governments to address the situation through

planning, greater monitoring, and full transparency in reporting and investigating

avian influenza occurrences. The United States and these international partners

have led global efforts to encourage countries to heighten surveillance for

outbreaks in poultry and significant numbers of deaths in migratory birds and to
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rapidly introduce containment measures. The U.S. Agency for International

Development (USAID) and the U.S. Department of State, the U.S. Department of

Health and Human Services (HHS), and Agriculture (USDA) are coordinating

future international response measures on behalf of the White House with

departments and agencies across the federal government".

Together steps are being taken to "minimize the risk of further spread in animal

populations", "reduce the risk of human infections", and "further support

pandemic planning and preparedness".

Ongoing detailed mutually coordinated onsite surveillance and analysis of human

and animal H5N1 avian flu outbreaks are being conducted and reported by the

USGS National Wildlife Health Center, the Centers for Disease Control and

Prevention, the World Health Organization, the European Commission, and

others.

Infectivity

Highly pathogenic H5N1
http://en.wikipedia.org/wiki/U.S._Agency_for_International_Developmenthttp://en.wikipedia.org/wiki/U.S._Agency_for_International_Developmenthttp://en.wikipedia.org/wiki/U.S._Department_of_Statehttp://en.wikipedia.org/wiki/U.S._Department_of_Health_and_Human_Serviceshttp://en.wikipedia.org/wiki/U.S._Department_of_Health_and_Human_Serviceshttp://en.wikipedia.org/wiki/U.S._Department_of_Agriculturehttp://en.wikipedia.org/wiki/USGShttp://en.wikipedia.org/wiki/Centers_for_Disease_Control_and_Preventionhttp://en.wikipedia.org/wiki/Centers_for_Disease_Control_and_Preventionhttp://en.wikipedia.org/wiki/World_Health_Organizationhttp://en.wikipedia.org/wiki/European_Commissionhttp://en.wikipedia.org/wiki/U.S._Agency_for_International_Developmenthttp://en.wikipedia.org/wiki/U.S._Agency_for_International_Developmenthttp://en.wikipedia.org/wiki/U.S._Department_of_Statehttp://en.wikipedia.org/wiki/U.S._Department_of_Health_and_Human_Serviceshttp://en.wikipedia.org/wiki/U.S._Department_of_Health_and_Human_Serviceshttp://en.wikipedia.org/wiki/U.S._Department_of_Agriculturehttp://en.wikipedia.org/wiki/USGShttp://en.wikipedia.org/wiki/Centers_for_Disease_Control_and_Preventionhttp://en.wikipedia.org/wiki/Centers_for_Disease_Control_and_Preventionhttp://en.wikipedia.org/wiki/World_Health_Organizationhttp://en.wikipedia.org/wiki/European_Commission


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Countries with poultry or wild birds killed by H5N1.

Countries with humans, poultry and wild birds killed by H5N1.

H5N1 is easily transmissible between birds facilitating a potentialglobal spread of

H5N1. While H5N1 undergoes mutation and reassortment, creating variations

which can infect species not previously known to carry the virus, not all of these

variant forms can infect humans. H5N1 as an avian virus preferentially binds to a

type ofgalactose receptors that populate the avian respiratory tract from the

nose to the lungs and are virtually absent in humans, occurring only in and

around the alveoli, structures deep in the lungs where oxygen is passed to the

blood. Therefore, the virus is not easily expelled by coughing and sneezing, the

usual route of transmission.

H5N1 is mainly spread by domestic poultry, both through the movements of

infected birds and poultry products and through the use of infected poultry

manure as fertilizer or feed. Humans with H5N1 have typically caught it from

chickens, which were in turn infected by other poultry or waterfowl. Migrating

waterfowl (wild ducks, geese and swans) carry H5N1, often without becoming

sick. Many species of birds and mammals can be infected with HPAI A(H5N1),

but the role of animals other than poultry and waterfowl as disease-spreading

hosts is unknown.
http://en.wikipedia.org/wiki/Global_spread_of_H5N1http://en.wikipedia.org/wiki/Global_spread_of_H5N1http://en.wikipedia.org/wiki/Galactosehttp://en.wikipedia.org/wiki/Alveolihttp://en.wikipedia.org/wiki/Poultryhttp://en.wikipedia.org/wiki/Waterfowlhttp://en.wikipedia.org/wiki/Duckhttp://en.wikipedia.org/wiki/Geesehttp://en.wikipedia.org/wiki/Swanhttp://en.wikipedia.org/wiki/Image:Global_spread_of_H5N1_map.PNGhttp://en.wikipedia.org/wiki/Global_spread_of_H5N1http://en.wikipedia.org/wiki/Global_spread_of_H5N1http://en.wikipedia.org/wiki/Galactosehttp://en.wikipedia.org/wiki/Alveolihttp://en.wikipedia.org/wiki/Poultryhttp://en.wikipedia.org/wiki/Waterfowlhttp://en.wikipedia.org/wiki/Duckhttp://en.wikipedia.org/wiki/Geesehttp://en.wikipedia.org/wiki/Swan


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According to a report by the World Health Organization, H5N1 may be spread

indirectly. The report stated that the virus may sometimes stick to surfaces or get

kicked up in fertilizer dust to infect people.

How is avian influenza in humans treated?
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Studies done in laboratories suggest that the prescription medicines approved for

human influenza viruses should work in treating avian influenza infection in

humans. However, influenza viruses can become resistant to these drugs, so

these medications may not always work. Additional studies are needed to

determine the effectiveness of these medicines.

Does seasonal influenza vaccine protect against avian influenza infection

in people?

No. Seasonal influenza vaccine does not provide protection against avian

influenza.

Documents

What is Bird Flu