It’s pretty hard to escape the recent headlines about the latest disease epidemic Avian Flu or “bird flu” (flu burung). It has been declared a pandemic among birds and international health organizations are telling us that they are on high alert and battling to control the spread of the disease throughout Asia.
Currently it seems that the virus is capable of infecting humans via livestock, with a fatality rate of about 50%. The concern, according to experts in the field of viral epidemiology, is that this virus could mutate to become a disease that is transmissible from human to human. Based on historical patterns, influenza pandemics can be expected to occur, on average, three to four times each century when new virus subtypes emerge and are readily transmitted from person to person. However, the occurrence of influenza pandemics is unpredictable. In the 20th century, the great influenza pandemic of 1918–1919, which caused an estimated 40 to 50 million deaths worldwide, was followed by pandemics in 1957–1958 and 1968–1969.
What is Bird flu? – The virulent avian influenza otherwise known as H5N1 is a highly contagious viral disease, which may cause up to 100% mortality in domestic fowls.
Transmission – Transmission of the disease in the bird population seems to be via direct or indirect contact (likely through drinking water) with migratory waterfowl as the most likely source of infection in poultry – this would explain why the disease has spread so rapidly throughout Asia & Eastern Europe. The virus is highly concentrated in the manure and in nasal and eye discharges of the infected birds, and the most common route of transmission to humans is via inhaling the virus from dried chicken dung or by handling the birds or eggs directly. The single most important thing to realize is that so far (at the time this article was written), there is no evidence of human-to-human transmission.
Symptoms - The reported symptoms of avian influenza in humans have ranged from typical influenza-like symptoms (e.g., fever, cough, sore throat and muscle aches) to eye infections. In several of the fatal cases, pneumonia, and acute respiratory distress secondary to viral pneumonia developed. (In birds the signs of the disease are variable. In very severe forms the disease appears suddenly and birds die quickly. Some may appear depressed, egg production falls and soft-shelled eggs produced. There may be watery diarrhoea, combs and wattles may become blue and respiration may be laboured. In less severe forms, the clinical signs may include decreased egg production, depression, respiratory signs suggestive of a cold, swelling of the face, possibly some nervous signs and diarrhoea).
1. Treatment - Studies to date suggest that the prescription medications approved for human influenza strains (E.g.Tamiflu) would be effective in preventing avian influenza infection in humans.
2. Prevention – Workers involved in poultry flocks must be protected, by proper clothing and equipment, against infection. Caution should be used when preparing poultry for consumption, and all chicken meat should be thoroughly cooked before serving. Keep knives and chopping boards separate from those used for fresh fruit and vegetables. All utensils used in the preparation of meat should be soaked in a mild bleach solution. Eggs should be washed thoroughly in a mild bleach solution (Soak eggs in 5ml or a teaspoon of bleach “sunlight” to one bucket of water for 10 minutes).
3. Travel - Travelers to countries in Asia with H5N1 outbreaks are advised to:
a. Avoid poultry farms,
b. Avoid contact with animals in live food markets and any surfaces that appear to be contaminated with faeces from poultry or other animals
c. Eat chicken only when it is well cooked and only eat cooked eggs
d. Anyone developing fever, muscular aches and severe respiratory problems should report to health professionals
e. Farm workers should wash their hands thoroughly & anyone working with poultry should wear masks and gloves
f. The practice of marketing live poultry directly to consumers should be discouraged in areas currently experiencing outbreaks of highly pathogenic H5N1 avian influenza among poultry.
4. Vaccination –The vaccination of people at high risk of exposure to infected poultry, using existing vaccines effective against currently circulating human influenza strains, can reduce the likelihood of co-infection. As yet there is no specific vaccine against the Avian flu. It will take approximately 6 months to commercially produce a specific vaccine for any given virus. The concern here is that by the time a vaccine is produced, the virus may actually already have changed its form (mutated) and the vaccine will therefore be ineffective. Random and over-use of inappropriate vaccine may actually cause the virus to be become stronger.
Information in this article has been extracted from sites
CDC (http://www.cdc.gov/flu/avian/index.htm),
WHO (http://www.who.int/csr/disease/avian_influenza/en/),
Intl SOS (http://wwwinternationalsos.com/members_home/avianflu) and current information on the Avian flu may be viewed on these sites.
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Kim Patra is a qualified Registered Nurse and Midwife that has been living and working in Bali for almost twenty years. She now runs her own private practice and medical referral service from her Kuta office. Kim is happy to discuss any health concerns with you and she may be contacted via e-mail at info@chcbali.com”.
