So now it’s in your face; no longer another distant
place, another Island, “somewhere else”, it is
here, right in our own back yards. Avian flu, the virus that
scientists fear may mutate to become the next global flu pandemic
(mega- epidemic) is here. Some studies have suggested that
the virus may already be able to infect “human to human”,
rather than just “bird to human”, however these
studies are inconclusive.
Few areas in Bali can now claim that they are bird-flu free
as far as livestock are concerned, and in the past month Bali
has suffered three confirmed human fatalities from the disease.
It seems like all eyes are on us at this time, just to see
how the virus will behave and what precautions and treatment
this Island can provide.
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 should this virus could mutate to become a disease
that is transmissible 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 other
wise 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 washed in very hot soapy water then soaked
in a mild bleach solution. Eggs should be washed thoroughly
removing all dirt (yes they come from chickens bums!!) and
soaked in a mild bleach solution (Soak eggs in 2.5ml or a
half teaspoon of bleach to one liter 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 feces 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
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.
If you have concerns regarding birds or livestock that you
own or that you have seen on neighboring properties, you may
report this to the Department of Agriculture (Dinas Peternakan)
Jln Angsoka, Kreneng, Bali, Tel. 0361-224184
Should you suspect that any person appears to be suffering
from the symptoms of Avian Flu you may report this to Dr.Ken
RSUP Sanglah, Tel. 0361-7844453
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.
“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 or Hp. 081 2366 0000”.
