What You Need to Know About Avian

Flu

Muntu R. Davis, M.D., M.P.H.Deputy Health Officer

Alameda County Public Health Department

Separating Fact from Fiction

Commonly Used Terms

TermLaw

EnforcementPublic Health

CaseA body of evidence

A person with the disease of

interest

SuspectA person under

suspicionA person who may be a case

SurveillanceWatching

individualsTracking disease

Evidence Proof of a crime

Information used to

identify and/or to treat disease

What is avian influenza?

An infection caused by viruses that normally cause disease in

birds, e.g., waterfowl, shorebirds or poultry (chickens, ducks, and turkeys), and, less commonly, in

pigs.

(Also known as avian flu or ‘bird flu’)

What is so special about the current

outbreaks of avian flu in poultry?

Largest and most severe on record

Many countries affected simultaneously

Avian influenza A (H5N1), especially difficult to control

150 million birds dead or destroyed, but virus now considered endemic (occurring within a specific area or region)

Spreading due to bird migration patterns

Do bird flu viruses infect people?

Not usually.

However, a growing number of cases of human infection with bird flu viruses, mainly

in Southeast Asia, have occurred since 1997.

How do people become infected?

Outbreak of avian flu in poultry (chicken, ducks, turkeys)

plus

Contact with infected poultry or surfaces contaminated with

excretions from infected birds

means

Possible risk of avian flu to person

What about eating chicken and eggs?

To date, no studies have linked any human cases of avian flu to

eating poultry products.

What are the symptoms of bird flu

in people?

Typical flu-like symptoms

FeverCough

Sore throat

Muscle aches

Eye infectionsDifficulty breathing due to

pneumoniaOther severe and life-threatening

complications

Is it here yet?

No.

There has been no detection of the H5N1 virus found in Asia and Europe and no human

cases of avian flu in the United States to date.

So, why all of the attention and fear?

Reason #1:Overlap of bird migratory

flyways with outbreak areas

Reason #2:Influenza pandemics have happened in the

past ‘Spanish flu’, 1918-19, caused by H1N1

‘Asian flu’, 1957-58, caused by H2N2**

‘Hong Kong flu’, 1968-69, caused by H3N2**

** These were caused by new viruses, containing both human and avian genes.

Appearance of new influenza virus in humans to which the human population has little or no immunity

Ability of the virus to replicate and cause disease in large numbers

Spreads easily from person-to-person

Spread to another continent

Influenza Pandemic

The 1918 influenza virus infected ~30% of the world's population

and killed up to 40 million individuals,

particularly young people

Reason #3:Avian influenza A

(H5N1) virus new to humans

All prerequisites for a pandemic to start except human-to-human transmission

More severe and difficult to control than most avian strainsNew animals infected for first timeLittle or no immunity in humans

Ducks have virus with no symptoms, but excrete virus, so sustainable reservoirHuman cases concentrated in previously healthy children and young adults

HumanHuman

virus

Re-assortant

virusvirus

Non-Non-human

virusvirus

Reason #4:Viral gene re-assortment

Non-Non-

human

virusvirus

Will the flu shot protect from bird flu?

There is no vaccine currently to protect from bird flu.

However, flu shots will protect you from common influenza viruses

that commonly cause severe flu in people.

**Ask your doctor about if you should get a flu shot.

What about the pneumonia shot?

This is for pneumonia caused by certain bacteria, not viruses.

However, pneumonia shots will protect you from 23 of the most common types of Streptococcus

pneumonia bacteria, which cause pneumonia, blood poisoning and

meningitis.

**Ask your doctor about if you should get a pneumonia shot.

What if I had pneumonia before?

Again, this is a new virus to humans and, therefore, the

general population will have little or no immunity to it.

What should travelers do when traveling to infected countries? Know the signs and symptoms of bird flu. Get up-to-date vaccinations. Get a physical check-up at least 4 weeks prior to travel. Practice good hygiene; wash your hands frequently with soap and water. Avoid poultry farms and live animal markets. Do not feed pigeons or other birds.Wash your hands immediately after contact with birds or poultry.

Do not eat undercooked poultry. Do not eat raw eggs or dip cooked food into any sauce containing raw eggs. Listen to the news and stay informed if there is an outbreak.

After you return from your travel: Monitor your health for 10 days. If you develop flu-like symptoms within 10 days of your return, call your doctor. It is important to tell your doctor that you have recently traveled to a country with a known bird flu outbreak.

Sources: Centers for Disease Control, World Health Organization, The Center for Health and Health Care in

Schools

Public Health Resources for an Influenza

PandemicPublic Health Departments

Help educate about diseases, diagnosis and treatment

EpidemiologistsDisease surveillance (study disease, find source and characteristics) and track new cases

ScientistsIdentify agents and provide technical information

Stay informed! Visit these websites for more information about Avian Flu. Centers for Disease Control (CDC): http://www.cdc.gov/flu/avian/

World Health Organization: http://www.who.int/csr/disease/avian_influenza/en/

CDC Notice to Travelers: http://www.cdc.gov/travel/other/avian_influenza_se_asia_2005.htm

Thank you !

Questions?