What You Need to Know About Avian Flu

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What You Need to Know About Avian Flu
Separating Fact from Fiction

• Muntu R. Davis, M.D., M.P.H.
• Deputy Health Officer
• Alameda County Public Health Department

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Commonly Used Terms
Term Law Enforcement Public Health
Case A body of evidence A person with the disease of interest
Suspect A person under suspicion A person who may be a case
Surveillance Watching individuals Tracking disease
Evidence Proof of a crime Information used to identify and/or to treat disease
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What is avian influenza?
(Also known as avian flu or bird flu)

• 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.

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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)

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Spreading due to bird migration patterns
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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.
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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
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What about eating chicken and eggs?

• To date, no studies have linked any human cases
  of avian flu to eating poultry products.

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What are the symptoms of bird flu in people?
Typical flu-like symptoms Fever
Typical flu-like symptoms Cough
Typical flu-like symptoms Sore throat
Typical flu-like symptoms Muscle aches
Eye infections Eye infections
Difficulty breathing due to pneumonia Difficulty breathing due to pneumonia
Other severe and life-threatening complications Other severe and life-threatening complications
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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.
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So, why all of the attention and fear?
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Reason 1 Overlap of bird migratory flyways with
outbreak areas
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Reason 2Influenza 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.

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Influenza Pandemic

• 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

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The 1918 influenza virus infected 30 of the
world's population and killed up to 40 million
individuals, particularly young people
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Reason 3Avian 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 strains
• New animals infected for first time
• Little or no immunity in humans
• Ducks have virus with no symptoms, but excrete
  virus, so sustainable reservoir
• Human cases concentrated in previously healthy
  children and young adults

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Reason 4 Viral gene re-assortment
Non-human virus
Non-human virus
Human virus
Re-assortant virus
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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.

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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.

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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.

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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.

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• 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
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Public Health Resources for an Influenza Pandemic

• Public Health Departments
• Help educate about diseases, diagnosis and
  treatment
• Epidemiologists
• Disease surveillance (study disease, find source
  and characteristics) and track new cases
• Scientists
• Identify agents and provide technical information

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• 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/avi
  an_influenza/en/
• CDC Notice to Travelers
  http//www.cdc.gov/travel/other/
  avian_influenza_se_asia_2005.htm

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Thank you !
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Questions?