Communicable Disease

FAQ's and Facts about bird flu

What's the difference between bird flu, seasonal flu and pandemic flu?

Bird or Avian Flu is a flu virus that is common in wild birds and is deadly to domestic flocks. It can also be transmitted by birds to humans. There is no human immunity and no vaccine available at this time

Seasonal flu is an annual illness caused by viruses to which humans have some immunity. Annual vaccines are made of three different viruses that are anticipated each year.

Pandemic flu is virulent human flu that causes global outbreak, or pandemic, or serious illness. Because there is little natural immunity, the disease can spread easily person to person. Currently, there is no pandemic flu.

I keep hearing bird flu and pandemic flu together so are they the same?
Seasonal, Avian and pandemic flu are not the same although each is related. Many “bird flu” viruses occur naturally in wild birds, especially waterfowl and shorebirds and in domestic poultry. The bird flu in the news is caused by the "H5N1" influenza virus and is different because it is more deadly than some other bird flu viruses. Infected birds can spread the virus through bodily fluids to other birds. It can also spread to other animals including pigs, cats and very rarely to humans. Many people who catch bird flu live or work closely with infected birds. This week ten cases of H5N1, the virus responsible for bird flu, was reported internationally as transferred to a human who became symptomatic and three died. It is a good idea for countries to prepare and protect: wash hands, cover coughs, treat early and “heal in place.”

A pandemic can strike at any time. Most health care leaders believe we are over due for a pandemic. They also believe the H5N1 has the potential to become easily transmitted person-to-person. Again they don't know when or even if this will happen.

How could the bird flu virus evolve so easily to become transmissible from person-to-person?
The most likely scenario is a host (human or animal) with the human flu virus catches the bird flu at the same time. So the two viruses mix their genes and form a hybrid virus that continues to spread. The chances of human contact increase with more infected birds and normal virus mutation.

Hasn't the bird flu killed people too?
Yes. There have been 310 confirmed cases by the World Health Organization (WHO) of those 189 have died as of June 6, 2007. Most cases in humans have resulted from contact with infected poultry (e.g. domestic chickens, ducks, and turkeys) or surfaces contaminated with secretions/bird excretions from infected birds. Human to human spread is limited and has not continued beyond very few, close contact groups. Health officials are concerned that the virus could mutate to become easily transmissible person-to-person.

The World Health categorizes risk for the US at Stage 0-1 and as follows internationally for week 49 of 2007

December 18th the Ministry of Health in Indonesia announced the death of a confirmed case of H5N1 infection.

· The Ministry of Health in Pakistan (Dec 15) has informed WHO of 8 suspected human cases of H5N1 avian influenza infection in the Peshawar area of the country. These cases were detected following a series of culling operations in response to outbreaks of H5N1 in poultry. One of the cases has now recovered and a further two suspected cases have since died. Samples taken from the suspected cases have tested positive for H5N1 in the national laboratory and are being forwarded to a WHO H5 Reference Laboratory for confirmation and further analysis. The MoH is taking steps to investigate and contain this event, including case isolation and contact tracing and monitoring, detailed epidemiological investigations, providing oseltamivir for case management and prophylaxis, reviewing hospital infection control measures and enhancing health care-based and community-based surveillance for acute respiratory infections. WHO is providing technical support to the MoH in epidemiological investigations, reviewing the surveillance, prevention and control measures that have been implemented and carrying out viral sequencing of avian and human isolates.

· The Ministry of Health in Myanmar (Dec. 14) has confirmed the country's first case of human infection with the H5N1 avian influenza virus. The case is a 7-year-old female from Kyaing Tone Township, Shan State (East). The case was detected through routine surveillance following an outbreak of H5N1 in poultry in the area in mid-November. She developed symptoms of fever and headache on 21 November 2007 and was hospitalized on 27 November. She has now recovered. Samples taken from the case tested positive for H5N1 at the National Health Laboratory in Yangon, and the National Institute of Health in Thailand. The diagnosis was further confirmed at the WHO Collaborating Centre for Reference and Research on Influenza, National Institute of Infectious Diseases in Tokyo, Japan. A team from the Ministry of Health, the Ministry of Livestock and Fisheries and the WHO Country Office are conducting investigations to confirm the source of her infection. Initial findings indicate poultry die off in the vicinity of the case's home in the week prior to the onset of illness. To date, all identified contacts of the case remain healthy and ongoing surveillance activities in the area have not detected any further cases.

The world is presently in phase 3: a new influenza virus subtype is causing disease in humans, but is not yet spreading efficiently and sustainably among humans.

How do I protect myself and my family?
Don't panic, be aware and prepare. First, if you read the above, you know, there's no reason to panic and every reason to be aware and to prepare.

Should I put off traveled countries were bird flu has struck?
Health authorities say travel is fine, but avoid contact with live animal markets and poultry farms. The World Health Organization will keep us updated, and you should check with your County Health Department before you go.

Will a flu shot protect me from the bird flu?
No. However, you should get your flu shots so you can stay as healthy as possible. Every year, seasonal flu kills 36,000 Americans. Even if you're healthy and likely to recover, seasonal flu can put you in bed for a week.

When will bird flu vaccine be available?
When or if the bird flu mutates to cause easy person to person transmission it will no longer be called bird flu but pandemic flu. There will be no pandemic flu vaccine ready for about 9 months after the pandemic starts. It takes about 6 months to develop the vaccines and then more to mass produce it.

Should I stockpile the flu drug Tamiflu?
No. You won't be able to tell if early symptoms are the flu or another virus. Using the drug unnecessarily wastes it and can prompt development of Tamiflu resistant strains. Private hoarding also hinders hospitals ability to get Tamiflu for patients, who really need it.

How is the government preparing for a pandemic?
The government has been stockpiling Tamiflu, other drugs and supplies, and some experimental H5N1 vaccine to buy time if a similar strain sparks a pandemic. Also they have been improving vaccine manufacturing so that one day, vaccine to match whatever super-flu emerges could be produced quickly. Finally, the government is actively encouraging communities to plan how food shipments, electricity, security and other needs would be taken care of during a pandemic's chaos.

How will I know when a pandemic begins?
The World Health Organization, with help from influenza specialists in the U.S. and elsewhere, is closely monitoring flu infections around the globe and will announce when a potential pandemic strain emerges.

During a pandemic, how will I know what kind of flu I have?
It will take a laboratory test.

How can I protect myself during a pandemic?
Stay healthy, get your flu shots, be physically active, and use good personal hygiene. Like in any flu season, common sense hygiene is key. Wash your hands a lot - chances are somebody just sneezed into his hand and then touched the same doorknob you did. Cover coughs and sneezes so you don't spread germs. Sneeze into a tissue or your sleeve; if you use your hands, wash them immediately.

During the SARS outbreak, I saw people and affected countries wearing paper masks. Should I stockpile masks?
There is no reason to stockpile the masks as there should be no shortage of masks. However, having a few surgical masks on hand for you in your family is reasonable. During a pandemic, the sick will be told to wear so-called surgical or procedure masks, as will doctors and others caring for them. You can pick up such masks at most pharmacies and hardware's.

If I suffer symptoms during a pandemic, what should I do?
Stay home from work or school. Know the difference between a cold and the flu. Learn now how to take care of yourself or a loved one who is sick. (Hospitals may be inaccessible due to the number of sick). Call your doctor for instructions unless it's an emergency, to avoid exposing others in the waiting room.

Will I be quarantined?
The stereotype of forced quarantine isn't likely. After all, flu can spread a day before symptoms appear. But the sick would be isolated - cared for in separate rooms - to limit spread. Travel restrictions on initially affected countries would be imposed, and people known to be exposed to infection might be asked to stay home for five days or so to watch for symptoms.

Is there anything I should be doing now?
Stay informed. Stay Healthy. Get your flu shot. Ask your doctor about a pneumonia shot. Use good respiratory etiquette. Start the process of preparing your home and family for the ability to stay home for extended periods of time of up to 6 weeks. Education is the best defense. Here are some facts about bird flu and how it differs from common human flu:

Is it safe to eat chicken and turkey?
Yes. Currently there are no reported poultry flocks in the U.S. infected with avian flu. Poultry is safe to eat, but you should always follow safe preparation and cooking procedures when handling any raw poultry. Cook your poultry thoroughly. Be sure to thoroughly wash your hands after handling any uncooked meat.

For more information: the Washington State Department of Fish and Wildlife monitors wild birds in our state, and the Department of Agriculture monitors U.S. birds in the farming and poultry industries.

Are my pets safe from avian flu?
There are some reports of cats and other animals getting H5N1 in areas where the wild birds have the bird flu. Currently you have no reason to be concerned in the United States. However, when a pandemic flu comes here are some suggestions from pandemicflu.gov.

• Report to the local veterinary authority any evidence of significant bird mortality both wild and domestic.
  
• Be especially vigilant for any dead or sick cats and report such findings to the local vet.
  
• Make sure contact between cats and wild birds or poultry (or their feces) is avoided and/or keep cats inside.
  
• If cats bring a sick or dead bird inside the house, put on plastic gloves and dispense of the bird in plastic bags for collection by local veterinary animal handlers.
  
• Keep stray cats outside the house and avoid contact with them.
  
• If cats show breathing problems or nasal discharge, a veterinarian should be consulted.
  
• Do not touch or handle any sick-looking or dead cat (or any animal) and report to the authorities.
  
• Wash hands with water and soap regularly especially after handling animals and cleaning their litter boxes or coming in contact with feces or saliva.
  
• Dogs can only be taken outside the premises if kept restraint.
  
• Disinfect (e.g. with bleach 2-3 %) cages or other hardware with which sick animals have been transported or been in contact with.
  
• Washing animal blankets with soap or any other commercial detergent.
  
  

Are birds with avian flu a health threat if they land in the lakes or rivers that supply my drinking water?
No. Even if avian flu were to be present in wild or migratory birds, the virus that causes the flu is easily killed by the disinfectants, such as chlorine and ozone, used to make drinking water safe. Most public water systems also use filtration processes capable of removing viruses from the water

LINKS
How to prepare yourself for disaster/bird flu http://www.metrokc.gov/health/pandemicflu
Washington State Department of Health www.doh.wa.gov/panflu/
Centers for Disease Control and Prevention (CDC) www.cdc.gov/flu/pandemic/
World Health Organization (WHO) www.who.int
New: Avian Flu Information http://skagit.wsu.edu/
Germ Trail at www.doh.wa.gov/panflu/video.htm#germ
Bird testing completed; http://wildlifedisease.nbii.gov/ai/
Washington State Department of Fish and Wildlife: http://www.Wdfw.wa.gov/factshts/avian_flu.htm

Skagit County Health Departments Basic Home Care (Pdf)