FREQUENTLY ASKED QUESTIONS ABOUT BIRD FLU

1. What is Bird Flu?

Bird flu or avian influenza is an infectious disease of birds ranging from mild to severe form of
illness. All birds are thought to be susceptible to bird flu, though some species are more resistant
to infection than others. Some forms of bird flu can cause illness to humans.

2. What causes bird flu?

Bird flu is caused by different subtypes of influenza A virus affecting chickens, ducks and other
birds Viruses which cause mild disease can mutate into viruses that can cause serious disease
(highly pathogenic).
To date, all outbreaks of the highly pathogenic form have been caused by Influenza A /H5N1
virus, the only subtype that cause severe disease in humans.

3. How is bird flu transmitted in chickens and other birds?

? Direct contact with discharges from infected birds, especially feces and respiratory
secretions

? Contaminated feed, water, cages equipment, vehicles and clothing

? Clinically normal waterfowl and sea birds my introduce the virus into flocks

? Eggs from infected hens can break and contaminate incubators

Birds that survive infection excrete virus for at least 10 days, orally and in feces. Highly
pathogenic viruses can survive for long periods in tissue, water and the environment, especially
when temperatures are low.

4. How do outbreaks of bird flu spread within the country?

1. Domestic birds can get the infection when they:

? roam freely

? share water supply with wild birds

? use a water supply that might be contaminated by infected droppings

2. Contaminated equipment, vehicles, feeds, cages, or clothing, especially shoes can carry
the virus from farm to farm

3. Wet markets where live chickens and other birds are sold under crowded and sometimes
unsanitary conditions

5. How is bird flu transmitted to humans?

Bird flu is transmitted to humans from direct or indirect contact with infected wild ducks and
chickens through infected aerosols, discharges and surfaces.

A person handling or taking care infected chickens or came near or inside a poultry or market
where there are sick chickens can inhale the particles from dried discharges or feces with the bird flu virus.

Discharges can get in contact with the nose or eyes of a person handling infected chickens.

There is no reported case of bird flu in humans after handling dressed chicken. Since the virus
is easily inactivated by heat, one does not get bird flu from thoroughly cooked chicken meat.
There is no evidence of human-to- human transmission.

6. Why are we concerned with bird flu?

There are a number of reasons why we are concerned with bird flu:

? Bird flu or Avian influenza (AI) causes serious illness and death in humans

? Avian and human influenza viruses can recombine to form a totally new influenza A virus
which is capable of spreading from person to person and from which the human
population do not have protection

? AI causes severe epidemics and mass death of chickens affecting the poultry industry.

7. What are the signs and symptoms of bird flu in chickens?

Infection causes a wide spectrum of symptoms in birds, ranging from mild illness to a highly
contagious and rapidly fatal disease resulting in severe epidemics.

? Decrease in activity
? Drastic decline in egg production
? Facial swelling with swollen and bluish-violet colored combs and wattles
? Hemorrhages on internal membrane surfaces
? Virus isolation needed for definitive diagnosis
? Gasping for breath
? Muscle
? Weakness/paralysis
? Diarrhea
? Sudden deaths (mortality that can reach 100%)

8. What are the signs and symptoms of bird flu in humans?

Bird flu is very similar to other influenza viruses. Initial symptoms are :

? Fever
? Muscle weakness and/or pain
? Sore throat and cough
? Sore eyes (conjunctivitis) is seen in some patients
? Causes of death and complications are:
? Severe viral pneumonia
? Respiratory distress syndrome
? Multi- organ failure

9. Since there are so many cases of influenza, pneumonia or any other respiratory illness, when does one suspect that the patient is a case of bird flu?

One suspects that a patient with influenza or pneumonia or any other respiratory illness is a
case of bird flu avian influenza if the patient has had direct or indirect contact through handling or having taken care or getting near sick chickens or other birds.

A laboratory confirmation of the bird flu infection and epidemiologic link with unusual death or
epidemics of chickens will support the diagnosis of bird flu.

10. What is the treatment of bird flu?

Treatment for H5N1 infection is essentially the same as for other influenza viruses. Antiviral
drugs, some of which can be used for both treatment and prevention, are clinically effective
against influenza A virus strains in otherwise healthy adults and children, but have some
limitations. Some of these drugs are also expensive and supplies are limited.

11. Is there a vaccine against bird flu?

No. The vaccine currently available against the circulating strains in humans will not protect
from the disease caused by H5N1. However, it is recommended for individuals who are
potentially exposed to bird flu like poultry handlers, workers and breeders to prevent
recombination of avian with the human influenza virus.

12. How do we prevent bird flu?

The ban on importation of live chickens and other poultry products from countries affected with
bird flu is a critical step to prevent the entry of bird flu into the country.

For poultry caretakers and handlers of chickens and other birds:

? Avoid contact of poultry with wild birds, in particular waterfowl
? Control human traffic into poultry farms
? Practice proper hand washing and cleaning and disinfection procedures in poultries
? Report to authorities any unusual death or illness of chickens and other birds
? Report to authorities any illness among the workers in poultry farms

For the general public:

? Thoroughly wash hands with soap and water before and after handling chicken meat
? Clean kitchen surfaces and utensils before and after use
? Cook chicken well by seeing to it that the boiling temperature is reached
? Do not sell live chickens in the market while there is a threat of bird flu.
? Do not let chickens roam freely. Keep them in cages or pens.
? Do not place chickens, ducks and pigs together in one area, cage or pen.
? Do not catch, get near or keep in captivity wild birds.
? Report to authorities any unusual death or illness of chickens and other birds
? Report to authorities any case of respiratory illness with history of exposure to sick or
dead chickens and other birds

13. What should Local Government Officials do?

? Monitor and apprehend smuggling activities and illegal trading of poultry like game fowl,
breeders and wild birds coming from countries affected by bird flu.

? Pass and enforce local ordinances on the ff:

o prohibition of live chickens in the market while there is a threat of bird flu
o not allowing chickens to roam freely
o prohibition of placing chickens, ducks and pigs together in one area,
cages or pens

? Provide correct information to the community.

? Advise public not to catch, get near or keep in captivity wild birds

? Coordinate with the local agricultural office for any unusual death or sickness of chicken
and other fowl.

? Coordinate with the nearest health worker for any suspected case of bird flu.

14. How is infection with H5N1 virus in humans treated?

Two antiviral medications commonly used for treatment of patients with avian influenza Antiviral medications, oseltamivir (Tamiflu)and zanamavir, would probably work to treat influenza caused by H5N1 virus, but additional studies are needed to demonstrate their current and ongoing effectiveness.

15. Is there a vaccine to protect humans from H5N1 virus?

There currently is no commercially available vaccine to protect humans against the H5N1 virus
that is being detected in Asia and Europe. However, vaccine development efforts are taking
place. Research studies to test a vaccine that will protect humans against H5N1 virus began in
April 2005, and a series of clinical trials is under way.

16. HOW CAN I TELL WHETHER I HAVE REGULAR FLU OR BIRD FLU?

Your chance of contracting the H5N1 virus is currently almost nonexistent unless you've been
near sick birds or have eaten undercooked poultry in regions afflicted by the virus. That said,
here's how avian flu differs from seasonal flu: While both generally cause high fever and
coughing, bird flu does not usually produce the runny nose, inflamed sinuses, or upper-
respiratory congestion typical of seasonal flu. Instead, the sickness often advances rapidly to
pneumonia, which is the most common cause of death.

17. DO FLU DRUGS OR ANY MEDICATIONS WORK AGAINST BIRD FLU?

Animal studies suggest that two prescription drugs—oseltamivir (Tamiflu) pills and zanamivir
(Relenza), an inhaled medication—may reduce the severity of the illness. Limited experience in
humans suggests that starting treatment early may boost the chance of survival. However, higher
doses and longer treatment may be required for bird flu than for ordinary flu. And in at least two
patients, the H5N1 virus has developed resistance to oseltamivir. Currently, the H5N1 virus is
clearly resistant to an older class of flu drugs, including rimantadine (Flumadine) and amantadine
(Symmetrel).

18. SHOULD I STOCK UP ON THE NEWER ANTI-VIRAL DRUGS?

That's a bad idea. You should use oseltamivir and zanamivir only if your doctor confirms the
diagnosis. With a private supply available at home, you or your family members could be tempted
to take the medicine when it's not needed, for instance, when you just have a bad cold. That
needlessly exposes you to possible side effects and, on a broader scale, it may increase
resistance to the drug. Moreover, private hoarding could worsen current worldwide shortages and
hamper efforts to make emergency supplies available to people who need them the most.

19. WOULD ANY SUPPLEMENTS HELP?

Beware of sales pitches for formulas and supplements claiming to protect you from bird flu.

20. CAN MASKS OR ANYTHING ELSE HELP PROTECT ME?

A disposable mask which is rated N-95 or higher and that fits tightly over your nose and mouth
can prevent inhalation of virus-bearing droplets from a cough or sneeze. In a pandemic, it would
make sense to wear one in trains, buses, and other crowded places. Simple hand washing
provides significant protection against flu viruses of all kinds. Using soap and warm, running
water, rub your hands together vigorously for 15 to 20 seconds before eating or preparing meals
and after using the bathroom or blowing your nose.

21. WHAT DO I NEED TO KNOW ABOUT A POSSIBLE QUARANTINE?

Most likely recommended is voluntary home quarantines, with exposed individuals checking
themselves for fever and reporting early symptoms to public-health authorities. If you're exposed
to a sick person, your quarantine time would depend on the incubation period of the particular
influenza: about four to seven days for seasonal flu, up to eight days or maybe longer for bird flu.

22. IS IT SAFE TO TRAVEL ?

There's no reason not to, provided you take certain precautions. Travelers to areas with known
outbreaks of H5N1 should avoid contact with chickens, ducks, and geese, live food markets, and
other places likely to be contaminated with poultry or other animal excrement. And make sure
your food is well cooked: Poultry should be heated until the interior is no longer pink, and eggs
until the yolk is firm.

23. Is it safe to travel to countries affected with bird flu?

Bird flu is not transmitted from one person to another. Individuals at risk are those are directly
or indirectly exposed to sick chickens and other fowl. Advice for travelers to countries affected
with bird flu is not to go to bird parks (aviaries), poultry farms or market where live poultry is sold.

Take care


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