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Avian Flu

Quick Overview

What is avian flu?

Avian flu is an infection caused by bird flu viruses, which occur naturally among birds. Wild birds worldwide carry the viruses in their intestines, but usually do not get sick from them. However, avian flu is very contagious among birds and can prove lethal for domesticated birds, including chickens, ducks, and turkeys.

Certain subtypes of avian flu can spread easily to humans. For instance, the H5N1 virus is an influenza A virus subtype that occurs mainly in birds and is neither highly contagious nor highly lethal. Infections from this virus have occurred in humans, although they remain rare. Most cases resulted from people having direct or close contact with H5N1-infected poultry or H5N1-contaminated surfaces.

According to the World Health Organization, since 2003, 467 cases of H5N1 virus have occurred in the world, and among them, 282 were fatal. In 2009, human cases of H5N1 have been reported in Cambodia (1 case, no death), China (7 cases, 4 deaths), Egypt (39 cases, no death), Indonesia (20 cases, 19 deaths), and Vietnam (5 cases, all lethal).

An effective vaccine against the H5N1 virus is not available yet. Vaccines are produced each year for seasonal influenza but do not protect against pandemic influenza.

Immunity

Immunity mechanisms remain widely unknown for the time being. As of today, there is no known acquired immunity against the human form of avian flu.

Risks for Travellers

Vectors

For human influenza A (H5N1) infections, there is evidence of bird-to-human and possibly environment-to-human transmission; however, as of today, there is no proof of human-to-human transmission.

High-risk population

People in close contact with infected domestic poultry are particularly at risk. Travellers are at risk if visiting poultry or wild bird markets, eating uncooked or undercooked poultry products (eggs and meat).

What are the consequences of avian flu?

Incubation period

The first symptoms usually occur within two to eight days after exposure.

Main symptoms of avian flu

Most patients have symptoms of high fever, typically a temperature of more than 38°C, and flu-like symptoms including fever, chills, headaches, nausea... Patients may experience cough, shortness of breath and fluid in the lungs.

Prevention and Treatment

Prevention

Certain behavioral measures can be taken to prevent avian flu. Travellers should avoid any contact with poultry and should not eat uncooked or undercooked bird product (eggs and meat). It is also recommended to avoid all contact with surfaces that seem to be contaminated with feces or fluids from poultry or other animals. In all cases, travellers should always wash their hands prior to eating, after using the bathrooms or changing diapers, and after direct contact with babies, animals or any feces.

Treatment

Vaccines effective against H5N1 human virus are not yet available. Vaccines are produced each year for seasonal influenza but will not protect against pandemic influenza.

One drug, the oseltamivir (commercial name: Tamiflu), which belongs to the neuraminidase inhibitors class, can reduce the severity and duration of illness caused by seasonal influenza. The efficacy of the neuraminidase inhibitors depends on early administration (within 48 hours afer symptom onset), among other factrs. For cases of human infection with H5N1, Tamiflu may improve chances of survival, if administered early, but clinical data remain limited.

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