Dr. Chourjit Singh
Prof. of Pediatrics, Manipur

Avian influenza is an infection caused by avian (bird) influenzae (flu) viruses. Globally, the viruses are carried in the intestine of wild birds. It is very contagious among wild birds and can spread very fast to domestic birds like chicken, ducks, turkeys etc and kill them in thousands and millions in a very short period of time.

Through

1. Saliva.
2. Nasal secretions.
3. Surfaces that is contaminated with these secretions.
4. Direct contact with water fowl.
5. Other infected poultry contact like dirt or cages.
6. Other materials like water/feed.
7. Directly from birds or from avian virus contaminated environment to people.
8. Through an intermediate host such as pig

1. Low pathogenic may go undetected as associated with mild symptoms such as ruffled feathers and drop in egg production.
2. High pathogenic spreads very fastl and may affect multiple internal organs. Mortality rate may reach to 90-100% often within 48 hrs.

There are many subtypes of avian influenza viruses. Difference is due to certain proteins on the surface of virus i.e. hemagglutinin (HA) AND neuraminidase proteins There are 16 known HA subtypes and 9 known NA subtypes of A influenza viruses. Avian influenza virus refers to influenza A viruses found in birds. These viruses can infect human population through out the world, confirmed cases of avian influenza infection have reported since 1997, as a result of contact with infected poultry or infected birds .The spread of bird from ill person to another person is rarely reported . HINI, H1N2, H3N2, H5N1 are subtypes which human health risks during out break

Avian Influenza is not a disease which normally affects human? beings. Bird flu which struck in the Nandurbar, Maharashtra was a very serious contagious disease affecting millions of poultry and birds. This disease has the potential of rapidly spreading among the poultry. As per report on Feb 27^, 2006, 93 human deaths from 172 laboratories confirmed cases from countries like as Cambodia, China, Indonesia, Iraq, Thailand, Turkey and Vietnam have been reported.

This disease not only has serious economic consequences due to massive destruction of poultry but also has the potential to spread fast among human beings

Typical human influenza like symptoms:

1. fever.
2. cough.
3. sore throat.
4. muscle pain.
5. bodyache.
6. eye infection.
7. pneumonia.
8. severe respiratory distress
9. life threatening complications

The severity of the symptoms may depend on which type of virus.

Human being, especially children , who come in contact with live infected birds, their mucus, dropping , or even feathers risk being infected.

Typical human influenza like symptoms:

1. Amantadine if resistant, Oseltamavir.
2. Rimantadine if resistant, Zanamavir.

For H5N1 virus in humans.

Managed using, isolation precautions identical to those recommended for SARS.

No vaccine is available against H5N1 but on pipeline of clinical trial.

Indian Red Cross Society : Do's and Don'ts

DO'S - IN AFFECTED AREAS(AT INDIVIDUAL LEVEL)

1. Eat only cooked poultry meat and eggs. Heating at temperature of 70 degree centigrade or more for at least 20 rains inactivates the virus.
2. Wash your hands thoroughly with soap, after handling frozen or raw poultry and egg.
3. Wash and disinfect all surfaces and utensils that have been in contact with raw meat and eggs.
4. Separate raw meat from cooked, or ready-to-eat foods to avoid contamination.
5. Drink and use chlorinated water.
6. Use fresh and clean food material; wash fruits and vegetable thoroughly especially if they are to be eaten raw.
7. Frequently clean the mouth pieces of telephones, door knobs, utensils, keyboards and all such items which are touched. ^Cover your mouth and nose with handkerchief while sneezing or coughing.

DONT'S - IN AFFECTED AREAS

1. Do not eat ram poultry parts, including raw blood or raw eggs.
2. Do not use frozen meat as the virus is capable of surviving for long periods in freezing temperatures.
3. Do not handle raw or cooked food without washing your hands.
4. Do not visit crowed places, if possible.
5. Do not bring footwear or clothing into the house if you have passed through an animal market.
6. Do not rub your eyes, nose or mouth with unwashed hands after touching birds.
7. Do not bring live birds or objects such as cages or feed of animal or birds into the house.
8. Do not touch bird droppings with bare hands.
9. Do not stock Tamiflu; access it through the health system, if required.
10. Do not panic and self - medicate.
11. Do not resist culling of poultry by the authorities.
12. Do not allow sale of sick birds in the market.
13. Do not allow children to touch, carry or play with birds.

DO'S - AT COMMUNITY LEVEL

1. Report sick and dead birds in and around your area.
2. Report people who work in close contact with poultry and have developed flu-like symptoms to the health authorities.
3. Cover bird droppings with bleaching powder/solution or soapy water.
4. Use masks and gloves when handing sick/suspected cases/birds/animals or infected articles.
5. Isolate people suspected of being infected.
6. Ensure that dead/culled bird are safely disposed off.
7. Bury the used protective / preventive equipment deep.

WHEN TRAVELLING

1. WHO does not recommend any restrictions on travel to any area affected by the bird flu.
2. WHO advised travelers to avoid contact with high-risk environments in affected areas.
3. Who dose not recommend screening of travelers coming from bird flu areas.

FOR ALL AREAS

1. Remain alert and vigilant deaths in the bird population.
2. Report sick and birds in and around your area.
3. Set up a network of volunteers for surveillance of the bird population at the local level.

DON'TS

1. Do not use chicken droppings as fertilizers.
2. Do not touch or handle sick birds or those that have died unexpectedly.
3. Cover your mouth and. nose with handkerchief while sneezing or coughing.