What Is avian influenza?

Should I be worried about avian influenza?

No—and it is important to keep this in perspective. However, you should be aware of the wider consequences if a pandemic strain arises or if you are traveling to areas of the world that have had avian influenza outbreaks. The current strain of avian flu (H5N1) affects birds and does not easily transfer to humans. There have been no reported cases of H5N1 influenza in humans in the UK.

How does avian influenza spread?

The current avian influenza (H5N1) is highly contagious among birds. Infected birds pass the influenza virus through their saliva, nasal secretions and droppings. The virus can live for several days in bird faeces. Susceptible birds (and possibly other animals such as cats and pigs) pick up the disease when they ingest or inhale contaminated secretions or excretions. Migratory waterfowl (e.g. wild ducks and swans) are able to carry the virus great distances and could be directly spreading the highly pathogenic H5N1 virus to domestic poultry flocks as they travel around the world.

The humans who contracted the disease most probably picked up the virus through close direct contact with infected birds. The first cases occurred following close contact with diseased birds on farms and in live poultry markets. All have coincided with outbreaks of highly pathogenic H5N1 in poultry. So far, there have been no confirmed cases of H5N1 spreading from person to person. Although, some instances have been reported, these have been rare, have not continued beyond one person, and the route of infection has not been confirmed.

Which countries have had infected birds?

Between late 2003 and early 2004, outbreaks of H5N1 occurred among poultry in eight countries in Asia (Cambodia, China, Indonesia, Japan, Laos, South Korea, Thailand and Vietnam). More than 100 million birds in the affected countries either died from the disease, or were killed in order to try to control the outbreak. By March 2004, the outbreak was thought to be under control. Since late June 2004, however, many countries in Asia, Europe, the Middle East and Africa have reported new outbreaks of influenza H5N1 among domestic poultry. Infections in wild birds and pigs have also occurred.

In the UK there have been two reports of individual birds with the H5N1 virus and so far one report of an outbreak in a commercial poultry flock. The first case was in October 2005, in an imported parrot in a quarantine unit in Essex. There was no evidence of disease spread. The second case was identified on 6 April 2006, when a dead swan was found in Fife, Scotland. However, increased surveillance has not revealed any other cases. On 3rd February 2007 the first mass outbreak in a commercial poultry flock was reported with the death of 2,600 turkeys on a farm at Holton, Suffolk. The Department for the Environment, Food and Rural Affairs (DEFRA) immediately initiated a programme to contain the outbreak which included the culling of the remaining 159,000 birds within the flock, imposing controls on the movement of birds within the immediate vicinity of the farm, and setting up a further three-kilometre protection zone and 10km surveillance zone around the centre of the outbreak. DEFRA continue to monitor the situation with the hope that the outbreak has been contained.

Click here for the World Organisation on Animal Health’s latest update on outbreaks in birds and other animals.

Which countries have had human cases of avian influenza (H5N1)?

As of 3 February 2007, 271 human cases of avian influenza have been confirmed in Azerbaijan, Cambodia, China, Djibouti, Egypt, Indonesia, Iraq, Thailand, Turkey and Vietnam. Of these cases, 165 have been fatal. So far, no human cases have occurred in the UK. Click here for the latest situation update.

What are the symptoms of avian influenza in humans?

When humans have acquired the H5N1 virus from birds, the reported symptoms have ranged from typical flu-like symptoms (e.g. fever, cough, shortness of breath, sore throat and muscle aches) and eye infections (conjunctivitis), to pneumonia, acute respiratory distress and other severe and life-threatening complications. Some patients have also had diarrhoea, vomiting, abdominal pain, chest pain and bleeding from the nose and gums in the early stages of infection.

Unlike seasonal influenza (normal flu), which usually only causes mild respiratory symptoms in most people, avian influenza infection can cause rapid deterioration (within 1 to 3 days) and high fatality. Pneumonia and multi-organ failure have been common among people who have become ill with avian influenza. Children and young adults seem to be most susceptible.

Again, it is important to stress that globally the incidence of avian influenza in humans is still low.

What precautions should I take if I am visiting an area affected by bird flu?

If you are visiting a country with a reported outbreak with H5N1 among its poultry, the Department of Health recommends that you should:

• not visit bird or poultry farms or markets
• avoid close contact with live or dead poultry
• not eat raw or poorly cooked poultry or poultry products (e.g. eggs)
• wash your hands frequently with soap and water
• not attempt to bring any live birds or poultry products back to the UK

If you are exposed to poultry in an affected country and develop any flu-like symptoms (e.g. fever, cough, shortness of breath, headache, sore throat, sore eyes, muscle aches), make sure you seek immediate medical attention.

Click here to check Government advice before you travel.

Are there any drugs available to treat it?

Antiviral drugs can be used to help reduce the symptoms and the length the illness. In the event of an outbreak of a pandemic flu, Government Medical advisors, working with GPs will provide recommendations to the public on the best form of treatment.

How can I help to protect my family?

Good personal and home hygiene is an important way of protecting ourselves from many different types of infection, including influenza. If pandemic flu arrives in the UK, it will be essential that we all adopt good hygiene practices. The Department of Health recommends the following precautions to reduce the risk of catching or spreading influenza during a pandemic:

• When coughing or sneezing, cover your mouth and nose with a tissue.
• Dispose of used tissues promptly and carefully. Put them in a bag and then bin them.
• Avoid non-essential travel and large crowds whenever possible.
• Wash your hands frequently in soap and water to reduce the risk of picking the virus up from surfaces and passing it on. It is important to educate family members about the importance of proper hand washing. Click here for further information about hand washing.
• Clean hard surfaces frequently. Cleaning surfaces with detergent and water will remove dirt and sufficient germs from an object provided you scrub all the surfaces and rinse them thoroughly with clean water. However, where this is not possible (e.g. for large or fixed surfaces such as kitchen worktops, toilet flushes and door handles) it is important to use a disinfectant to kill the germs. Cleaning and disinfecting surfaces that may be contaminated with flu secretions using products that destroy influenza viruses will give extra reassurance. Click here for more information.
• Ensure children follow this advice

Is it safe to eat cooked poultry and poultry products in areas experiencing outbreaks of avian influenza?

Yes. Thorough cooking kills avian influenza viruses, so provided you follow the normal precautions of cooking these items thoroughly and handling them hygienically during food preparation there is no risk of infection. Click here for more information about the safe preparation of poultry and poultry products and the risks of avian influenza.

So what is the real threat from avian influenza?

The real threat from avian influenza comes from the ability of influenza viruses to mutate. If the H5N1 virus acquired the ability to spread easily from person to person, because this virus would be new to humans, there would be little or no immunity to it in the human population and an influenza pandemic (a worldwide outbreak of disease) would be likely to occur. Click here for more information. It is important to remember that currently this has not occurred. Government health officials and health agencies around the world continue to remain vigilant in their fight against avian influenza. For an update on the current status of avian flu outbreaks and the latest Government advice, click here.