The Asian Bird Flu
A Asian bird flu, also known as avian influenza could pose a bigger problem than SARS, the World Health Organization has warned.
If the avian flu virus develops the ability to spread through human contact, the outbreak could become a health crisis, said WHO regional co-ordinator Peter Cordingley. The virus poses "a bigger potential problem than SARS because we don't have any defences against the disease," he said in Manila. "If it latches on to a human influenza virus, then it could cause serious international damage."
Last year, severe acute respiratory syndrome killed 800 people around the world, including 44 in Toronto and 350 in China. It became an international crisis that resulted in travel advisories and economic chaos.
WHO officials say there has been no evidence the avian flu disease has spread from person to person. Human infections are blamed on contact with the feces of sick birds. Symptoms in humans include fever and coughing, eventually leading to pneumonia.
The avian flu has also infected millions of chickens in South Korea, Vietnam and Japan. Officials have ordered massive culls on poultry farms to try to stem the outbreak. Hong Kong and Cambodia have closed their borders to chickens from affected countries.
Avian Bird Flu: What you need to know
• Avian influenza is an infectious disease of birds caused by type A strains of the influenza virus. The disease, first identified in Italy more than 100 years ago, occurs worldwide.
• All birds are thought to be susceptible to the avian influenza, though some species, such as wild ducks, are more resistant than others. Domestic poultry, such as chickens or turkeys, are particularly susceptible.
• Infection triggers a wide spectrum of symptoms in birds, ranging from mild illness to a highly contagious and rapidly fatal disease resulting in severe epidemics.
• In severe cases, the flu is characterized by a sudden onset of severe illness, and rapid death, with a mortality that can approach 100 percent.
Have humans come down with bird flu?
• Avian influenza does not normally infect species other than birds and pigs. But humans came down with the bird flu in Hong Kong in 1997, when the H5N1 strain infecting 18 humans, 6 of whom died.
• Then, people became infected after coming into close contact with live infected poultry.
• Genetic studies showed the virus jumped directly from birds to humans, and caused severe illness with high mortality.
• Hong Kong's entire poultry population, estimated at around 1.5 million birds, was destroyed within three days.
• The World Health Organization has said the H5N1 bird flu virus is responsible for a number of deaths in Vietnam. They suspect people became ill after coming into contact with chicken feces.
Why is H5N1 of particular concern?
Of the 15 avian influenza virus subtypes, H5N1 is of particular concern because:
• It mutates rapidly and seems to acquire genes from viruses infecting other animal species.
• It can cause severe disease in humans.
• Birds that survive infection excrete virus for at least 10 days, orally and in feces, helping spread the virus at live poultry markets and by migratory birds.
• The more birds that come down with bird flu, the greater the opportunity for direct infection of humans.
• The more humans get infected, the greater the likelihood people can become infected with both human and bird flu strains.
• Humans could then serve as a "mixing vessel" for a new type of virus that could easily be transmitted from person to person. Such an event would mark the start of an influenza pandemic.
What are the symptoms, can it be tested and how do you treat it?
• When humans came down with H5N1 bird flu in Hong Kong in 1997, patients developed symptoms of fever, sore throat, cough and, in several of the fatal cases, severe respiratory distress secondary to viral pneumonia.
• Previously healthy adults and children, and some with chronic medical conditions, were affected.
• Tests for diagnosing all influenza strains of animals and humans are rapid and reliable.
• 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.
• At least four months would be needed to produce a new vaccine, in significant quantities, capable of conferring protection against a new virus subtype.
-- Compiled from a World Health Organization fact sheet.
What Happened Last Time
Here's why the experts worry. The part of the flu bug that determines immunity is the H (for hemagglutinin) molecule on the outside of the virus. There are 15 different H molecules in birds. But people get only three kinds: H1, H2, and H3.
Type A flu is a wily bug. It likes to shift its genes around. That happened this year, when the H3 Panama flu morphed into the H3 Fujian flu. But that difference -- called a drift -- isn't as bad as when the flu bug "shifts." That happens when it picks up a new H gene from an animal flu virus.
Once upon a time, people didn't get much influenza type A. Then the bug learned to pick up genes that let it spread from human to human. It's happened three times:
- "Spanish flu" -- H1 -- broke out in 1918-1919. It killed 500,000 people in the U.S. and as many as 50 million people worldwide.
- "Asian flu" -- H2 -- broke out in 1957-1958. It killed 70,000 Americans.
- "Hong Kong flu" -- H3 -- broke out in 1968-1969. It caused 34,000 U.S. deaths. This strain is still around. This year's "Fujian flu" is an H3 variant.
The bird flu sweeping Asia is an H5 flu bug. It's tried to break out before. In 1997 it broke out in Hong Kong. Eighteen people got infected; six died. Authorities ordered the extermination of all the chickens in Hong Kong.
Last year, an H7 bird flu infected chicken handlers in the Netherlands. One veterinarian died. Authorities called for the slaughter of infected birds. And health authorities gave human flu vaccines to all poultry handlers in an effort to prevent dual infection that might lead to a new human flu.
What's Happened This Year -- so Far
Likely carried by wild ducks and/or geese, an H5 bird flu swept through South Korea and turned up in Vietnam and Japan. Other nations deny a problem, although last December both Japan and Taiwan reported finding H5 flu in ducks illegally smuggled out of China.
Since last October, hospitals in the Hanoi region admitted 14 people with severe respiratory illness -- 13 children and one adult. Eleven have died, including the mother of one of the deceased children. She -- and two of the children -- died of an H5 bird flu.
There have been unconfirmed reports that the H5 virus has been detected in pigs. That would be a concern, because pigs -- unlike birds -- can also carry human flu viruses.
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