Recently there has been much interest in avian influenza also called bird flu. There are concerns that an influenza pandemic is likely if the bird flu mutates into a form capable of spreading easily from person to person. There is no evidence of an influenza pandemic at this time. It is usual to have small outbreaks of influenza each year in several countries and these usually have the greatest impact on the very young, the elderly and the seriously ill individuals.

Dr. Brett Hodge

What is influenza pandemic?
An influenza pandemic is a global outbreak of disease that occurs when a new influenza virus appears in the human population and then spreads easily. Past influenza pandemics have occurred and have resulted in much illness, death and economic loss. A pandemic is different from the usual outbreaks of influenza illnesses that occur at various times of the year.

What is bird flu?
Bird flu is an infection caused by avian (bird) influenza (flu) viruses. Bird flu viruses do not usually infect humans but several cases of human infection with bird flu viruses have occurred since 1997. Bird flu viruses are complex with a number of subtypes and strains. The most virulent strain of bird flu virus is (A) H5N1 and this can develop life threatening complications. H5N1 strain has killed more than 60 people in South East Asia since 2003. There have been outbreaks of bird flu virus infections in Asia and Europe but so far there have been no cases in the Caribbean region.

How do humans get bird flu?
Migratory water fowl, and ducks in particular, carry the virus that causes bird flu. The host birds can spread the infection to susceptible species especially domesticated chickens, turkeys and geese. Infected birds shed the flu virus in their saliva, nasal secretions and faeces. H5N1 became the first known bird flu virus to jump directly from birds to people when it surfaced in Hong Kong in 1997.
The ease of worldwide travel has the potential to spread bird flu around the globe, although this has not yet happened.

What are the symptoms of bird flu?
The exact incubation period for the bird flu is not known but illness seems to develop within one to five days of exposure to the virus. The symptoms in humans are the usual flu-like symptoms and include the following:
• Fever
• Cough
• Sore throat
• Muscle pains
People with the most virulent type of bird flu virus - (A) H5N1 may develop pneumonia and acute respiratory distress syndrome and 50% of them die from their illness.
Treatment
A flu drug oseltamivir (Tamiflu) is available. This must be taken within 2 days of symptoms and only limits the infection. It does not prevent the viral infection. There is no vaccine available at this time against bird flu virus. Influenza A viruses change quickly and constantly hence the difficulty in making an effective vaccine.

Prevention
If you are traveling to South East Asia, or any region with bird flu outbreaks, you should consider the following:
• Avoid domesticated birds.
• Avoid open-air markets.
• Wash your hands. Tthis is simple and probably the best way to prevent infection.
• See your doctor as soon as possible if you develop flu-like symptoms.
Health planners and other public health officials must plan preparedness activities that will permit a prompt and effective public health response if there is bird flu outbreak, or bird flu pandemic, in Anguilla.

Conclusion
Most public health experts are very concerned that a human flu pandemic is very likely to occur. The H5N1 virus is a new virus that is very virulent in humans. If it mutates and spreads easily to humans, combined with the easy of global travel today, then a pandemic is very likely. Efforts continue internationally to destroy infected birds and other hosts of this virus in an effort to limit its spread. An effective vaccine is still not available for use against the H5N1 virus. High risk individuals such as the elderly, very young and sick should continue taking their usual vaccines so that they do not develop other viral infections.

Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. Dr. Brett Hodge is an obstetrician/gynaecologist and family doctor who has over twenty years in clinical practice. Dr. Hodge has a medical practice in the Johnson Building in The Valley.

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