# Presentation: 834098

## Avian Influenza

- Bird Flu
- H5N1

## Avian Influenza...

- ...is a respiratory illness in birds.
- Wild birds and ducks are the natural reservoir for infection, though they are generally unaffected by the virus.
- Usually does not affect humans; however, in 1997, there were documented cases of humans infected with avian influenza viruses.

## The H5N1 Virus Is...

- ...a particularly virulent strain of the avian flu virus that can cause severe illness in birds
- One of the strains “jumping the species barrier” and being transmitted from sick birds to people.
*	**According to the Centers for Disease Control (CDC), all influenza viruses have the ability to change and H5N1 could one day be able to spread easily from one person to another.*

## Avian Influenza H5N1

- Scientists believe most cases in humans resulted from contact with the infected saliva, blood or feces of infected poultry or contaminated surfaces.
- So far the spread of H5N1 flu virus from person to person has been rare.

## Requirements for a Pandemic

- A new virus emerges for which the population has no immunity.
- The new virus must be able to replicate in humans and cause disease.
- The new virus must be efficiently transmitted from human to human.
- We do not yet know if H5N1 will develop into a pandemic.

## Avian Flu Vaccine to combat H5N1

- Human trials conducted.  Needs further development.
- $100 million contract for production awarded mid-September 2005.
- Possibly available in 6-9 months.

## Situation in Hong Kong

- The HKG implemented a strict surveillance regime on all poultry farms operating within Hong Kong and conducts regular checks on live poultry imported into the territory as well as migratory birds passing through the Mai Po Nature Reserve.
- Hong Kong is conducting temperature screening of travelers at the airport and is considering instituting temperature screenings at all points of entry.

## The HKG currently has a stockpile of 3.7 million capsules of Tamiflu and will have 20.5 million capsules by 2007, enough to treat approximately 30% of Hong Kong's population.

- The Hospital Authority has 1400 isolation beds divided among 14 hospitals.

## Evacuation/Travel

-  Possible restrictions on commercial travel.
-  There are no plans to conduct mass evacuations of American Citizens.  Americans are urged to begin personal preparedness now to ensure the best possible conditions for themselves should transportation not be available.
-  Should the Department of State evacuate official USG personnel, Americans will receive that information and be able to plan accordingly.

## Early symptoms include: fever, cough, sore throat, muscle aches.
Later in the disease, respiratory complications (like pneumonia) can develop.
If you were in contact with contaminated birds 2-6 days before the onset of symptoms.
Laboratory tests.

- Early symptoms include: fever, cough, sore throat, muscle aches.
- Later in the disease, respiratory complications (like pneumonia) can develop.
- If you were in contact with contaminated birds 2-6 days before the onset of symptoms.
- Laboratory tests.

*How do you know if you have Avian Flu?*

## Preventive Measures

- Eat only well-cooked meat and eggs.
- Practice proper hygiene when preparing food.
- Wash hands frequently with soap and water (at least 15-20 seconds).
- Cover your nose and mouth when coughing.
- If you are sick, stay home; avoid other people who are obviously sick.
- Avoid live animal markets that sell birds, chickens, and ducks.
- Get the flu shot.

**Notes:**
One case of avian flu traced to drinking raw duck blood.

For more on why you should get a flu shot as a preventive measure (even though it won’t prevent avian flu), see slide #`15.

## Stay home.  Rest, drink plenty of fluids.
Avoid others, practice good hygiene (avoid coughing onto other people, wash hands, don’t share food and drink).
Notify your doctor, who can evaluate your symptoms.

- Stay home.  Rest, drink plenty of fluids.
- Avoid others, practice good hygiene (avoid coughing onto other people, wash hands, don’t share food and drink).
- Notify your doctor, who can evaluate your symptoms.

*What if I have flu symptoms?*

## Close monitoring by health professionals, symptomatic support.
Although still under study, Tamiflu (oseltamivir) is one of the drugs to be considered in the treatment of Avian Flu.

- Close monitoring by health professionals, symptomatic support.
- Although still under study, Tamiflu (oseltamivir) is one of the drugs to be considered in the treatment of Avian Flu.

*Treatment*

## Tamiflu® prophylaxis

- Local doctors in Hong Kong are only writing prescriptions for Tamiflu for treatment, no longer for personal stockpiling.
- Manufacturers are only filling orders for public hospitals.  Local pharmacies have no supplies.
- Be careful of fake, black market and Internet Tamiflu.

## Get the flu shot!

- Best time to get it is October to November, peak season is December to March.
- Availability in Hong Kong is currently limited.
- Vaccine is 70% - 90% effective.
- Some people should not get the vaccine – speak to your doctor.
- Does not prevent Avian Flu.

**Notes:**
Although the annual flu shot will not prevent Avian Flu, it is useful for three reasons:

Help prevent the non-avian flu, which still kills millions of people each year worldwide.
Lessens the likelihood of “mixing,” in which a person with the regular flu is exposed to H5N1, giving the H5N1 the opportunity to mix with a human influenza.  This could speed up the mutation of the H5N1 strain into a human-to-human transmitted form of the virus.
Assist in the diagnoses of H5N1 if physicians know a person exhibiting symptoms has received a regular flu shot.

## Flu Vaccine (Vaxigrip)

**Drs. Nicolson + Associates**, 200HKD, by appointment, tel 2525-1251.
**Central Medical Practice**, Dr. John Simon, 200HKD, by appointment, tel 2521-2567.
**Hong Kong Adventist Hospital**, 280HKD/shot, including GP Consultation, by appointment, tel 2574-6211.

## What you need to do now

- Supplies: Stock up on non-perishable food items and medicine to prepare for social distancing.
- Update your contact information.
- Get the flu shot when available.
- Ensure you are registered with the Consulate– www.hongkongacs.com

## Summary: Avian Flu Precautions

- Learn about the basics of Avian Flu.
- Be on high alert about flu-like symptoms and report your symptoms to your health care provider in a timely fashion.

## For further information

- http://www.cdc.gov/flu/avian
- http://www.who.int/csr/disease/
-    avian_influenza/en/
- http://www.pandemicflu.gov
- http://travel.state.gov/travel/tips/health/health_1181.html
- Centre for Health Protection (http://www.chp.gov.hk/)

**Notes:**
Please keep in contact with your Health Unit and RMO

## Questions?