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Pandemic and Avian Flu

What is pandemic influenza?
Pandemic influenza is a global outbreak of disease from a new influenza A virus that is unlike past influenza viruses. Because people have not been infected with a similar virus in the past, most or all people will not have any natural immunity (protection) to a new pandemic virus.

How is a pandemic different from regular flu season?
Pandemic flu could be much more serious than flu seen in a typical flu season. Humans would have no or little natural resistance to a new strain of influenza virus. While, there is a vaccine for seasonal flu, which is prepared each season against new variations of the seasonal influenza virus, there is no vaccine available at this time for a pandemic flu. It is expected to take at least six months after a pandemic flu appears to develop a vaccine.

Why is pandemic influenza serious?
Most or all people would not have immunity to a new pandemic virus, large numbers of persons around the world could be infected. If the pandemic virus causes severe disease, many people may develop serious illnesses.

Once a pandemic virus develops, it can spread rapidly, causing outbreaks around the world. The U.S. Centers for Disease Control and Prevention (CDC) predicts that as much as 25% to 30% of the US population could be affected.

Can pandemic flu be prevented?
It is not possible to prevent or stop a pandemic once it begins. A person infected with influenza virus can be contagious for 24 hours before the onset of symptoms, and for seven days thereafter, making it extremely easy for the virus to spread rapidly to large numbers of people.

Although the federal government is stockpiling medical supplies and antiviral drugs, no country in the world has enough antiviral drugs to protect all their citizens. Anti-viral drugs can be used to treat severe cases as long as there was a reasonable chance that the drugs might help save lives. Antiviral drugs might also be prioritized for people who work in essential occupations, such as health care workers.

Other strategies for slowing the spread of a severe influenza outbreak could include temporarily closing schools, sports arenas, theaters, restaurants, taverns, and other public gathering places and facilities.

There currently is no vaccine to protect humans against a pandemic influenza virus. However, vaccine development efforts are under way to protect humans against a pandemic influenza virus that might develop from the current bird flu virus in Asia. (See information on bird flu below).

Calvert County Health Department is working with federal, state, and other local government agencies to respond to pandemic influenza and to maintain essential health care and community services if an outbreak should occur. In fact, governments all around the world are preparing for the possibility of a pandemic outbreak under the leadership of the World Health Organization.

When is pandemic influenza A expected?
There were 3 pandemics in the 20th century. The pandemic of 1918-19 was the most severe pandemic on record, in which 50 million or more persons around the world died, including approximately 650,000 Americans.

It is not possible to predict accurately when influenza pandemics will occur or how severe they will be. However, the current outbreak of avian influenza in Asia and Europe has influenza experts concerned that a pandemic is developing, and that it may be severe.

Why does the current bird flu outbreak in Southeast Asia pose a risk of causing a pandemic influenza A outbreak in humans?
New human influenza viruses arise from bird influenza viruses that then change to a form that can infect humans and spread readily from person to person. The current bird flu outbreak in Asia is caused by a type of influenza A virus called "H5N1." The H5N1 outbreak among domestic chickens and ducks in Asia is widespread and uncontrolled. Human infections and deaths due to the avian H5N1 virus have occurred, although the virus has at this time not developed the ability to pass easily from person to person and cause outbreaks in humans.

What are the symptoms of bird flu in humans?
The reported symptoms of bird flu in humans have ranged from typical influenza-like symptoms (e.g., fever, cough, sore throat, and muscle aches) to eye infections (conjunctivitis), pneumonia, acute respiratory distress, viral pneumonia, and other severe and life-threatening complications.

What can the public do to reduce their risk of pandemic influenza?
Stay informed. These web sites provide regularly updated information about bird flu and pandemic flu:

  • Centers for Disease Control and Prevention (CDC)
  • Get this free guide: Pandemic Influenza Planning: Guide for Individuals and Families. The guide includes checklists and information on how to prepare for a potential pandemic.
  • For information on the vaccine development process, visit the National Institutes of Health.

Stop germs from spreading.

  • Stay home when you are sick
  • Cover your mouth and nose with tissue when coughing and sneezing
  • Wash your hands often. The key is to wash thoroughly with warm water and soap, and to wash frequently.
  • When hand washing is not possible, use an alcohol based hand cleaner
  • Avoid touching your mouth, nose, and eyes
  • Have a good home and workplace disaster plan www.redcross.org/services/disaster
  • Visit Public Health's Stop Germs web site (King County, Washington web site)
  • If you plan to travel to Southeast Asia, check the CDC web site for travel advisories

How is pandemic influenza spread?
Pandemic influenza spreads from person to person primarily through "respiratory secretions," the same way seasonal influenza viruses and other common respiratory infections spread. Respiratory secretions are virus-containing droplets (such as saliva or mucous) that are spread when infected persons cough or sneeze. These droplets land on the surfaces of the mouth, nose, and throat of persons who are near (within 3 feet) the ill person. Virus may also be spread through contact with the infectious respiratory secretions on the hands of an infected person and other objects and surfaces, such as doorknobs.

Adults can spread influenza virus one day before symptoms appear and up to five days after the onset of illness.

Will the regular (seasonal) flu shot provide any protection against the pandemic influenza virus?
The regular flu shot will protect you against the influenza viruses circulating right now, but may provide very minimal, if any, protection against pandemic influenza virus.
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When a Pandemic is Present

What is the best way to protect myself from pandemic influenza?
Begin now to practice simple but important habits that reduce the spread of germs:

  • Stay home when you are sick
  • Avoid close contact with ill persons.
  • Cover your mouth and nose with tissue when coughing and sneezing
  • Wash your hands often. The key is to wash thoroughly with warm water and soap, and to wash frequently.
  • When hand washing is not possible, use an alcohol based hand cleaner
  • Avoid touching your mouth, nose, and eyes
  • Have a good home and workplace disaster plan
    www.redcross.org/services/disaster.
  • Visit Public Health's Stop Germs web site (King County, Washington web site).

If I feel "fluish," should I ask my doctor to perform a particular test to check for the bird flu virus?
Only if you have a recently returned from travel to an area where bird flu is present. Depending on your symptoms, dates of travel, and activities, additional testing might be recommended. Let you healthcare provider know about your travel history and if you had contact with poultry or bird markets.

Should I buy Tamiflu (oseltamivir) for my home?
Tamiflu is a prescription antiviral drug that works against influenza viruses. It is not known if it will be useful against a pandemic influenza virus. Tamiflu is not recommended for persons to keep at home in case of a pandemic.

Will there be enough Tamiflu for everyone if there is a global pandemic influenza outbreak, and if not, who will get it?
Although the federal government is stockpiling medical supplies and antiviral drugs such as Tamiflu, no country in the world has enough Tamiflu to protect all their citizens.

Public health officials have recommended using available supplies of Tamiflu first to treat persons with severe infections that require hospitalization, and to treat persons who will perform vital functions that the public will need in a pandemic. These groups include healthcare workers and emergency responders.
Because the drug needs to be taken every day for weeks in order to prevent influenza infections and the supply is limited, Tamiflu is not recommended for this purpose during a pandemic.

Tamiflu is currently manufactured by one company in Switzerland. Government agencies and the manufacturer of Tamiflu are attempting to find ways to is negotiating with generic drug companies to increase production of the medicine.

Should I wear a mask at work to protect myself from pandemic influenza?
Masks are recommended for use in health care settings by ill persons and healthcare workers to prevent spread of infection. At this time, masks are not recommended for use by well persons in the community. There is no guarantee that masks would prevent the spread of the infection in the population.

If persons decide to wear masks during a pandemic influenza outbreak, it is likely they will need to wear them any time they are in a public place and when they are around other household members.

More information on the use of masks from the Centers for Disease Control and Prevention (CDC).

Do I need to disinfect surfaces that have been in contact with a person with influenza?
Yes, wipe down any surfaces that may have been contaminated by saliva or other respiratory secretions.

Use a household disinfectant labeled for activity against bacteria and viruses, an EPA-registered hospital disinfectant, or mix and use� cup chlorine bleach with 1 gallon of cool water.

Influenza viruses are known to survive on non-porous surfaces such as steel and plastic, for up to 24 to 48 hours after inoculation and from cloth, paper, and tissues for up to 8 to 12 hours. Viable virus can be transferred from non-porous surfaces to hands for 24 hours and from tissues to hands for 15 minutes.
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Bird flu

Is it safe to eat chicken, poultry, and eggs?
Yes, eating properly cooked poultry, as well as eggs, is safe. The U.S. government has banned imported poultry from countries affected by bird flu. At the present time, bird flu is not present in the U.S.

For protection against many types of food borne diseases, such as Salmonella, all poultry should be cooked to 165 degrees F or hotter. Cooking also destroys flu viruses.

I live near people who keep chickens and other poultry? Am I safe?
This does not present a risk. At the present time, the H5N1 strain of bird flu that has spread through poultry farms in Southeast Asia and into Eastern Europe, but is not present in the U.S. Even if the H5N1 strain were to appear in the U.S., transmission from birds to people would require close contact with birds, such as handling, butchering, or exposure to bird droppings.

I have a bird feeder and a birdbath in my yard. Is this safe?
Maintaining a clean bird feeder or birdbath is generally safe, unless these are attracting rodents or raccoons. It is always best to wear protective gloves when handling or cleaning these items to avoid contact with bird droppings or contaminated water in a birdbath. Always wash your hands with soap and water after doing these chores.

Does owning a caged pet bird increase the possibility of catching or spreading avian flu?
The likelihood of getting a pet bird that is already infected with avian flu is very low. It is illegal in the U.S. to import pet birds from regions that are infected with bird flu. In addition, if you're concerned and already own a pet bird, keep it inside to avoid exposure to wild or migratory birds.

If you are buying a new bird, especially an exotic variety, be sure it has been legally imported. Smuggled birds from affected areas could possibly be infected with the bird flu virus. Information about federal embargoes on bird importation can be found at http://www.cdc.gov/flu/avian/outbreaks/embargo.htm.

Can bird flu virus spread to my pet dog and cat?
There is no evidence that bird flu is a risk to dogs. Recently, there have been reports of a canine influenza virus in the U.S. but this is a different flu virus that affects only dogs. There is evidence from the Asian outbreak that the bird flu virus might affect cats fed raw poultry, but there is currently no cause for concern because the virus is not present in the U.S.

What is being done to monitor for bird flu in wild birds?
Several agencies are conducting surveillance for bird flu among wild birds, especially migratory waterfowl. Surveillance is being strengthened in certain parts of the country such as Alaska because it is believed that migratory birds like ducks and geese could carry bird flu there from Asia and Russia. for information on Avian Influenza and hunting wild birds click here

A fact sheet about the ecology of bird flu (avian influenza) viruses in wild bird populations can be found at the National Wildlife Health Center's website at http://www.nwhc.usgs.gov/our_research/ecology_of_avian_species.jsp

What should I do if I find a dead bird?
You may dispose of dead birds found on your property by double bagging in plastic bags and discarding in your household garbage. Use gloves or a shovel to avoid touching the bird or any other dead animal with your bare hands.

Dead birds should be reported under unusual circumstances only, such as: a number of dead birds (referred to as "bird kills") are found at the same time or an unusual species is found dead, such as a bald eagle. Call USDA Wildlife Services at 1/877/463-6497.

I have a small flock of chickens in my backyard. Are there any special precautions I should take to keep them from getting bird flu?
You should practice good sanitation and preventive measures, such as reducing exposure to wild birds, to guard against a variety of diseases. Excellent information on "backyard biosecurity for the birds" is available at http://www.aphis.usda.gov/animal_health/birdbiosecurity/

It is important to look for and report signs of illness or the unexpected deaths of birds in your flock immediately. Call your private veterinarian, your local Maryland County Extension Agent, and the Maryland Department of Agriculture at http://www.mda.state.md.us./

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* Information adapted from Public Health Seattle and King County, Washington web site at www.metrokc.gov/health/pandemicflu with permission


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