Avian influenza (or bird flu) is a highly infectious disease. It affects many species of birds, including chickens, ducks, turkeys and geese. The disease can be passed between commercial, wild and pet birds, and can kill them.

Bird flu is caused by a flu virus that is closely related to human flu viruses. There are 16 types of bird flu, but the type that has caused concern in recent years is the deadly H5N1 strain. The H5N1 virus does not usually infect people, but infections with this virus have occurred in humans around the world.

Human cases

Since 2003, the World Health Organization (WHO) has confirmed over 400 cases of H5N1 in humans that led to over 250 deaths. All these people are thought to have contracted the virus following close or direct contact with infected birds. Millions of poultry have been killed in South East Asia and other countries during outbreaks, to prevent the disease from spreading among birds and to stop it being passed on to people.

Risks

The concern is that the H5N1 strain may undergo genetic changes that could enable it to spread easily from person to person. If these changes occur, there would be a greater risk to people. At the moment, the H5N1 virus does not infect humans easily, and if a person is infected, it is very difficult for the virus to spread to another person.

Symptoms of avian flu 

Symptoms of avian flu in humans are similar to those of other types of flu. They include:

• sudden fever (a temperature of 38°C/100.4°F or above),
• dry, chesty cough,
• headache,
• tiredness,
• chills,
• aching muscles,
• limb or joint pain,
• diarrhoea or stomach upset,
• sore throat,
• runny or blocked nose,
• sneezing,
• loss of appetite, and
• difficulty sleeping

These symptoms can come on suddenly. The time from infection to the start of symptoms (incubation period) is usually three to five days, although in some cases it can be up to seven days. Symptoms usually last for up to a week.

Complications

In rare cases, avian flu can cause rapid deterioration, pneumonia and multiple organ failure, which can be fatal.

Causes of avian flu 

People can catch bird flu by being close to live infected birds. This includes:

• touching or defeathering infected birds,
• being in contact with the saliva or fluids from infected birds,
• being in contact with (or inhaling) dried dust from the droppings of infected birds, or
• slaughtering, butchering or preparing infected poultry for cooking.

Another source of bird flu can be live markets, where birds are sold in crowded and sometimes unsanitary (unclean) conditions. Do not visit these markets if you are travelling in countries that have had an outbreak.

Avian flu is not transmitted through cooked food. In areas that have experienced outbreaks of bird flu, poultry and eggs can be safely eaten.

How it is spread

Bird droppings can contaminate dust, soil, water, feed, equipment, vehicles, clothing and shoes, which can lead to the spread of avian flu. The virus can also be carried on the feet and bodies of animals, which can cause the disease to spread.

Making a diagnosis

A diagnosis is made based on your symptoms and the likelihood that you have been exposed to an infected bird. The doctor will ask if you have recently travelled to an area affected by avian flu and if you have been close (within one metre) to live or dead domestic fowl or wild birds, including those at bird markets. You will also be asked if you have had close contact (touching or speaking distance) with anyone who has a severe respiratory illness, or if you have had contact with anyone who had an unexplained death and who was from an area that had an outbreak.

Tests

The following tests will be done to establish whether you have avian flu:

• chest X-ray,
• liver function tests,
• nose and throat swab,
• blood tests, and
• gram stain (a process that detects different bacteria).

If the laboratory tests and chest X-ray are normal, it is unlikely to be avian flu.

Treating avian flu 

Patients who have suspected symptoms of avian flu will be advised to stay at home or will be cared for in hospital (in isolation from other patients). The patient may be kept in isolation for seven to 10 days, depending on the type of flu.

The main types of treatment include:

• rest,
• drinking plenty of fluids combined with proper nutrition, and
• taking medications to help with fever and pain, such as aspirin (not suitable for children) and paracetamol.

Antiviral medication

Antiviral drugs work by stopping the virus from multiplying in your body.

Oseltamivir (Tamiflu) and zanamivir (Relenza) would probably be effective in treating influenza caused by the H5N1 (bird flu) virus, but more studies are needed to demonstrate their effectiveness.

Treating complications

Complications, such as bacterial pneumonia, may develop in some people and can be treated with antibiotics. Those who are severely affected may need to receive extra oxygen to help them breathe and/or be put on a ventilator (machine to help you breathe).

Preventing avian flu 

As the avian flu virus is carried by birds, there is no way to prevent it from spreading. However, monitoring how wild birds migrate should give early warnings of the arrival of infected flocks. This means that the birds could be targeted and collected on arrival to stop the virus spreading to other birds.

Current flu vaccinations do not protect against disease caused by the H5N1 strain. Various worldwide organisations are working together to produce a vaccine against avian flu. There are many ways that individuals can protect themselves and others from all types of respiratory disease. These are outlined below.

General precautions

1. Practise good hygiene, such as washing your hands regularly.
2. Turn away from other people and cover your mouth with tissues when you cough or sneeze.
3. Put the tissues in the bin straight away after use and wash your hands with soap and warm water.
4. Do not go to public places if you are ill and avoid contact with children or people with underlying illnesses.
5. When you go to a doctor surgery, tell the receptionist about your symptoms so you can be seated away from other people and given a surgical mask if necessary.
6. Stay in good general health and make sure you have had any recommended vaccinations, such as the pneumococcal vaccination and seasonal flu vaccine if you are in a high-risk group (for example, if you have asthma or are over 65).

Preparing meat

Avian flu is not transmitted through cooked food. It is safe to eat poultry and eggs in areas that have had outbreaks of bird flu. As a precaution, always follow good hygiene when preparing and cooking meat:

• Use different utensils for cooked and raw meat.
• Wash your hands thoroughly with soap and warm water before and after handling meat.
• Make sure meat is thoroughly cooked and piping hot before serving.

Contact with birds

You can feed wild birds and ducks, but it is important to wash your hands thoroughly afterwards. Do not go near sick or dead birds.

Contact the appropriate authorities if you find:

• one or more dead wild swans, ducks or geese (wild fowl), 
• three or more dead wild birds of the same species, or
• five or more dead birds of different species in the same place.

Keep away from bird droppings if possible and wash your hands thoroughly if you accidentally touch some.

Pets

In general, you do not need to change the way you look after your pets. If you have a dog that sometimes catches wild birds, try to avoid areas where this is likely to happen. In theory, H5N1 can be passed on to other animals, but it is very unlikely.

Travel

If you are travelling in a country that has had avian flu outbreaks, do not go to live animal markets or poultry farms. Do not go near bird droppings or dead birds, and do not bring any live birds or poultry products back with you, including feathers.

Related articles:

1. Flu: How swine flu is spread 
2. Flu: It is import­ant you know the facts 
3. H1N1 flu virus spread­ing accross Europe and Asia
4. Inflamed air­ways — Bron­chitis 
5. Res­pir­at­ory tract infec­tion — Bron­chi­olitis
6. Fungal infec­tions — Asper­gil­losis
7. Chest infec­tion in adults 
8. Cystic fibrosis
9. Asbestosis – Chronic lung dis­ease 

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