Avian Influenza (Bird Flu)

Overview

What is bird flu?

Bird flu is an infection caused by a certain kind of avian influenza virus. Although there are many kinds of bird flu, the kind that now concerns health workers is the H5N1 bird flu virus. This virus is found in wild birds. Most of the time, wild birds don't get sick from the virus. But wild birds can easily pass the virus to birds that are being raised for food, such as chickens, ducks, and turkeys. The virus can cause them to get very sick.

Usually bird flu virus is not passed from birds to people. But since 1997, some people have become sick with this serious, deadly kind of bird flu. Most of these infections have been in Asian countries among people who have had close contact with birds raised on farms. But experts believe that the virus may eventually spread to all parts of the world. So far, no cases of H5N1 bird flu in humans have been found in Canada or the United States.

What causes bird flu?

Bird flu is caused by a virus. After a wild bird infects a farm-raised bird, the virus can easily and quickly spread among hundreds or thousands of birds. Sick birds must then be killed to stop the virus from spreading.

People who come into contact with sick chickens, ducks, or turkeys are more likely to get the virus. Bird flu virus can be passed through bird droppings and saliva. It can also live on surfaces such as cages, tractors, and other farm equipment.

Most people don't need to worry about getting sick with bird flu virus. You cannot get bird flu from eating fully cooked chicken, turkey, or duck, because heat kills the virus.

Why are people so worried about bird flu?

In a few cases, experts think that bird flu was passed from one person to another person, not from a bird to a person. Because viruses can change quickly (mutate), experts worry that bird flu will one day be passed easily from person to person. This is a scary possibility, because the H5N1 bird flu virus can make people sicker than other kinds of flu viruses. Even though only a few hundred people are known to have been sick with bird flu, more than half of them have died.

Experts also worry because the H5N1 bird flu virus is so different from other flu viruses that our bodies do not have any immunity. Not having immunity means that our bodies have a hard time fighting the virus. It also means that anyone, including those who are otherwise very healthy, can get seriously ill if he or she gets this kind of bird flu.

What are the symptoms?

At first, the symptoms of bird flu can be the same as common flu symptoms, such as:

• A fever.
• A cough.
• A sore throat.
• Muscle aches.

Bird flu may also cause an eye infection (conjunctivitis).

But bird flu can quickly progress to pneumonia and acute respiratory distress syndrome, a serious lung problem that can be deadly. For the people who die from bird flu, the average length of time from the start of symptoms until death is 9 to 10 days.¹

Call your doctor right away if you have traveled somewhere or live in an area where there is bird flu and you have a fever and a hard time breathing.

How is bird flu diagnosed and treated?

If your doctor thinks that you may have bird flu, he or she will do a physical exam and ask you questions about your symptoms and past health. Your doctor will also ask where you live, where you have traveled recently, and if you have been near any birds. Then your doctor may order blood tests, nasal swabs, or other tests, such as X-rays, to help find out what is making you sick.

Some questions your doctor might ask are:

• Have you been within 3 ft (1 m) of live, sick, or dead poultry, or with wild birds?
• Have you eaten raw or poorly cooked poultry or eggs?
• Have you had close contact (touching or speaking distance) with someone from an area affected with H5N1 bird flu virus who has a severe respiratory illness or who later died from an unknown cause?
• Are you a lab or poultry worker who might have been exposed to H5N1 bird flu virus?

How bird flu is treated depends on what the virus is doing to your body. In some cases, antiviral medicines may help you feel better. But experts are concerned that certain antiviral medicines may not work against bird flu. Viruses become resistant when they change over time, and then the medicines that worked in the past no longer work well.

If you have bird flu, you will stay in a private hospital room (isolation room) to reduce the chances of spreading the virus to others. When your doctors and nurses are caring for you, they will wear gloves and gowns. Some people who have bird flu may need a machine called a ventilator to help them breathe better. Other people may need a machine to help the kidneys work better (dialysis). More than half of the time, bird flu leads to death.

How can bird flu be prevented?

The World Health Organization and the U.S. Centers for Disease Control and Prevention are preparing for the possibility that bird flu could spread to people all over the world in what is called a pandemic. In 2007, the U.S. Food and Drug Administration (FDA) approved the first vaccine for humans against bird flu. Immunization is not currently recommended for the public. The vaccine will be kept in the U.S. government stockpile.² Officials are also storing up large supplies of antiviral medicines. The U.S. government has also developed a flu plan. This is a plan to prepare for a pandemic and to make sure that as few people as possible get the virus.

International health organizations now require that all infected birds be killed. Some countries have programs to clean up poultry farms and to check that all birds are healthy before they are sold. In 2004, the United States stopped buying poultry from most Asian countries.

Even though there is a lot of talk about bird flu, most people in the United States don't have to worry about getting it. As of February 2007, no cases of bird flu in humans had been found in the U.S. But you can take steps to lower your chances of getting infected.

• If you live in an area with bird flu, or if you are traveling to a country where there is bird flu:
  • Avoid poultry farms, poultry-processing factories or plants, and close contact with chickens, turkeys, or ducks.
  • Stay away from open-air markets where live birds are sold.
• If you are traveling to a country where there is bird flu, you can also do the following:
  • Ask your doctor about getting a regular flu shot. It is best to do this at least 2 weeks before you leave. This will not prevent bird flu, but it may help you avoid getting the regular flu.
• Keep your hands clean by washing them often with soap and warm water or using a hand gel that kills germs. If you use a hand gel, be sure to buy only gels made with alcohol. They do the best job of cleaning your hands.
• Do not eat raw or poorly cooked eggs or poultry. But you can safely eat fully cooked eggs and fully cooked chicken, duck, and turkey, because heat kills the virus.

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Author:	Maria G. Essig, MS, ELS	Last Updated: July 31, 2008
Medical Review:	E. Gregory Thompson, MD - Internal Medicine Christine Hahn, MD - Epidemiology
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