Avian Flu Advisory

Avian flu is receiving worldwide attention as global spread of this viral infection of birds is detected. Avian flu is an Influenza A virus subtype (H5N1) that occurs mainly in birds, is highly contagious among birds, and can be deadly to them. Outbreaks of H5N1 among poultry are ongoing in a number of countries.

While H5N1 does not usually infect people, human cases of H5N1 infection associated with these outbreaks have been reported. Most of these cases have occurred from direct or close contact with infected poultry or contaminated surfaces; however, a few rare cases of human-to-human spread of H5N1 virus have occurred, though transmission has not continued beyond one person.

• Contact with sick or dead poultry as well as with poultry that have no apparent symptoms should be avoided.
• Contact with surfaces that may have been contaminated by poultry feces or secretions should also be avoided.
• Transmission of H5N1 viruses to two persons through consumption of uncooked duck blood may also have occurred in Vietnam in 2005. Therefore, uncooked poultry or poultry products, including blood, should not be consumed.
• Well-cooked chicken is safe to eat

We want you to know that we are monitoring this situation closely and are following medical advice for students safe participation in our programs. We advise students, parents, and advisors to check the CDC (www.cdc.org) and WHO (www.who.org) websites for the latest official information on advisories for international travelers. This message provides factual information on the concerns related to avian flu and UW IPE Study Abroad recommendations regarding health and safety during international travel.

(Adapted from http://www.cdc.org: Update: Guidelines and Recommendations Interim Guidance about Avian Influenza A (H5N1) for U.S. Citizens Living Abroad)

INFORMATION

Is there a vaccine against avian flu?

A vaccine to protect humans against influenza A (H5N1) is not yet available, but a candidate vaccine is undergoing human clinical trials in the United States.

What is the treatment for avian flu?

The H5N1 viruses currently infecting birds and some humans are resistant to amantadine and rimantadine, two antiviral medications commonly used to treat influenza. Most of the H5N1 viruses tested have been susceptible to the antiviral medications oseltamivir (Tamiflu) and zanamivir (Relenza), but resistance has been reported. The effectiveness of these drugs when used for treatment of H5N1 virus infection is unknown. For more information about influenza antiviral drugs, see http://www.cdc.gov/flu/professionals/treatment/.

The U.S. Department of State has decided to provide oseltamivir at its embassies and consulates for eligible U.S. government employees and their families serving abroad who become ill with avian influenza. For more information about this policy, see http://travel.state.gov/travel/tips/health/health_1181.html. Other Americans living in affected areas or planning long-term travel to these areas may wish to discuss antiviral medication with their health-care providers.

Where is avian flu a problem?

Animal Cases: Summary of Current Situation

Since December 2003, avian influenza A (H5N1) infections in poultry or wild birds have been reported in the following countries:

• Niger
• Nigeria

• Cambodia
• China
• Hong Kong (SARPRC)
• Indonesia
• Japan
• Laos
• Malaysia
• Mongolia
• Thailand
• Vietnam

• Austria
• Azerbaijan
• Bosnia & Herzegovina (H5)
• Bulgaria
• Croatia
• France
• Germany
• Greece
• Hungary
• Italy
• Romania
• Russia
• Slovak Republic
• Slovenia
• Switzerland (H5)
• Turkey
• Ukraine

• Egypt
• Iraq (H5)
• Iran

• India
• Kazakhstan

For additional information about these reports, visit the World Organization for Animal Health Web site.

Human Cases: Summary of Current Situation

Since January, 2004 WHO has reported human cases of avian influenza A (H5N1) in the following countries:

• Cambodia
• China
• Indonesia
• Thailand
• Vietnam

• Turkey

• Iraq (see preliminary report)

Updated February 8, 2006

What is the difference between avian flu and regular flu?

• Early in the illness, it is impossible to tell avian flu from a case of regular flu based on symptoms.
• Regular flu is a respiratory illness that affects the whole body. Fatigue, fever, headache, and dry cough may be accompanied by high chills, and severe body aches. Nausea, vomiting, and diarrhea are not usually symptoms of the flu, except in very young children.
• Avian influenza also starts with a fever and influenza-like symptoms such as a cough, sore throat, muscle aches, and headache, but becomes more severe. Severe pneumonia and acute respiratory distress may occur. Some people experience eye inflammation, seizures, or coma.

AVIAN FLU PRECAUTIONS

To reduce the risk of infection, students living in areas where outbreaks of H5N1 among poultry or human H5N1 cases have been reported should observe the following measures to help avoid illness.

Before Travel:

• Students are advised NOT to travel to/from an H5N1 (avian flu) area if they have a fever.
• Students should consult their physicians about obtaining an influenza vaccine prior to travel.
• Students should consult their physicians as to whether they should bring a supply of the antiviral medications such as oseltamivir (Tamiflu) or zanavir (Relenza) in case of an outbreak of avian influenza in humans.
• Students with chronic health conditions such as asthma, diabetes, heart disease, or on medications that suppress immunity should discuss this information with their medical provider during the pre-travel health screen, so that practical aspects of access to appropriate medical care and treatment abroad can be considered.

During Travel and during Study Abroad Period:

• Clean your hands often, using either soap and water (or waterless, alcohol-based hand gels when soap is not available and hands are not visibly soiled) to remove potentially infectious materials from your skin and help prevent disease transmission.
• Avoid all contact with poultry (e.g., chickens, ducks, geese, pigeons, turkeys, and quail) or any wild birds, and avoid settings where H5N1-infected poultry may be present, such as commercial or backyard poultry farms and live poultry markets.
• Cook all poultry and poultry products thoroughly before eating.Do not eat uncooked or undercooked poultry or poultry products, including dishes made with uncooked poultry blood.
• The CDC does not recommend the routine use of masks or other personal protective equipment while in public areas. However, these may be recommended by local public health authorities during an outbreak in an affected region.
• Take your temperature regularly (ideally daily). If there is an avian flu outbreak, temperatures should be taken several times a day.
• If you become sick with symptoms, inform your health care provider immediately of possible exposure and seek medical services. If advised by your health care provider, take antiviral medications.

NOTE: if you are traveling in an area of malaria risk, remember that a fever could mean that you have contracted malaria, even if you are regularly taking drugs for malaria prevention. That is why it is vital that you contact a health care provider before you start to take antiviral medications such as oseltamivir (Tamiflu) and zanamivir (Relenza).

After Travel:

If you believe you might have been exposed to avian influenza, take the following precautions:

• Monitor your health for 10 days.
• If you become ill with fever and develop a cough, sore throat, or difficulty breathing or if you develop any illness with fever during this 10-day period, consult a health-care provider. Before you visit a health-care setting, tell the provider the following: 1) your symptoms, 2) where you traveled, and 3) if you have had direct poultry contact with poultry. The U.S. embassy or consulate also can provide names and addresses of local physicians.
• Do not travel while ill, unless traveling locally for medical care. Limiting contact with others as much as possible can help prevent the spread of an infectious illness.

What to travel with:

• First aid kit and medical supplies
• Oral thermometer and probe covers
• Alcohol-based wipes/ hand sanitizer
• If recommended by your medical provider, antiviral medications against influenza/avian influenza
• Disposable gloves, masks, and plastic storage bags

With reasonable attention to health and safety recommendations, your study abroad experience should be a healthy one. Take good care of yourself!