Showing posts with label Bird Flu. Show all posts
Showing posts with label Bird Flu. Show all posts

Tuesday 30 November 2021

Bird Flu Vaccines: What is Taking So Long?

This article explains how the bird flu vaccines is made. It also explains why the bird flu virus is taking a long time to develop.


With the current development of a vaccine for the H5N1 strain of the Bird Flu Virus still 2 to 3 years away. We don’t have much of a choice but to really be very cautious that the H5N1 strain does not mutate with a human flu virus.


If the outbreak we fear does happen without the vaccines ready yet, all we can possibly do is just quarantine the geographical area where the virus is rampant. Give them the vaccines that have been developed and prevent them from spreading it further. This will only work if the outbreak is limited geographically. When the outbreak does happen to 10,000 places, we’re in Big S*%T. 


The development of a vaccine is so slow because we still use methods dating back 50 years ago. Ironically this is because they still use chicken eggs to develop the vaccines. New methods are on the horizon, instead of using chicken eggs, they may be able to use mammal cells.


Scientist would be storing the mammal cells in large numbers. So that when a flu strain or threat develops, they can just inject it to the cells. The injected cells will then burst and die. The scientist will then harvest the proteins of the influenza and distribute them as vaccines already. 


Vaccines made from DNA are really appealing because they could be made and administered quickly. However this kind of vaccine is still being tested on humans. DNA vaccine works by attaching itself to a segment of our DNA. It contains the coded information of the flu virus’ protein. 


Now you would want to ask why we would vaccinate everyone instead of just treating them.  This is because giving vaccines is cheaper compared to treating everyone. With a vaccine the person only needs one or two doses in total. Compared to giving two doses a day for a period of time to treat the viral problem. It is also pretty stupid to wait for someone to suffer before treating the person. The person might not even live to see the day just to receive the medication. 


The current stand of some people however is that why waste precious money on a threat that may never materialize. The best answer here is it’s better to be prepared than be sorry. 


In the last 87 years we have had three pandemics. So it’s better to prepare for something that could be really catastrophic. The longer our world goes without a pandemic; there is more chance that it could occur in the upcoming years.


That’s why we should be very thankful for every company out there trying to create a vaccine for a pandemic that might hit us. Rather than be worried of money that might get wasted.

Bird Flu No Risk To Poultry Consumers

News about avian influenza--often called bird flu--is everywhere these days. But American consumers needn't worry. Experts at the American Meat Institute in Washington, D.C., say they can continue to enjoy their meals with confidence because U.S. poultry is among the healthiest and safest in the world. 


"Multi-Firewall" Strategy 


Protects U.S. Poultry 


Multiple U.S. "firewalls" are in place to prevent the high pathogenic H5N1 avian influenza virus now making news from crossing our borders--and to detect, contain and destroy it rapidly if it does occur here. They include: 


Import controls. Americans consume poultry from North America. Strict import restrictions prohibit imports of poultry from nations with the high pathogenic H5N1 virus. 


Surveillance. The U.S. government and industry have aggressive surveillance programs in place that aim to detect the virus if it does enter the U.S. This surveillance is currently on "high alert." 


Target and destroy. If the virus were to occur here, the U.S. Department of Agriculture would isolate and humanely destroy affected flocks. 


U.S. Production 


U.S. poultry is produced in secure farms where bio-security is the top priority. These controlled systems protect poultry from a host of viruses that can threaten their health. In some regions of the world, however, community-raised poultry can move through towns and streets freely and come into contact with each other and with people. As a result, the high pathogenic H5N1 virus has spread rapidly from bird to bird and in some extreme cases, to people who have come into close contact with live birds. 


Americans rarely come into contact with live poultry and those who work in poultry facilities receive special training. Together, U.S. firewalls and secure production systems have helped keep the U.S. free of the high pathogenic H5N1 avian influenza strain. 


No Food Safety Issue 


Leading animal health experts say that the chance of an infected bird entering the food supply is virtually zero. Poultry that do become infected are detected through surveillance or become noticeably sick and cannot survive transportation to a processing plant. All birds that do arrive at plants undergo health screening by federal veterinarians, making the chance of infected poultry entering the food system extremely low, according to the U.S. Department of Agriculture. 


Consumers should be reassured, however, that ordinary safe handling practices, like - hand-washing, separating raw and cooked foods, and cooking thoroughly as measured with a thermometer - destroy viruses like avian influenza in the same way they destroy bacteria. Experts say unequivocally that properly cooked and handled poultry products do not pose a risk of avian influenza.

Bird Flu Information and Update

Laboratory tests have confirmed that bird flu was the cause of death of a middle-aged Indonesian male in November 2005. The man was the 14th fatality of bird flu infections in Indonesia, and the ninth bird flu case confirmed by the World Health Organization after the case was sent by local health officials to Hong Kong for verification. 


The confirmation brings to 70 the number of people in Asia who have died in the last two years from the H5N1 strain, now considered the deadliest avian influenza virus subtype. Antiviral medications such as amantadine and rimantadine, which are usually given to treat influenza, do not work on the avian flu virus. Drugs are being developed and temporarily used on patients who appear to have succumbed to the avian flu disease. Although they appear to be responding to treatment and are showing improvements, further tests need to be done to ensure the effectivity of these new drugs.


With avian influenza, birds could transmit the disease to humans. Birds carry the bird flu virus in their intestines when they migrate for the winter. The virus, which does not affect the carriers, is deadly to those who come in contact with birds carrying the virus. When chickens, birds or geese come in contact with a bird carrying the virus through the bird’s saliva, nasal secretions or faeces, they can become infected, fall ill and die in 48 hours.


Humans infected with the avian flu have symptoms that include a fever, sore throat or muscle pain, which are similar to symptoms of human influenza. Thus, it is easy to mistakenly diagnose an actual avian flu as human influenza. However, humans infected with avian flu would have worse symptoms - eye infections and respiratory problems that could become life threatening.


It’s important to note that humans will not usually get avian flu unless they have been in close contact with infected poultry. Since the number of people that has been infected with the disease is still low and confined to a few children and adults, there is no serious cause of alarm yet. However, scientists and the health community are concerned that the disease, which usually affects poultry livestock, may evolve into something that will adversely affect humans.


Before the bird flu, there was a disease that came from bovines, commonly known as mad cow disease. This disease came about from the practice of feeding cattle with processed foods. Later on, the cows developed an infection in the brain. The infection caused cows’ brains to produce sponges, which made the animals go wild and die. Humans who ate meat from infected cattle fell sick and died. To rid of the mad cow disease problem, entire livestock were slaughtered, killed and burned. This prevented the outbreak from reaching other farms. Slaughtering infected cattle was done in many countries in the Asian region, including parts of Eastern Europe and Russia.


The bubonic plague killed millions of people in the 14th century. Transmitted by rats, the disease originated from China and spread on to Europe through merchants who came back from the long voyage from China. The same disease was also transmitted by fleas, which proved fatal when it was passed on to humans. The disease dragged on for years, killing millions more. The bubonic plague happened centuries ago, when medical science was not yet developed to cope with the epidemic and save lives of millions. 


However, with the advances in technology today, scientists will be able to study the avian flu disease further. By closely watching the migratory patterns of birds and understanding the disease, scientists may help prevent avian flu from becoming another global outbreak.

Bird Flu and You: How Will The Flu Affect You?

Flu is a common disease nowadays, with most people having developed the antibodies to fight against the disease. So the mention of "flu" doesn’t really create any alarm. However, say "bird flu" and there’s likely to be a pandemonium. 


Bird flu, or avian influenza, is a highly pathogenic virus of 15 types. The virus spreads to poultry through direct or close contact with nasal secretions, saliva and faeces of infected birds. What is alarming about this virus is that it has the ability to rapidly mutate into different forms that can affect human beings. Believed to be worse than the SARS outbreak, the bird flu outbreak brought millions of dead birds worldwide and at least 70 people dead in Asia.


From a not-so-harmful H5N2 virus strain, it can mutate into a killer virus with a low spread rate once the virus is transmitted to a bird. The virus has an incubation period of six to nine months before it becomes a full-blown, deadly pathogen. A bird that has been infected with the virus but has survived the disease continues to carry the virus in its body for more than week. When this happens, the bird passes on the disease to other birds that come in close contact with its secretions, saliva and faeces.


Bird flu and ordinary human flu have the almost the same symptoms. These symptoms are fever, muscle pains and cough. This is the reason that a person who is actually infected with bird flu may be mistakenly diagnosed as simply having ordinary flu. However, bird flu symptoms can escalate into several life-threatening conditions. Some of these life-threatening conditions are lung inflammation, eye infections and pneumonia. 


Because of the severity of symptoms of bird flu infection, the World Health Organization (WHO) is in the midst of a widespread effort to prevent the virus from infecting humans, particularly those whose who depend on poultry and livestock as their livelihood. 


Bird flu virus and its subtypes can easily mutate into other forms. For example, the virus that was transferred from one animal to another is the H5N2 strain. However, the virus mutated into the H5N1 strain, which has been responsible for the death of at least 50 people. It is a very surprising discovery how these viruses can mutate itself from pathogens that can harm humans as it had started with birds.


In Asia, the countries plagued by the avian flu are Vietnam, Japan, Cambodia, South Korea, China, Indonesia, Laos, Thailand, Kazakhstan, Malaysia, Mongolia, Russia, Thailand. In Europe, Turkey, Romania and Croatia are the hardest hit by the disease.


WHO has issued a warning to travellers to these countries to avoid going to live poultry markets, getting close contact to any farms and having direct exposure to feathers, faeces or droppings, eggs and poultry meat products. Travelers need to know that most contamination occurs during the slaughtering of poultry and being in direct contact with faecal matter.


No travel advisory has been issued restricting anyone from going to countries with the H5N2 strain. Travelers coming from afflicted countries are also not being screened. However, precautionary measures are in place, particularly in the media. Information is being disseminated in order to make people aware of the bird flu, its effects and what to do to avoid getting infected. 


To date, no vaccines have been developed or available to fight the illness. However, anti-viral medicines are being used as alternatives in helping alleviate the severity of symptoms on those infected. While M2 inhibitors would be helpful, the body tends to develop resistance to those, diminishing the efficiency and effectivity of inhibitors.


The bird flu problem is both a government and global issue. Governments are in charge of making reliable declarations, initiating studies and putting objective measures in place. There is no reason to panic if the virus has not reached your area yet. The best thing you can do is to take practical steps in taking of your body and helping it build resistance to any kind of illnesses.

Bird Flu and Tamiflu, Making Your Supply of Tamiflu Go Farther in an Emergency Situation

I have discussed Tamiflu (oseltamivir) and Relenza (zanamivir) previously - see Bird Flu: Tamiflu and Relenza for Prevention and Treatment in the Articles section on our Web site, This current article adds important information about making your supply of Tamiflu go farther in an emergency situation.


First, as I noted in my previous article, it is important to be aware of the fact that the effectiveness of Tamiflu and Relenza has been studied against circulating strains of human influenza (so called seasonal influenza), not against the bird flu virus. In a study reported in the August 2005 issue of the Journal of Infectious Diseases, Dr. Yen and others from St. Jude Children’s Research Hospital in Memphis, Tennessee found that in animal experiments eight-day regimens of Tamiflu were more effective than the suggested five-day regimen for treating infections with the H5N1 bird-flu virus. 


The authors concluded that a prolonged and higher-dose oseltamivir regimen may be required for the most beneficial antiviral effect.  This possibility was recently underscored when two Vietnamese (one a 13 year old girl) died of bird flu, as reported in a December 2005 issue of the New England Journal of Medicine, even after receiving treatment within the required 48 hours after the start of infection with standard doses of Tamiflu.


Let’s assume that you have one treatment course of Tamiflu (one 75 mg tablet taken twice a day for five days, for a total of 10 pills), that you either acquired on your own or that was given to you by your healthcare provider or by the government. Unfortunately you are still not home free yet, so to speak. You now may face one of two problems:


Problem 1: If preliminary scientific studies indicating that a course of treatment of bird flu using higher doses than those currently recommended by the FDA, for more than the current recommended five days of treatment are correct, as indicated by Dr. Yen’s research, you will need more that one dose pack.  In fact, the best treatment might mean taking two pills (150 mg) twice a day for eight or even ten days. That would mean that you should have FOUR dose packs (40 pills) for the treatment of one person, not just one!  


Problem 2: You have a dose pack, officially the amount need to treatment one person, but there are two people who just became infected with bird flu in your family.  If you combine this problem with problem number one, you now actually need EIGHT dose packs, not just two!


What can you do? There are two possible solutions:


Solution 1: Take PROBENECID, a medicine approved for the treatment of gout, along with the Tamiflu. Probenecid interferes with the normal metabolism of Tamiflu, increasing the blood level of Tamiflu and keeping it in circulation longer, effectively doubling the amount of Tamiflu “exposure.” The precise dose is unclear. Until more scientific information becomes available, in an emergency situation, for otherwise healthy adults, I would recommend taking one 500 mg tablet twice daily. Probenecid is generally very safe. Nevertheless, I have included detailed information about it below.


According to information about probenecid from the National Library of Medicine’s and the National Institutes of Health’s Web site Medline Plus (available at


Probenecid (proe-BEN-e-sid) is used in the treatment of chronic gout or gouty arthritis. These conditions are caused by too much uric acid in the blood. The medicine works by removing the extra uric acid from the body. Probenecid does not cure gout, but after you have been taking it for a few months it will help prevent gout attacks. This medicine will help prevent gout attacks only as long as you continue to take it. 


Probenecid is also used to prevent or treat other medical problems that may occur if too much uric acid is present in the body. 


Probenecid is sometimes used with certain kinds of antibiotics to make them more effective in the treatment of infections. 


Probenecid is available only with your doctor's prescription, in the following dosage form (tablets): 


a. Before Using This Medicine 


In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For probenecid, the following should be considered: 


  • Allergies, Tell your doctor if you have ever had any unusual or allergic reaction to probenecid. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.
  • Pregnancy, Probenecid has not been shown to cause birth defects or other problems in humans.
  • Breast-feeding, Probenecid has not been reported to cause problems in nursing babies.
  • Children, Probenecid has been tested in children 2 to 14 years of age for use together with antibiotics. It has not been shown to cause different side effects or problems than it does in adults. Studies on the effects of probenecid in patients with gout have been done only in adults. Gout is very rare in children.
  • Older adults, Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. There is no specific information comparing use of probenecid in the elderly with use in other age groups.


Other medicines, Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking probenecid, it is especially important that your health care professional know if you are taking any of the following: 


  • Antineoplastics (cancer medicine), The chance of serious side effects may be increased 
  • Aspirin or other salicylates, These medicines may keep probenecid from working properly for treating gout, depending on the amount of aspirin or other salicylate that you take and how often you take it 
  • Heparin, Probenecid may increase the effects of heparin, which increases the chance of side effects 
  • Indomethacin (e.g., Indocin) 
  • Ketoprofen (e.g., Orudis) 
  • Methotrexate (e.g., Mexate), Probenecid may increase the blood levels of these medicines, which increases the chance of side effects 
  • Medicine for infection, including tuberculosis or virus infection, Probenecid may increase the blood levels of many of these medicines. In some cases, this is a desired effect and probenecid may be used to help the other medicine work better. However, the chance of side effects is sometimes also increased 
  • Nitrofurantoin (e.g., Furadantin), Probenecid may keep nitrofurantoin from working properly 
  • Zidovudine (e.g., AZT, Retrovir), Probenecid increases the blood level of zidovudine and may allow lower doses of zidovudine to be used. However, the chance of side effects is also increased 


Other medical problems, The presence of other medical problems may affect the use of probenecid. Make sure you tell your doctor if you have any other medical problems, especially: 


  • Blood disease or 
  • Cancer being treated by antineoplastics (cancer medicine) or radiation (x-rays) or 
  • Kidney disease or stones (or history of) or 
  • Stomach ulcer (history of), The chance of side effects may be increased 


b. Proper Use of This Medicine 


If probenecid upsets your stomach, it may be taken with food. If this does not work, an antacid may be taken. If stomach upset (nausea, vomiting, or loss of appetite) continues, check with your doctor. 


For patients taking probenecid for gout: 


After you begin to take probenecid, gout attacks may continue to occur for a while. However, if you take this medicine regularly as directed by your doctor, the attacks will gradually become less frequent and less painful than before. After you have been taking probenecid for several months, they may stop completely. 

This medicine will help prevent gout attacks but it will not relieve an attack that has already started. Even if you take another medicine for gout attacks, continue to take this medicine also. If you have any questions about this, check with your doctor. 

For patients taking probenecid for gout or to help remove uric acid from the body: 

  • When you first begin taking probenecid, the amount of uric acid in the kidneys is greatly increased. This may cause kidney stones or other kidney problems in some people. To help prevent this, your doctor may want you to drink at least 10 to 12 full glasses (8 ounces each) of fluids each day, or to take another medicine to make your urine less acid. It is important that you follow your doctor's instructions very carefully. 




The dose of probenecid will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of probenecid. If your dose is different, do not change it unless your doctor tells you to do so. 


For treating gout or removing uric acid from the body: 


  • Adults: 250 mg (one-half of a 500-mg tablet) two times a day for about one week, then 500 mg (one tablet) two times a day for a few weeks. After this, the dose will depend on the amount of uric acid in your blood or urine. Most people need 2, 3, or 4 tablets a day, but some people may need higher doses. 

  • Children: It is not likely that probenecid will be needed to treat gout or to remove uric acid from the body in children. If a child needs this medicine, however, the dose would have to be determined by the doctor. 


For helping antibiotics work better: 


Adults: The amount of probenecid will depend on the condition being treated. Sometimes, only one dose of 2 tablets is needed. Other times, the dose will be 1 tablet four times a day. 


Children: The dose will have to be determined by the doctor. It depends on the child's weight, as well as on the condition being treated. Older children and teenagers may need the same amount as adults. 


Missed Dose


If you are taking probenecid regularly and you miss a dose, take the missed dose as soon as possible. However, if you do not remember until it is almost time for the next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses. 




To store this medicine: 


  • Keep out of the reach of children. 
  • Store away from heat and direct light. 
  • Do not store this medicine in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down. 
  • Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children. 


c. Precautions While Using This Medicine 


If you will be taking probenecid for more than a few weeks, your doctor should check your progress at regular visits. 


Before you have any medical tests, tell the person in charge that you are taking this medicine. The results of some tests may be affected by probenecid. 


For diabetic patients: 


Probenecid may cause false test results with copper sulfate urine sugar tests (ClinitestÆ), but not with glucose enzymatic urine sugar tests (ClinistixÆ). If you have any questions about this, check with your health care professional. 


For patients taking probenecid for gout or to help remove uric acid from the body: 


Taking aspirin or other salicylates may lessen the effects of probenecid. This will depend on the dose of aspirin or other salicylate that you take, and on how often you take it. Also, drinking too much alcohol may increase the amount of uric acid in the blood and lessen the effects of this medicine. Therefore, do not take aspirin or other salicylates or drink alcoholic beverages while taking this medicine, unless you have first checked with your doctor. 


Side Effects of This Medicine 


Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.


The following side effects may mean that you are having an allergic reaction to this medicine. Check with your doctor immediately if any of the following side effects occur: 




Fast or irregular breathing; puffiness or swellings of the eyelids or around the eyes;  shortness of breath, troubled breathing, tightness in chest, or wheezing; changes in the skin colour of the face occurring together with any of the other side effects listed here; or skin rash, hives, or itching occurring together with any of the other side effects listed here.


Also, check with your doctor as soon as possible if any of the following side effects occur:


Less Common 


Bloody urine; difficult or painful urination; lower back or side pain (especially if severe or sharp); skin rash, hives, or itching (occurring without other signs of an allergic reaction).




Cloudy urine; cough or hoarseness; fast or irregular breathing; fever; pain in back and/or ribs; sores, ulcers, or white spots on lips or in mouth; sore throat and fever with or without chills; sudden decrease in the amount of urine; swelling of face, fingers, feet, and/or lower legs; swollen and/or painful glands; unusual bleeding or bruising; unusual tiredness or weakness; yellow eyes or skin; weight gain.  


Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome: 


More Common 


Headache; joint pain, redness, or swelling ;  loss of appetite;  nausea or vomiting (mild)  


Less common 


Dizziness; flushing or redness of face (occurring without any signs of an allergic reaction); frequent urge to urinate; sore gums.


Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.


Solution 2: Unless you are a divine follower of the late Mahatma Gandhi, who used to drink his urine daily, this solution is not nearly as appealing as taking probenecid. However, it apparently would be very effective. Dr. Grattan Woodson, a specialist in internal medicine at the Druid Oaks Health Center in Decatur, Georgia, offers the following advice for emergency treatment of bird flu:*  This is an advanced, potentially life-saving emergency strategy, that should only be done under medical supervision, unless none is available.


Tamiflu Re-Administration Strategy: Tamiflu is excreted unchanged almost entirely in the urine. If Tamiflu supplies are limited, as they most certainly will be [during a bird-flu pandemic], consider giving the patient two Tamiflu tablets at the same time, collect the patient’s urine and re-administer it to the patient via naso-gastric (NG) tube or orally. If managed carefully, this approach means that you can completely treat a patient with only 2 Tamiflu tablets [by re-administering the patient’s urine daily for five to 10 days]. 


*Woodson G: Preparing for The Coming Influenza Pandemic. Available at:

Bird Flu: Who Is at Greatest Risk of Dying?

Avian influenza or “bird flu” has now caused more than 60 deaths worldwide, with the most recent epidemic in Indonesia, where four people have died. On a global basis, 60 deaths are not very many. So why are health experts becoming alarmed about the H5N1 (“bird flu”) virus? People are concerned because the virus has demonstrated the ability to kill a high percentage of the humans it infects. In addition, it has spread from birds to many other species, which is very uncharacteristic of viruses. The spread of infection in birds increases the opportunities for direct infection of humans. If more humans become infected over time, the likelihood also increases that humans, if concurrently infected with human and avian-influenza strains, could serve as the “mixing vessel” for the emergence of a novel subtype, with sufficient human genes to be easily transmitted from person to person. 


Once the virus acquires the capability to “go human,” an influenza pandemic (that is, a worldwide epidemic) would likely ensue in a matter of weeks. To date, the vast majority of infections of bird flu in humans have been acquired by close contact with domestic poultry. However, there is one documented case of human-to-human transmission in Thailand. It remains a curious fact that most people who have worked with poultry infected with the bird-flu virus, culling infected birds for example, have not become infected, a fact that no one seems able to adequately explain.


The antigenic changes (that is, changes in the exterior proteins, Hemagglutinin and Neuraminidase) in bird and human influenza viruses go on year after year.  Annual influenza outbreaks typically do not cause severe illness and death, because people have built up natural immunity to the viruses over a period of years. Rapid spread of H5N1 viruses between humans, on the other hand, will led to explosive global expansion in which everyone is at risk for infection, illness, and death because of a complete lack of natural immunity to the virus.


Because avian influenza or “bird flu” is much more deadly than the regular annual flu in humans, coupled with the high infectiousness of influenza viruses in general, a bird-flu pandemic is potentially very deadly, causing many tens, or even hundreds, of millions of deaths across the globe. In September 2005, Dr. David Nabarro of the World Health Organization (WHO) stated, “A new pandemic would claim between 5 million and 150 million people.”


Once a flu pandemic starts, everyone will be at risk of getting pandemic flu, because no one has natural immunity to the virus. However, certain groups may be at greater risk of dying than others. There are strong indications that the coming bird-flu pandemic may be similar to the influenza pandemic of 1918 and, if so, healthy adults would be most at risk of dying, along with pregnant women and the elderly.  


Why are healthy adults at greatest risk? It appears that the H5N1 bird-flu virus causes a massive immunological response against the virus in those with the strongest immune systems.  Unfortunately, this causes the release of human enzymes called “cytokines,” which destroy lung cells along with viral particles.  This, in turn, causes a deadly outpouring of fluids into the lung, which interferes with the exchange of oxygen and carbon dioxide. This reaction is frequently fatal.  There are few effective treatments, one of the only treatments available is to place the patient on a ventilator, a mechanical respirator. Even with this treatment, patients often die from complications.


Bradford Frank, M.D., M.P.H., M.B.A.

The Frank Group 

P.O. Box 138

Lakewood, NY 14750

Avian Influenza - Bird Flu FAQ

As more and more cases of bird flu are reported, the world faces an immediate threat of a deadly pandemic. Pandemics (Global Disease Outbreaks) are known to be like flash floods. They start abruptly, spread fast and cause a lot of damage all over the world.


A few facts that everyone should know:


What is Avian Influenza?


As the name suggests, avian influenza refers to the infection caused by avian (bird) influenza (flu) viruses. These viruses are commonly found in intestines of wild birds and these birds can carry the viruses without getting sick. However the viruses can be pathogenic to domesticated birds like chickens, ducks and turkeys. Domesticated birds become infected through exposure to other birds or through surfaces contaminated by secretions and faeces of the infected birds.


These viruses are classified as Low Pathogenicity and High Pathogenicity. Most strains of Avian Influenza come under Low Pathogenicity Avian Influenza (LPAI) Group and produce mild symptoms in the infected birds. Common symptoms are ruffled feathers, decreased food appetite, decreased egg production, sneezing and coughing. Many times LPAI may go undetected.


High Pathogenicity Avian Influenza (HPAI) has more severe symptoms which include sudden death, loss of energy and appetite, decreased egg production, respiratory problems, facial oedema (swelling), poorly formed eggs and diarrhoea. HPAI can reach a mortality rate of nearly 100%.


What Is H5N1 strain of Bird Flu?


All flu viruses are classified as type A, B or C depending on their structural arrangement. Type A is responsible for lethal pandemics and is found in both animals and humans. Type B causes local outbreaks of flu. Type C is the most stable of the three and infected people show only mild symptoms of flu. Type B and C are usually found only in humans. Type B and C are more stable than type A and are not classified according to their subtypes.


Influenza viruses of type A are divided into subtypes and the naming is done on the basis of two proteins (antigens) found on their surface - Hemagglutinin (HA) and Neuraminidase (NA). Sixteen types of HA and nine types of NA exist. Thus a total 144 combinations are possible.


Thus H5N1 is a type A virus and gets its name from HA 5 protein and NA 1 protein present on its surface.


How Do Type A Viruses Cause A Pandemic?


Type A viruses are further classified into strains. These strains can continuously evolve into different strains. Their ability to exchange genetic material with other viruses and create new influenza viruses makes them unpredictable and difficult to fight with. Humans have to develop new immunity (antibodies) every time new strains are created.


Viruses cannot repair genetic damage, small changes known as "Antigen Drift", are continuously creating new strains of viruses. However when genetic material from Type A viruses from different species - say a bird and a human, comes together and merges, an entirely new strain is created. This is known as "Antigen Shift" Humans have no immunity to such a strain and the strain can spread rapidly causing a Pandemic.


How Is The Virus Transmitted To Humans From Birds?


Usually Avian Influenza viruses do not infect humans. Migratory birds act as carriers of these viruses and do not get affected by them. These birds then come in contact with domesticated birds such as chickens and turkeys and spread the infection to them. Domesticated birds may get the virus from contact with contaminated surfaces too. Once a virus infects domesticated birds, it can cause severe epidemic among the birds. Humans come in contact with infected birds or contaminated surfaces and pick up the virus.


In the human body, this avian flu virus then undergoes an antigenic shift, combines with genetic material of a human strain of influenza virus and creates an entirely new strain of virus against which humans have little or no immunity. These genetic reassortments may also take place is the body of a third species (susceptible to both avian and human viruses) like the pig, where an avian influenza A virus and human influenza virus mix their genetic information and produce a new virus which might be able to infect humans.


Why is H5N1 dangerous?


The first reported cases of H5N1 infections were detected in geese in 1997 in Southern China. A total of 18 human infections were reported and six of them succumbed to it. The infection spread quickly to poultry in Hong Kong. At that time a million and half chickens were culled in Hong Kong to keep the virus under control. The virus disappeared for a few years, but resurfaced in 2002 in Hong Kong again. Since then it has killed millions of birds in Asia and many cases of human infections have been reported.


The persistence of this H5N1 strain of virus is a great concern for humans. Although the virus does not spread from birds to humans easily, the severity of the infection of H5N1 in humans is frightening. The virus has killed every second person infected by it. These cases were reported in perfectly healthy individuals who had no past history of infections. However the greater concern for the world is the POSSIBILITY THAT THE VIRUS MAY MUTATE (UNDERGO ANTIGENIC SHIFT) AND CREATE A FORM THAT MAY SPREAD FROM HUMAN TO HUMAN. Such a strain of virus may result in a pandemic, killing millions of people worldwide.


Is Consumption Of Poultry Birds Safe?


Yes, it is safe to consume THOROUGHLY COOKED poultry products. The H5N1 virus is sensitive to heat and gets destroyed by normal cooking temperatures of 70- 100 degree Celsius. If meat from poultry birds and eggs are cooked properly, the virus will be destroyed. Just make sure that no part of the meat remains raw or uncooked.


How Big Is The Risk Of A Pandemic Breaking Out?


The world had to face a Bird Flu Pandemic, thrice in the twentieth century. In 1918-1919, "Spanish Flu" killed anywhere between 20 million to 50 million people (exact figures not known), including half a million in the United States alone. The "Asian flu" in 1957-58 killed 70,000 in the United States and in 1968-1969, the "Hong Kong flu" killed 34,000 in the USA.


Currently the risk of H5N1 strain leading to a Pandemic is high. The virus is spreading fast to new areas and the efforts made to curtail it have proved inadequate.


Domestic ducks have now become a "reservoir" for the virus. They are acting like a carrier for the virus - their bodies carry the virus without showing signs of any infection. Infected ducks then release large quantities of the virus in pathogenic form in their excretions spreading the virus to other birds or humans. This has made detection of the virus difficult especially in rural areas.


According to health experts, the virus has already met the first two prerequisites for starting a pandemic. First it has attained a form, for which humans have no inbuilt immunity; and second, it has proved pathogenic enough to cause serious illness and death in humans.


The present risk of a pandemic is very high. The only factor that has prevented a pandemic so far is that the virus has not mutated into a form that would allow it to transmit efficiently from one human to another. Once such a genetic change takes place for the virus, a pandemic will be inevitable. The first signs of such a reassortment will be presence of the clusters of patients with flu symptoms, closely related - both in time and space. This would be a clear indication of virus having the ability to transmit from human-to-human.


Currently no vaccine has been developed for fighting H5N1 strain. Simultaneous work is being done in many countries for developing a vaccine, but no success has been achieved. The exact virus that may cause the pandemic cannot be predetermined. Thus mass production of vaccine before the pandemic starts is ruled out. The worldwide manufacturing capacity is inadequate to match the sudden demand surge during a pandemic. The best that scientists can do is to carry out a study and determine the smallest amount of antigen per dose that will provide sufficient protection and thus maximise the number of vaccines produced.


What Are The Precautions Necessary To Prevent A Pandemic?


The logical first step is to control the disease from spreading among birds, but this seems a difficult task now. Bird Flu has become a bird epidemic in many parts of Asia and is spreading fast.


The Next step is to prevent the disease from getting passed on to humans. People who come in close contact with birds (like poultry farmers) are advised to keep a close watch on the health of birds, notify any sort of sickness in birds to the health authorities and avoid direct contact with sick birds in all cases. (Ducks have become a reservoir for the virus and may not exhibit signs of sickness even if they are carrying the virus.)


In case the flu becomes a pandemic, most countries of the world will be affected. In such a scenario, the best preventive measures would be personal hygiene, avoiding crowded places and staying away from raw meat and eggs.


A flu shot does not prevent bird flu, but it can protect a person from other forms of flu and avoid complications. Persons above 65 years of age, children, health services workers, people with chronic respiratory disorders, travellers to flu affected countries and pregnant women may consult a doctor regarding flu vaccination.


What Are The Symptoms In Humans and Treatment Options For Bird Flu?


A person infected by bird flu may have all symptoms of common flu like fever, persistent cough, sore throat and body ache. Moreover, there is a high risk of complications such as pneumonia, bronchitis, eye and ear infections and severe breathing problems.


Presently four drugs are used to combat influenza.


The most effective drugs known for seasonal flu are Oseltamivir (commercial name Tamiflu) and Zanamavir (Commercial name Relenza). Both of these are known to reduce severity and duration of seasonal flu, but they may prove ineffective if the virus is allowed to stay in the body for too long. Health professionals advise that TREATMENT OF FLU WITH THESE DRUGS SHOULD START WITHIN 48 HOURS OF FIRST APPEARANCE FLU SYMPTOMS.


Oseltamivir and Zanamavir fall in the Neuraminidase inhibitors class. The surface protein Neuraminidase breaks bonds between new viruses and infected cells. By blocking the activity of Neuraminidase, these two drugs prevent the new viruses from being released.


Another class of drugs - the M2 inhibitors is also available, but viruses develop resistance to these drugs quickly and thus these drugs may prove ineffective in controlling pandemics. Amantadine and Rimantadine are two drugs from this class. These drugs inhibit the activity of M2 protein, which forms a channel in membranes of viruses and thereby preventing the viruses from replicating.


One should consult a doctor before taking any of these drugs as THESE DRUGS ARE KNOWN TO HAVE SIDE EFFECTS IN SOME CASES. For example, Zanamavir is not recommended to people having chronic respiratory diseases such as asthma.

Avian Flu: Are We All Sitting Ducks?

Unless you’ve been living under a rock for the last few months, you’ve heard the buzz: bird flu, avian flu, pandemic. Heck, even Ted Koppel admitted he’s been doing outside reading on the Flu’s origin. What does it all mean? Is it really cause for concern? As always it’s best to educate yourself on the state of affairs, then decide what you can do.


What we know: President Bush has outlined a 7 billion dollar program to prepare the US for the outbreak of the avian flu virus. Thanks much, but studies also report that even with this large number there could be a shortage if we reach a full blown pandemic (Never mind the question, where-o-where will we find the 7 billion?).


Therefore, before we become panic stricken, let’s first note the facts beginning with the query: Why is this flu such a concern? 


What we know: The particular strain of influenza H5N1 has shown up in birds first in Hong Kong and moved throughout Asia. The cases of human casualty have all been with persons in contact with the virus (I could only find one exception to this). Thus, the majority of deaths (somewhere around 60) have resulted from contact with an infected bird. From this we conclude, in all likelihood H5N1 in its current form does not spread from person to person.


The fear: The virus mutates to form a hybrid version that can become airborne and spread from human to human at an alarming rate. This frightens researchers because humans have not developed immunity to one particular protein in the strain. In all likelihood? The mutation could simply lead to a less severe version of the original. The absolute worst case scenario: The virus becomes self-evolving creating a rapidly spreading pandemic.


What we know: Immunologists seem in agreement that most humans build an immunity to a variety of influenza strains and a strong immune system can be the first responder to a flu attack. Although several prototype vaccines are currently being developed, there is no guarantee that they will be able to conquer a mutated virus, and while two antiviral drugs “Tamiflu” and “Relenza” are believed to reduce the severity of H5N1, they must be given within a 24-48 hour period after infection. Yet the same mutation disclaimer could also apply. The shot then, while always a good idea for special populations and children, does not offer a magic bullet as far as this scientist can speculate . 


Are we all sitting ducks then, waiting to be swallowed up by such devastation? I say: a resounding “No!” What we should be publicizing is: There is much you can do to arm yourself. First, have hope. Next, learn to build your immune system. Exercise, proper nutrition, sound sleep and meditation are all things you can do on a daily basis that will stimulate the immune system and build your force field against dangerous pathogens. It’s not just me saying so, either. This is the prescription given by researchers at Columbia University's School of Public Health.


And finally, As much as I believe it is important to be well informed about the state of the world at large, take a break from the negativity, and forget about natural selection. While Darwin may be looking down and wringing his hands from above, God knows we’ve all got better things to do.


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