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

www.AvoidBirdFlu.com

Bipolar Disorder

Do you know someone who is sometimes almost manic but at others seems depressed? Do their moods shift from a “high” to a “low”? If you do, then you might know someone who has what has been diagnosed as bipolar disorder. 

 

Bipolar disorder is a serious illness that can affect ones relationships, careers and self. People with bipolar disorder swing between manic moods like exhibiting high energy, becoming very talkative, restless or reckless and becoming depressed exhibiting sadness, crying, lack of energy and sometimes sleep problems. 

 

This disorder effects over 2 million people and occurs equally in men and women. Although the onset of bipolar disorder sets in during the early 20s there are often symptoms early in childhood. Some people have found a connection with BPD and ADHD.

 

Because BPD and ADHD symptoms are closely mirrored, BPD is hard to diagnose in young children. It is equally difficult to diagnose adolescents as this is typically a very unbalanced period in our development overall. It is difficult to discern if the adolescent is portraying normal behaviours or if the mood swings are symptoms of BPD. In adults, there are other problems that will most often occur in conjunction with BPD. About 60% of men and women also have problems with drugs or alcohol, seasonal depression and anxiety disorders. 

 

Doctors are not completely sure what causes bipolar disorder. There is evidence however, that it is genetic and runs in families. There is also growing evidence that lifestyle and stress are contributors to BPD. Overall, medical experts have come to the conclusion that BPD is related to the chemicals produced by the brain. When the productions levels are higher, people feel a sense of mania. When levels are lower, that is when the lows, or depressions, set in. 

 

There are ways to treat BPD. The most popular ways are with mood stabilizing drugs. These, combined with psychotherapy have proven to yield positive results. A few considerations need to be taken into account when taking medication. Children and young adults sometimes have heightened suicidal tendencies while on mood stabilizing drugs. Medications should be used under extreme caution or other measures of control should be put into practice for younger people diagnosed with BPD. Another thing to consider is that even though one may feel as though they have been “cured”, continuous therapy should be used. 

 

A medical doctor, teamed with a psychiatrist to prescribe appropriate medications and a psychologist to assess mental health should provide a qualified team to affectively monitor and prevent the illness from worsening. 

 

Unfortunately, there is no way to prevent BPD, especially since there is so much that needs to be learned about this illness. The best way to prevent or treat BPD is to be familiar with the symptoms. Symptoms of BPD include:

 

• Excessive happiness or hopefulness 
• Restlessness coupled with a need for less sleep 
• Distractibility
• Racing thoughts 
• High sex drive 
• Inflated self-esteem 
• Tendency to make larger than attainable plans 
• Tendency to make rash or poor decisions such as the decision to quit a job 
• Sad, anxious or irritability 
• Lack of energy 
• Increased need for sleep 
• Insomnia
• Change in appetite causing weight loss or gain 
• Thoughts of death or suicide 
• Suicide attempt 

 

If you feel that you, or someone you know, may have BPD, then it is important that you note the severity of the symptoms listed above and how long they last. 

 

The most telling symptom of BPD however, is extreme mood swings of extreme highs and lows that do not follow a set pattern. BPD is not an illness that should be self-diagnosed however. If you suspect BPD seek medical attention as soon as possible from a psychiatrist or psychologist.

Bipolar Disorder - What Is It And What Are The Symptoms?

This article summarises from a lay persons perspective what bipolar disorder actually is. The writer, Ric, is a sufferer of the disorder and was diagnosed 8 years ago. Ric is currently writing a book on his experiences which will soon be published on a new web site.

 

What is Bipolar Disorder?

 

I'm not going to try and give a medical definition here of bipolar disorder. There are plenty of those around on the internet if you care to do a search. I am simply going to give you my opinion, based on my experience.

 

Bipolar disorder was formerly known as manic depression and this term for the disorder is still used in some quarters today. Bipolar disorder, as the name suggests, involves mood swings between depression and elevation plus all points in between. It does not only affect your mood however. It can affect your behaviour, your thought patterns, sleep patterns and feelings. These affects may be minor or major, but the effects of bipolar disorder in whatever its form require management and treatment. Untreated, a person who suffers from bipolar disorder can be well and truly on a path of self-destruction. Indeed, the suicide rate amongst bipolar is quite high.

 

Interestingly enough, bipolar disorder is referred to as a “mental illness”, yet if this is true and it is something in the mind, then how is it that it is treated with drugs? No-one has yet identified specifically what or how bipolar is caused, but the most common suggestions are that it is something to do with cells and activity in the brain. The brain is the organ we know least about, but it is a physical organ. That being the case, perhaps we should be referring to bipolar disorder as being as much a physical illness or disorder as diabetes.

 

Bipolar disorder is a chronic disorder. That is, once it has been diagnosed you've won the lottery. You have it for life.

 

The symptoms of bipolar disorder are broken up into two groups for all intents and purposes. These are depressive symptoms and manic symptoms. Manic symptoms are broken down however into a further sub-group known as “hypomanic” symptoms.

 

Depression

 

• Feelings of nothingness, a total "void"
• Feelings of sadness and/or anxiety
• Wanting to cry, but unable to do so
• Crying uncontrollably
• Remaining in bed for days
• Constant tiredness and fatigue
• Complete loss of interest in things you enjoyed
• Ignoring daily responsibilities and/or personal hygiene
• Loss of self-esteem
• Inability to make even simple decisions
• Wanting to die
• Suicide ideation
• Restlessness, anger or irritability

 

Mania

 

• Filled with energy, too much to burn
• Extravagant spending, even with credit cards
• Increased sexual activity and desires
• Going without sleep but not getting tired
• Feelings of extreme superiority
• Delusions of grandeur
• Reckless behaviour even at personal risk
• Rapid speech
• Racing thoughts
• Grandiose ideas and schemes
• Inappropriate behaviour
• Total self-confidence, being "bullet proof"

 

A lower form of mania also can exist which is known as hypomania. Symptoms of hypomania can include all of the above, but to a lesser degree. A person in a hypomanic state may exhibit many of the above symptoms but only to the point where they appear to be very happy or cheerful. Consequently, it is not as visible or easy to diagnose as a full blown manic episode.

 

Because of the two types of mania, bipolar disorder is broken down into two groups, that of ‘Bipolar 1’ and ‘Bipolar 2’, and it is here that I will quote from the American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th Ed.

 

Bipolar 1

 

Characterized by the occurrence of one or more Manic Episodes or Mixed Episodes. Often individuals have also had one or more Major Depressive Episodes.

 

Bipolar 2

 

Characterized by the occurrence of one or more Major Depressive Episodes accompanied by at least one Hypomanic Episode.

Bad Breath and Gingivitis

Does this sound familiar to you? My dentist and hygienist mentioned that I had irritated gums as they cleaned my teeth. This is a symptom of gingivitis.

 

Gingivitis can be a stepping stone to major problems in the mouth and gum line. It can lead to periodontal disease, which is a much more serious problem with the potential for actual bone loss.

 

Halitosis (bad breath) could be related to a gingivitis infection as both are caused by bacteria. Red, swollen and/or bleeding gums characterize gingivitis. These symptoms are most evident upon flossing and sometimes from brushing.

 

Bacteria cause gingivitis. And bacteria are considered to be responsible for bad breath.

 

Sometimes, I could even see the bloodstains that the hygienist quietly wiped away with a towel. It was embarrassing enough to know that I wasn't controlling my gingivitis problem, but to know that she was actually trying not to make a big deal out of it was troubling.

 

I knew my dentist was concerned because she gave me a bottle of alcohol based mouthwash to try and mentioned that she wanted to see how I looked next time. I don't like using it; there is too much alcohol and the taste is not very pleasant. Alcohol may also dry the mucous membranes in the mouth.

 

The Problem

 

Bacteria can stick to your teeth and secrete acid onto them contributing to cavity formation. They can also infect the gums, particularly around the gum line, causing gingivitis. This can manifest initially as bleeding and irritated gums.

 

Having a lot of uncontrolled bacteria multiplying in the mouth may also lead to bad breath, but there is a natural and normal amount of bacteria in the mouth, and you will never completely get rid of them all, nor would you want to.

 

Theory has it that it is actually the anaerobic bacteria that live in the tongue and throat that produce sulphur that in turn produce hard to get rid of bad breath. These anaerobes create VSCs or volatile sulphur compounds. One type is the familiar rotten egg smell. There are other odours coming from VSCs as well. These sulphur-producing bacteria may feed on certain foods, like coffee, alcohol and meats.

 

A gingivitis problem can offer a way for bacteria to easily enter your blood stream and that can lead to additional problems. Systemic infections could come from this. Gingivitis can be something that makes your gums bleed easily in a mild case or it can be the root of deep gum recession, leading to bone loss in the worst case scenarios (Periodontal disease).

 

Loss of gum line can be discouraging. A friend of mind once described the process as, “getting long in the tooth". Sometimes, people experience this problem by brushing too hard. TIP: Using a soft bristled toothbrush with the type of motion that your hygienist recommends may help prevent eroded gum lines.

 

Treatment and Prevention

 

Had you ever heard of under-the-gum cleanings? This could be part of the protocol your dentist might invoke, should you develop periodontal disease. If you know people that have had an under-the-gum cleaning; they may tell you that it is not very pleasant.

 

Your dentist can deal with this problem in a variety of ways. However, prevention probably is the best option. Include good flossing and brushing habits - see your dentist for details. And you could add a non-alcohol based mouthwash alternative to your regimen.

 

I'm currently using a special toothbrush that uses vibration to clean the teeth. This device does a better job than a regular toothbrush in keeping my teeth clean. It does take a little while to get used to because of the vibration. It makes many, many vibrations per second. This helps to give it such wonderful cleaning abilities.

 

Don't feel sad if you have excellent oral health habits but you still have bad breath. This is common and many people experience this same situation. Oral health products that don't contain sodium lauryl sulphates or artificial flavours that can still kill the bacteria that cause bad breath without using harsh alcohol or tough chemicals may be helpful.

 

I am not a dentist. This article is for information purposes only. This article is not meant for diagnosis, treatment or prevention nor is it meant to give advice. If you have or suspect you have gingivitis, periodontal disease or any other dental problems, visit your dentist for a consultation.

Bad Breath, It Happens To The Best Of Us

So why do we get bad breath and how the heck can we get rid of it? These are two very common and very important questions that we have all had to ask ourselves at some time or another. The reason it is such an important thing to figure out is that it is so much a part of who we are. It affects our confidence with people and our reputation around people. Talking is such a part of our daily life and if we have bad breath we are either not talking for fear that someone will find out how nasty we are or we are embarrassing or offending those we are talking to. Bad breath is also not only offensive to others, it carries with it a taste that is offensive to the owner as well.

 

Now it is one thing to have bad breath once in a while or in the morning before we brush our teeth. This kind of problem is easily remedied with simple hygiene. But can you imagine (and some of you can) having bad breath chronically and so bad that simply brushing your teeth or avoiding spicy food at lunch is not enough. Well some people have to live with this nightmare called chronic halitosis.

 

So if you are one of these people you need to first know that there are very good remedies to most people's cases of bad breath that are worse than normal. First you should go see your dentist which is pretty obvious. You see bad body odours in general are secondary to the growth of microorganisms (bacteria, yeast, etc.) that are producing noxious fumes as a by-product of their metabolisms. It is always important to go and see that you don't have a major infection that is causing the rotten (literally!) smell in your mouth.

 

Often however there isn't a huge cavity or pharyngeal abscess to explain the terrible smells and because the aetiology is less obvious the solution is less obvious as well. Killing the bacteria is still the name of the game though and it just because people with chronic bad breath were unlucky enough to have gotten a particularly smelly strain of bacteria.

 

How do you do this? Well in several ways. One is to brush your teeth more often like every time you have food. Another is to get in the habit of brushing your tongue. Another is to buy a good mouth wash that kills the bacteria. Then lastly and maybe not so obvious is eating yogurt. You see yogurt contains a bacteria that lives well in the body and is very benign in terms of bad effects. If you do these things you may just find that your bad breath takes a hike.

Backgammon Rules: Learn How to Play Backgammon

Learn how to play backgammon, one of the most popular board games in the world.

 

The board game backgammon is one of the most ancient games known to man. It is believed that early variations of the game were played in Ancient Egypt, Mesopotamia and Ancient Rome. Since then, the game has evolved, changed several names and spread to different parts of the world. It is currently a popular pastime all over the US, East Asia, Europe, and the Middle East. 

 

In order to play backgammon all you need is a partner, two dice and a special backgammon board with checkers. The backgammon board is divided into two sides with each one is the mirror reflection of the other. Each side contains 12 triangles called points numbered from 1 to 24. 

 

• Points 1 to 6: Home Board or Inner Board
• Points 7 to 12: Outer Board
• 7 point: Bar Point
• 13 point: Mid-Point

 

At the starting position of the game, each player has 2 checkers on the 24 point, 3 checkers on the 8 point and 5 on the 13 and 6 point. Each player moves from his home board through the outer board towards the opponent home board. 

 

The object of backgammon, then, is to move your checkers towards your opponent home board and remove them off the board before your opponent moves his checkers towards your home board. The speed of the progress of each move is determined by the outcome of the dice roll. 

 

The backgammon play begins with both players tossing one die. The player whose outcome is the highest, makes the first move using both his and his opponents number. If the outcome of the dice toss is even, the players toss the dice again until an uneven outcome appears. From now on, each player tosses both dice on his turn. 

 

After each toss of dice, you should move your checkers forward the number of steps appears on both dice. You can move either one checker the number of steps summed up by both die or move two checkers. To make it clearer: if the outcome of the dice roll is 5 and 4, you can either move one checker 9 steps forward or move one checker 5 steps forward and then move the other piece 4 steps forward

 

If the dice rolls a double, which means an even number on both dice, you can move double the number appears on the dice. For example, if you roll double 2, you can move 2 points four times. In that case, you can either move one checker 8 steps forward; move two checkers a total of 4 steps; move two checkers a total of 2 steps each plus a total of 4 steps; move one checker a total of 6 steps plus 2 steps; or move four checkers 2 steps.

 

You can move a checker to a point where there is another one of your checkers or no more than one checker of your opponent, called blot. When you hit a blot, it is moved to the middle of the board to the part divided between the home board and the outer boards, called the bar. 

 

The checkers placed on the bar are kept out of play until the bar can be entered by a dice roll in the opponent’s home boards. For example, if you roll 2, you can enter a checker to the 23 point and enter the opponents home board and re-enter the bar checkers into the game. You cannot move the other checkers unless your entire bar checkers are at your opponent’s home board. 

 

By the time your checkers are in your home board, you must remove the checkers from the board, to bear off, using a roll of dice. For example, if you roll 1, you can bear off one checker from the 1 point; if you roll 2, you can move a checker form the 2 point, and so on. 

 

If your opponent has not borne off any checkers while you have borne off 15 checkers, you win the gammon. If your opponent has not borne off any checkers and still some of his checkers are placed on the bar, while you have borne off 15 checkers, then you win the backgammon.

Baccarat History and American Baccarat Rules

Here you can learn how to play the American version of baccarat and learn about the history of the game.

 

If we put aside the black ties, the velvet curtains and the overall exclusive atmosphere, baccarat is one of the simplest casino games around. In addition, baccarat is a beatable game with a low house edge, which makes it one of the best bets you can make! Here you can read about baccarat history and learn how to play the game. 

 

Both the American and European versions of baccarat and the French Chemin de Fer are late developments of the Italian game called baccara, which means zero in Italian. The origins of baccara go back to an old Etruscan myth. According to the myth, a blonde virgin had to toss a nine sided die to decide on her destiny. If the die landed on eight or nine, she would have to fulfil her destiny and become a priest. If the die landed on six or seven, she would be forbidden to participate in any religious activity. If the die landed on any other number, the virgin had to walk into the sea. 

 

The Italian game baccara was popular among French aristocracy during the end of the 15th century. Baccara had evolved to the European version of baccarat, which is still played in European casinos today as well as the French variation of baccarat known as Chemin de Fer, which is mainly played in casinos in France. The American version of the game was introduced to Nevada casinos in the 1950s by Francis Tommy Renzoni, who imported the game from Havana. 

 

Baccarat still carries an aroma of aristocracy and exclusivity. In American casinos, baccarat is played in a separated area of the casino, hidden behind velvet curtains. Baccarat players are usually dressed up and the betting limits are higher comparing to other table games. In order to attract the medium budget players, a lower limit version of baccarat, called mini baccarat, was invented. Mini baccarat is played on a smaller table, inside the casino gambling area with lower betting limits than baccarat. 

 

How to Play Baccarat

 

Baccarat is played with 3 dealers and up to 12 or 14 players. Baccarat is usually played with 8 standard card decks. Aces valued as one, face cards and ten cards valued as zero, and the rest of the number cards worth their face value. The suit has no meaning. The object of the game is to get as close to 9 as possible.

 

The play begins by all players, including the dealer, placing their bets either on the player, the banker, or on a tie. Traditionally, the dealer bets on the banker. The dealer can be the house dealer or one of the players. After everyone has placed their bets, the dealer gives two cards to each player and to the banker.

 

The score of each hand is calculated as the sum of the two cards minus the left digit. For example, if the sum of the two cards is 15, the score would be 5. The decision whether to deal a third card is determined by a set of rules and it is not up to the player or the dealers decision.  

 

• If the score of the players hand is 9 or 8, he wins
• If the score of the dealers hand is 9 or 8, it is a tie
• If a players score is 7 or 6, he can be dealt a third card
• If a players score is 5 or less, he has to receive a third card
• If a player gets a third card and the score of the dealers hand is 2, 1 or 0, he must draw a third card
• If the score of the dealers hand is 3 and the players third card is any value but 8, he must draw a third card
• If the score of the dealers hand is 4 and the players third card value is between 2 and 7, he must draw a third card
• If the score of the dealers hand is 5 and the players third card value is between 4 and seven, he must draw a third card
• If the score of the dealers hand is 6 and the players third card is 6 or 7, he must draw a third card.
• If the score of the dealers hand is 7, he cannot draw a third card.

Avoiding and Preventing Cancer: Simple Steps to Take

With its fairly unique characteristics, cancer strikes intense fear in many people and all would like to find ways to preventing and avoiding cancer. Obviously, any disease that is a) fatal, b) incurable and c) derived from unknown causes will earn a position of esteemed concern among the general public.

 

The faulty basis regarding the incurability of cancer is something you will find in my most recent book, but for now let us acknowledge that most people believe this to be true.

 

Cancer is a unique illness, in that it is created within our cells, by our cells. Damaged DNA causes a cell to divide without limits, producing more cells with damaged DNA that divide without limits. Soon, the cells create a massive tumour which is often fatal. Is it really possible to avoid and prevent cancer?

 

The most reliable medical treatments for cancer are essentially poisonous. We poison our body, depending on the fact that the cancerous portion will perish first. This theory has proven itself workable, though it often generates effects which are as lethal as the cancer.

 

Luckily for us, our bodies were created with an inherent set of tools, our immune system, designed to keep illness from settling in and destroying us. Not so luckily for us, we live in an age where the maintenance of those tools is incredibly poor.

 

To increase the abilities of our immune system and ensure that it can do its job, we must strive to be as healthy as possible. Our immune system will help us prevent and defeat disease, but it won’t do it all by itself: we must be willing to help. There are indeed some simple steps you can take to avoid and prevent cancer.

 

After all, if we don’t care enough about our health to fight for it, why should our immune system? If you do care enough to fight for it, how do you go about it?

 

Start exercising. This is actually one of the cheapest, easiest and potentially most effective tactics we have in promoting a healthy, active and forceful immune system. We make it hard, even though it doesn’t need to be. There is no need to join a health club or purchase fancy equipment.

 

If you have stairs in your home, spend 15 minutes a day walking up and down them. Do sit-ups and push-ups. The key is to do something, which will always be better than doing nothing regarding exercise.

 

Eat better. While there may not be a scientifically backed study indicating that a regular diet of deep fried fast food causes cancer, it has certainly been linked to a variety of health problems. Remember that any health problem drains your immune system which, in turn, makes you more susceptible to other health problems.

 

I’m not suggesting that you become a vegetarian and start shopping exclusively at organic health stores, although you may want to look into those options. But you may stop giving into the so-called “easy” way of eating.

 

Look at it from a new perspective. Certainly, every time you pick up a quick dinner at the local grease market you are saving yourself the time and trouble of preparing a healthy meal.

 

What’s really happening with those “savings,” however, is that you’re stashing them into a “time bank.” Like most savings, that time earns interest. In this case, the interest you are earning is pain, problems and suffering. When you finally withdraw all of that saved time, later in your life, you have to withdraw the earned interest as well.

 

Reduce stress. Stress is a massive immune system inhibitor. It comes at you from all angles, in every direction and with varying intensity. Recognize the sources of stress in your life and then work on healing them. A great number of options exist to reduce stress, you simply need to find the one that works best for you.

 

Of the options, one that is particularly viable to the prevention and avoidance of cancer is meditation. Drop the images you may be having of monks in robes. Meditation can be done in a very secular way, with no dogma attached.

 

Simply sit undisturbed in a comfortable position while visualizing yourself at the peak of health. When your mind strays, as it will, from the visualization of yourself at peak health, all you need to do is simply bring it back.

 

After practicing this for a while, you’ll find that your mind hardly drifts at all. You’ll also find yourself feel much better than you’ve felt in a long time, and it won’t even cost you a penny. This simple step could indeed be the start of avoiding and preventing cancer.

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.