Children's Health: Avian Flu

Children's Health: Avian Flu

A Public Health Threat
News reports about a potentially dangerous avian flu might make you worry about the possibility of the flu someday spreading rapidly around the world, infecting humans.

While the bird flu can be serious, unless you have household chickens and live in a country where there's an outbreak now, the bird flu probably is not an immediate health threat for you or your family. Experts believe only 160 people have contracted the disease since it was identified as a threat in 1997.

The avian flu that has affected birds and people in Asia, Europe, Africa and the Middle East, is different from the flu that many people get during the cold-weather months. Poultry — like chickens and turkeys — tend to get infected with the bird flu by migrating waterfowl (like ducks, geese, and swans), and spread it to other birds through their infected feces, saliva, or secretions.

The people who have gotten sick or died from the bird flu in Asia have had direct contact with infected birds, or surfaces that have been contaminated by them. This strain of the bird flu — which is called H5N1 — can't be spread from person to person.

Experts are concerned that this flu could mutate (undergo a genetic change) into a new form that can spread from person to person. Right now there's no vaccine for the bird flu, so they're worried that if it does mutate, it will be difficult to stop and will cause a pandemic, which is a global outbreak.

Health officials around the world are taking precautions to make sure that the bird flu doesn't spread, and to keep people safe from it if it does. Many countries — including the United States — aren't importing poultry from countries where there have been avian flu outbreaks.

Meanwhile, scientists are working on developing a vaccine to keep people from getting the avian flu.

In most places, there's no immediate threat from bird flu. All the same, the best thing you can do to safeguard your family from any contagious illness is to practice good hand-washing habits, teach your child to do the same, and take proper food safety precautions. (Never eat undercooked or uncooked poultry, and wash any kitchen surfaces where you have handled or worked with any uncooked meat.)

If you're traveling to a country where there has been a bird flu outbreak, it's best to talk with your doctor and look to agencies like the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO).

Here are answers to common questions about avian flu:

What Is Avian Flu?
It is a form of the flu (influenza) virus that usually only infects birds and sometimes infects pigs. There are many different strains of the avian flu. Some strains only cause mild symptoms in birds, ruffling their feathers and reducing their egg production. Other strains, including some of the H5 strains, are more dangerous — they spread quickly, cause more severe symptoms, and are almost always fatal to the birds.

An estimated 160 people have contracted the H5N1 strain of the flu, and about half of them have died. In an effort to keep the flu from spreading, hundreds of birds in those countries have been destroyed. The WHO is estimating that it will take at least 2 years to contain this outbreak of the bird flu.

Where Is the Avian Flu an Urgent Concern?
Over the past couple of years experts have recorded and confirmed outbreaks of H5N1 among birds in countries in Asia, Europe, Africa, and the Middle East.

Could Avian Flu Become a Concern in the United States?
The strain of flu virus that has spread in Asia, the Middle East, and Eastern Europe has not been found in birds — or humans — in the United States. There's a very low risk that people in the United States will get infected with the avian flu unless there's a global outbreak.

But this strain of the virus has been around since 1997. And the longer it lingers, spreading among birds in Asia, the more opportunities there are for the virus to infect people. The more people that are infected with the virus, the more opportunities the virus will have to mutate into a form that could spread from person to person. That could lead to a pandemic. As a precaution, the United States is not importing any birds from countries that have reported outbreaks of the bird flu.

How Do Birds Spread the Flu to Other Birds?
Researchers think that migrating birds, like ducks, geese, and swans, can carry and spread the virus to other birds but generally don't get sick from it. Bird flu can sicken domesticated birds, like chickens and turkeys, and kill them.

A bird can get the bird flu from another bird by coming into close contact with its infected feces, secretions, or saliva, or surfaces, dirt, or cages that have been contaminated by them. That's why researchers think live bird markets, where birds are kept in close quarters, are places where the virus has rapidly spread.

The virus also can spread from farm to farm if birds' infected feces and saliva get on farming equipment, like tractor wheels, clothing, and cages.

How Has Avian Flu Spread to Humans?
Experts think that the people who were infected by the bird flu had direct contact with infected poultry. They lived in rural areas where many families have small household poultry flocks, and slaughter, defeather, and butcher poultry themselves. Poultry also roam freely in some of those areas, and there are lots of opportunities to be exposed to their infected feces.

Can a Person With Avian Flu Spread it to Other People?
It's unlikely that a person who gets infected with this strain of the avian flu would spread it to other people. All human cases of bird flu so far have happened because people came into close contact with infected birds.

What Are the Symptoms of Avian Flu in Humans?
The symptoms of bird flu in people tend to be similar to the typical flu: fever, cough, sore throat, muscle aches. But this flu also can lead to eye infections, pneumonia, and severe coughing and breathing problems.

What Are the Signs of a Pandemic?
If clusters of people start showing symptoms of the flu around the same time, in the same place, in a country where it's known that the virus is spreading, it would signal that the virus has mutated and is more readily spreading from person to person. Doctors and public health officials would try to find out how the people got sick, and use that information to try to track and stop the disease from spreading.

What Are Public Officials Doing to Prevent the Spread of Avian Flu?
Officials in Japan, Korea, and Malaysia have announced that their local outbreaks have been controlled, and that there's no more of the virus there.

Even so, the WHO has started stockpiling antiviral medications and created an emergency plan in case there is a pandemic. The agency is providing guidance for all nations to do the same and is closely monitoring countries where there have been outbreaks, watching for further cases and any possible mutations.

The United States announced a plan that includes stockpiling medications to help reduce effects of the flu, producing more flu vaccine, and developing a vaccine for the avian flu.

Should I Stop Eating Chicken and Turkey?
It's safe to eat properly cooked chicken, turkey, and any other poultry in the United States. But do not eat raw (uncooked) or undercooked poultry or poultry products. When you're cooking, separate raw meat from cooked or ready-to-eat foods. Don't use the same cutting boards, knives, or utensils on uncooked meats and other foods. Heat can destroy flu viruses, so you should cook poultry until the temperature of the meat reaches at least 158° Fahrenheit (70° Celsius).

How Can I Protect My Family From Avian Flu?
If you plan to travel to a country where there has been an outbreak, avoid any contact with chickens, ducks, geese, pigeons, turkeys, quail, or any wild birds. Stay away from live bird markets, local poultry farms, or any other settings where there might be infected poultry. Avoid touching surfaces that could have been contaminated by bird saliva, feces, or urine. Check with agencies like the CDC for travel advisories.

At this point, if you live in a country where there's not a bird flu outbreak, there aren't any special precautions you need to take. But in general, hand washing keeps viruses and other contagious illnesses from spreading.

So no matter where you live or how healthy you are, be sure to frequently and thoroughly wash your hands with soap and water, particularly after going to the bathroom and before preparing meals and eating, and after taking care of a sick person. Encourage your kids to develop healthy hand-washing habits.

Can the Flu Shot Prevent Avian Flu?
No vaccine is currently available for the avian flu, although one is under development. However, experts stress that the strains of common flu virus that circle the globe each year are much more likely to pose a threat to human health during flu season. And in this case protection is available for that.

So consider getting a flu shot for yourself and your family to help you stay well during flu season (November to April), particularly if any of you are considered to be in a high-risk group. Pregnant women, babies from 6 to 23 months old, anyone who lives with or cares for infants under 6 months old, and people with certain chronic medical conditions are all considered high risk.

What's the Treatment for Avian Flu?
Doctors hope that antiviral medications will help keep the flu from spreading if it mutates and becomes contagious to humans. These medications can't cure the bird flu, but they can make the symptoms less severe. Still, flu viruses can become resistant to these drugs, so they may not always work. More studies are underway to determine how effective these medications are.

Can My Pet Bird Get Infected With the Avian Flu?
Your pet bird could contract the avian flu if it is exposed to another bird that's carrying the virus. So it's important to keep your bird and its food and water inside, away from any place where it could be exposed to infected migrating or domestic birds. That way your pet won't be at risk for getting the bird flu.

In addition, take these precautions to guard against the bird flu virus and other illnesses:

Don't allow your bird to drink or eat from ponds or other places that migrating birds may have flown over.
Keep your pet bird's cage clean.
Wash your hands after handling your pet bird, cleaning its cage, or after having any contact with your bird's secretions.
If you have any questions about your bird's health, talk with your veterinarian.
Government officials from the United States and other countries have stopped importing live birds and bird products (like meat and eggs) from countries where there have been outbreaks of the bird flu. So if you buy a pet bird, it should not have been exposed to the virus.

Still, there is an illegal market for buying and selling exotic birds and other animals. So just to be safe, before you buy any animal as a pet, find out where it was born and raised. If you have additional questions, contact a veterinarian or officials with the CDC or the WHO.

Reviewed by: Joel Klein, MD