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How serious is the threat of an Avian flu Human Pandemic . Avian (Bird) December 2005. Virus Bacteria Infection Mutation. Carrier of infection Resistance to infection Spread of infection Genetic material. Avian Flu . General Background Terms . Avian Flu. Historical Development

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avian flu
Virus

Bacteria

Infection

Mutation

Carrier of infection

Resistance to infection

Spread of infection

Genetic material

Avian Flu

General Background Terms

avian flu3
Avian Flu

Historical Development

Influenza Virus (worldwide problem)

Types A-B-C

  • “HN” Classification of virus (lab testing)
    • Hemagglutinin
    • Neuraminidase
  • 1918 “Spanish” Flu (H1N1)
    • Killed 50 million people worldwide
  • 1961 H 5N1 found in wild birds in South Africa
  • 1997 H5N1 found in Hong Kong
  • 2003 Bird Flu re-emergence in South Asia
avian flu4
Avian Flu

Mechanism of Non-Human Spread

  • Once spread from wild bird population to domestic birds (Chickens): a first serious step has occurred
  • A viral “jump” to more domestic animals (horses, cats, pigs): a second serious step will have occurred
  • This broad “mixing pot” of genetic material; makes the spread to humans more likely from such a pool of replicating gene fragments
avian flu5
Avian Flu

Isolated Facts

New H5N1 virus comes from mostly avian gene pool (not

mammals) like the H1N1 Spanish flu did (1918)

      • Why has it now become lethal in some humans? Unknown!
  • H5N1 virus remain “alive” in feces, oral droppings, contaminated water for 7-10 days
  • Asian human H5N1 infections are in younger population (17-31yrs)
  • In south Asia, human infection has mostly involved direct, close contact with infected birds (blood, feces, feathers)
avian flu6
Avian Flu

Isolated Facts Cont’d

  • Current human Influenza A vaccine does not protect against H5N1

Flu; eating “cooked” infected chickens will not cause infection

  • Domestic ducks can carry H5N1 “silently”: so a reservoir for potential carrier of infection
  • Domestic chickens get “infected” from contact with shed droppings from “migratory waterfowl/ducks”

The H5N1 avian flu is 32 times more infective than SARS Virus (2003)

avian flu7
Avian Flu

Human Pandemic Requires:

  • Highly virulent organism
  • Lack of sufficient human immunity
  • Easy spread from human to human

This is currently absent

avian flu8
Avian Flu

Potential Catastrophic Change

H 5 N1 Virus Invades Human Cell

Replicates

Organ Damage Invades Other Cells

Lung

Heart

Kidney

“Mutates”

avian flu9
Avian Flu

Human Diagnosis

  • Spot testing
  • Local Labs
  • Reference Labs (CDC)
  • Physicians/Hospitals
avian flu10
Initial

High fever

Chest pain

Cough

Weakness, muscle aches

Easy bleeding

Diarrhea

Late

Pneumonia

Encephalitis

Kidney failure

Avian Flu

Human signs and Symptoms

Currently in East Asia : mortality 50 %

(n=150 cases)

avian flu11
Avian Flu

Current Spread of Avian Disease (Asia to Europe)

North to Mongolia/Siberia

East Asia

West to Ukraine, Croatia,

Turkey

avian flu12
Avian Flu

Treatment

Surveillance

  • China may be Ground Zero (1st line of defense)
    • 1.3 billion people
    • 13 billion birds
    • 75% of population live on farms
    • Medical system weak
  • Prophylaxis (For Chickens)
    • Twice a year vaccines
  • Bird Flu Outbreak
    • Authorities kill hundreds of thousands of birds
avian flu13
Avian Flu

Human Treatment

Quarantine

  • World health Organization (WHO)
    • 21 days to “control”
  • Before disease affects 20-30 people
  • Hard for doctor to diagnosis quickly/implement isolation
  • Area may be as large as a city
avian flu14
Avian Flu

Human Treatment

  • Vaccine
    • Available for bird now
    • In development for human
    • Problems with application
      • New mutation may limit effectiveness
  • Antivirals
    • Tamiflu (oral)
    • Relenza (inhalation)
    • Problems with application of these meds
      • Not thoroughly tested
      • Resistance occurs
      • Stockpilling can be disruptive
avian flu15
Avian Flu

Possible Global Threat (Worst case scenario)

  • Estimate 150 million human deaths worldwide
  • Estimate economic cost : 800 billion dollars
  • Theoretical terrorist operation:

steal deadly viral genome

harvest “live” virus in lab

deliver as aerosol to unsuspecting populace

avian flu16
Avian Flu

Conclusions

  • Far-reaching spread of deadly virus to USA (Unlikely)
  • Danger ofH5N1reaching USA is real
  • Interconnected world (infection carriers)

Wild birds (could first reach Alaska & Canada)

Human travelers (a flight away)

No intervention has been successful stopping a pandemic once it starts

avian flu17
Avian Flu

Conclusions

  • Surveillance, global cooperation, vaccination, antiviral agents,quarantine, infected chicken elimination will prevent epidemic spread in USA
  • Gene Mutation and Viral human to human spread is random and cannot be controlled

SO

viral illnesses are a stark reality we have to fight

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