Thursday, December 08, 2005

News - Bird flu threat grows: Take precautions - myDNA

An editorial in the December 2005 Mayo Clinic Proceedings journal paints a picture of a world population very susceptible to an avian flu pandemic. It also offers suggestions for physicians to relieve patients' anxieties about the flu.

Many indicators suggest that the influenza A (H5N1) virus will spread beyond Southeast Asia, write the editorial's coauthors, Priya Sampathkumar, M.D., of Mayo Clinic's Division of Infectious Diseases, and Dennis Maki, M.D., of University of Wisconsin Medical School's Section of Infectious Diseases.

Asia's bird flu outbreak is caused by the H5N1 virus, an influenza A virus subtype that produces serious disease in domestic poultry. The coauthors note that recent genetic research on the influenza A virus responsible for the largest documented influenza pandemic on record - the Spanish flu of 1918 - shows that this virus was entirely of avian origin. The 1918 pandemic was the first confirmed bird flu outbreak in humans. However, Sampathkumar and Maki emphasize that major genetic alterations in the current H5N1 virus must occur before rapid human-to-human spread - essential for a pandemic - is likely.

"If an avian flu pandemic were to occur this winter, we would not be adequately prepared to deal with it," Sampathkumar says. However, the coauthors say that quarantining methods, antiviral medications and other measures could help contain an outbreak at its earliest stages, if health professionals can ensure the following:

Very early identification of cases and efficient ongoing surveillance for new cases
Sufficient stockpiles of antivirals, with the capacity for rapid delivery of antivirals to the target groups
Rapid institution and enforcement of quarantine measures and a high level of compliance with these measures among the target population.

International cooperation with the strategies above, including travel restrictions and, perhaps most importantly, sharing of national antiviral stockpiles
The coauthors say that even if these strategies don't curtail a pandemic, they might buy the world precious time to better prepare by ramping up production of vaccine and antivirals, both of which could save millions of lives

These suggestions to practicing physicians may help answer patients' questions:

Will getting a flu shot protect me from avian influenza? The annual flu shot does not protect against the new avian flu strain that originated in Asia. But getting the flu shot is a good idea to protect against seasonal influenza.

What can I do to protect myself against influenza - especially if I travel frequently? Travelers to countries where avian flu is endemic in bird populations should avoid contact with poultry or surfaces that may have been contaminated by poultry or their feces or secretions. Eating poultry products is safe so long as they are fully cooked. Practice frequent hand washing.
Do antivirals work? Should I have my own supply of antivirals? The antiviral drugs - oseltamivir (Tamiflu) and zanamivir (Relenza) - have shown good activity against most H5N1 strains. However, giving prescriptions for these drugs to individual patients in advance of a pandemic may divert the limited supplies of these medications from people who need them. Many health care centers, including the Mayo Clinic in Rochester, Minn., have pre-emptively restricted prescribing oseltamivir, limiting it to patients with clear indications for treatment of probable influenza or its prevention.

News: Bird flu threat grows: Take precautions - myDNA

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