News - Bird flu and travel: the facts

Panic about bird flu is spreading. All last week television news bulletins showed pictures of chickens being slaughtered in Turkey, and headlines warned tourists to stay away. But advice to travellers has been confused, with even official sources giving contradictory signals - on the same day that the chief executive of the government-funded Medical Research Council advised people not to go east of Ankara, the British ambassador said there was 'absolutely no reason' to cancel trips to Turkey. Our guide to the facts should help you make your own decision.
Q: Is the official advice to stay away from Turkey?
A: No, contrary to the impression given by some media reports, the Foreign Office says the risk from bird flu is 'very low' and is not advising against travel. Some have accused the Foreign Office of being slow to react and playing down the risks, but the American State Department, which usually takes a more cautious line, plus the World Health Organisation and the American government's Center for Disease Control and Prevention (CDC) are all taking a similar view. They suggest you should stay away from infected areas, take some basic precautions, but otherwise advise holidays can go ahead.
Q: How many people have died?
A: As we go to press, there have been three confirmed deaths from bird flu in Turkey, and 15 more people are confirmed to have the disease. Worldwide 79 people have died since the outbreak of the H5N1 virus in Vietnam in 2003. To put that into perspective, malaria kills between 1.5 million and 2.7 million people every year, but around 3 million British tourists still travel to infected areas without taking the correct precautions. 'Ordinary' flu kills around 3,000 to 4,000 in Britain per year, and in 1989, an epidemic year, the figure was 30,000.
Q: Are lots of tourists cancelling trips?
A: Not yet, according to the Association of British Travel Agents, which says it has had only two phone calls on the matter. This is probably mainly due to it being low season in Turkey.
Q: Which areas are affected, and are they near resorts?
A: None of the confirmed human cases are close to Turkey's popular seaside resorts. There have been three cases in the capital Ankara, but few tourists fly there. However, infected birds have been discovered in Istanbul and in the coastal resorts of Izmir and Kusadasi. Officials are culling birds in all the affected areas.
Q: Isn't that enough reason not to go?
A: Officials have not sounded the alarm bells so far because it is only people who have been in direct contact with poultry who have been infected, particularly farmers or children. Tourists run little risk provided they avoid all contact with poultry - including live, healthy looking birds, and surfaces contaminated with uncooked poultry, bird droppings or feathers. The upshot is that poultry farms, slaughter houses and butchers should be avoided - hardly likely destinations for tourists - as well as markets selling live animals.
Q: How do you catch it?
A: Typically like this: infected birds (normally chickens) shed the virus in their faeces, then humans breathe in dust from dried droppings. Many of those infected have been children, who have been playing near chickens, touched their droppings and then put their hands to their mouths. The virus will also be present in poultry meat, blood and eggs.
Q: So can you get it from eating chicken in a resort?
A: The virus is killed by temperatures of about 70C, so if the chicken is well cooked there should be no problem. The same applies to eggs, although yolks must not be left runny.
Q: What about wild birds?
A: Ducks can carry it without suffering its symptoms and most wild birds can catch it. So avoid contact with wild birds.
Q: Should we take special medical kit?
A: As with most infectious disease, hand washing is one of the most important preventative measures. The US CDC recommends you take a bottle of alcohol handwash so you can clean your hands even when not near soap and water.
Q: What if it spreads suddenly?
A: The key fact is that so far there have been no recorded cases of human-to-human infection. So, as long as you avoid birds, you have little to fear. However, the more humans are infected the greater the chance that the virus will mutate and start to be transmitted between humans. If that happens, as with Sars (see below), the WHO and similar bodies would almost certainly change their guidance and order widespread travel bans. During Sars they warned against travel to all of China.
Q: Where else is there a risk?
A: People have died in six countries, with most confirmed human cases in Vietnam, but there have been no new human cases confirmed this month outside Turkey. In China there were eight human cases and five deaths in the last six weeks of 2005. Experts suggest visitors to all six countries should take similar precautions about avoiding poultry in farms and markets.
Q: What are the symptoms?
A: Fever, cough, sore throat and trouble breathing. The CDC advises checking for these symptoms for 10 days after you return from an affected country.
Q: Will tour companies cancel trips?
A: Very unlikely. Tour operators are loath to cancel trips unless the official FO guidance warns against travel.
Q: If I cancel, will I get my money back?
A: Probably not. The normal cancellation conditions will apply, ie the same as if you cancelled for your own reasons. If it's a long way before your departure, you may lose the deposit; close to departure and you may lose it all.
Sars: The pandemic that never was
Severe Acute Respiratory Syndrome, or Sars, was the bird flu of 2003. Scientists cited it as the 'long overdue pandemic' which would sweep across the world.
The disease took hold in November 2002 in the Chinese province of Guangdong, but the Chinese government covered it up until February 2003, by which time 305 of its citizens had been infected and it was on its way around the world. By April, Sars was perceived to be a major international health risk and had spread to 20 countries, infecting 3,400 people.
The lack of a cure and the fact that Sars is transmitted easily through coughing or sneezing caused panic. Tourism and the air industry suffered and at the scare's height almost half of Cathay Pacific's fleet was grounded.
But while fear spread, scientists indicated that Sars might have been blown out of proportion. Governments' efforts to quarantine people displaying symptoms paid off, and by June 2003 the disease was under control. After Sars had infected 8,459 worldwide and killed 805, the World Health Organisation declared the threat over.

The Observer Travel Bird flu and travel: the facts