Learn the Risks of Avian Flu
-- Are travelers at risk for the bird flu? What are the symptoms associated with this illness? ABCNEWS.com asked Dr. William Schaffner to answer questions about the risks the disease poses to the U.S. population. Schaffner is an infectious disease specialist and the chairman of the Department of Preventive Medicine at Vanderbilt University in Nashville, Tenn.
Question: What is bird flu?
Answer: Influenza comes in a variety of forms and this is a type of influenza that is for all intents and purposes confined to birds.
This virus is found principally in Southeast Asia but it has also infected flocks of migratory water fowl, and their migration patterns extend into Eastern Europe. That's important because it opens up the possibility that this virus could be transported by migratory water fowl and get into the poultry populations of Eastern Europe.
Although bird-related influenza has been known for years, a single strain that could spread geographically so extensively is a new phenomenon.
Question: How is it contracted?
Answer: Influenza is what we call a respiratory virus. When we breath out, there are microscopic secretions that can contain a virus. And if you're close to an individual and in turn inhale those secretions, you can get an infection.
Also, if I get these secretions on my hands I can touch someone else and perhaps inoculate them.
Influenza has the capacity to spread rather rapidly in enclosed spaces, and remember: This is a wintertime virus, as most respiratory viruses are.
Eating an infected chicken won't give you the infection; that's not a risk. The problem is that you don't want an infected flock around that could spread it to more chickens or humans.
Question: What are the symptoms?
Answer: All influenza manifests itself pretty much the same way: You feel poorly. You develop a fever, general aches and pains, you lose your appetite and your energy, and importantly you develop a cough. We're talking about adults here – in children they may cough a little less and have abdominal pain.
Influenza viruses can range – as with most infections diseases – from relatively mild to severe and overwhelming, and because humans have not had experience with this sort of influenza virus before, it is anticipated that basically anyone on the planet is susceptible and therefore illness would be rather severe.
This anticipation of avian flu is born out of these few early cases in humans, where about half the people have died. That's a frightening thought.
Question: Is there a cure?
Answer: Yes, fortunately we have antiviral drugs and the most common one is Tamiflu. It has to be administered early and it is effective in shortening the course of infection and bringing it more rapidly to a close.
Of course there's also supportive care, keeping up your liquids, perhaps taking medication for the fever, going to bed for a few days, and seriously ill people would have to be admitted to the hospital.
Question: How do you know if you are at risk for avian flu?
Answer: There is a notification network around the world run by the World Health Organization that will let us know if the bird flu has developed the capacity to get into humans and has spread.
When that happens, we will be tracking this bird flu. So it's not a matter of someone in Peoria, Ill., or New Mexico becoming ill and thinking, "Gee I might have the bird flu." It doesn't happen in isolation like that. We will know it's coming.
The Centers for Disease Control would let us know and the various state health departments would be involved. This happens every year with regular influenza.
Question: Is there an added risk for those who frequently travel abroad?
Answer: The concern is for that very small proportion of international travelers who find themselves out in the agricultural areas of China, Vietnam, Thailand and the like.
In those circumstances, they will find that those farmers are using precautions and they should be careful. Spend as little time as needed there, don't get close to the chickens and certainly wash yourself very quickly when you leave. If you have soiled garments or shoes, handle them carefully and get them cleaned.
This is not to be a major concern until early cases are discovered and start to spread, and when that happens we would hear a lot just as we did during the era of SARS. They can travel from one country to another and when they land they can spread the disease. There's also some spread on airplanes because one of the things we know is you can start exhaling the infective virus 24 or 48 hours before you get sick, so you can be completely healthy and transmit the virus.
Question: How concerned do you think Americans should be?
Answer: There should be a degree of concern, but free-floating anxiety doesn't help us very much.
I regard this a little bit like the levees in New Orleans. There has to be a sense in the population that the national influenza preparedness plan be completed and that we actually engage in it. Now, this costs money and so the average person can let their member of Congress know or send a note to the White House that says you are concerned about the bird flu.
It's a little bit like hurricanes in New Orleans – we don't know when it's going to come but we know it will come, so let's spend some money. I think it's worrisome that in this era there are proposals to reduce the CDC's budget; that seems awkward as we're trying to prepare ourselves for pandemic flu. The CDC is the lead agency that would active at the whole public health system in our response.