HEALTH Human case of avian flu H5N1 (bird flu) Hong Kong

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I get these medical alerts periodically. This came today in my email.

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Hong Kong (SAR)
Human case of avian flu H5N1 (bird flu)

Created: November 17, 2010 19:58 GMT

Updated: November 17, 2010 22:11 GMT

For the first time since 2003, someone in Hong Kong has tested positive for avian flu H5N1. A 59-year-old woman who had recently traveled to mainland China was hospitalized with the disease on November 14. Although her husband had a brief respiratory illness, he has recovered and does not appear to have had influenza. None of the woman's other contacts have symptoms.

The patient and her family traveled to mainland China from October 23 through November 1. She visited Nanjing, Shanghai and Hangzhou, and went to local markets. Avian flu is endemic, or consistently present, among poultry in China. She also went to a live bird market in Tuen Mun, Hong Kong, after returning home. Tests are underway to determine if she was infected while on her trip or if she contracted the virus within Hong Kong. No cases have been reported among poultry in Hong Kong for nearly two years.

Authorities have raised Hong Kong's flu pandemic response level up to "serious", the second level on the three-tiered system. They notified the World Health Organization about the case. Disease surveillance efforts will be increased, and wild birds as well as domestic and imported poultry will be monitored.

Avian Flu Summary
Avian influenza virus has not acquired the ability to pass easily from person to person.

"Avian flu" mainly affects poultry and waterfowl
Avian influenza A/H5N1, also known as "bird flu", is a disease that kills domestic poultry flocks. The outbreak began in several South East Asian countries and has spread into Russia, Europe and Africa. Huge numbers of chickens, ducks, geese, and other domestic birds have been culled in affected countries in an attempt to slow or stop the spread of the virus. Other animal species, such as cats, dogs and pigs, can be infected, however whether they are able to infect humans is unknown. More than 60 countries have reported cases among birds, and 15 of these have also reported human infections.

Human cases so far
The virus is contained in the excrement of infected birds, and most people who have contracted bird flu work with or live near poultry. The human mortality rate is approximately 60 percent. At this time, the virus does not have the ability to spread easily from human to human.

Possibility of a bird flu pandemic (worldwide epidemic)
Bird flu is a global concern, and the virus kills a much higher proportion of infected people than the currently-circulating pandemic H1N1 flu. Avian flu A/H5N1 virus could undergo genetic changes that would allow it to spread easily from human to human. If this occurred, the world could face a global influenza epidemic (also known as a pandemic) similar to the devastating 1917-18 Spanish Flu pandemic.

International SOS Comment

Travel to Hong Kong can proceed. There appears to be little risk for travelers and expatriates at this time. Most or all humans infected with H5N1 flu have been in close contact with sick birds, or had close contact with an infected family member. Nevertheless, take precautions to prevent possible exposure.

Avoid live animal markets as well as poultry and pig farms.
Do not handle sick or dead birds.
Avoid any sick animals, including cats. Do not touch them.
Avoid touching any surfaces that may be contaminated by poultry droppings. Do not swim in any body of water that is used by birds.
Always maintain high levels of personal hygiene. Frequent handwashing is very important. Wash hands before and after food preparation.
Poultry products and eggs must be thoroughly cooked before eating. Do not consume raw poultry products, such as raw duck blood.
Thoroughly cook pork products.
Consider having an influenza vaccination. Although it will not protect you against avian flu, it reduces your risk of a "co-infection" with human influenza. Co-infections could allow the viruses to 'mix' and create a new flu strain.
While in an affected region, monitor your health for flu-like symptoms such as fever, cough, and fatigue - especially if they come on suddenly. If you get these symptoms and have had significant exposure to birds (particularly sick poultry), seek medical attention. Call the medical facility before arriving for care and alert them that you may have been exposed to avian influenza.

For further information, see the avian flu section of the International SOS pandemic preparedness website.


Authors:
Dr. Doug Quarry
Dr. Irene Lai
Viki Hansen-Landis, MPH
David DoQuang, MPH
 
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