Newswise — As has been reported in the news, the federal government recently announced a $7.1 billion national strategy to combat pandemic influenza. This large-scale effort to develop medical, financial and communication strategies is a response to public concerns about the growing number of Asian Bird Flu cases reported in parts of Asia and the Middle East. The U.S. Centers for Disease Control and Prevention report that this avian flu strain has been identified in Cambodia, China, Indonesia, Kazakhastan, Malaysia, Mongolia, Russia, Thailand, Vietnam, Turkey and Romania. Most recently, two people died in China after contracting the virus from poultry. To help your audience understand the various issues surrounding the Asian Bird Flu, expert sources are available at the University of Missouri-Columbia.
IN THIS ISSUE:
"¢ MU Veterinary Medical Diagnostic Laboratory equipped to face flu "¢ Asian Bird Flu unlikely to be transmitted among humans"¢ U.S. technology and economy prepared to contain infection"¢ MU's University Hospital ready for worst-case scenario________________________________________________________________________
¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬MU Veterinary Medical Diagnostic Laboratory Equipped to Diagnose and Contain New Strain of Avian Flu If Necessary
According to Alex Bermudez, director of the MU Veterinary Medical Diagnostic Laboratory, there are 135 known avian influenza A virus subtypes. Most are common and innocuous, or harmless, but the H5N1 subtype, better known as the Asian Bird Flu, is a form of highly pathogenic avian influenza that can cause severe disease in poultry. The H5N1 subtype has infected birds in countries in Southeast Asia and, more recently, Romania and Turkey, but no cases have been identified in the U.S.
In an avian flu outbreak in Hong Kong in 1997, 18 humans were infected with the H5N1 virus, and six died from the infection. Since then, several countries have reported human infection including Cambodia, Indonesia, Thailand and Vietnam. The World Health Organization reports that symptoms of human infection include: fever, tiredness, muscle aches, sore throat, cough, and severe respiratory distress.
Bermudez said the H5N1 virus in Asia causes severe respiratory, intestinal and neurologic signs of infection with high mortality rates. Although this might alarm farmers or veterinarians, these symptoms are not diagnostic. For the virus to be properly diagnosed, several tests must be conducted, beginning with serology, the testing for particular antibodies in the blood to determine the subtype of the virus. Other, more definitive diagnostic tests include: the polymerase chain reaction test (PCR) to detect segments of viral RNA, or ribonucleic acid; the virus isolation test to isolate the virus in fertile eggs; and other tests to determine the level of pathogenicity, or disease-causing capabilities, of the virus. In America, many of these tests, as well as the final virus identification, are completed by experts at the National Veterinary Services Laboratory (NVSL) in Ames, Iowa.
At the MU Veterinary Medical Diagnostic Laboratory, all sick, live birds undergo serology testing, and if, at any time, an avian influenza virus is suspected, all birds, dead or alive, undergo PCR testing. Bermudez said any avian influenza-positive results are reported to Missouri's federal Area Veterinarian in Charge in Jefferson City, Mo., and samples are sent with his permission to the NVSL for further testing and virus confirmation.
H5N1 Unlikely To Be Transmitted Among Humans
Human infection of the Asian Bird Flu is rare and can only occur when a person comes in close contact with a live, infected bird or an infected bird's feces, said Jeffre Firman, professor of animal science. The virus is transmitted by the infected bird's respiratory moisture, nasal mucus or feces.
The H5N1 avian flu strain, characterized by a particular arrangement of proteins on the surface of the virus, is not host-adapted, meaning that the human is a dead end for the virus, and it cannot spread through human-to-human transmission. Alex Bermudez, director of the MU Veterinary Medical Diagnostic Laboratory, said the greatest public health concern is that the strain will host-adapt, and the flu will become contagious among humans. He said the chances of this adaptation are unknown but public health officials are concerned about the possibility. The current H5N1 virus or Asian Bird Flu has been circulating in Asia since 1997 and host adaptation to humans has not occurred to this date.
According to Azlin Mustapha, associate professor of food microbiology at MU, most influenza virus subtypes evolve when genes from human and bird flu viruses mix, re-assort and mutate into a human host-adapted virus. She said the pig is a good medium for this to occur, because pigs are susceptible to infection by both avian influenza virus strains and human influenza virus strains. However, the H5N1 subtype appears to have bypassed this step and has jumped directly from birds to humans. The human body's immune system offers some protection against common flu viral infections, but the H5N1 is fairly new and very lethal. In addition, humans were not exposed to this subtype before the late 1990s, so the risk of a pandemic is high once the virus mutates and perfects the way it can spread from human to human. The H5N1 virus cannot be categorized as a pandemic influenza virus unless human-to-human transmission causes a global disease outbreak. Mustapha said when and if this will occur and whether or not H5N1 will be the culprit is anyone's guess.
New Technology and Strong Economy Prepare United States to Handle a Pandemic
Azlin Mustapha, associate professor of food microbiology, said there currently is no increased risk of infection from eating or handling cooked poultry or poultry products, as long as the poultry is cooked to the recommended 165 degrees Fahrenheit.
In the United States, a highly commercialized poultry industry structure prevents poultry from coming in contact with infected wild birds. Director of the MU Veterinary Medical Diagnostic Laboratory Alex Bermudez said the United States has the resources necessary to identify and dispose of infected birds in an appropriate manner following guidelines set by the Environmental Protection Agency. In countries where outbreaks have occurred, the most industrialized nations, such as Japan and South Korea, were able to contain the virus. Other countries, such as Vietnam that rely on subsistence farming and a less-developed economy, have not been able to eradicate the infection due to cultural, financial and geographic circumstances.
Officials at the University of Missouri-Columbia's University Hospital said that an avian flu pandemic similar to the 1918 flu pandemic that killed 40 to 50 million people can be prevented. Now, scientists can monitor the flu, study its genetic structure and work to develop a vaccine to treat it. Containment tips from the University Hospital include:
"¢ get a flu shot"¢ practice "respiratory etiquette" by shielding coughs and sneezes"¢ wash hands with soap and water "¢ stay home from work or school if experiencing flu-like symptoms.
University of Missouri-Columbia's University Hospital Works Toward Readiness
As part of an ongoing effort to prepare Columbia and the MU campus for the possibility of an avian flu outbreak, University of Missouri Health Care officials are addressing the needs for additional equipment such as high-efficiency face masks, as well as planning for and maintaining adequate staffing, bed capacity and flu vaccinations for current flu strains. University Hospital staff is being educated on the Asian Bird Flu and its symptoms and treatment. In addition, officials are developing a coordinated response among MU, state and federal entities including the Centers for Disease Control and Prevention, the U.S. Department of Health and Human Services, and the National Institutes of Health.
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