Avian Flu

Simplified Bird flu timeline (HONG KONG) - 18 Hong Kong people infected by Avian influenza - Epidemic of bird flu in local poultry Population, caused by The same strain (VIETNAM) -8 confirmed cases In people -Try to eliminate the threat by killing millions of birds 2005 March people in Vietnam, Cambodia and Thailand Had come down with The flu (42 died) June 2005 (INDONESIA) -A man and his two daughters die of H5N1,although none of them worked around poultry. October H5N1 has confirmed to spread to birds in Turkey and Romania Spreading from Asia to East Europe

Cumulative total cases in Asia Russia China Vietnam

Last week China: 4 cases in one month Inner Mongolia  Anhui  Hunan  Liaoning follow the route of migratory birds Vietnam: confirmed more bird flu outbreaks among poultry in three villages

What the world is fearing of? H5N1 virus may mutate to flavour human- to-human transmission Another pandemic? - previous one in , Spanish Flu killed million people - Experts agree that another one is inevitable and probably imminent

What the world is fearing of? Another pandemic? (cont’) - Prof. KY Yuen stated that the mortality of bird flu in human race would be 50%, even much higher than SARS - UN Secretary General Kofi Annan: - health systems overburdened - families, communities and whole societies devastated - transport and trade, education and other services disrupted or stop - economic and social progress of nations risks reversed

Main causes of avian flu Bird flu in birds: Influenza A virus affect chickens, ducks and other birds Transmitted to human by: - direct/indirect contact with wild ducks and chickens - unhygienic handling of infected poultry e.g. not washing hands  in contact with eyes and nose Migratory birds’ spreading

Symptoms in human avian flu Fever Fatigue Cough Sore throat Eye infections Muscle aches

Protection Vaccine: - currently, no vaccines - approximately 4 months to make one vaccine - impossible to make vaccine a virus that hasn't been identified (no human-to- human transmission strain yet)

Protection Antiviral drug: - e.g. Tamiflu - taken very soon (often within 48 hours) after an infection is suspected  one pill every day - WHO: those governments that can afford Tamiflu should stockpile it - The Swiss maker of Tamiflu, Roche, halt the supply to local pharmacies and private clinics temporarily  reserve all stocks for future -Third World country gets generic version (because can’t afford the brand name version)

Prevention Avoid touching live poultry or their droppings Wash your hands thoroughly with liquid soap and water immediately after contact with live poultry, birds or their droppings Have a healthy lifestyle Maintain good indoor ventilation

What did HK government do? Immigration control measures Suspend import of poultry and poultry meat from infected regions (e.g. vietnam, Hunan and Liaoning) Stockpile tamiflu - Department of Health 2.7-million doses - Hospital Authority 800,000 doses A patient transfer mechanism will be formed between public and private hospitals Regular drills are conducted Free vaccination programme to safeguard chickens

Are the world ready? WHO: No!!!!! - Urge all countries to develop preparedness plan  only 40 countries done it - Urge countries to stockpile antiviral drugs  30 doing, but manufactory has no capacity to fill immediately - Present trend: no access to vaccine or drug if the flu break out The only thing we can do: Pray, prevent and wait