1. An window on Bird Flu

2. What is Bird Flu
It is an influenza like fever affecting birds with potential to affect humans and animals like cats and pigs
This disease is different from SARS and more readily spread although their symptoms are similar
It is caused by influenza virus
15 different strains of this virus can cause the disease
The present outbreak is by H5N1 strain

3. Organisms responsible for Bird Flu
The current epidemic is caused by H5N1 strain
There is evidence of man to man spread of this virus
The ‘fear’ is that if human and bird flu affect a single individual it may mutate (change itself) to produce a new strain highly infective to humans
In last such change in Spanish bird flu pandemic killed 50 million people world wide

4. How the disease spreads ?
Till now bird flu spreads through domestic foul and wild migratory birds.
Spread to humans is through contact with birds and their droppings.
Human to human transmission causes milder disease.
If the virus mutates and combines with human influenza virus it can readily spread from person to person.

5. Disease trajectory 1918-1919- Spain 1997- Hong Kong 2003- Korea
2004- Vietnam
2005- Turkey, France
2006- Nadurbar Mumbai india

6. What are the signs and symptoms of bird flu ?
In humans (it is by eating infected bird meat or close association with birds)
Varied range of symptoms like fever sore throat , cough, muscle aches, pneumonia, difficulty in breathing .
Symptoms appear within 5 days of exposure
Mostly symptoms are same as human flu.
A life threatening complication adult respiratory distress .syndrome (ARDS) may result in some cases.
In Birds
They are irritable , wild and later lethargic
They die in hordes within short span of time
Birds who survive remain infective for 10 days with potential to spread to others (birds and animals like cats ,pigs and humans)

7. How to diagnose bird flu
Clinical symptoms in the reported areas of infection , it should be followed by lab tests
The lab tests
EIA- enzyme immuno assay
Immunofluoresence DFA antibody stain
RT-PCR reverse transcriptase
polymerase chain reaction test.
Rapid influenza tests meant for tourists and suspects

8. How to treat a case First contact a physician It is by antiviral drugs
Neuramidase inhibitors .
Oseltamivir (Fluvir) Zenamivir (Relenza)
Oseltamivir is a oral form and used as tablest.
Zenamivir is an inhalational powder
Older drugs for flu like amantidine and rimantidine are not effective against bird flu
Drugs have to be started within 36 hours of onset of flu symptoms

9. Are Drugs available in India?
Yes
Antiflu by CIPLA
Fluvir by GenX
Relenza by Gen X
Tamiflu imported drug

10. How to prevent Bird Flu?
WHO recommends rapid elimination of disease among birds and animals by killing exposed birds.
Protective N 95 masks reduce possibility of transmission of disease.
3DGs(Double gloves, Double gowns and Goggles) and PPEs (personal protective equipments) are to be used by persons who come in contact with birds and health care workers.

11. Is there a vaccine available ?
Vaccine uncertain whether it will be available in all regions during a problem
Bird Vaccine is available
Human vaccine is waiting to be developed