The death of millions of birds in Asia has grabbed national headlines for the past few months, prompting concern from governmental officials and doctors alike. This concern is not for the birds per se, but rather for the cause of their death and its potential implications for humans around the world.
The H5N1 influenza, commonly called the avian or bird flu, is a disease that affects domesticated birds.
Last week the Associated Press reported that the most recent bird flu outbreak discovered Oct. 26 in China and Vietnam killed 8,940 chickens and prompted officials to destroy another 369,900. The AP reported yesterday that a Vietnamese man died last month from bird flu after eating a chicken.
According to the U.K. Health Protection Agency, H5N1 has appeared in many Asian countries as well as Russia, Turkey, Croatia and Romania. More isolated cases also have appeared in western European nations.
Flu Basics
Julie Gerberding, Director of the Center for Disease Control, discussed the avian flu in a recent online forum. While she noted that outbreaks of the avian flu occur about every two years, she said this year's outbreak is different.
"Migratory birds typically carry a variety of bird flu strains," Gerberding said in the forum. "What's different this time is that the strain they are carrying is the H5N1 strain, which is highly contagious to poultry, but more importantly, it's highly lethal to poultry. So, it is not only easily transmitted to a variety of bird species but when most birds get it, they die."
The H5 strain of the influenza, however, is not only highly deadly in poultry but also in humans, according to the Elson Student Health Center Director James Turner.
"We are not usually exposed to H5 strains," Turner said. "Therefore, we do not have antibodies in our immune system that can fight it, and it would spread quickly."
The threat posed to humans by the bird flu has come under a lot of debate.
"Right now, the H5N1 avian flu is primarily a problem for birds," Gerberding said. "It is not a pandemic, and there is no evidence at the current time that it will ever be a pandemic, but we have to be prepared. It's possible that this virus, which has only occasionally infected people with high mortality rates, could evolve to become more contagious, and that is why we are really scaling up our efforts to be prepared."
Jumping to humans
One hundred and twenty humans have contracted the avian flu thus far, and most of these individuals have had heavy contact with domesticated poultry, Turner said. He added that there is no evidence that the humans sick with the current form of the avian flu can pass it on to others.
But there is a chance that the flu can mutate into a strain that is contagious among humans.
"The fact that this particular avian virus is spreading so rapidly, there is a pretty good chance that it will mix with the human flu virus," Turner said.
According to Turner, it is hypothesized that if a person contracted a regular form of the seasonal influenza and was then exposed to the avian flu, the two viruses could mix and mutate in the person's body, leading to the creation of an avian flu virus that could be spread via person-to-person contact.
"That is the rational behind encouraging people to get the regular flu shot," Tuner said.
But, unfortunately no amount of flu shots can stem a potential pandemic, Turner said.
"If you look at the three pandemics that have occurred in the past century, all of those flu strains have been genetically linked to an avian flu virus," Turner said. "We know that pandemics are on 30- to 40-year cycles, so we are actually overdue for one."
The deadliest flu pandemic of the 20th century occurred in 1918-1919 when 500,000 generally healthy Americans died, according to the Center for Disease Control. The most recent pandemic took place in 1968-1969 and killed 34,000 people in the United States.
The president's preventative plan
In order to protect the American people in the case of another pandemic, President George W. Bush proposed a $7.1 billion plan to prepare the nation in the case of another outbreak.
The plan put out by the president, in conjunction with the Department of Health and Human Services outlines a number of requirements for hospitals and healthcare facilities around the country in preparation for a pandemic, the Department of Health and Human Services reported.
HHS Secretary Mike Levitt said in a Nov. 2 press conference that the main focus of the plan includes staffing needs in case of a pandemic, vaccine and medication distribution plans, and measures to control the spread of the infection throughout the community.
Officials from the HHS and CDC did not return requests for comment.
U.Va.'s plans
"The Bush plan hasn't really altered our plans," said Marjorie Sidebottom, Emergency Preparedness Director at the University Medical Center. "It's just making us look again to make sure everything in our plans is in accordance with the Bush plan."
Sidebottom emphasized that in the case of a pandemic, the Medical Center will be acting in conjunction with other hospitals in the area, the state health department and federal officials.
"We all hold parts of [the plan] that dovetail together to make sure that we can get the right information out to the citizenry and that we can protect our citizenry with what we have at hand," she said.
Sidebottom said the Medical Center would put into motion a series of procedures to separate those with the influenza from those who are well, should a pandemic occur. Individuals might also have to limit their activity in order to avoid contracting the disease, she added.
"There are tried and true infection control methods that we will follow and add anything to the CDC tells us," Sidebottom said.
Because of the wide variety of patients the Medical Center sees each day, the doctors, nurses and staff have practice dealing with those who are highly infectious, Sidebottom said.
"We see infectious patients every day, so there is a procedure developed," she said.
The Medical Center also has taken part in planning for the outbreak of other potentially highly infectious diseases.
"Here at U.Va. we have been through SARS and bio-terrorism planning, so we have a head start," Turner said. "The University is in really good shape. The biggest thing is deciding if and when we implement some of these public health containment measures."
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