October 27, 2005

By Tom Burkindine
The Kaselehlie Press

During the second annual Micronesia Medical Symposium earlier this month, health experts discussed the region's preparedness in the case of an outbreak of avian influenza, a strain of influenza that is threatening to affect the world. The conclusion reached was that Guam was unprepared to handle such a threat and would be unable to contain further spreading in Micronesia. Last week, lawmakers in Guam introduced referendums to address the health community's concerns. Although there is no evidence of the disease in the region yet, it has steadily spread through Asia and cases in Europe have begun to surface.

Avian influenza, or bird flu, is a strain of the common flu virus and primarily affects chickens, ducks, geese, and pigs. The flu is spread through infected poultry meat, feathers, and fecal matter. Humans can be affected if they are in close contact with infected animals, according to the International Federation of Red Cross (IFRC).

Experts are comparing the widespread outbreak of bird flu in Southeast Asia to pandemics, global epidemics, in the past. The World Health Organization stated that statistically, the bird flu kills between 40 and 60 percent of humans who become affected. It has been compared closely to the ebola virus, which is the most deadly infectious disease known today. Since December, 2003, cases of bird flu have increased dramatically, killing at least 57 people and infecting more than 100. Outbreaks have been confirmed in Vietnam, Taiwan, Thailand, South Korea, Japan, Laos, China, Cambodia, Indonesia, and Pakistan. Last week, cases of infected birds were verified in both Germany and England.

The virus survives primarily in contaminated poultry (although it can survive in pork) and can be spread through frozen meat. Experts believe that all parts of the bird are affected. The virus can survive for at least 35 days at temperatures of four degrees Celsius or lower, and six days at 37 degrees Celsius, according to the IFRC. The virus can also survive in environments such as a poultry house for more than two weeks.

Bird flu does not typically infect species other than birds and pigs. The first case of a human infection occurred in Hong Kong in 1997 when 18 people suffered from severe respiratory disease as a result. Six of those affected died. The flu is able to mutate rapidly, making humans susceptible. Typical symptoms include fever, muscle aches, fatigue, sore throat, cough, and severe respiratory distress secondary to viral pneumonia.

The virus often changes its genetic composition and can become aggressive and more infectious to humans. It incorporates genetic material from other viruses, also changing its behavior. This is what makes experts fear that it will react as other pandemics have in the past.

There have been three influenza pandemics in history, the worst being the Spanish Flu in 1918, which killed between 20 and 40 million. The 1957 Asian Flu and 1968 Hong Kong Flu were less deadly, but still killed millions. Experts seem to concur that the avian flu is on the verge of becoming the fourth influenza pandemic.

Among preventative measures suggested are quarantining or destroying infected fowl or pigs, distribution of antiviral drugs to those working with the animals, and dissemination of information to authorities if cases are documented. Measures suggested measures to prevent the spread of bird flu to humans are regular hand washing, covering mouth when coughing, avoiding contact with sick or dead poultry or pigs, and ensuring that all poultry, pork, and eggs are well cooked throughout. The virus is killed when cooking temperatures exceed 70 degrees Celsius.

While there is a vaccine for birds, there is no vaccine for the bird flu among humans. Although there are vaccines in development, none have been proven safe and the virus' behavior makes testing vaccines difficult. Typically, vaccines are developed by using fertilized chicken embryos. However, the bird flu kills the embryos before any helpful data can be accumulated.

Fairly reliable protection against the virus is available through inexpensive antiviral drugs such as Amantadine and Rimantadin, according to IFRC. Pregnant woman, however, should not take these drugs. Tamiflu has been suggested although the virus' resistance to that treatment has been recorded in Japan and Vietnam. Health officials have suggested that medical officials in close proximity to affected areas should stockpile surgical masks.