Avian Influenza

Avian influenza, sometimes avian flu, and commonly bird flu, refers to "influenza caused by viruses adapted to birds.Of greatest concern is highly pathogenic avian influenza (HPAI).

"Bird flu" is a phrase similar to "swine flu," "dog flu," "horse flu," or "human flu" in that it refers to an illness caused by any of many different strains of influenza viruses that have adapted to a specific host. All known viruses that cause influenza in birds belong to the species influenza A virus. All subtypes (but not all strains of all subtypes) of influenza A virus are adapted to birds, which is why for many purposes avian flu virus is the influenza A virus (note that the "A" does not stand for "avian").

Adaptation is non-exclusive. Being adapted towards a particular species does not preclude adaptations, or partial adaptations, towards infecting different species. In this way strains of influenza viruses are adapted to multiple species, though may be preferential towards a particular host. For example, viruses responsible for influenza pandemics are adapted to both humans and birds. Recent influenza research into the genes of the Spanish flu virus shows it to have genes adapted to both birds and humans; with more of its genes from birds than less deadly later pandemic strains.
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Influenza pandemic

Pandemic flu viruses have some avian flu virus genes and usually some human flu virus genes. Both the H2N2 and H3N2 pandemic strains contained genes from avian influenza viruses. The new subtypes arose in pigs coinfected with avian and human viruses and were soon transferred to humans. Swine were considered the original "intermediate host" for influenza, because they supported reassortment of divergent subtypes. However, other hosts appear capable of similar coinfection (e.g., many poultry species), and direct transmission of avian viruses to humans is possible.The Spanish flu virus strain may have been transmitted directly from birds to humans.

In spite of their pandemic connection, avian influenza viruses are noninfectious for most species. When they are infectious they are usually asymptomatic, so the carrier does not have any disease from it. Thus while infected with an avian flu virus, the animal doesn't have a "flu". Typically, when illness (called "flu") from an avian flu virus does occur, it is the result of an avian flu virus strain adapted to one species spreading to another species (usually from one bird species to another bird species). So far as is known, the most common result of this is an illness so minor as to be not worth noticing (and thus little studied). But with the domestication of chickens and turkeys, humans have created species subtypes (domesticated poultry) that can catch an avian flu virus adapted to waterfowl and have it rapidly mutate into a form that kills in days over 90% of an entire flock and spread to other flocks and kill 90% of them and can only be stopped by killing every domestic bird in the area. Until H5N1 infected humans in the 1990s, this was the only reason avian flu was considered important. Since then, avian flu viruses have been intensively studied; resulting in changes in what is believed about flu pandemics, changes in poultry farming, changes in flu vaccination research, and changes in flu pandemic planning.

H5N1 has evolved into a flu virus strain that infects more species than any previously known flu virus strain, is deadlier than any previously known flu virus strain, and continues to evolve becoming both more widespread and more deadly causing Robert Webster, a leading expert on avian flu, to publish an article titled "The world is teetering on the edge of a pandemic that could kill a large fraction of the human population" in American Scientist. He called for adequate resources to fight what he sees as a major world threat to possibly billions of lives.Since the article was written, the world community has spent billions of dollars fighting this threat with limited success.

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Influenza A(H1N1) - update 43

3 June 2009 -- As of 06:00 GMT, 3 June 2009, 66 countries have officially reported 19,273 cases of influenza A(H1N1) infection, including 117 deaths.
The breakdown of the number of laboratory-confirmed cases by country is given in the following table and map.
Map of the spread of Influenza A(H1N1): number of laboratory confirmed cases and deaths [jpg 1.00Mb]
As of 06:00 GMT, 3 June 2009...

Laboratory-confirmed cases of new influenza A(H1N1) as officially reported to WHO by States Parties to the International Health Regulations (2005)

Country Cumulative total Newly confirmed since the last reporting period
Cases Deaths Cases Deaths
Argentina 131 0 31 0
Australia 501 0 204 0
Austria 1 0 0 0
Bahamas 1 0 0 0
Bahrain 1 0 0 0
Belgium 13 0 1 0
Bolivia 3 0 0 0
Brazil 20 0 2 0
Bulgaria 1 0 1 0
Canada 1530 2 194 0
Chile 313 0 63 0
China 69 0 17 0
Colombia 20 0 0 0
Costa Rica 50 1 13 0
Cuba 4 0 0 0
Cyprus 1 0 0 0
Czech Republic 1 0 0 0
Denmark 1 0 0 0
Dominican Republic 11 0 9 0
Ecuador 39 0 0 0
Egypt 1 0 1 0
El Salvador 41 0 14 0
Estonia 1 0 0 0
Finland 4 0 1 0
France 26 0 2 0
Germany 28 0 0 0
Greece 5 0 1 0
Guatemala 14 0 2 0
Honduras 2 0 0 0
Hungary 1 0 0 0
Iceland 1 0 0 0
India 1 0 0 0
Ireland 4 0 0 0
Israel 33 0 14 0
Italy 30 0 1 0
Jamaica 2 0 0 0
Japan 385 0 15 0
Korea, Republic of 41 0 8 0
Kuwait 18 0 0 0
Lebanon 3 0 3 0
Malaysia 2 0 0 0
Mexico 5029 97 0 0
Netherlands 4 0 1 0
New Zealand 10 0 1 0
Nicaragua 1 0 1 0
Norway 4 0 0 0
Panama 155 0 48 0
Paraguay 5 0 0 0
Peru 40 0 4 0
Philippines 16 0 0 0
Poland 4 0 0 0
Portugal 2 0 1 0
Romania 5 0 2 0
Russia 3 0 0 0
Singapore 9 0 4 0
Slovakia 2 0 0 0
Spain 180 0 2 0
Sweden 7 0 3 0
Switzerland 10 0 2 0
Thailand 2 0 0 0
Turkey 4 0 0 0
United Kingdom 339 0 110 0
United States of Ame 10053 17 1078 2
Uruguay 15 0 4 0
Venezuela 3 0 1 0
Viet Nam 3 0 2 0
Grand Total 19273 117 1863 2
Chinese Taipei has reported 14 confirmed case of influenza A (H1N1) with 0 deaths. Cases from Chinese Taipei are included in the cumulative totals provided in the table above.
Cumulative and new figures are subject to revision



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Avoid And Beat The Avian And Other Influenzas

Are you worried about the possible outbreak of the Avian Flu among humans? You should be! Hopefully, all of publicity about the Bird Flu will prove to be false alarms, but the worst thing any of us could do is to ignore it and hope it goes away, because it may not and one shudders to think about what could happen if it ever mutates to where it can be spread from human to human. Let's take a look at...

what we know so far about the Avian Flu:

First of all, the Avian Flu has not yet mutated and there is no need for panic, but there certainly is plenty of reasons for concern and a need to be vigilant, because the flu could easily mutate to one that is spread by humans - and it is the very nature of viruses to mutate. We should also be mindful of the fact that the world is due for another outbreak of a widespread and dangerous influenza epidemic of the kind that appear to occur on a regular basis about every 30 years.

If the Avian Flu does mutate to a human flu and is even partially as deadly as some predict, the resulting worldwide pandemic could be an epic modern day plague that changes the world as we know it and makes HIV, 9/11, the great Tsunami and the destruction of New Orleans seem mild by comparison - and there would likely be very little the world can do to prevent it. We can only hope that the next big worldwide influenza outbreak does not involve the current Avian Flu, or any other avian flu, because such flu would be a type that humans have not been exposed to and thus have no built in resistance to. Owing to this lack of built in resistance, such an outbreak involving that kind of flu could prove to be uniquely horrific.

In a normal outbreak of influenza, the most vulnerable are usually the elderly, the very young, and those who are already ill or otherwise in a weakened state - in other words, those whose immune systems are not strong enough to successfully ward off and fight illness. While a human version of the Avian Flu is likely to be every bit as deadly or more so for those who are the usual flu victims, unlike the usual varieties of influenza, the Avian Flu would actually be even more deadly for the group that is usually least affected by flu outbreaks: the most robust and healthy among us, the adults in the prime of life. That is because an avian flu like the Avian Flu turns the body's own immune system against itself and a strong immune system can become a deadly instrument of death as it over-reacts to a threat it has never been exposed to and releases a torrent of chemicals to combat the new threat which end up literally filling and eating up the lungs, suffocating what had been a strong and vigorous individual.

Such was exactly the case in a previous outbreak of another avian flu, one very similar to the Avian Flu. The Spanish Flu of 1918-19 was the most deadly epidemic in recorded history, killing 30 to 40 million or more people in one year – more than were killed in any war including Great World War, more than were killed in the 4 terrifying years of the Plague of Black Death (the Bubonic Plague) of 1347-1351, and more than were killed by HIV-AIDS in it’s first 25 years of existence. In the United States it infected 28% of all Americans, caused the deaths of at least 675,000 and in a single year was responsible for a 10 year drop in the life expectancy rate. In 1918, the death rate for influenza and pneumonia for 15 to 35 year olds was 20 times higher than in previous years.

Many authorities fear that if the modern day Avian Flu mutates to one that can be spread by humans, it could be an even more deadly flu than the one in 1918-19. Indeed, where humans have been exposed to infected birds and contracted the Avian Flu so far, the death rate appears to be significantly higher than it was for the deadly Spanish Flu.

The picture becomes truly staggering when you add to the expected high death rate the fact that the world population is now 2 1/2 times greater than it was in 1918-19 and not only is the population much larger, it is also much more concentrated with much more human interaction. And then you have the fact that, unlike the horse and buggy days of 1918-19, modern travel brings humans almost instantly to and from all points of the globe.

In all likelihood, only an immediate worldwide quarantine and shutdown of all travel would have a chance at stopping the spread of a worldwide pandemic, and that is something that is both unachievable and, at this point, unthinkable (although if the pandemic were to turn out to be as dire as some predict, such measures would probably be attempted out of desperation, but would surely prove far too late to stop the spread of the disease). Given the woeful response to the destruction of New Orleans, and the shortage of flu shots caused by the loss of a single facility only last year, perhaps one can more easily understand the estimates of many authorities and scientific figures that forecast staggering death tolls, some as high as 300 million or more worldwide.

The world has largely forgotten the horrible death tolls of the Spanish Flu, as well as the plague-like conditions that led to quarantines, death wagons, corpses lying abandoned in public streets, and breakdowns of social order and lawlessness that broke out in many places around the world. For those of us who would like a reminder, I suggest a trip to an old cemetery and take a look at the tombstones and grave markers for the years 1918-19, see how many there are compared to other years and how many times you will find multiple deaths in the same family for those years. It was a horrible time, now largely forgotten and to a great deal overshadowed by the end of World War I, but it is a lesson for us all if only we will open our eyes and see.

Perhaps the nightmare scenario I have painted is merely the stuff of dreams, and I certainly hope that proves to be the case. But I strongly suggest that we all take steps to prepare for the worst, just in case. Better that than be like the old fellow on the side of Mount Saint Helens who ignored all the warning signs, disbelieved all the scientists and scoffed at the idea of a deadly eruption right up to the point that he was incinerated.

While there may be little the world's governments may be able to do to stop the spread of a truly horrible influenza pandemic, there are things that we all can do to help avoid catching such a flu and to fight it off if we do catch it. Common sense tells us to practice very good hygiene and to avoid exposure to those who are infected. If a vaccine is available, it is probably a better idea to take it than not - even though vaccines are likely to be in short supply, will likely be mere guesswork since the virus has yet to mutate to a form that can be spread by humans and is likely to continue to mutate once it does, and is likely to contain mercury due to the probable use of an agent called thimerosal that is used to sterilize flu vaccines.

Beyond those obvious measures, I have also compiled the following information for anyone who wishes to avoid and combat influenza:

Avoiding the Flu:

The good news is that you can take steps to help you avoid the Bird Flu or any other flu when it comes, and to survive it if you happen to catch it. Included in these steps would be the things that you should do to protect yourself from virtually all diseases and illnesses: get plenty of rest, exercise, quit smoking, eat a nutritious diet, avoid stress and, above all, to make your body's natural first line of defense, your immune system, strong and robust.

Some of the very best immune boosters are:

* Echinacea (Despite the latest study)
* Pau d’arco
* Suma
* Astragalus
* Medicinal mushrooms
* Beta glucans
* Aloe vera
* Alkygycerol
* Lactoferrin
* Bovine colostrums
* Glutathione
* Mangosteen

The next thing you should do is to also take one or more good natural anti-viral agents, ESPECIALLY if the Bird Flu does mutate and begin to spread from human to human, because unlike other illnesses or flues, the Bird Flu will use your own immune system to attack you. This is because we have never been exposed to a strain of flu like the Bird Flu and it is likely that biochemical cascade of immune cells and immune system bio-chemicals such as interferon, interleukin, monokines and cytokines will literally pour into the lungs and eat your lungs up. With the Bird Flu, it is essential to also include good natural anti-viral supplements along with immune boosters - and it is a good idea to do that anyway.

Among the very best natural pathogen destroyers are:

* Garlic
* Olive leaf extract
* Oil of wild mountain oregano
* Grapefruit seed extract
* Colloidal Silver

A third thing to do would be to take regular preventative doses of a natural remedy known as “Oleander Soup”, which can be made at home according to the instructions in the e-book “Cancer’s Natural Enemy” (written by the author of this article).

Oleander extract has been proven in clinical trials, decades of medical practice and literally centuries of use as a folk remedy to be a very strong immune booster and disease and illness preventer. It has also demonstrated strong anti-viral abilities in the way that it attacks and kills cancer cells, as well as it’s effectiveness against hepatitis-C and HIV.

The fourth thing you should do is endeavor to stop the spread of airborne viruses during the flu season:

* Protect yourself from others by gargling daily with 1 drop each of the essential oils of tea tree (Melaleuca alternifolia) and lemon in a glass of warm water; stir well before each mouthful. Do not swallow.

* Mix a blend of essential oils to use in your diffuser or for use in steam inhalation.

Blend together:

* ravensare - 3 parts
* naiouli or eucalyptus - 1 part
* lemon - 1 part
* rosewood - 1 part
* lavender - 1 part

Ravensare and naiouli have antiviral properties, while the other essential oils in the blend act as antiseptics while at the same time providing a wonderful aroma.

Diffuser Application - Add about 50 drops of the above blend to your diffuser at a time.

Fumigate the house with oils to help prevent the spread of flu. Put 2-3 drops on a radiator to evaporate or add 10 drops of essential oils to a small plant spray filled with water. Spray the room frequently.

Hopefully, no serious flu outbreak will take place in your neighborhood, but forearmed is forewarned. Take the simple measures outlined above and your chances of beating the flu and perhaps avoiding it all together are much improved.

Live long, live healthy, live happy!
by: Tony Isaacs
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Avian Influenza: Current H5N1 Situation

The highly pathogenic avian influenza A (H5N1) epizootic (animal outbreak) in Asia, Europe, the Near East, and Africa is not expected to diminish significantly in the short term. It is likely that H5N1 virus infections among domestic poultry have become endemic in certain areas and that sporadic human infections resulting from direct contact with infected poultry and/or...

wild birds will continue to occur. So far, the spread of H5N1 virus from person-to-person has been very rare, limited and unsustained. However, this epizootic continues to pose an important public health threat.

There is little pre-existing natural immunity to H5N1 virus infection in the human population. If H5N1 viruses gain the ability for efficient and sustained transmission among humans, an influenza pandemic could result, with potentially high rates of illness and death worldwide. No evidence for genetic reassortment between human and avian influenza A virus genes has been found to date, and there is no evidence of any significant changes to circulating H5N1 virus strains to suggest greater transmissibility to or among humans. Genetic sequencing of avian influenza A (H5N1) viruses from human cases in Vietnam, Thailand, and Indonesia shows resistance to the antiviral medications amantadine and rimantadine, two of the medications commonly used for treatment of influenza. This leaves two remaining antiviral medications (oseltamivir and zanamivir) that should still be effective against currently circulating strains of H5N1 viruses. A small number of oseltamivir resistant H5N1 virus infections of humans have been reported. Efforts to produce pre-pandemic vaccine candidates for humans that would be effective against avian influenza A (H5N1) viruses are ongoing. However, no H5N1 vaccines are currently available for human use.

Research suggests that currently circulating strains of H5N1 viruses are becoming more capable of causing disease (pathogenic) in animals than were earlier H5N1 viruses. One study found that ducks infected with H5N1 virus are now shedding more virus for longer periods without showing symptoms of illness. This finding has implications for the role of ducks in transmitting disease to other birds and possibly to humans as well. Additionally, other findings have documented H5N1 virus infection among pigs in China and Vietnam; H5N1 virus infection of cats (experimental infection of housecats in the Netherlands, isolation of H5N1 virus from domestic cats in Germany and Thailand, and detection of H5N1 viral RNA in domestic cats in Iraq and Austria); H5N1 virus infection of dogs (isolation of H5N1 virus from a domestic dog in Thailand); and isolation of H5N1 viruses from tigers and leopards at zoos in Thailand). In addition, H5N1 virus infection in a wild stone marten (a weasel-like mammal) was reported in Germany and in a wild civet cat in Vietnam. Avian influenza A (H5N1) virus strains that emerged in Asia in 2003 continue to evolve and may adapt so that other mammals may be susceptible to infection as well.
Notable findings of epidemiologic investigations of human H5N1 cases include:

* Thailand, 2004: An investigation concluded that probable limited human-to-human spread of influenza A (H5N1) had occurred in a family as a result of prolonged and very close contact between an ill child and her mother in a hospital. Transmission did not continue beyond one person.
* Vietnam, 2004: While the majority of known human H5N1 cases have begun with respiratory symptoms, one atypical fatal H5N1 case in a child in southern Vietnam presented with fever, diarrhea and seizures, and was initially diagnosed as encephalitis. The etiology was identified retrospectively as H5N1 virus through testing of cerebrospinal fluid, fecal matter, and throat and serum samples. Further research is needed to ascertain the implications of such findings.
* Vietnam, 2005: Investigations suggest transmission of H5N1 viruses to two persons through consumption of uncooked duck blood.
* Azerbaijan, 2006: Investigations revealed contact with H5N1-infected wild dead birds (swans) as the most plausible source of infection in several cases in teenagers involved in removing feathers from the birds.
* Indonesia, 2006: WHO reported evidence of limited human-to-human spread of H5N1 virus. In this situation, 8 people in one family were affected, with 7 deaths. H5N1 virus was isolated from 7 cases. The first family member is thought to have become ill through contact with infected poultry. This person then infected six family members. One of those six people (a child) then infected another family member (his father). No further spread outside of the exposed family was documented or suspected.
* Vietnam, 2006: A study reported a correlation between high H5N1 viral concentration and elevated inflammatory cytokine levels in fatal cases. The authors concluded that early antiviral treatment is needed to suppress H5N1 viral replication to prevent the inflammatory response that appears to be implicated in the pathogenesis of H5N1 virus infection.

Human H5N1 Cases

(WHO) has reported human cases of avian influenza A (H5N1) in Asia, Africa, the Pacific, Europe and the Near East. Indonesia and Vietnam have reported the highest number of H5N1 cases to date. Overall mortality in reported H5N1 cases is approximately 60%. The majority of cases have occurred among children and adults aged less than 40 years old. Mortality was highest in cases aged 10-19 years old. Studies have documented the most significant risk factors for human H5N1 infection to be direct contact with sick or dead poultry or wild birds, or visiting a live poultry market. Most human H5N1 cases have been hospitalized late in their illness with severe respiratory disease. A small number of clinically mild H5N1 cases have been reported. The current cumulative number of confirmed human cases of avian influenza A/(H5N1) is available on the WHO Avian Influenza website. Despite the high mortality, human cases of H5N1 remain rare to date.
Clusters of Human H5N1 Cases

Clusters of human H5N1 cases ranging from 2-8 cases per cluster have been identified in most countries that have reported H5N1 cases. Nearly all of the cluster cases have occurred among blood-related family members living in the same household. Whether such clusters are related to genetic or other factors is currently unknown. While most people in these clusters have been infected with H5N1 virus through direct contact with sick or dead poultry or wild birds, limited human-to-human transmission of H5N1 virus cannot be excluded in some clusters.
Animal H5N1 Cases

Since December 2003, avian influenza A (H5N1) virus infections in animals have been reported in Asia, Africa, the Pacific, Europe and the Near East. View the update on avian influenza in animals from the World Organization for Animal Health Web site.
Bird Import Ban

There is currently a ban on the importation of birds and bird products from H5N1-affected countries. The regulation states that no person may import or attempt to import any birds (Class Aves), whether dead or alive, or any products derived from birds (including hatching eggs), from the specified countries. For more information, see Embargo of Birds from Specified Countries.
Travel

Updated Information for Travelers about Avian Influenza A(H5N1) is available at the CDC Travelers’ Health Web site. Also see Guidelines and Recommendations - Interim Guidance about Avian Influenza A (H5N1) for U.S. Citizens Living Abroad.
CDC Response

CDC is working with WHO and other international partners to monitor the situation closely. In addition, CDC continues to work with WHO and the National Institutes of Health (NIH) on development of a vaccine for influenza A (H5N1). For more information view CDC's Response to Avian Influenza.

* Also see Updated Interim Guidance for Laboratory Testing of Persons with Suspected Infection with Avian Influenza A (H5N1) Virus in the United States for CDC’s domestic H5N1 surveillance recommendations.

The World Health Organization has additional resources and information on avian influenza A H5N1, including

* Recommendations and laboratory procedures for detection of avian influenza A(H5N1) virus in specimens from suspected human cases (pdf 165K, 28 pages)
* WHO guidelines for investigation of human cases of avian influenza A(H5N1) (pdf 115K, 18 pages)
* Collecting, preserving and shipping specimens for the diagnosis of avian influenza A(H5N1) virus infection Guide for field operations (pdf 2.36M, 83 pages)

Background on the Current Outbreaks

Highly pathogenic avian influenza A (H5N1) virus is an influenza A virus subtype that occurs mainly in birds and is highly contagious among birds, causing high mortality among domestic poultry. Outbreaks of highly pathogenic H5N1 among poultry and wild birds are ongoing in a number of countries. Currently, there are two different groups (or clades) of H5N1 viruses circulating among poultry (clade 1, and clade 2 viruses). At least three subgroups or subclades of clade 2 H5N1 viruses have infected humans to date: subclades 2.1, 2.2, and 2.3 viruses. H5N1 virus infections of humans are rare and most cases have been associated with direct poultry contact during poultry outbreaks. While the H5N1 virus does not now infect people easily, infection in humans is very serious when it occurs; so far, more than half of people reported infected have died. Rare cases of limited human-to-human spread of H5N1 virus may have occurred, but there is no evidence of sustained human-to-human transmission.

Nonetheless, because all influenza viruses have the ability to change, scientists are concerned that H5N1 viruses one day could be able to infect humans more easily and spread easily from one person to another. Because H5N1 viruses have not infected many humans worldwide, there is little or no immune protection against them in the human population and an influenza pandemic (worldwide outbreak of disease) could begin if sustained H5N1 virus transmission occurred. Experts from around the world are watching the H5N1 situation very closely and are preparing for the possibility that H5N1 viruses may begin to spread more easily from person to person.

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Avian Influenza-Situation in Egypt

15 May 2009 -- The Ministry of Health of Egypt has reported a new confirmed human case of avian influenza. The case is a 5-year old female from Tama District, Sohag Governorate. Her symptoms began on 7 May and she was admitted...

in Sohag Fever Hospital on 9 May where she received oseltamivir. She is in a stable condition.

The case was confirmed by the Egyptian Central Public Health Laboratories on 10 May 2009.

Investigations into the source of infection indicate close contact with dead and sick poultry.

The Ministry of Health of Egypt has announced the deaths of previously confirmed cases of H5N1 as follows:

6-year-old male from Qaliobia Governorate;
33-year-old female from Kfr El Sheikh Governorate
25-year-old female from Cairo Governorate

Of the 69 cases confirmed to date in Egypt, 26 have been fatal.

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