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Spotlight on Bird Flu
| What is bird flu (avian influenza)? |
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Avian influenza, or bird flu, is an infectious disease that is caused by a type of influenza virus. As the name implies, the disease mostly affects birds, but it can also affect humans, as well as animals such as cats. The disease, first identified in Italy more than 100 years ago, occurs worldwide.
All birds are thought to be susceptible to the avian influenza, though some species, such as wild ducks, are more resistant than others. Domestic poultry, such as chickens or turkeys, are particularly susceptible.
These flu viruses occur naturally among birds. Wild birds worldwide carry the viruses in their intestines, but usually do not get sick from them. However, bird flu is very contagious among birds and can make some domesticated birds, including chickens, ducks, and turkeys, very sick and kill them.
Infection with avian influenza viruses in domestic poultry causes two main forms of disease that are distinguished by low and high extremes of virulence. The "low pathogenic" form may go undetected and usually causes only mild symptoms (such as ruffled feathers and a drop in egg production). However, the "highly pathogenic" form spreads more rapidly through flocks of poultry. This form may cause disease that affects multiple internal organs and has a mortality rate that can reach 90-100%, often within 48 hours. |
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| How does avian influenza spread among birds? |
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Infected birds shed influenza virus in their saliva, nasal secretions, and feces. Susceptible birds become infected when they have contact with contaminated excretions or with surfaces that are contaminated with excretions or secretions. Domesticated birds may become infected with avian influenza virus through direct contact with infected waterfowl or other infected poultry or through contact with surfaces (such as dirt or cages) or materials (such as water or feed) that have been contaminated with the virus.
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| Do bird flu viruses infect humans? |
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Bird flu viruses do not usually infect humans, but more than 100 confirmed cases of human infection with bird flu viruses have occurred since 1997. |
| How do people become infected with avian influenza viruses? |
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| Most cases of avian influenza infection in humans have resulted from direct or close contact with infected poultry (e.g., domesticated chicken, ducks, and turkeys) or surfaces contaminated with secretions and excretions from infected birds. The spread of avian influenza viruses from an ill person to another person has been reported very rarely, and transmission has not been observed to continue beyond one person. During an outbreak of avian influenza among poultry, there is a possible risk to people who have direct or close contact with infected birds or with surfaces that have been contaminated with secretions and excretions from infected birds. |
| What are the symptoms of avian influenza in humans? |
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Symptoms of avian influenza in humans have ranged from typical human influenza-like symptoms (fever, cough, sore throat, and muscle aches) to eye infections, pneumonia, severe respiratory diseases (such as acute respiratory distress syndrome), and other severe and life-threatening complications. The symptoms of avian influenza may depend on which specific virus subtype and strain caused the infection. |
| How is avian influenza detected in humans? |
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| A laboratory test is needed to confirm avian influenza in humans. |
| What are the implications of avian influenza to human health? |
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Two main risks for human health from avian influenza are 1) the risk of direct infection when the virus passes from the infected bird to humans, sometimes resulting in severe disease; and 2) the risk that the virus - if given enough opportunities - will change into a form that is highly infectious for humans and spreads easily from person to person. |
| How is avian influenza in humans treated? |
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Oseltamivir (Beximco Pharma brand Oseflu) and zanamivir - antiviral medications used to treat regular flu - may be helpful in the treatment of bird flu. However, their effectiveness against the H5N1 subtype of the virus is uncertain. To have any effect, these medications need to be taken within 2 days of the symptoms first appearing.
Is there a bird flu vaccine?
There is currently no vaccine against bird flu. Vaccines are being developed, |
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but it usually takes several months to produce significant quantities of a new vaccine that is capable of providing protection against a new viral subtype.
Is there a risk for becoming infected with avian influenza by eating poultry?
There is no evidence that properly cooked poultry or eggs can be a source of infection for avian influenza viruses. |
| What precautions can be taken to reduce the risk for infection from wild birds? |
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As a general rule, the public should observe wildlife, including wild birds, from a distance. This protects from possible exposure to pathogens and minimizes disturbance to the animal. Avoid touching wildlife. If there is contact with wildlife do not rub eyes, eat, drink, or smoke before washing hands with soap and water. Do not pick up diseased or dead wildlife. Contact state, tribal or federal natural resource agency if a sick or dead animal is found. |
| What is the avian influenza A (H5N1) virus that has been reported in Asia and Europe? |
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Influenza A (H5N1) virus - also called "H5N1 virus" - is an influenza A virus subtype that occurs mainly in birds, is highly contagious among birds, and can be deadly to them.
Outbreaks of avian influenza H5N1 occurred among poultry in eight countries in Asia (Cambodia, China, Indonesia, Japan, Laos, South Korea, Thailand, and Vietnam) during late 2003 and early 2004. At that time, more than 100 million birds in the affected countries either died from the disease or were killed in order to try to control the outbreaks. By March 2004, the outbreak was reported to be under control.
Since late June 2004, however, new outbreaks of influenza H5N1 among poultry have been reported by several countries in Asia (Cambodia, China [Tibet], Indonesia, Kazakhstan, Malaysia, Mongolia, Russia [Siberia], Thailand, and Vietnam). It is believed that these outbreaks are ongoing. Influenza H5N1 infection also has been reported among poultry in Turkey and Romania and among wild migratory birds in Croatia.
Human cases of influenza A (H5N1) infection have been reported in Cambodia, China, Indonesia, Thailand, Turkey, and Vietnam. |
| What are the risks to humans from the current H5N1 outbreak in Asia and Europe? |
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H5N1 virus does not usually infect people, but more than 140 human cases have been reported. Most of these cases have occurred from direct or close contact with infected poultry or contaminated surfaces; however, a few cases of human-to-human spread of H5N1 virus have occurred.
So far, spread of H5N1 virus from person to person has been rare and has not continued beyond one person. Nonetheless, because all influenza viruses have the ability to change, scientists are concerned that H5N1 virus one day could be able to infect humans and spread easily from one person to another. Because these viruses do not commonly infect humans, there is little or no immune protection against them in the human population.
If H5N1 virus were to gain the capacity to spread easily from person to person, an influenza pandemic (worldwide outbreak of disease) could begin. No one can predict when a pandemic might occur. However, experts from around the world are watching the H5N1 situation in Asia and Europe very closely and are preparing for the possibility that the virus may begin to spread more easily from person to person. |
| How does H5N1 virus differ from seasonal influenza viruses that infect humans? |
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Of the few avian influenza viruses that have crossed the species barrier to infect humans, H5N1 virus has caused the largest number of reported cases of severe disease and death in humans. In the current |
| How can I avoid catching bird flu while travelling? |
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If you are travelling overseas, take the following steps to protect yourself:
- avoid domesticated birds, poultry farms and live bird markets;
- regularly wash your hands or use alcohol-based hand sanitisers;
- wash your hands thoroughly after handling any uncooked poultry or eggs;
- avoid eating any foods that contain raw or undercooked eggs; and
- if you are eating chicken, make sure it is thoroughly cooked.
It may also be a good idea to have a flu shot before you leave. Although it won't protect you from bird flu, it can prevent simultaneous infection with both regular flu and bird flu viruses.
If you do become unwell or experience any flu-like symptoms on your return to Bangladesh, you should see your doctor. Make sure you tell your doctor that you have been travelling, and which areas you visited. Your doctor also needs to know if you visited any open-air markets or farms. |
Since most early cases of prostate cancer produce no symptoms, it
may first be suspected after one of the screening tools is implemented.
Other signs may include difficulty in starting or maintaining a flow
of urine, increase in the urge to urinate, or blood in the urine.
Symptoms of advanced prostate cancer can include pain in the pelvis,
hips, spine or ribs, weight loss, weakness, and swelling of the lymph
nodes in the groin.
Once the suspicion of prostate cancer exists, a biopsy will be needed
to confirm the diagnosis and plan the best course of treatment. A
biopsy can be performed via the TRUS, whereby a selection of tissue
is removed from several areas of the prostate gland to get an adequate
sampling and determine how invasive the disease has become. The biopsy
can be performed in a doctor's office or outpatient setting.
After a biopsy is obtained, the tissue is sent to a laboratory and
examined by a pathologist. A report will be available in about 1 week.
If the biopsy is positive, meaning that cancer cells have been identified,
a grading system will be used to estimate the aggressiveness of the
tumor cells and the likelihood that the cancer will proliferate.
If the biopsy report indicates the presence of cancer, additional
testing will be needed to find out if the disease has spread beyond
the prostate gland to surrounding organs. This is referred to as staging.
The stage of cancer is the most important factor in determining treatment
options.
Tests that may be necessary to determine the stage of prostate cancer
include a computed tomography (CT) scan, magnetic resonance imaging
(MRI) scan, bone scan, and lymph node biopsy. |
How often a person will need to visit a doctor will depend on various
factors such as how close to normal the blood glucose levels are,
what symptoms a person may be experiencing, what other health conditions
are being treated for, and how comfortable the person is with current
treatment plan for managing diabetes.
The American Diabetes Association recommends that all patients with
type 2 diabetes should visit their doctor at least 2 to 4 times
per year. If the patient is newly diagnosed or experiencing symptoms
he/she may need to visit the doctor more often.
During each doctor visit the patient should be prepared to discuss
about blood glucose readings. The doctor will record the weight
and blood pressure at each visit. As part of routine physical examination
the doctor will also check the eyes and feet to screen for diabetic
complications. An annual examination by an eye doctor is also recommended.
Several blood tests to check cholesterol, lipids, and glycosylated
hemoglobin (a blood test that gives information about how well controlled
the blood sugars have been during the last 2 to 3 months) may also
be done. A urine test should also be performed to check for protein.
During each office visit, the patient should have an opportunity
to review treatment plan and set goals together with physician.
It should be remembered that diabetes management is a joint effort
that will only produce good results when both the patient and doctor
work together cooperatively. |
The commonest manifestation is an itchy rash that develops over a few days, after skin contact with a substance. The affected area first becomes itchy, then red and swollen with vesicles (water bubbles).
Although usually confined to the area of contact, sometimes strikingly so the rash can spread to other parts of the body.
occasionally the rash is more chronic, manifesting as an itchy patch that does not heal for weeks or even months. This usually occurs when there is frequent contact with the substance e.g. a watch strap. The rash resulting from contact allergy is called allergic contact dermatitis. |
A substance that can cause contact allergy is called a contact allergen. Common contact allergens are:
- metals e.g. nickel in watch straps, chrome in cement
- skin care products e.g. fragrances, lanolin
- medication e.g. flavine, neomycin.
A skin test called a patch test is used to confirm contact allergy. The upper back is used as a test site. A small amount of the suspected contact allergen (diluted to a non-irritant concentration) is applied onto the skin in an aluminium chamber and sealed with hypoallergenic tape. Usually, several suspected allergens are tested simultaneously. They are left on the skin for 48 hours and read at 48 and 96 hours. A positive reaction indicates that he patient is allergic to the test substance. This is a very safe procedure. |
Very often it is. An example of the need for a patch test is when a skin rash has persisted for a long time. Many skin care products and medication would have been tried. It is necessary to identify the cause of contact allergy. A patch test will help to ascertain the cause.
Another situation whereby a patch test is important is when a dermatitis is suspected to be due to work. There are many substances in the workplace that may cause contact allergy. |
In many cases, removing the cause i.e. the allergen from skin contact will result in a cure. Usually, once allergy to a substance has developed, it remains for life. That is to say, future contact with the substance will result in an allergic contact dermatitis again. This is exactly like a drug allergy. It is advisable for patients to carry a card to remind themselves and their doctors of their contact allergy. |
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