::: Star Weekend Magazine :::

Health

Syeda Samin Mortada

When chickens in a Savar poultry farm were detected with the dreaded H5NI virus followed by the government's prompt action in culling chickens in many farms (including the Savar farm), the fear of 'bird flu' has been spreading across the nation. While there is no reason to panic yet- it is important for us to know more about this virus and the precautionary steps we can take. Avian influenza is a type of influenza virulent in birds. It was first identified in Italy in the early 1900's and is now known to exist worldwide. Like humans, birds are susceptible to the flu; there are many types of bird or avian flu, but the most contagious one currently causing concern is the highly pathogenic Asian strain of the H5N1 virus. Scientists have discovered four different subtypes of H5N1, and there could well be more. Wild birds worldwide, are natural carriers of the viruses, they carry the viruses in their intestines but are unlikely to actually develop an infection and get sick from them. The risk is that they pass it on to domestic birds, which are extremely susceptible to the virus, and this can make them very sick and ultimately kill them. This 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. It is widely believed that migratory birds are one of the most prevalent carriers of the disease.

In the past, Bird Flu was thought only to infect birds until the first human cases were seen in Hong Kong in 1997, and the first victim was a three-year-old boy. As of January 2007, the World Health Organization (WHO) had confirmed around 270 cases of H5N1 in humans, resulting in 167 deaths till date. Indonesia reported the largest number of cases in 2006, a total of 56 cases out of which 46 were fatal. So far those people who have been infected are mostly poultry workers who had contact with infected birds. There may have been examples of human-to-human transmission, but so far not in the form which could fuel a pandemic. Now, if the virus gained the ability to transmit easily between humans, there would be a mass outbreak and the result would be devastating. Worldwide experts apprehend that it could cause anything between 2 million and 50 million deaths.

Most cases of avian influenza infection in humans have resulted from direct or close contact with infected poultry or surfaces contaminated with secretions and excretions from infected birds. Some of the symptoms may include fever (higher than 100 °F), malaise, sore throats, eye infection, cough, muscle ache, diarrhoea or abdominal pain, bleeding of nose and gums, and even vomiting. People can also develop conjunctivitis. Pneumonia, severe respiratory diseases (such as acute respiratory distress syndrome), and other life-threatening complications may also occur. The symptoms of avian influenza may depend on which specific virus subtype and strain caused the infection. Researchers are now concerned because scientists studying a case in Vietnam found the virus can affect all parts of the body, not just the lungs. According to Dr. Jahangir Hossain, Asst Scientist, ICDDR,B “No human cases of avian influenza have been found in our country till now.” When asked about necessary vaccinations or medications related to the flu, the doctor said “There is no vaccine for bird flu yet, but a medicine named Tamiflu, can be prescribed to those already diagnosed with bird flu or are showing symptoms of the Influenza and to those who have had Epidemiological link with influenza (Direct or close contact with confirmed or suspected bird flu virus). For preventive measures Prophylaxis Tamiflu is prescribed, i.e. the medicine is given after the person is exposed or thought to be infected from poultry or wild birds.”

Experts say, if we are aware of the disease and know what to do there is no reason why we should abstain from consuming chicken. Bird flu is not a food born disease so eating chicken is safe. WHO recommends that the meat should be cooked at a temperature of at least 70C. We just need to be certain that all parts of the poultry are fully cooked (no "pink" parts) and that eggs, too, are properly cooked (no "runny" yolks). We should also be aware of the risk of cross-contamination. Juices from raw poultry and poultry products should never be allowed, during food preparation, to touch or mix with items eaten raw. When handling raw poultry or raw poultry products, persons involved in food preparation should wash their hands thoroughly and clean and disinfect surfaces in contact with the poultry products Soap and hot water are sufficient for this purpose. Fingernails can harbour dirt and germs, so use a nailbrush to scrub those fingernails clean. Use a clean plate to put your cooked food on. Never reuse the cutting board you cut raw poultry on until after you have sanitised it. Do not forget to thoroughly clean your sponges and washcloths too and wear kitchen gloves to protect your hands. In areas experiencing outbreaks in poultry, raw eggs should not be used in foods that will not be further heat-treated as for example by cooking or baking. If you're living less than a mile from the outbreak, you should be a bit more careful. As a general rule, the public should observe wildlife, including wild birds, from a distance. This will protect us from possible exposure to pathogens and minimise disturbance to the animals. 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 responsible officials if a sick or dead animal is found.

Our country is in a susceptible situation as it lies on the major route of migratory birds. According to National Avian Influenza and Pandemic Influenza Preparedness and Response Plan Bangladesh, 244 species of migratory birds visit Bangladesh in the winter season every year (October-March) of which approximately 21 species may carry the H5N1 or HPAI (Highly Pathogenic Avian Influenza) virus. The dense population and close living quarters increase potentials for virus transmission. Dr. C.S. Karim, Adviser to the Caretaker Government, Ministry of Environment, Agriculture, Fisheries and Livestock says there is no reason to panic. “This is nobody's fault”, says Karim, “Both the developed and developing countries have been affected by the bird flu. But there is no need to be afraid, all proactive and preventive measures have already been taken.” When asked if there was any risk of a pandemic Dr. Karim says “Everything is under control at the moment and there is nothing to worry about. Nevertheless, we cannot rule out anything altogether and it is always better to be prepared for the worst. All guidelines are ready, the concerned persons know their duties, necessary equipment is all set, donors are willing to render help and most importantly we follow an open policy where people share important information.” The advisor further adds “It is safe to eat bird meat, poultry meat and eggs. Just remember to cook the meat properly, try to eat boiled eggs and if you prefer to fry them, make sure you fry both the sides. We all just need to be a bit careful, that's all.”