Health and Safety

Current Health Information for
Harvard Students Planning Travel Abroad, Parents and Advisors

(excerpted from the International Travel Handbook)

Harvard University Health Services
Information on Avian Influenza
The United States Center for Disease Control is a source for current information about Avian Flu.

What is Avian Influenza (Bird flu)?
Avian influenza (Influenza A – the H5N1 virus) is a contagious disease of animals caused by viruses that normally affect only birds and, less commonly, pigs. It was first isolated in birds in South Africa in 1961. Avian influenza viruses are highly species-specific, but have on rare occasions crossed the species barrier to infect humans.

Does the virus spread easily from birds to humans?
No, although more than a hundred human cases have occurred in the current outbreak, this is a small number compared with the huge number of birds affected and the numerous associated opportunities for human exposure, especially in rural areas in some countries where animals live in close quarters with humans. It is not presently understood why some people, and not others, become ill following similar exposures. No infected birds have been identified in the US so far.

How do people become infected?
Infected birds shed flu virus in their saliva, nasal secretions and feces. Other birds become infected when they have contact with contaminated excretions or surfaces that are contaminated with excretions. The main route of human infection is direct contact with infected poultry or surfaces and objects contaminated with excrement. Infection can be spread during slaughter, defeathering butchering or preparing poultry for cooking. There is no concern that properly cooked poultry or eggs would be a source of infection.

What are the symptoms of the avian flu in humans?
Symptoms can range from typical flu-like symptoms (fever, cough, sore throat and muscle aches) to eye infections, pneumonia, significant respiratory distress, organ failure and other severe, life threatening complications.

How is it treated?
Two drugs (oseltamivir and zanamivir) have been used to reduce the severity and duration of illness caused by seasonal influenza. They must be administered within 48 hours of the onset of symptoms. The drugs may improve the prospects for survival in those infected with the H5N1 influenza virus but clinical data are limited. Other older antiviral drugs (amantidine and rimantadine) could potentially also be used but resistance to these drugs develops quickly and limits their effectiveness.

Is a vaccine being produced?
A vaccine is under development in several countries but is not ready for commercial production. Because the vaccine must closely match the actual H5N1 pandemic virus, production would not start until the new virus has emerged and a pandemic has been declared. It would then take several months to create and distribute adequate vaccine supplies to affected areas. The current “flu vaccine” does not offer protection from the H5N1 virus.

CDC recommendations to reduce risk
The same suggestions for prevention of other common viruses and colds apply:

· Good hand hygiene with either soap and water or an alcohol based hand gel (Purell)

· Do not share glasses, eating utensils, water bottles, etc.

· Dispose of used tissues and other similar objects appropriately

· To protect others, always cover your nose and mouth when you cough or sneeze

· Avoid spending prolonged time with those who appear ill

· Try to maintain a healthy immune system by good diet, adequate rest and drinking plenty of fluids

Immunization with the current influenza vaccine is suggested, even though it does not provide protection from avian influenza. There is no evidence that any human cases of avian influenza have been acquired by eating poultry products. The virus is destroyed by adequate heat, as are other food borne pathogens. In general, good food preparation and handling practices include:

· Cook all poultry and poultry products (including eggs) thoroughly before eating – at least to a temperature of 180 degrees F throughout

· Raw poultry should always be handled carefully because it can be associated with many infections including salmonella. All utensils, surfaces and hands that come in contact with raw poultry should be cleaned well with soap and water immediately afterwards.

Travelers to countries where there are known outbreaks of the avian flu are advised to avoid poultry farms, contact with animals in live food markets and any surfaces that appear to be contaminated with excrement from poultry or other animals. The CDC has not put in place any travel restrictions to affected countries at this time. Health departments have been alerted to provide continued surveillance for detection and diagnosis of suspicious influenza like illnesses in the human population as well as monitoring of birds and live stock by animal control agencies. Provision of appropriate lab testing is available at the state level and through the CDC to assist in isolation and identification of any suspicious viruses.