BIRD FLU (AVIAN FLU)

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2009-02-08T20:30:00.000-08:00

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2009-01-12T00:25:00.000-08:00

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2008-11-04T14:39:00.001-08:00

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2008-10-19T05:25:00.000-07:00

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2008-08-30T17:25:00.000-07:00

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2008-08-26T17:16:00.000-07:00

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2008-08-05T17:16:00.000-07:00

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2008-08-05T16:59:00.000-07:00

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2008-07-12T10:04:00.000-07:00

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2008-07-12T09:09:00.000-07:00

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2008-07-12T07:52:00.000-07:00

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2008-07-12T07:28:00.000-07:00

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2008-07-12T01:17:00.000-07:00

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2008-07-11T17:51:00.000-07:00

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2008-07-11T16:05:00.000-07:00

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2008-07-11T08:04:00.002-07:00

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2008-07-11T07:16:00.000-07:00

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2008-07-10T16:28:00.000-07:00

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2008-07-10T07:48:00.000-07:00

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2008-07-06T08:04:00.000-07:00

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2008-02-29T10:09:00.000-08:00

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2008-02-22T20:24:00.000-08:00

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The Research of the Bird Flu Virus in America

2008-01-10T05:05:00.000-08:00

The Avian virus, that caused bird flu, destroyed a large number of chickens in South-East Asia. Although as far as this is concerned only a small number of people who was affected by this illness, there was the virus concern will spread in the human circle. In the Maryland University, that was close Washington DC, a project was just held to study the virus avian this.

The scientist the Maryland University of Daniel Perez raced against time. He chaired the program that was aimed to stop the spreading of the Avian virus in the chicken circle and other poultries before the virus became the big threat for humankind.

The scientists in the Maryland university hoped could study how the organism was very small this could double himself so as to be able to stop his spreading. Birds that lived in water or birds that liked to migrate could tolerate this virus, by means of throwing their waste to the pond, the lake and the river away. But the virus became the death when infecting the poultry that lived in the land, especially the chicken. Perez said, many chickens that were sick in countries as China, Thailand, Indonesia, Cambodia, Vietnam and South Korea were destroyed to stop the spreading of the illness.

A said, the Avian virus tended bermutasi and possibly to more was easy to spread to humankind. He said, this virus was not really expected, and unfortunately the scientists were not yet enough to know what made the virus could spread to humankind.

The person could be sick by handling the poultry that was infected or poultry meat that was contaminated. At this time, there was no vaccine that could protect humankind from the kind of this bird flu of the deadly virus. Last year, more than 50 people in South-East Asia tertular this illness and most died. Perez said: Gejalanya is normally begun with a kind of sign of flu. However, the sign did not subside as in the case of the normal flu infection in the normal adult, but got bad and caused the inflammation of the lungs and the death.

The researchers in the Maryland University came from various corners of the world, including Bangladesh, Israel and the Philippines. Hongquan Wan from China explored how the virus was spread from the poultry to the mammal. He said, one bird flu reason spread so fast in China because the farmers raised chickens and other animals together in the very dirty condition. In his country, he often said to the farmers concerning the problem.

He said: I often met them and said what happened and how prevented this illness moving from the chicken and the other species to humankind.

The researcher Gloria Ramirez from Kolombia said, although not having the report concerning the virus in Latin America, the plague could happen every time. Ramirez said: If the virus attacked Kolombia, for example, and we had the population that did not have the protection apapaun, without immunity, as a result could be very great.

Nevertheless, Perez concerned several countries in the world hid the epidemic of flu avian. He said the epidemic was the problem of the health of the big community so as iia hoped countries have an attitude more was open whether they experienced him or not. Perez hoped the researchers could find the method of overcoming bird flu. Nevertheless, he knew, that that will not be realised immediately and was needed by the long-term plan to be able to combat this virus. The main aim of this research prevented the possibility that the virus spread from the chicken to humankind, not from the chicken to the chicken.

COUNTRIES WITH HUMAN CASES IN THE CURRENT OUTBREAK

2008-01-10T04:58:00.001-08:00

To date, human cases have been reported in six countries, most of which are in Asia: Cambodia, China, Indonesia, Thailand, Turkey, and Viet Nam. The first patients in the current outbreak, which were reported from Viet Nam, developed symptoms in December 2003 but were not confirmed as H5N1 infection until 11 January 2004. Thailand reported its first cases on 23 January 2004. The first case in Cambodia was reported on 2 February 2005. The next country to report cases was Indonesia, which confirmed its first infection on 21 July. China’s first two cases were reported on 16 November 2005. Confirmation of the first cases in Turkey came on 5 January 2006. All human cases have coincided with outbreaks of highly pathogenic H5N1 avian influenza in poultry. To date, Viet Nam has been the most severely affected country, with more than 90 cases.

Clinical Features

2008-01-10T04:55:00.002-08:00

In many patients, the disease caused by the H5N1 virus follows an unusually aggressive clinical course, with rapid deterioration and high fatality. Like most emerging disease, H5N1 influenza in humans is poorly understood. Clinical data from cases in 1997 and the current outbreak are beginning to provide a picture of the clinical features of disease, but much remains to be learned. Moreover, the current picture could change given the propensity of this virus to mutate rapidly and unpredictably.

The incubation period for H5N1 avian influenza may be longer than that for normal seasonal influenza, which is around 2 to 3 days. Current data for H5N1 infection indicate an incubation period ranging from 2 to 8 days and possibly as long as 17 days. However, the possibility of multiple exposure to the virus makes it difficult to define the incubation period precisely. WHO currently recommends that an incubation period of 7 days be used for field investigations and the monitoring of patient contacts.

Initial symptoms include a high fever, usually with a temperature higher than 38^oC, and influenza-like symptoms. Diarrhoea, vomiting, abdominal pain, chest pain, and bleeding from the nose and gums have also been reported as early symptoms in some patients.

Watery diarrhoea without blood appears to be more common in H5N1 avian influenza than in normal seasonal influenza. The spectrum of clinical symptoms may, however, be broader, and not all confirmed patients have presented with respiratory symptoms. In two patients from southern Viet Nam, the clinical diagnosis was acute encephalitis; neither patient had respiratory symptoms at presentation. In another case, from Thailand, the patient presented with fever and diarrhoea, but no respiratory symptoms. All three patients had a recent history of direct exposure to infected poultry.

One feature seen in many patients is the development of manifestations in the lower respiratory tract early in the illness. Many patients have symptoms in the lower respiratory tract when they first seek treatment. On present evidence, difficulty in breathing develops around 5 days following the first symptoms. Respiratory distress, a hoarse voice, and a crackling sound when inhaling are commonly seen. Sputum production is variable and sometimes bloody. Most recently, blood-tinted respiratory secretions have been observed in Turkey. Almost all patients develop pneumonia. During the Hong Kong outbreak, all severely ill patients had primary viral pneumonia, which did not respond to antibiotics. Limited data on patients in the current outbreak indicate the presence of a primary viral pneumonia in H5N1, usually without microbiological evidence of bacterial supra-infection at presentation. Turkish clinicians have also reported pneumonia as a consistent feature in severe cases; as elsewhere, these patients did not respond to treatment with antibiotics.

In patients infected with the H5N1 virus, clinical deterioration is rapid. In Thailand, the time between onset of illness to the development of acute respiratory distress was around 6 days, with a range of 4 to 13 days. In severe cases in Turkey, clinicians have observed respiratory failure 3 to 5 days after symptom onset. Another common feature is multiorgan dysfunction, notably involving the kidney and heart. Common laboratory abnormalities include lymphopenia, leukopenia, elevated aminotransferases, and mild-to-moderate thrombocytopenia with some instances of disseminated intravascular coagulation.

Limited evidence suggests that some antiviral drugs, notably oseltamivir (commercially known as Tamiflu), can reduce the duration of viral replication and improve prospects of survival, provided they are administered within 48 hours following symptom onset. However, prior to the outbreak in Turkey, most patients have been detected and treated late in the course of illness. For this reason, clinical data on the effectiveness of oseltamivir are limited. Moreover, oseltamivir and other antiviral drugs were developed for the treatment and prophylaxis of seasonal influenza, which is a less severe disease associated with less prolonged viral replication. Recommendations on the optimum dose and duration of treatment for H5N1 avian influenza, also in children, need to undergo urgent review, and this is being undertaken by WHO.

In suspected cases, oseltamivir should be prescribed as soon as possible (ideally, within 48 hours following symptom onset) to maximize its therapeutic benefits. However, given the significant mortality currently associated with H5N1 infection and evidence of prolonged viral replication in this disease, administration of the drug should also be considered in patients presenting later in the course of illness.

Currently recommended doses of oseltamivir for the treatment of influenza are contained in the product information at the manufacturer’s web site. The recommended dose of oseltamivir for the treatment of influenza, in adults and adolescents 13 years of age and older, is 150 mg per day, given as 75 mg twice a day for 5 days. Oseltamivir is not indicated for the treatment of children younger than 1 year of age.

As the duration of viral replication may be prolonged in cases of H5N1 infection, clinicians should consider increasing the duration of treatment to 7 to 10 days in patients who are not showing a clinical response. In cases of severe infection with the H5N1 virus, clinicians may need to consider increasing the recommended daily dose or the duration of treatment, keeping in mind that doses above 300 mg per day are associated with increased side effects. For all treated patients, consideration should be given to taking serial clinical samples for later assay to monitor changes in viral load, to assess drug susceptibility, and to assess drug levels. These samples should be taken only in the presence of appropriate measures for infection control.

In severely ill H5N1 patients or in H5N1 patients with severe gastrointestinal symptoms, drug absorption may be impaired. This possibility should be considered when managing these patients.