New AI

Avian Influenza in Romania: 

Avian Influenza in Romania Health Unit U.S. Embassy, Bucharest March 2006

Influenza Definitions: 

Influenza Definitions Seasonal Influenza – human viruses Avian Influenza (AI) – viral disease that affects primarily birds Pandemic Influenza (PI) – when a new influenza virus appears that people have not been previously exposed to before

H5N1 Among Animals: 

H5N1 Among Animals Avian influenza A (H5N1) infections in poultry or wild birds have occurred in many countries in Asia, Europe and Africa. Several cases of infected domestic cats have been discovered in Europe.

Countries Affected by Avian Influenza in Animals: 

Countries Affected by Avian Influenza in Animals

H5N1 Among Humans: 

H5N1 Among Humans WHO has reported human cases of avian influenza A (H5N1) in the following countries: Cambodia China Indonesia Thailand Turkey Vietnam Iraq Azerbaijan 184 cases, 103 deaths (as of 21 March 2006)

Countries With Confirmed Human Cases of H5N1: 

Countries With Confirmed Human Cases of H5N1

H5N1 AI In Our Region: 

H5N1 AI In Our Region October 15, 2005 outbreak in Romania’s Danube Delta confirmed as H5N1 October 16, 2005 outbreak in Turkey confirmed as H5N1 October 26, 2005 Croatia confirms H5N1 in wild birds December 5, 2005 Ukraine reports H5N1 in domestic birds January 4, 2006 human infection first announced in Turkey February 11, 2006 Bulgaria, Greece and Italy confirm H5N1 in wild birds February 21, 2006 Hungary confirms H5N1 in wild birds February 25, 2006 Bonsia-Herzegovina confirms H5N1 in wild birds March 2, 2006 Serbia-Montenegro reports H5N1 in wild birds

H5N1 Transmission to Humans: 

H5N1 Transmission to Humans Reservoir – water fowl Spread through domestic and wild fowl Direct contact with sick or infected birds Saliva, blood, feces… Contaminated surfaces Human-to-human transmission extremely rare

H5N1 Among Humans in Turkey: 

H5N1 Among Humans in Turkey Human cases have now been reported in 9 provinces Laboratory confirmed disease according the Turkish Ministry of Health is 20. Total deaths from laboratory confirmed disease 4

H5N1 Among Humans in Turkey: 

H5N1 Among Humans in Turkey Affected primarily young children NO evidence of human-to-human transmission All cases have had direct contact with sick or dead poultry or wild birds

What’s Being Done? : 

What’s Being Done?

Ministry of Agriculture: 

Ministry of Agriculture Information Quarantines Culling birds Effect on commercial operations

Ministry of Health: 

Ministry of Health Working with International Organizations Care for the sick Testing suspected cases Tamiflu

U.S. Government: 

U.S. Government U.S. Embassy is monitoring the situation Warden notices, information on website Inter-agency team (USDA, USAID, HHS) here in Romania, meeting with GOR counterparts Assessing situation and ways USG can support Romania

Pandemic Influenza vs Avian Influenza What is the Difference?: 

Pandemic Influenza vs Avian Influenza What is the Difference? Avian Influenza (AI) – large group of influenza viruses that primarily affect birds Pandemic influenza (PI) – when a new sub-strain emerges not previously circulated in humans Once adaptation occurs, it will be a human influenza virus H5N1 strain has pandemic potential

Requirements for a Pandemic: 

Requirements for a Pandemic A new virus emerges for which the population has no immunity The new virus must be able to replicate in humans and cause disease The new virus must be efficiently transmitted from human to human

Is a Pandemic imminent?: 

Is a Pandemic imminent? Influenza pandemics are rare but recurring events Some scientists believe it is only a matter of time until next pandemic Timing and severity cannot be predicted Influenza pandemics occurred three times in last century: 1918, 1957; 1968

Characteristics and Challenges of a Pandemic: 

Characteristics and Challenges of a Pandemic Rapid world wide spread Global spread is inevitable Border closures and travel restrictions may delay arrival of virus, but cannot stop it Occurs in “waves” – from 6-12 weeks long Second wave occurs 3-12 months after first

Health Care Challenges: 

Health Care Challenges Most people have little or no immunity Infection and illness rates will dramatically increase Many people will require some form of medical care Inadequate supplies of anti-viral drugs Resistance to anti-viral drugs

What is the US Government Doing?: 

What is the US Government Doing? www.pandemicflu.gov Collaborating with WHO to monitor and contain outbreaks Developing stockpiles of medications Support testing and manufacture of vaccines Helping local and international gov’ts and businesses to prepare for PI outbreak

Department of State Plan: 

Department of State Plan Well along in development – modeled after Federal Gov’t plan Information Preparation Washington Field

Embassy/Consulate Plan: 

Embassy/Consulate Plan Monitoring Planning Preparing

What can you do?: 

What can you do?

What can you do?: 

What can you do? Inform yourself Avoid contact with poultry and wild birds Avoid backyard farms Avoid live poultry markets Wash your hands frequently (soap and water, or alcohol based hand gels)

Model good hygiene: 

Model good hygiene Preventing respiratory infection is key Cover your nose/mouth when coughing or sneezing Use disposable tissues – then dispose of them! Wash hands frequently with soap and water or alcohol hand gel. Stay away from sick people. STAY HOME from work and school if sick!

When Preparing Food : 

When Preparing Food Separate raw meat and its juices from cooked or ready-to-eat foods Use separate cutting boards Do not place cooked meat back on same surface or plate it was on before it was cooked Wash eggs (shells) in soapy water Cook all poultry products thoroughly (70˚C or 158˚F) Wash all surfaces with soap and water

Plan for a Pandemic: 

Plan for a Pandemic Store a supply of food and water Obtain an extra supply of your regular prescription medication Have other nonprescription drugs and medical/health supplies on hand Plan how you or your family members would obtain or give care at home if sick

Items to have on hand for an extended stay at home: 

Items to have on hand for an extended stay at home

Food and Non-perishables: 

Food and Non-perishables Ready to eat canned meats, fruits, vegetables and soups Protein or fruit bars Dried fruit Crackers Bottled water Pet food

Medical & Health Supplies: 

Medical & Health Supplies Prescription medications Acetaminophen, Ibuprofen Anti-diarrhea medication Vitamins Fluids and electrolytes Thermometer Alcohol based hand wash

Emergency Supplies: 

Emergency Supplies Clorox or water purification tablets Flashlight / candles Batteries Portable radio Manual can opener Garbage bags Tissues, toilet paper, disposable diapers

If a Pandemic Occurs: 

If a Pandemic Occurs Avoid people who are sick If you are sick – STAY HOME Contact your health care provider

Summary: 

Summary Be informed Be prepared Practice healthy habits