1. Avian influenza
A simple introduction

2. What is avian influenza?
Bird flu
highly species-specific , birds
Occasionally, pigs and human
2 types
low pathogenic
go undetected
high pathogenic
~100% mortality within 48 hours

3. Structure of avian flu Type A influenza virus Classified by different
proteins on the surface
Influenza A virus, the virus that causes Avian flu. Transmission electron micrograph of negatively stained virus particles in late passage.

4. Structure of avian flu Negative sense, single-stranded, segmented
Have 10 genes on eight
separate RNA
Colorized transmission electron micrograph of H5N1 (golden) grown in Madin-Darby canine kidney cells (green).

5. Structure of avian flu

6. Structure of avian flu
This transmission electron micrograph (TEM), taken at a magnification of 150,000x, revealed the ultrastructural details of an avian influenza A (H5N1) virion, a type of bird flu virus which is a subtype of avian influenza A. At this magnification, one may note the stippled appearance of the roughened surface of the proteinaceous coat encasing the virion.

7. Structure of avian flu
This transmission electron micrograph (TEM), taken at a magnification of 108,000x, revealed the ultrastructural details of two avian influenza A (H5N1) virions, a type of bird flu virus, which is a subtype of avian influenza A. At this magnification, one may note the stippled appearance of the roughened surface of the proteinaceous coat encasing each virion.

8. How do people become infected?
Human infection
How do people become infected?
direct contact with infected poultry
intake of infected poultry
contact with contaminated water source
consumption of inadequately cooked poultry

9. Symptoms
Diarrhoea (腹瀉)
Vomiting
Abdominal and chest pain
Bleeding from nose and gums
High fever > 38oC
Respiratory symptoms

10. People's Republic of China
Confirmed cases of avian influenza of type A (H5N1) (Updated on March 24, 2006)
Country
Report dates
Total
2003
2004
2005
2006
cases
deaths
 Azerbaijan 7 5
71.4 %
 Cambodia 4
100 % 1
 People's Republic of China 8
62.5% 6
75.0% 16 11
68.8%
 Indonesia 17
64.7% 12
91.7% 29 22
75.9%

11. Confirmed cases of avian influenza of type A (H5N1) (Updated on March 24, 2006)
 Iraq 2
100 %
 Thailand 17 12
70.6% 5
40.0% 22 14
63.6%
 Turkey 4
33.3%
 Vietnam 3 29 20
69.0% 61 19
31.1% 93 42
45.2%
Total 46 32
69.6% 95 41
43.2%
186
105
56.5%
Source World Health Organization (WHO) : Communicable Disease Surveillance & Response (CSR).
Total cases
Total deaths

12. Highly pathogenic H5N1
 →  Countries with poultry or wild birds killed by it
 →  Countries with humans and poultry or wild birds killed by it

13. Only H5N1 is fatal to human
Why is it fatal to human?
Only H5N1 is fatal to human
no scientific confirmation yet
multi-organ dysfunction
difficulty in breathing
intravascular coagulation

14. A pandemic can start! Pandemic risk When ...
a new influenza virus subtype emerges
it infects humans, causing serious illness
it spreads easily and sustainably among humans.
A pandemic can start!

15. We are now in danger! Pandemic risk H5N1 has reached 2 conditions
it is a new virus for humans
it has infected more than humans, killing over half of them
We are now in danger!

16. 2 ways to become a pandemic virus
H5N1 as a pandemic virus
2 ways to become a pandemic virus
reassortment
result in a fully transmissible pandemic virus
adaptive mutation
a slower process
can be prevented

17. Prevention - Personal Avoid contact with live birds
Wash hands after any poultry contact
Cook poultry well done before eating
Avoid crowded places with poor ventilation
Wear gloves, a mask, goggles and a disposable gown when contact poultry

18. Prevention - Government
Provide vaccine injection
Kill birds infected with avian flu
Stop transport of poultry

19. Treatment Western Medicine oseltamivir (Tamiflu) / zanamivir (Relenza)
reduce the severity and duration of illness
useful with early
administration(48 hrs)
improve prospects of survival

20. Treatment (for interesting /reference ONLY...)
Chinese medicine - herbal remedy
It is still uncertain if it works...

21. Thanks for your attention!
END
Thanks for your attention!