1. mmmmm Mohamed M. B. Alnoor CHP400 COMMUNITY HEALTH PROGRAM-II Avian Influenza H5N1 Epidemiology & Control mmmmm

2. Avian Influenza Content Definition Transmission in birds Infection and Disease in poultry Epidemiology Prevention Features in humans

3. mmmmm Avian Influenza Definition Avian influenza is an infection caused by (bird) influenza viruses naturally occurring among birds. esp the waterfowl Avian Influenza H5N1 ducks geese swans البـط الأوز البجــع

4. mmmmm Avian Influenza Definition The complete host range is not known Wild birds worldwide carry the viruses in their intestines, but usually do not get sick from them. Avian Influenza H5N1

5. mmmmm Avian Influenza Transmission in birds  secretions  excretions  surfaces Avian Influenza H5N1 Infected birds shed influenza virus in:  saliva  nasal secretions  feces. Susceptible birds become infected when they have contact with contaminated For 10 days

6. mmmmm Avian Influenza Geographic Range Most reported isolations have been from North America, Europe and Asia A few isolations from Australia, Africa, and South America No reported isolations Antarctica Avian Influenza H5N1

7. mmmmm Avian Influenza  AIV is not normally found in domestic ducks, chicken and turkeys  Transmission of AIV from wild birds to domestic poultry species occurs commonly (ducks>turkeys>chicken)  AIV on rare occasions may become established in chicken and turkeys and result in serious disease outbreaks  AIV once adapted to chicken and turkeys can be difficult to eradicate Infection in Poultry Avian Influenza H5N1

8. mmmmm Avian Influenza Two main forms of disease: a- The low pathogenic :can go undetected and usually with mild symptoms b-The highly pathogenic : spreads more rapidly through flocks of poultry. It may affect multiple internal organs and has a mortality :90-100% often within 48 hours. Avian Influenza H5N1 Disease in Poultry

9. mmmmm Avian Influenza Epidemiology WHO: ≤ 3/2013 :622 human cases of avian influenza A (H5N1) in: Asia, Africa, the Pacific, Europe and the Near East. Indonesia and Vietnam have reported the highest number of cases. Case Fatality Rate(371/622) ≈ 60%. The majority of cases have occurred among children and adults <40 years. Avian Influenza H5N1 E x p o s u r e

10. mmmmm Avian Influenza Mortality was highest in cases aged 10-19 years old. Significant risk factors : direct contact with sick or dead poultry or wild birds, or visiting a live poultry market. Most human H5N1 cases have been hospitalized late in their illness with severe respiratory disease. A small number of clinically mild H5N1 cases have been reported. Epidemiology Avian Influenza H5N1 bird-to-human transmission

11. mmmmm Avian Influenza  Children and young adults  Abdominal symptoms common Avian Influenza H5N1  Diarrhoea  Vomiting  Abdominal pain  Pneumonia  Lymphopenia  Deranged LFTs Features in humans

12. mmmmm Avian Influenza SPREADING FEAR 1996 H5N1 virus is isolated from a farmed goose in Guangdong province, China 1997 Six deaths in Hong Kong linked to H5N1 12/2003 Two tigers and two leopards die after eating H5N1-infected chicken in Thai zoo 12/2003 South Korea: H5N1 as a cause of poultry deaths at 3 farms 1-2/2004 Vietnam, Japan, Thailand, Cambodia, Laos, Indonesia, China and Malaysia report H5N1 in poultry Avian Influenza H5N1

13. mmmmm Avian Influenza SPREADING FEAR 1-3/2004 8 deaths reported in Thailand and 16 in Vietnam 7/2005 Russia reports bird flu in Western Siberia 10/2005 H5N1 in poultry in Turkey & Romania and in wild birds in Croatia 1/2006 Iraq has its first human case 1/2006 3 children/same family die in Turkish outbreak 2/2006 8 fatality China and Indonesia its 18th 2/2006 Bulgaria, Greece, Italy, Slovenia, Austria and Germany: virus in swans. Nigeria: in chicken and Iran: in wild birds Avian Influenza H5N1

14. mmmmm Avian Influenza Transmission& Prevention Leaves original host Survives in transit Escapes host defenses Multiplies and causes illness Facemasks, cough etiquette Cleaning, hand washing Social distance, cohorting Facemasks, handwashing Vaccination Delivered to a susceptible host Reaches a susceptible part of the host Avian Influenza H5N1 The virus

15. mmmmm Avian Influenza Next is rodent flu

16. mmmmm Avian Influenza Conclusion Avian Influenza H5N1 H5N1 is a rare disease in people. The virus does not infect humans easily. Scientists are concerned that the virus one day could spread easily from person to person. High case fatality rate No pandemic so far!