Planning for Avian Influenza

Annals of Internal Medicine ^ | July 18, 2006 | John G. Bartlett, MD

[Judith Anne]

This is only part of a very long article that I really hope people unfamiliar with Avian Flu take the time to read.

For those of us who are already informed, here it is in a (rather large) nutshell.

[Judith Anne]

Please ping your lists to this article for discussion.

Thanks.

[mtbopfuyn]

While I agree that "Preevent planning is critical", I don't believe it's going to decimate the human population. There is a neighbor here who isn't picking her garden because birds might have pecked at something and she'll get bird flu. I really should ask if she's also quit eating chicken and beef.

[Mrs. Shawnlaw]

I'm holding out for eboli or swine flu.

[LucyT]

This planet is fortunate to produce people willing to care for others. It's more than "just a job." Another excerpt from the article:

Caring for victims of an influenza pandemic will endanger health care workers.
---
SARS was a recent prototypic example of an infection that had a high mortality rate and high risk for health care workers, who accounted for more than 20% of cases.

The health care professions rose to this occasion, and few if any reports of failure to serve exist.

A survey of 10 511 health care workers in Singapore during the SARS outbreak confirms this judgment:

Seventy-six percent of respondents said that caring for patients with SARS involved great personal risk but was also simply part of their job.

Forty-nine percent reported social stigmatization, and 31% reported ostracism by family members .. The experience in Toronto indicated good participation by health care workers but also a substantial psychological impact.

[Max in Utah]

...I don't believe it's going to decimate the human population.

If Avian Flu becomes as easily transmissible as common flu it could be nearly as bad as the Black Plague in medieval Europe, where about 1/3 of the total population died.

Because:

...this virus [avian flu] had caused ... infections in 218 patients, with 124 deaths—a mortality rate possibly as high as 55%

An unusual feature of the infection [1918 strain] was the high mortality rate in healthy persons 15 to 35 years of age.

Despite modern intensive care, the mortality rate for avian influenza is about 20-fold higher than that for the influenza of 1918.

...many of the patients with avian influenza died despite access to antibacterial agents, antiviral agents, and ventilatory support.

Hope someone comes up with an effective vaccine.

[blam]

"I really should ask if she's also quit eating chicken and beef."

I suggest you leave your neighbor alone.

[blam]

Climate Drives Migrating Birds Away From Eilat

By Zafrir Rinat

"Dr. Reuven Yosef, an ornithologist, decided to close the Eilat International Birding and Research Station, where he has been trapping and ringing birds for 20 years, a few weeks early this year. The reason: A sharp drop in the number of birds passing through Eilat on their annual spring journey from Africa to Europe."

"Worried about this shift in migration, Yosef contacted the Bonn, Germany-based organization responsible for implementing the international convention on protecting migrating birds, and asked it to conduct an urgent investigation into the acute decrease in the number of birds."

I wonder?

[Smokin' Joe]

ping

[Judith Anne]

It's hard to say what bird flu is going to do. Based on what it's already done, it's not good...But none of us can see around corners.

Obviously, I'm concerned about a pandemic. There are many nations in areas where H5N1 is endemic in the wild bird population who have little infrastructure to monitor and control outbreaks. WHO is, frankly, not much help.

But I guess it could just...go away.......

[Smokin' Joe]

From the AO Safety website:

What the General Public should know and understand about Respirators and Avian Influenza (H5N1)

Currently, we are not aware of any country or government in the world recommending the use of respirators by the general public for the virus that causes Avian Influenza H5N1 (Bird Flu) or any other influenza.

However, the World Health Organization (WHO), US Center for Disease Control (CDC), US Occupational Safety and Health Administration (OSHA), and several European and/ or National Health Protection agencies have recommended that health care workers exposed to patients with confirmed or suspected Avian Influenza use respiratory protection during certain procedures.

Government approved particulate respirators help reduce exposure to the Avian Influenza virus and recommendations include US NIOSH approved N95, European CE certified EN143P2 / EN149 FFP2, EN149FFP3, or higher-level respiratory protection.

Recommendations for respiratory protection have also been made for workers involved in culling and inspecting infected birds, and for people exposed to sick birds.

It is believed that most cases of Avian Influenza (H5N1) infection in humans have resulted from contact with infected poultry or contaminated surfaces.

In such situations, people should avoid contact with infected birds or contaminated surfaces, and should be careful when handling and cooking poultry.

Strict hand hygiene, such as frequent handwashing, must also be performed.

In addition to direct contact with infected poultry or contaminated surfaces, it is possible that the particles that contain Avian Flu virus could become airborne.

As other airborne biological agents, airborne Avian Flu virus, can be filtered by respirators with particulate filters.

Biological agents, such as viruses, are particles and can be filtered by particulate filters with the same efficiency as nonbiological particles having the same physical characteristics (size, shape, etc.).

However, unlike many non-biological particles, biological agents do not have exposure limits established by the government.

This means that any amount of virus particles you breathe may be unsafe.

Therefore, while respirators will help reduce exposure to airborne avian influenza virus particles, there is no guarantee that the user will not contract avian flu.

Respirators may help reduce exposures to airborne biological contaminants, but they don’t eliminate the risk of exposure, infection, illness, or death.

Nevertheless, if people in the general public make a personal decision to use a government approved respirator to help reduce their exposure to airborne influenza virus, they need to understand that:

1. Reducing exposure to the airborne influenza virus particles does not mean that the risk of exposure, infections and illness has been eliminated. Respirators only reduce the number of airborne particles that can get into your breathing zone.

Also, respirators will not prevent you from catching the flu in other ways such as touching your mouth, nose or eyes with contaminated hands or objects, or eating contaminated food.

At this time the CDC recommends the best precaution for the general public is hand washing.

2. In order for a respirator to be most effective, you must properly wear the respirator during the entire time you’re exposed. Removing the respirator to eat, drink, or smoke while you are in a contaminated area means you will be increasing the amount of virus particles you are breathing. You should contact the respirator manufacturer for further information on proper fit.

3. Fit of the respirator to your face is very important to minimize the number of virus particles getting inside your respirator. Particles can enter your respirator through any leaks between the respirator and your face large enough to let them in. Hair from beards and mustaches or anything that prevents the respirator from directly touching your skin can prevent a proper seal.

Following the fitting and the fit-checking instructions that come with the respirator are very important. Achieving a good fit means more of the air you breathe goes through the respirator filter.

4. Respirators are not intended for use by children or by individuals with a medical condition, such as asthma, emphysema or a history of heart disease, which may be aggravated by use of a respirator. If you have such a condition, consult your health care provider before use.

5. Disposable respirators should be thrown away after they are used and should not be shared with others.

6. Be sure to read and follow all instructions on the fit, use and warnings provided by the manufacturer before using any respirator.

7. Please be cautious of claims being made by websites and other sources regarding the use of respirators for protection against Avian influenza. We recommend that you reference CDC, WHO, and other government authorities for guidance.

February 3, 2006

[Judith Anne]

Thanks, Joe. Taking them off and decontaminating them also presents a risk. Respirators and other personal protective equipment can help, but are not foolproof.

[Smokin' Joe]

I wonder, too. There is a marked political tendency among the socialists' scientists to blame everything on global warming and other politically corect causes, and that may well bite us all. At least this scientist is calling for investigation into the matter, and not doing the usual knee jerk stuff (good science--cool!)

Are a significant portion of the birds which might have otherwise have been migrating through dead somewhere, or have they been accounted for in other areas?

In the article he notes:

He is not the only one to express concern recently over the fate of migrating birds. Early this month, BirdLife, the foremost bird protection organization in the world, published a long-term study revealing that over the last three years, the number of bird species that migrate from Africa to Europe - to nest in the spring - has fallen by more than 50 percent. Researchers in Eilat and Europe believe that the dwindling numbers are connected to environmental problems like climatic changes, and increased use of herbicides and pesticides in Africa.

snip

Alon says that the falling numbers in Eilat may have been caused by some birds choosing alternative migration paths. He notes that shifts in the number of migrating birds from year to year are not extraordinary. He also cites massive flooding at the Eilat birding park this year, which may have prevented the birds from stopping at the site. "We observed a decrease mainly in the species of birds that pass over Eilat rather than those in the north of the country," Yosef says.

"The flood at the birding park did not damage the area where we do our tagging, where birds may stop to rest and eat. It is true that there are years when we witness a shift in the numbers of birds, but the decrease this year is far beyond the usual changes, and represents something extreme. We must examine whether this is an ongoing problem."

(emphasis mine)

[bitt]

thanks for the ping!

[Gabz]

There is a marked political tendency among the socialists' scientists to blame everything on global warming and other politically corect causes, and that may well bite us all.

I agree. In Delaware and New Jersey they are blaming lower numbers of certain migratory birds on overharvesting of horseshoe crabs by commercial fishermen.

[Smokin' Joe]

I use a dual cartridge (R-61-P100) at work, because I need to cut down on some of the lung irritants I am exposed to. I work in a microenvironment (lab) on wellsite which after years was beginning to have a notoceable short-term effect on my lungs. (fine rock dust, petroleum vapors, and combustion byproducts/flue gasses from the gas detection equipment, and when the wind was wrong, exhaust from the diesels on the drilling rig--High SO2 off-road use diesel exhaust).

One day's worth of beard renders a respirator largely ineffective--in a chemical/fine particulate environment.

A five-O'clock shadow might be enough to cause exposure to a biological through leakage, so everyone who has to shave better add lots of razor blades to their list as well...

[Smokin' Joe]

When I lived in Maryland, the only time you saw horseshoe crabs was during the mating season. Otherwise, they were offshore doing their thing and rarely sighted.

Offhand, that sounds like another PC reason to me.

Which birds are they blaming the shortage on?

[Gabz]

You would have to ask that question, wouldn't you.

I knew the name when I typed the first message, but it is gone....

But yes, I agree it could be another PC reason, which to me is REALLY assinine, considering the nature of the poultry industry not only in Delaware, but the entire DelMarVa Peninsula.

OTOH, the people blaming the commercial fishermen have long been trying to shut those guys down in Delaware and will resort to any means possible - but that's a topic for another day and another thread.

[little jeremiah]

Thanks for posting this, will read later and pass on to anyone I know who hasn't gotten it yet.

[tinacart]

I'm holding out for mad cow...