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What is avian influenza (bird flu)?
Avian influenza is a type of influenza that usually infects birds. There are a number of different avian influenza strains, and they vary in severity. The strain that is currently causing a lot of concern is called H5N1. It was first found in Asia in 1997. Since 2003, more than 200 people in Asia, Europe, the Middle East, and Africa are known to have been infected with this form of bird flu. About half of these people have died. Most people infected with avian influenza have had direct contact with infected chickens or other poultry. So far, there is no evidence that bird flu can spread readily from one person to another. It is possible, however, that the virus could change (mutate) into a form that could spread easily from person-to-person. If that happens, a global outbreak could occur, causing much illness and many deaths. This is why governments around the world are keeping a close eye on the bird flu virus.
What is a flu pandemic?
A pandemic is a global outbreak. Fortunately, flu pandemics are rare. They happen only when a new strain of flu appears in the human population, and spreads readily from person-to-person worldwide. Flu pandemics can be much more serious than seasonal outbreaks of flu. Compared to seasonal outbreaks, which happen every winter, pandemics can cause more severe illness because most people have never been exposed to the new strains of flu and therefore have no immunity.
A pandemic of avian flu would only occur if these bird flu viruses change so that they can be passed readily from human to human. This has not yet been shown to occur during the current bird flu situation. The current highly pathogenic avian influenza H5N1 strain does not spread readily from person to person. Experts are monitoring this strain for changes in the virus that might indicate that it could start a pandemic, but at this time it is still a disease primarily of birds, not humans.
The flu pandemic of 1918, killed at least 20 million people worldwide and caused great suffering and financial loss. Flu pandemics in 1957 and 1968 also killed millions worldwide. For more information on these pandemics, visit CDC's website.
What is the New York City Department of Health and Mental Hygiene doing to prepare for a possible flu pandemic?
The Department is working with many organizations and partners, including the medical community, City hospitals, and state and federal health officials, to prepare for a possible flu pandemic in New York City. Planning includes making sure hospitals are ready to treat patients, educating doctors, and providing information to all New Yorkers. The City has a number of systems in place to identify where and when flu viruses occur, and to help us communicate quickly with doctors and the public about how to avoid infection.
How does bird flu spread?
The avian flu virus H5N1 is present in the saliva, nasal secretions, and droppings of infected birds. Birds spread the virus to other birds through either direct contact, or contact with surfaces contaminated with these secretions and/or feces. Health officials believe that nearly all people with H5N1 since 2003 became infected through direct contact with infected poultry.
What are the symptoms of avian flu?
Symptoms are different in different people. Some people have had typical flu-like symptoms, such as fever, cough, sore throat, and muscle aches. Others have had eye infections, pneumonia, severe respiratory disease, gastrointestinal illness and other serious and life-threatening complications.
Is there a bird flu vaccine?
Not yet. The federal government has been working since April 2005 to develop a vaccine, and clinical trials are now underway. For more information about vaccine development, visit the National Institutes of Health's website.
Once a vaccine becomes available, how would I be able to get one?
If a pandemic were to occur, supplies of vaccine would be prioritized in stages over the weeks and months of the pandemic. People who would be first responders to the pandemic, and those at highest risk for serious illness and death from avian flu would be offered vaccine first. After that, the City is preparing to open large-scale vaccination clinics called Points of Dispensing (POD) Sites. Finally, when enough vaccine is available, people would most likely be able to get it from their doctors.
If there is an outbreak of pandemic flu, is there any way to protect myself?
The best way to avoid spreading flu and many other respiratory diseases is for people to cover their noses and mouths when they cough or sneeze. Frequent hand washing with soap or an alcohol-based cleaner helps prevent the spread of germs. Also, anyone with cough and a fever over 101 degrees Fahrenheit should stay at home until the fever subsides. People who are more severely ill should see a doctor, especially if they have shortness of breath and chest pain. Everyone should take these precautions during “regular” flu season as well.
How is bird flu infection treated in people?
Treatment is mainly supportive care (e.g., get plenty of fluids and rest). Doctors might also give antibiotics to prevent or treat bacterial infections that sometimes accompany the flu. Some antiviral medications commonly used to treat “regular” flu symptoms may be used to treat avian flu in persons most at risk for severe illness or death, including older adults and people with lung or heart disease. One of these medications, Tamiflu®, may help reduce the seriousness of avian influenza H5N1. However, there may not be enough of these medications available to treat everyone in the early stages of a pandemic.
Should I ask my doctor for Tamiflu® now so that I can take it if there is ever a pandemic in New York City?
No. Doctors should not prescribe Tamiflu® to people who do not need it. We strongly discourage people from getting or stockpiling the drug if they are not ill. Taking Tamiflu® improperly could lead to drug resistance. Supplies of the drug are needed to treat people who are sick with the “regular” human type of flu that appears every year. Also, it is not clear whether Tamiflu® would be effective against the particular strain that was circulating if a pandemic occurred.
What is currently going on with H5N1 bird flu worldwide?
Human infections of avian flu have been reported in Azerbaijan, Cambodia, China, Egypt, Indonesia, Iraq, Thailand, Turkey, and Vietnam. Outbreaks of bird flu were first noted among birds in Asia in late 2003 and early 2004. In 2005, outbreaks of the deadly bird virus were reported in Eastern European countries and again in South Asia. 2006 has seen the virus spread among birds to countries in Africa, Western Europe, and the Middle East. More than 100 million birds in these countries either died from the disease or were killed to control its spread.
What is the risk to people from the H5N1 virus in Asia, the Middle East, Europe, and Africa?
So far, spread of H5N1 virus from person to person has been extremely rare. However, because all flu viruses have the ability to change, the H5N1 virus could one day become highly infectious and spread easily from one person to another. Experts from around the world are watching the situation very carefully and preparing for the possibility that the virus may begin to spread more readily and widely.
What is the risk to people in the United States from the H5N1 bird flu outbreak overseas?
The strain of H5N1 virus found overseas has not been found in the United States, or anywhere else in North or South America. It is possible that travelers returning from affected countries in Asia could be infected if they were exposed to the virus as a result of direct contact with infected poultry (at a live poultry market, for example) or with a person infected with avian flu. Since February 2004, medical and public health professionals have been on alert to find any such cases, but there have been no bird or human cases of H5N1 flu in the United States. For more information on travel to countries affected by avian flu visit the CDC's website
If I see a dead bird in New York City, should I report it?Dead birds can be reported to 311 during West Nile virus season (which runs from May 1 through October 31 each year). While individual dead birds may be collected and tested for WNV, a smaller proportion of those birds may also be tested for avian influenza. Year round, the DOHMH will work with other city, state and federal agencies and partners to investigate clusters of dead birds that are reported in New York City.
H5N1, the strain of bird flu causing bird illness overseas has not been found in birds or humans in New York City, or anywhere in the western hemisphere at this time. Federal and state agriculture agencies are monitoring poultry and migratory birds for avian influenza. DOHMH is working closely with these agencies so that H5N1 avian flu could be detected quickly if it appeared in New York City. For more information about surveillance for H5N1 in migratory birds visit the United States Department of Agriculture's website.
And about surveillance in poultry visit the NYS Department of Agriculture and Markets website.
Could I get bird flu from a bird in New York City?
H5N1, the strain of bird flu causing serious problems overseas, has not been found in birds in New York City. Contact with birds found in New York City does not pose a risk for infection with H5N1.
Should I avoid eating eggs or poultry?
No. There is not currently any evidence to suggest that eating eggs or poultry in the U.S. could cause infection with avian flu. For general food safety, however, whole poultry should always be cooked to 180° F, and chicken breasts to 170° F. Eggs should be cooked until the yolks and whites are firm. Always wash hands, cutting boards, dishes, and utensils with hot, soapy water after they come in contact with raw meat, poultry, and seafood.
For more information about avian influenza:Centers for Disease Control and Prevention (CDC)
World Health Organization (WHO)
Last Updated: May 9, 2006