What Is Bird Flu? Should We Be Concerned? (cont.)
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dennis Lee, MD
Dennis Lee, MD
Dr. Lee was born in Shanghai, China, and received his college and medical training in the United States. He is fluent in English and three Chinese dialects. He graduated with chemistry departmental honors from Harvey Mudd College. He was appointed president of AOA society at UCLA School of Medicine. He underwent internal medicine residency and gastroenterology fellowship training at Cedars Sinai Medical Center.
By March 2004, this outbreak was considered to be under control. Beginning in late June 2004, however, new outbreaks of influenza H5N1 among poultry were reported by several countries in Asia (Cambodia, China [Tibet], Indonesia, Kazakhstan, Malaysia, Mongolia, Russia [Siberia], Thailand, and Vietnam). Most recently, influenza H5N1 has been reported among poultry in Turkey and Romania. Outbreaks in wild and domestic birds are also under investigation in other countries.
Despite efforts to contain the outbreak, the World Health Organization (WHO) now considers the virus to be endemic in birds (meaning that the infection is steadily maintained) in many parts of Indonesia and Vietnam and in some parts of China, Cambodia, and Thailand.
In April 2013, four people in China were reported to be infected with a new strain of bird flu, known as H7N9. Two of the infected people died, and studies are under way to characterize how the virus was transmitted and whether or not it could be spread among humans.
When bird flu infects humans
Bird flu symptoms in humans can vary and range from "typical" flu symptoms (fever, sore throat, muscle pain) to eye infections and pneumonia. The disease caused by the H5N1 virus is a particularly severe form of pneumonia that leads to viral pneumonia and multiorgan failure in many people who become infected. Up to 50% of humans who contract bird flu die from the infection. During an outbreak of bird flu, people should avoid contact with domesticated bird populations and surfaces that may have been contaminated by bird excretions.
Over 100 humans have become infected in the current bird flu outbreak. Confirmed cases of human infections have occurred in Cambodia, Indonesia, Thailand, and Vietnam. Most of those infected have come from rural areas where many people keep poultry flocks that often roam freely and enter dwellings. Infected birds shed virus in their feces, leading to widespread contamination of homes and surroundings. Most of the people who have become infected were previously healthy adults and children. Infection also occurs during the slaughter of infected birds.
Research has suggested that the prescription antiviral medicines approved to treat human flu virus infections (such as Tamiflu) should work in helping preventing bird flu infection in humans. However, flu viruses can become resistant to these drugs, so these medications may not always work. Additional studies are needed to prove the effectiveness of these medicines.
Why is there so much concern about bird flu?
There are many questions about bird flu that remain unanswered and are under investigation. It is known that some forms of bird flu viruses, such as H5N1, are more highly pathogenic (cause more serious illness) than others, yet the reasons for these differences are unclear. Human and bird influenza viruses have a similar structure but differ in the composition of proteins on their external surfaces. Because influenza viruses have the capacity to mutate, or undergo changes in their surface proteins, scientists are concerned that the bird flu viruses may eventually change into forms of the virus that are able to infect humans more easily.