Delphi AP Preparedness for Avian influenza (bird flu)

Contents
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. What is bird flu? What are the symptoms in humans? How does bird flu spread to humans? How long is a person with flu virus contagious? What can you do to prevent being infected? Eating Habits? Tips for cooking poultry Travel to other countries Vaccination What should I do if I suspect I have bird flu? Comparison with SARS & Flu WHO Update Action Plan?

Health & Safety Is the Overriding Priority

1 All Incidents Can Be Prevented

What is Avian influenza (bird flu)?

1. Bird flu is a disease affecting birds that is caused by several types of flu viruses. Highly Pathogenic bird flu (HPAI) is a highly contagious disease affecting wild birds and poultry This disease has been responsible for recent human outbreaks and deaths in European and Asian countries

2.

3.

4.

There are three types of flu viruses - A, B and C. Only types A and B cause significant human disease. Flu A is further sub-typed according to the type of proteins (H) and (N) proteins on its outer layer. There are 15 different H types (H1, H2, H3, etc) and 9 different N types (N1, N2, N3, etc).
The current outbreak of bird flu in poultry which affected humans is caused by the H5N1 subtype of flu A virus

5.

Health & Safety Is the Overriding Priority

2 All Incidents Can Be Prevented

What are the symptoms in humans?

1. 2. 3. 4.

Fever, cough, muscle ache, runny nose, and sore throat Some may get eye infections and have difficulty breathing Pneumonia or other complications may occur at a later stage There is no evidence to date that the disease is spread through casual contacts. Concerned employees can contact their personal doctor or public health authorities

5.

Health & Safety Is the Overriding Priority

3 All Incidents Can Be Prevented

How does Avian Influenza spread to humans?

Bird flu spreads to humans mainly through contact with infected birds, which shed the virus in their saliva, nasal secretions and droppings. Very rarely, human-to-human transmission may occur (insufficient data to support this at this time)

Health & Safety Is the Overriding Priority

4 All Incidents Can Be Prevented

How long is a person with flu virus contagious? The period when an infected person is contagious depends on the age of the person. Adults may be contagious from one day prior to becoming sick and for three to seven days after they first develop symptoms. Some children may be contagious for longer than a week.

Health & Safety Is the Overriding Priority

5 All Incidents Can Be Prevented

What can you do to prevent being infected? 1. 2. Avoid visiting poultry farms. If you intend to travel to countries with cases of bird flu, you should adopt the following good hygiene practices to minimize your risk of acquiring bird flu: 3. Avoid contact with live poultry and birds, especially for children. Avoid crowded areas and stay in places with good ventilation. Wash hands thoroughly with soap and water after handling live poultry and birds, and when they are dirtied by respiratory secretions e.g. after sneezing. Observe good personal and environmental hygiene.

You should also build up a strong immunity system in your body. Start by having a regular exercise regime, a well-balanced diet that includes two servings of vegetables and two servings of fruits daily, adequate rest, reducing stress and not smoking.

Health & Safety Is the Overriding Priority

6 All Incidents Can Be Prevented

Eating Habits?
The poultry and eggs available in the market are safe to eat No evidence that you can get bird flu by eating cooked chicken or eggs or other poultry Canned poultry products such as essence of chicken are also safe to eat All canned products undergo a heat treatment process that effectively destroys any viruses

Health & Safety Is the Overriding Priority

7 All Incidents Can Be Prevented

Tips for cooking poultry Separate raw food from cooked food Wash your hands before and after preparing food Cook poultry meat thoroughly Avoid eating raw or half-boiled eggs or semi-cooked meat

Health & Safety Is the Overriding Priority

8 All Incidents Can Be Prevented

Travel to other countries

World Health Organization has not advised any travel restrictions so far No quarantines measures are in place in any country When visiting affected countries, avoid farms and live poultry and birds, and adopt good hygiene practices

Health & Safety Is the Overriding Priority

9 All Incidents Can Be Prevented

Vaccination

Should I get vaccinated against flu before I travel?

Health experts recommendation: Children aged 6 months and older should be vaccinated if travelling to countries where outbreaks have occured Persons likely to be exposed to infected chickens or farms should also be vaccinated Purpose of vaccination is to avoid risk of people being infected by bird and human virus at the same time

Health & Safety Is the Overriding Priority

10 All Incidents Can Be Prevented

What should I do if I suspect I have bird flu? Consult your doctor immediately if you have had contact with live birds or travelled to a country which has cases of bird flu Or call public health authority to take you to the Communicable Disease Centre for evaluation

Health & Safety Is the Overriding Priority

11 All Incidents Can Be Prevented

Comparison with SARS & Flu

Avian Flu Flu
H1H2H3N1N2 SARS CoV.
Fever38, dry cough, short breath, possibly headache, muscle stiffness, poor appetite, fatigue, diarrhea, or skin rash. Detection of pathological changes through Xray

SARS

Virus

H5N1H7N2
Headache, fever, cough, running noise, sore throat, muscle and joint ache, vomit, diarrhea, poor appetite (similar to common flu and hard to distinguish) 1-5 days, possibly contagious before and after symptoms appear Contact with bird feces or breath in dry bird feces ducts Avoid contact with birds, strict personal hygiene

Symptoms

Fever, cough, running noise, sore throat, body ache

Incubation period Transmissi on Route Prevention

About 1-3 days, contagious before and after symptoms appear Flying particles of saliva or phlegm

3-10 days, no indication to be transmitted during incubation period Close contact or breathe in flying particles of saliva, phlegm, or body fluids of SARS patients Wear surgical mask if fever occurs, frequently wash hands and measure body temperature, and avoid hospitals Antiviral medications, antibiotics, interferon, supportive treatments

Flu vaccination

Treatment

Influenza antiviral medications

Influenza antiviral medications

High Risk Industry

Poultry, butchery, & farm industries, hospital & medical personnel, laboratories

General population

Hospital & medical personnel, laboratories

Health & Safety Is the Overriding Priority

12 All Incidents Can Be Prevented

WHO Update 23 Jan 2006

Date of onset

Camb odia

China

Indonesia

Thailand

Turkey

Viet Nam

Total

c a s e s 2003 2004 2005 2006 Total 0 0 4 0 4

d e at h s 0 0 4 0 4

ca se s

de ath s

cases

deaths

cases

deat hs

cases

deat hs

cases

deaths

cases

deaths

0 0 8 1 9

0 0 5 1 6

0 0 16 3 19

0 0 11 3 14

0 17 5 0 22

0 12 2 0 14

0 0 0 4 4

0 0 0 2 2

3 29 61 0 93

3 20 19 0 42

3 46 94 8 151

3 32 41 6 82

Total number of cases includes number of deaths. WHO reports only laboratory-confirmed cases

Health & Safety Is the Overriding Priority

13 All Incidents Can Be Prevented

WHO Update
COUNTRIES WITH HUMAN CASES IN THE CURRENT OUTBREAK 1. To date, human cases have been reported in seven countries, most of which are in Asia: Cambodia, China, Indonesia, Thailand, Turkey,Viet Nam and some Africian countries like Nigeria. The first patients in the current outbreak, which were reported from Viet Nam, developed symptoms in December 2003 but were not confirmed as H5N1 infection until 11 January 2004. Thailand reported its first cases on 23 January 2004. The first case in Cambodia was reported on 2 February 2005. The next country to report cases was Indonesia, which confirmed its first infection on 21 July. Chinas first two cases were reported on 16 November 2005. Confirmation of the first cases in Turkey came on 5 January 2006. All human cases have coincided with outbreaks of highly pathogenic H5N1 bird flu in poultry. To date, Viet Nam has been the most severely affected country, with more than 90 cases. Altogether, more than half of the laboratory-confirmed cases have been fatal. H5N1 bird flu in humans is still a rare disease, but a severe one that must be closely watched and studied, particularly because of the potential this virus to evolve in ways that could start a pandemic.

2.

3.

4.

Health & Safety Is the Overriding Priority

14 All Incidents Can Be Prevented

Delphi Plan 1. 2. Keep track of travellers Employees to affected countries Travel control if there is an epidemic Country is affected 2 or more employees are affected Govt has recommendations on restriction Daily monitoring employees Monitoring of employees for symptoms Employees to keep company informed of family members affected Refer to designated doctor if necessary Delphi to work with Designated Company Doctor Doctor will coordinate with CDC if necessary Daily reporting to corporate

3.

4. 5. 6.

Health & Safety Is the Overriding Priority

15 All Incidents Can Be Prevented