THE BIRD FLU by G.W. von Kamrath Please Note: that the author is not a health professional, nor connected with the scientific community. The below information is has been compiled from various articles and reports available from sources in the public domain. We have all heard or read the alarming reports concerning avian influenza commonly referred to in the media as the “bird flu.” The Department Human Services and Heath (HS&H) announced in early March 2006, that citizens should stockpile at least three days’ supply of water, food stuffs, and required medications. This was followed by reports that Dr. Robert G. Webster of the World Health Organization (WHO), who first reported the deadly H5N1 strain of avian influenza back in 2003 and predicted the dire consequences of it spreading, had personally stored at least 90 days of supplies to survive without having to venture out into the public and urged others to do likewise in order to survive a worldwide pandemic of influenza that could result in a pandemic that would surpass the severe and fatal outbreaks of 1917, 1957, and 1968. Then there were reports that the Center for Disease Control (CDC) had failed to develop a serum to prevent the bird flu and the pharmaceutical industry was unable to produce enough cold and flu medicines to meet the coming crisis of an influenza pandemic. All of this and more was sensationalized by the world media and has led to a growing concern that has occasionally bordered upon panic…. We interrupt this prediction of civilization’s eminent collapse and the mass extinction of large numbers of species including mankind for some actual facts and common sense about avian influenza! What is avian influenza? Avian influenza is a viral infection caused by a strain(s) of influenza. These influenza viruses occur naturally among birds. Wild birds worldwide carry the viruses in their digestive systems – specifically their intestines. However, the birds usually do not become sick from the viruses. Avian influenza is extremely contagious and some strains can make domesticated birds, e.g. chickens, ducks, turkeys, etc., and even budgerigars, very sick and even kill them. How common is avian influenza? While avian influenza is commonly present among wild bird populations worldwide, avian influenza outbreaks among domesticated birds only occur periodically from time to time around the world. If avian influenza is so common, why doesn’t it cause annual epidemics killing hundreds of thousands of birds annually? The avian influenza viruses can be classified into two forms: Low pathogenicity and highly pathogenic based on the severity of the illness they cause in domesticated birds. The majority of avian influenza strains are classified as Low Pathogenicity Avian Influenza (LPAI) and have few signs or symptoms of inflection. However, High Pathogenicity Avian Influenza (HPAI) strains are extremely contagious, causing illness and death among infected birds. Between 1997 and 2005, alone in the United States, there were 16 recorded outbreaks of LPAI Type A viruses (H5 and H7 subtypes) and one outbreak of HPAI Type A (H5N2) in poultry flocks. In November 2003, a patient was admitted to a hospital in New York. One of the initial laboratory tests identified an influenza Type A virus that was thought to be H1N1. The patient recovered and was released. Subsequent tests in March 2004, samples from the patient identified the virus as avian influenza H7N2 Type A virus. On 19 February 2004, the Canadian Food Inspection Agency announced an outbreak of avian influenza H7N3 Type A in poultry in British Columbia. Culling operations and other measures were performed. Officials reported two human infections of influenza H7 Type A: one in a person who participated in the culling operation and the other in a poultry worker, and both recovered after treatment. In February 2004, an outbreak of LPAI H7N2 Type A was reported on two poultry farms in Delaware and in four live bird markets in New Jersey supplied by the Delaware farms. In March 2004, samples from a flock of chickens in Maryland also tested positive for LPAI H7N2. In all case the flocks were destroyed and the site sanitized. Also, in February 2004, an outbreak of HPAI H5N2 Type A was reported in a flock of chickens in Texas. This was the first outbreak of a HPAI virus in the United States in 20 years. The primary reason avian influenza is not constantly in the forefront of media reporting is that most strains are of the LPAI variety and occur unnoticed, because these strains do not result in the deaths of large numbers of wild and domestic birds. How is avian influenza virus spread? Infected birds spread the influenza virus through their saliva, nasal secretions, and feces. Other birds become infected when they have contact with contaminated secretions or excretions or with surfaces that are contaminated infected birds from inhaling or consuming the virus. Domesticated birds can become infected with the avian influenza virus through direct contact with infected wild birds or other infected domesticated birds. Infection with avian influenza viruses in domestic birds causes two main forms of disease that are distinguished by low and high extremes of virulence. The LPAI forms may go undetected and usually causes only mild symptoms, such as ruffled feathers and a drop in egg production. The HPAI forms of influenza spreads more rapidly through domesticated birds populations primarily because they are usually raised in crowded conditions by farmers and hobbyists. The highly pathogenic forms may cause disease that affects multiple internal organs and spreads extremely fast among domesticated flocks, and has a mortality rate that can reach 90-100% often within 48 hours. Can avian influenza inflect humans? LPAI viruses pose no known serious threat to humans. However, recent media reports have speculated about the significance of mutations in the HPAI H5N1 avian influenza virus. Some reports have suggested that the likelihood of another pandemic on a scale greater than the 1917 pandemic may have increased as a result of changes in the H5N1 virus. Until the late 1990s, it was not believed that the H5N1 virus strain could be spread to humans. Yet, influenza viruses are inherently unstable. Influenza viruses lack a genetic proof-reading mechanism of many other types of viruses, thus small mutations are constantly occurring when the virus is reproducing itself in a host. The vast majority of these changes go undetected and uncorrected. Many of these mutations matter little in the big picture of the scheme of things. However, specific mutations can cause an influenza virus to evolve in unpredictable ways and in some cases acquire the properties enabling them to spread to mammals and specifically humans. The lack of understanding and ability to predict when mutations will occur in a given influenza virus make it impossible to know if or when a virus such as H5N1 might increase its transmissibility to humans. These mutations continue to affect patterns of the influenza viruses’ transmission and their spread among wild and domestic birds. To date however, the mode in which avian influenza is transmitted between birds has not had any major impact on its transmission to human or the evolving of human form of the virus and it transmission between humans. By this it is meant that human infections from avian influenza remain extremely rare. Admittedly, there have been a small number of documented cases of human infection of H5N1 in Asia and the Middle East, but in almost all documented cases the virus was contracted by farmers and rural inhabitants who lived in very close contact with infected domesticated birds, i.e. chickens and ducks. It has been determined the virus was transmitted not by the handling of the infected birds, but by inhaling dried feces that have become trampled into dust or stuck to the feathers or other parts of the body of the infected birds. The virus cannot be transmitted by consuming cooked poultry. As a precaution the Federal Drug and Alcohol (FDA) Administration’s Center for Food Safety and Applied Nutrition has started an educational program stating poultry should be fully cook at 165o or more before consumption. Considering the billions of humans in the world it remains extremely rare of humans to contract “Bird Flu.” Since 1997, when the first human infections with avian influenza virus H5N1 were documented, the virus has continued to mutate. By 2004, avian influenza had been documented as having infected at least 44 people in eight Southeast Asian countries resulting in 32 fatalities. As of April 2006, the number of documented cases had only grown to 192, with fatalities in 109 of those. Scientists were concerned that the HPAI H5N1 Type A virus could merge with human strains of the influenza virus. This could result in a new and possibly fatal influenza virus that in worse case conditions could be passed rapidly from person to person with potentially devastating results especial in crowded communities. Several Asian governments have commenced culling domestic poultry stocks to prevent further spread of the H5N1 virus. This has resulted in the destruction of millions of chickens, ducks, and turkeys in China and Southeast Asia. If avian and human strains of influenza exchanged genes, a new, highly infective virus could evolve and be passed easily from person to person. Initial reports of human to human transmission have been reported in Thailand and Vietnam are worthy of concern. There are two theories of how avian and human influenzas could merge creating a new hybrid mutation: 1.) That a human who was already infected with a human strain of influenza and came into contacted with birds infected with a HPAI such as H5N1 could have the two strains mutate and exchange genes in their body. 2.) That pigs could serve as reservoir of the virus. Pigs are susceptible to both avian and human strains of influenza. In the past, various swine influenzas have been easily transmitted to humans. If a pig became infected with both avian H5N1 and a human strain of influenza, the pig could serve as the source for a new hybrid mutation of the virus that could be transmitted to humans and easily passed between humans. However, it must be stressed that scientists have found no evidence of a H5N1 strain possessing both avian and human influenza virus genes. It has been determined that these rare isolated incidences of human to human transmissions may have been caused by the transmission of the avian influenza virus and not a new mutation. As of April 2006 human cases have been reported in the following countries: Azerbaijan, Cambodia, China, Indonesia, Iraq, Thailand, Turkey, and Vietnam. If pigs can contract avian influenza are other animals equally susceptible? Since the first reports of the outbreak of the H5N1 virus in birds began mid-2003 in Southeast Asia, there have been a few reports of H5N1 infection in domestic cats. Eating raw infected domestic poultry has been considered the source of infection for the cats in these reports. Additionally, in published accounts from various zoological publications some studies have reported H5N1 infections in large cats kept in captivity. In December 2003, two tigers and two leopards died unexpectedly in a Thailand zoo. Postmortem investigations found the H5N1 virus in their tissue samples and the source was attributed to the feeding of fresh chicken carcasses that were inflected with the H5N1 virus. Subsequently in February 2004, the H5N1 virus was also detected in tissue samples of a clouded leopard that died in a Thailand zoo. A month later in March 2004, at the same zoo where the clouded leopard had died a white tiger died from the H4N1 virus. In a published report in September 2004, studies demonstrated that domestic cats could contract the H5N1 virus and transmit the virus to other cats. In these experiments, the subject cats were inoculation of virus isolated from a fatal human case and fed raw chicken inflected with the virus. In the case studies the cats developed the disease. Zoo officials in Thailand were not sharing the results of studies done earlier in the year, because in October 2004, 147 tigers out of 441 captive tigers fed in a Thailand zoo being fed fresh chicken carcasses began dying or had to be euthanized. Investigations proved that in some cases tiger-to-tiger transmission of the virus had occurred. Authorities in Germany announced in late February 2006, that a dead domestic cat on the Baltic island of Ruegen had died of H5N1 avian influenza. Since mid-February, more than 100 wild birds have been found on the island dead of the H5N1 infection and it is assumed that the cat had caught the virus from catching and eating infected wild birds. Contrary to the transmission of the disease between wild and domesticated birds, there is no evidence that cats can serve as a transmission cycle of H5N1 viruses. There are NO human cases linked to exposure to infected domestic cats. Has the H5N1 Avian Influenza Virus spread to the United States? As of April 2006, there have been no recorded cases of Avian Influenza H5N1 Type A virus in the United States. The below time line shows the spread of the H5N1 strain around the world: Mid-2003: The first detection of the H5N1 virus in wild birds begins in Southeast Asia is documented. Late June 2004: New outbreaks of H5N1 were reported among domestic poultry flocks in Cambodia, China, Indonesia, Malaysia, Thailand, and Vietnam. May 2005: Outbreaks of H5N1 were reported among poultry in Kazakhstan, Romania, Russia, Turkey, and Ukraine. Since May 2005: China, Croatia, Mongolia, and Romania have documented outbreaks of H5N1 in wild and migratory birds. January 2006: Hong Kong reported a signal case of H5N1 in a wild bird. February 2006: The first cases of H5N1 or H5 infections in poultry and/or wild birds are reported in the following countries: Albania, Austria, Azerbaijan, Bosnia and Herzegovina (H5), Bulgaria, Egypt, France, Georgia, Germany, Greece, Hungary, India, Iran, Iraq (H5), Italy, Niger, Nigeria, Pakistan (H5), Poland, Serbia and Montenegro (H5), Slovakia, Slovenia, and Switzerland. With populations of migratory bird from Asia and the Americas mixing in the summer months in Alaska and Canada it is expected the cases of H5N1 will be documented in northern Alaska and Canada within a very short period and the virus will spread south into the rest of North America and then South American with the southward migration of these wild bird starting in August of this year. What precautions are being made to combat the spread of H5N1? Over the counter medications such as “Airborne” and “Theraflu” treat symptoms, but do no combat the influenza virus. Current strains of H5N1 appear to be resistant to the drug, Flumadine, which is one of the major weapons used against influenza and it is questionable what positive affect the drug Tamiflu will have if not taken during the immediate onset of the virus. As of yet, there are no vaccines against avian influenza H5N1. The influenza vaccine, commonly known as the “Flu Shot,” is developed each year to combat only particular influenza strains that are emerging in Asia and have mutated into human viruses. The key point is ‘have mutated into human [influenza] viruses.” It is not a well-known fact, but the CDC and various pharmaceutical laboratories predict which strains of influenza will become prevalent in the human population for the following year. It is a guessing game at, which they have become very good at, which determines what vaccines are developed. In order for an influenza virus to spread among a human population, it must mutate and become somewhat consistent in its form to spread form human to human. Remember that influenza viruses are constant mutating. Only when the virus has evolved to this point where it a mutated and remains consistent enough in its form to spread among a human population is it possible for the development of an effective vaccine. It is a rather “catch-22” scenario, you can not develop a vaccine for influenza that has not infected enough of a population to obtain samples of the virus that has stabilized and allowed for development of a vaccine to fight it. Additionally, there are the economic factors in that it is not cost effective to spend millions of dollars for the development of vaccines to fight viruses that do not inflect hundreds of thousands or millions of people. This has not been the situation with the little over 100 documented cases in Asia, which for the most part were isolated forms of the virus, similar strains, but not completely identical forms of the same virus. The Federal government has set aside $3.8 billion to develop vaccine programs and stockpile Tamiflu in preparedness for the possibility of an influenza pandemic, commonly referred to as a “panflu.,” Currently, there is a ban on the importation of birds and bird products from H5N1-affected countries. The ban as of December 2005, prohibits the importation of any birds, whether dead or alive, or any products derived from birds, including feathers and eggs, from the following countries: Cambodia, China, Indonesia, Japan, Kazakhstan, Laos, Malaysia, Romania, Russia, South Korea, Thailand, Turkey, Ukraine, and Vietnam. This ban is to be expanded to include other countries as needed. Individual states across the United States have put in place plans for culling operations and other measures to be performed in an event of outbreaks of H5N1 in domestic flocks to control the spread of the virus. CDC and Department Human Services and Heath (HS&H) have stepped up the annual “flu season” education programs. Medical clinics and hospital have posted precautions to help reduce the spread of influenza. The basic precautions are plain old fashion common sense and courtesies. 1.) Eat healthy… a balanced diet with lots of fruits and vegetables. 2.) Wash you hands with warm water and soap for approximately three minutes frequently throughout the day. 3.) Disinfect work spaces, counter tops, door handles and other places frequently touched by others. 4.) Cover your mouth when you sneeze or cough. 5.) If you develop symptoms of influenza seek professional advice/care and avoid contact with others. In Japan, it common for people to wear masks over there mouths and noses to avoid infecting others with colds during the cold and flu season. Maybe a similar practice should be adopted in the U.S. Does Korean sour kraut cure avian influenza? Curing sick birds inflected with avian influenza would be the best way to halt the spread of H5N1. South Korean researchers at Seoul National University may just stumbled upon a cure. A traditional Korean cabbage dish called Kimchi may hold the answer. Any veteran who has been to South Korea will tell you that “Kimchi is a spicy hot sour kraut on steroids and best consumed with vast quantities of strong drink.” Kimchi is basically salted Chinese Napa cabbage, garlic, radishes, onions, and carrots in a fish sauce that has been allowed to ferment. In an initial study, South Korean researchers fed Kimchi to 13 chickens infected with avian influenza and after a week 11 of them started to recover. It is interesting to note that in Central Europe sour kraut has been a folk cure for illness for centuries. The National Institute of Allergy and Infectious Diseases (NIAID) has repeatedly stated until further studies are done they caution against claims that Kimchi or sour kraut can cure the “bird flu.” Nevertheless, the researchers claimed that the lactic enzyme found in fermented cabbage seems to possess curative properties in combating the virus in domestic poultry. Due to the internet, word of the study has spread worldwide and the Washington Post ran an article of the study resulting in sales of bottles of Kimchi has jumped by 20% in recent months. What does all of this mean to Budgerigar fanciers and pet owners? For those fanciers, who have outside aviaries or cages exposed to the outside where casual contact with wild birds is possible, there is the greatest risk of inflection of their birds with avian influenza. Example: The aviary owned by Kimberly and Katrina von Kamrath sits in the corner of their backyard. Due to the fact that a large number of sparrows, finches, and doves are already drawn to their backyard, because of wild bird feeders hanging under a near mulberry tree in the backyard, it is not uncommon to see wild birds on the roof and ground surrounding their aviary during the day feeding on dropped seed. Should an outbreak of H5N1 occur in San Diego County, it is possible that the infection could spread to the Budgerigars in their aviary. To reduce this possibility in an event of an avian influenza outbreak in their area, it has been suggested that they take down the wild bird feeders and endeavor to reduce the amount of seed that falls on the ground surrounding their aviary. Additionally, it is recommended that they use a disinfectant such as Avian Liquidator when cleaning their aviary. Furthermore, to avoid possible personal health problems the use of disposable rubber gloves and a particle mask over the nose and mouth, while seeming extreme could not hurt. In a worse case scenario, it remains unclear what local health officials plan to do in regards to the regulation or other measurements concerning individuals possessing birds on their property. However, there have been limited discussions amongst poultry businesses and other groups regarding culling similar to those of a couple of years ago when the Newcastle Disease outbreak occurred in the eastern portion of the county. Currently, there is no recognized effective treatment for birds inflected with H5N1, it is reasonable to believe that should the Budgerigars in their aviary contract the H5N1 culling of the flight would be required. In the case where flights of Budgerigars are maintained in enclosed spaces without exposure to wild birds the danger of inflection is greatly reduced. Yet, precautions should be taken when introducing materiels from outside such a branches as Eucalyptus, etc. that might have been exposed to inflected wild birds. However, at this point in time there is little reason to fear that the pet owner with a couple of American or English Budgerigars is in danger of their birds contracting an HPAI virus. Conclusion It should be noted that the Department Human Services and Heath (HS&H) announcement in early March 2006, that citizens should stockpile at least three days’ supply of water, food stuffs, and required medications was greatly sensationalized by the media. However, this is the same information is provided in most local telephone directories nationwide as a recommended precaution in case of a nature disaster. Not to down play its importance, but the recommendation was not developed just as a response to the possibility of an epidemic of the influenza. Federal Emergency Management Agency (FEMA) has likewise stressed this same precaution in the wake of the disastrous hurricanes in recent years in Florida and along the Gulf coast. There is huge amount of information out there on the internet, published in numerous professional medical and scientific journals and magazine available at good newsstands, bookstores, and university and public libraries, as well as reports and fact sheets from various local, state, and federal government agencies and departments. Readers are encouraged to available themselves of the information that is out there and accessible. Understandable it is a lot to wade through, but it provides solid information without the sensationalism sometimes encountered in the press. Post Scrip: December 2007 After the dire predictions of doom and gloom regarding the Bird Flu in 2005 and 2006, the sensational yellow press suddenly lost interest in the topic of the Bird Flu and the H5N1 strain. Did this mean all the hype in the press was for naught and the danger of a world pandemic over stated causing unwarranted fear in the general public not to mention poultry farmers and bird fanciers around the world? The answer is a simple and resounding NO! World organizations like the UN and the World Bank released a joint report at the end of 2007 stating that the current risk for a Bird Flu pandemic with strains that are able to be transmitted from bird and animals to human remain as high as they were in 2005, at the height of the Bird Flu scare. Despite advances by researchers in understanding the mechanics of the H5N1 virus and the creation of new vaccines to combat this deadly strain of influenza, the world’s governments and medical organizations remain unprepared to deal with the emergence of a pandemic in even the most basic of supplies such as syringes and intervenes bags, not to mention the many medical experts question the usefulness of many of the touted flu remedies sure as Theraflu and Airbourne on the market today. It is a well known fact in the medical community that the CDC in Atlanta has teams of researchers in the steppes of western Asia annually endeavoring to determine what emerging strains of influenza will spread across the globe in a given year and guides the pharmaceutical industry in the development of vaccines for the coming flu season based upon that research. Yet, in recent years it has not been the predicted strains that have emerged, but other strains rendering the flu shot almost useless some years. If there is some hope in all of this, it is that of the 340 cases of H5N1 reported in humans causing 290 deaths the impact of the virus as a whole on the human population was not worth calculating and the world’s organizations still have time to prepare for a true pandemic. Selected References: BBC Avian Flu Q&A. CDC Health Alert Network, Update on Avian Influenza H5N1. WHO and ASEAN+3 Health Ministers Meeting on Avian Influenza FAQ. WHO Avian Flu Fact Sheet. World Organization for Animal Health, Update on Avian Influenza in Animals. Originally published in the Budgie Fanciers of S.D. County’s monthly newsletter, A Bit of Budgie Chatter in two parts for the months of June and July 2006.