Avian Influenza: Emerging Infectious Diseases

Introduction

Emerging infectious diseases represent a group of conditions for which the outbreak was reported during the past twenty years, and there is a risk of spreading these diseases in the future. One of such infectious diseases is avian influenza (“bird flu”). The outbreak of this disease among humans was observed in Asian countries in 2003-2004, and it was discussed as a health crisis by the World Health Organization (WHO) and the global community because of its spread to Africa and Europe and severe consequences of this infection for humans (Holtz, 2017). The purpose of this report is to discuss the pathogen that causes avian influenza, disease transmission and symptoms, conditions that can contribute to the outbreak, preventive measures, treatment options, concerns, suggestions, differences of outbreaks in developed and developing countries, possible changes in routines, and the media coverage of the outbreak.

Pathogen

Avian influenza is usually caused by such influenza A virus subtype as H5N1 that typically spreads in poultry. The outbreak of avian influenza among humans in Asia in 2003-2004 was caused by the possibility of this highly pathogenic virus to cross species barriers (Li et al., 2014). As a result, not only birds but also humans were infected, and a pandemic threat was determined.

Disease Transmission

The outbreak of avian influenza in 2003-2004 was the re-emergence of the disease after reporting the first case in Asia in 1997. The mode of transmission among humans was determined to be a contact with poultry, but it was initially thought that human-to-human transmission was also possible. Today, researchers and clinicians state that the disease can be transmitted to humans because of their contact with infected domestic poultry and H5N1-contaminated environments (Lai et al., 2016). Furthermore, poultry can become infected because of contact with wild birds. The transmission of this virus from person to person is not typical, but it is possible in rare cases. During the outbreak in 2003-2004, the disease was treated with the help of antiviral medicines.

Disease Symptoms

Avian influenza develops as a severe respiratory disease, and its symptoms include fever (> 38°C), cough, sore throat, fatigue, and muscle aches. When the disease starts, it is possible to observe abdominal pain, diarrhea, and vomiting. At the next stages, clinicians report shortness of breath, the progress of pneumonia, and seizures. The development of the H5N1 infection is quick, and the rate of mortality among humans is about 60% (World Health Organization, 2017).

Conditions Contributing to the Outbreak

China, Indonesia, and Vietnam are the Asian countries where the number of persons infected with the H5N1 virus was the highest. The number of infected people in Egypt was also high. The primarily affected population included adults younger than 39 years old and children. The level of mortality was higher for persons aged 10-19 years (World Health Organization, 2017). Researchers determined the following conditions that could contribute to the outbreak: the spread of the virus among wild birds and poultry because of migrations, contaminated environments at farms, transportation of poultry, cross-infections, and open poultry markets among other possible conditions (Bui et al., 2016).

Preventive Measures

During the outbreak, the authorities of many countries focused on limiting the transportation and trade of poultry. Moreover, ill and possibly ill birds were killed. Clinicians insisted on hospitalizations when the first signs of avian influenza were observed because antiviral medications were effective only during the first 48 hours (Holtz, 2017). These preventive measures are discussed as contributing to addressing the pandemic. Current preventive measures include avoiding contact with wild birds and possibly ill domestic poultry (Li et al., 2014). Those people who have poultry should follow infection control practices, and much attention should be paid to following hygiene norms and cooking poultry products (Lai et al., 2016).

Treatment

The current treatment of avian influenza in humans is based on the prompt diagnosis of the disease and the use of such antiviral medicine as oseltamivir during the first 48 hours when symptoms become observed. The focus is on predicting the development of severe respiratory disease. Thus, hospitalization, intensive care, and antiviral medicines are required. Candidate vaccines to prevent the spread of the H5N1 virus are only developing (World Health Organization, 2017).

Concerns

There are several concerns that are associated with preventing and treating the H5N1 virus. Firstly, candidate vaccines to address the H5N1 infection are at the stage of development, and they cannot be used widely to prevent the disease. As a result, risks of future outbreaks are high. Secondly, although the disease can be successfully treated, some people have limited access to treatment because of the lack of oseltamivir in developing countries and asking for help after 48 hours of the onset of influenza symptoms (Durand et al., 2015). Thus, risks of mortality increase. Furthermore, the H5N1 virus can change or mutate, becoming more transmissible, and its resistance to oseltamivir increases.

Suggestions

To prevent the outbreak of the H5N1 infection from spreading, the following suggestions can be followed: contacts with live poultry at markets should be avoided, and the trade of poultry should be limited and controlled. In order to overcome the treatment concerns, it is necessary to guarantee that people in developing and developed countries have access to oseltamivir, as well as peramivir and zanamivir, that can cope with the virus (Centers for Disease Control and Prevention, 2017). To prepare for handling outbreaks in the future, it is important to stimulate the development of the vaccine and guarantee access to it in all countries. Furthermore, it is important to promote the seasonal influenza vaccination to reduce risks. Additionally, more attention should be paid to maintaining security and infection control at farms. Communities can prepare to handle an outbreak of the disease while using protective equipment, focusing on hygiene norms, avoiding contact with poultry, and following recommendations regarding cooking poultry products (Bui et al., 2016).

Differences in Outbreaks in Developed and Developing Countries

The outbreak occurred in developing Asian countries, and problems associated with addressing the pandemic were connected with the limited access to treatment and impossibilities to control the spread of the virus while restricting trade and transportation of poultry. In developed countries, the authorities and health organizations’ reactions to the pandemic can be more efficient (Holtz, 2017). Still, there is no widely used vaccine to prevent the spread of the virus and avoid future pandemics in both developed and developing countries.

Changes in Routines in Communities

The likelihood that the outbreak of avian influenza can occur in the United States in the future is comparably high. The reason is that, during 2003-2012, the virus typical of the Asian countries spread to Africa and Europe as well as North America with ill tourists who crossed the border to countries (Centers for Disease Control and Prevention, 2017). If there is a risk of the disease outbreak for a certain community, it is important to change some daily routines. As a healthcare professional, a person is expected to promote hygiene and cooking norms among community members. It is important to inform people that they can become infected after contacting sick or dead poultry and wild birds (Li et al., 2014). Still, cooked poultry and products are safe for eating. Personal modifications should include avoiding poultry markets, wild and dead birds.

Critique of the Media Coverage

Although there is no access to media reports regarding the outbreak of avian influenza in 2003-2004, it is possible to critique the general coverage of the pandemic in the media. During the first months of the outbreak in 2003, the description of the disease was not accurate enough to provide people with information regarding modes of transmission and actual causes of observed cases of avian influenza in humans. There were situations when reporters showed bias regarding the nature of the pandemic and its threats. In 2004, reporters began to use more “scare tactics” associated with authorities’ actions and killings of chickens in Asia and Europe (Holtz, 2017; Lai et al., 2016). The discussion of the “next steps” was also associated with limiting the consumption of poultry products, and this conclusion was rather biased.

It is important to compare the epidemiology of avian influenza with cholera, as well as the media coverage of the outbreaks. Both infectious diseases develop as a result of human contact with the virus. For cholera, the dangerous source of this infection is water (Johnson, 2006). For the H5N1 virus, the source includes poultry, wild birds, and their feathers. The seasonality of these diseases is not studied properly, but both conditions can develop as a result of ignoring hygiene norms. Furthermore, cholera and avian influenza develop rapidly (Bui et al., 2016). In the media, both the outbreak of cholera in London in 1854 and the outbreak of avian influenza in Asian countries were discussed from the perspective of their impacts not only on the health of populations but also on national economies.

Conclusion

The completed report accentuates the significance of studying emerging infectious diseases with the focus on analyzing preventive and treatment measures. This report has provided information on measures to avoid the spread of avian influenza and decrease its impact on humans. Much attention has been paid to analyzing the spread of the H5N1 virus locally, nationally, and internationally with reference to contributing factors. Furthermore, appropriate suggestions to address the issue have been formulated. Finally, the problem of the media coverage of the outbreak has also been discussed.

References

Bui, C., Bethmont, A., Chughtai, A. A., Gardner, L., Sarkar, S., Hassan, S.,… MacIntyre, C. R. (2016). A systematic review of the comparative epidemiology of avian and human influenza A H5N1 and H7N9: Lessons and unanswered questions. Transboundary and Emerging Diseases, 63(6), 602-620.

Centers for Disease Control and Prevention. (2017). Information on avian influenza. Web.

Durand, L. O., Glew, P., Gross, D., Kasper, M., Trock, S., Kim, I. K.,… Azziz-Baumgartner, E. (2015). Timing of influenza A (H5N1) in poultry and humans and seasonal influenza activity worldwide, 2004–2013. Emerging Infectious Diseases, 21(2), 202-210.

Holtz, C. (Ed.). (2017). Global health care: Issues and policies (3rd ed.). Burlington, MA: Jones & Bartlett Learning.

Johnson, S. (2006). The ghost map. New York, NY: Riverhead Books.

Lai, S., Qin, Y., Cowling, B. J., Ren, X., Wardrop, N. A., Gilbert, M.,… Peng, Z. (2016). Global epidemiology of avian influenza A H5N1 virus infection in humans, 1997–2015: A systematic review of individual case data. The Lancet Infectious Diseases, 16(7), e108-e118.

Li, X., Zhang, Z., Yu, A., Ho, S. Y., Carr, M. J., Zheng, W.,… Shi, W. (2014). Global and local persistence of influenza A (H5N1) virus. Emerging Infectious Diseases, 20(8), 1287-1295.

World Health Organization. (2017). FAQs: H5N1 influenza. Web.