Transmission from poultry to humans is uncommon but it has occurred amongadults and children exposed to sick or dying chicken. Relatively few deaths of human infection have occurred to date but mortality at 61 per cent worldwideis very high. There are a few examples of human cases occurring in clusters. In2004, Thailand reported a case when a mother fell ill after providing care toher sick daughter in hospital; she had otherwise no exposure to sick or dyingchicken. Then, in 2006, several members of one family developed avianinfluenza in Karo, Indonesia after being exposed to a sick family member athome. There have been a few clusters reported in Vietnam too. Althoughtransmission of avian influenza from human to human is rare, preparedness ispivotal in view of the dynamic nature of the situation. At least two of the threepandemics that occurred in the last century originated from Asia and this is asobering thought. Will the next pandemic virus also emerge from Asia? It isanybody’s guess.
Control measures and precautions
A prerequisite for preventing the pandemic is containing the virus at the sourceitself - in this case, in the animal sector. The most important control measuresinclude practicing bio-security, culling of poultry combined with quick andadequate compensation to farmers. The control measures in the human sectorinclude prevention of exposure to infected poultry and reducing case fatalityrates. The precautions that people must take in an outbreak area are fairlystraightforward: knowing how to steer clear of getting infected by avoidingexposure to and contact with sick and dying chicken, and not de-featheringpoultry at home. In the event that one develops an influenza-like illness,prompt consultation at a health facility is recommended with suitable anti-virals taken within 48 hours. Consuming chicken is safe as long as it is cookedthoroughly at a high temperature since the virus cannot survive at boilingtemperature.
Lessons learnt from past:
Avian influenza outbreaks have brought to light several dimensions. Thecultural and economic spin-offs from a traditional way of life, especially inAsia, have been brought under the spotlight. The political commitment tointer-Sectoral collaboration, particularly between the agriculture and healthsectors, has led to rapid and successful containment of the outbreaks in manycountries including India. The high case fatality rates documented in theoutbreaks, especially in Indonesia nearly 85 per cent recently, is of immenseconcern. In order to understand why, and what can be done to reduce this,research is a priority. The communication messages needed to alter riskbehavior and improve case management to reduce death from avian influenzapose key challenges. To prevent avian influenza and to rapidly contain itsspread. Table-top exercises and mock simulation drills are being suggested tohelp fine-tune the response mechanism. The rapid containment strategiesinclude early and strategic use of anti-virals and public health measures such associal distancing, school closure, restricting gatherings and cough etiquette.