Pandemic and Avian Flu
Pandemic Flu
A pandemic happens when a new virus spreads rapidly around the world,
infecting most of the world’s population. Pandemic flu is much worse than
the seasonal flu we see every year because no one has immunity to it.
There were three flu pandemics in the 20th century, including the 1918
flu. It infected most of the world’s population and killed tens of
millions of people.
There is concern about the new avian or bird flu. Medical experts fear
it could mutate into a strain that spreads easily among people with a high
death rate. If such a pandemic flu comes to the U.S., it is expected that
up to 15% to 30% of the whole population could become sick at the same
time. There are not enough doctors, nurses, or hospital beds to take care
of more than 1% of the population at the same time, so hospitals would
fill up quickly and would then not be able to admit even very sick
patients.
Also, in the case of a very deadly flu, basic services such as
utilities (electricity, water, natural gas), grocery stores, pharmacies,
and gas stations, etc. might not stay open. The following information is
an attempt to help citizens get prepared to take care of themselves and
their families if such an epidemic were to happen. It also includes basic
preparations to care for sick family members.
First, you and your family should make every effort to avoid catching
the flu. You need to prepare to stay home and distance yourself from
others who may spread the disease to you or your loved ones.
How Not to Catch the Flu
The flu virus is spread by coughing and sneezing. Respiratory droplets
contain millions of viruses. If you breathe them into your lungs, you
become infected. So stay away from people who are coughing or sneezing.
Also, avoid breathing where someone has just coughed or sneezed. Ask
people who are coughing or sneezing to stay home and not go to work or
school if they are sick, especially if they have had a fever, fatigue, and
muscle aches, indicating they are probably infected with flu virus.
Flu viruses are also spread by people’s hands. Everything an infected
person touches is contaminated with millions of viruses; if you touch it
within several days (door knob, pen, any object or surface, etc), your
hands pick up hundreds, thousands, millions of viruses. If you then touch
the mucous membranes of your eyes, nose, or mouth, or you touch your food,
you will transfer viruses to yourself and become infected. Washing your
hands right before you eat or touch your eyes, nose, or mouth, without
touching anything in between, is your best strategy to avoid infecting
yourself with your hands.
So practice now, and avoid catching common colds and seasonal flu. At a
restaurant after you have handled the menu and ordered, wash your hands
and use a paper towel to turn off the faucet and open the door. Don’t
touch anything except the food you are about to eat. Frequent hand washing
in the kitchen when preparing food helps prevent contamination from food
packaging handled by many people on its way to your house. No matter how
many times you wash your hands, if you touch something touched by you or
someone else with unwashed hands, your hands will very likely become
contaminated again. So the timing of hand washing is more important than
how often you wash.
Then there is the question of masks. Infectious disease experts now
recommend that doctors offices put a simple ear loop procedure mask on all
patients who are coughing or febrile and on all providers who deal with
them. Patients are kept three to six feet apart to allow airborne droplets
room to fall to the floor and not be breathed in by someone else. While
viruses themselves are tiny and can easily go through any mask through
which a person could breathe, the masks will greatly reduce the spray of
virus containing fluid droplets in a cough or sneeze. So a mask may afford
some, probably quite limited, protection against airborne transfer of
viruses. Staying away from sick people is best.
Get your regular or seasonal flu shot every year. Experts believe
regular flu shots will build up immunity to a variety of flu viruses,
which could conceivably help a little with a new more deadly strain of the
same type that is common with seasonal flu. And you’ll stay healthier to
fight off a more serious virus when it comes.
Don’t count on antiviral medicine or flu shots. Either they don’t work
or they won’t be available soon enough or in large enough quantities.
Supplies for Staying At Home
Water and food supplies for two to four weeks:
• 1 gallon of water for each person for each day, extra for pets
• ready-to-eat canned food including meats, fish, fruits, and vegetables;
include some thin soups for sick persons
• protein bars or energy bars or fruit bars
• dry cereal or granola or trail mix
• saltines and other dry crackers
• peanut butter and jelly
• nuts
• dried fruit
• powered milk
• baby formula, baby foods
• pet food
• vitamins
• crackers
• rice, beans, grits – assuming you have power to cook
• orange juice, salt, and baking soda for making your own oral rehydrating
solution; Gatorade or Pedialyte
• CAN OPENER (not electric, in case your power is out)
Medical supplies:
• thermometer
• bleach (one part bleach to ten parts water will disinfect or kill most
all germs and viruses.) Plain bleach (without additives to make it look or
smell better) can be used to help keep your stored water safe for
drinking; just add 16 drops of bleach to 1 gallon of water using a
medicine dropper.
• medicine dropper
• masks – some medical experts feel masks won’t work because people won’t
wear them correctly or keep them on all the time; however, they will help
keep the virus from spreading in droplets if worn by people who are
coughing or sneezing and worn by people near them.
• gloves can be effective if you are handling items or cleaning surfaces
contaminated by a sick person’s respiratory droplets by touch or coughing.
• hot water, detergent, and bleach for contaminated clothing, sheets, etc.
• soap and water are first choice for hand washing.
• alcohol-based hand sanitizer if soap and water are not practical for
hand washing
• ibuprofen for adults, liquid and drops for children and infants.
• acetaminophen (Tylenol) for adults, liquid and drops for children and
infants
• cough syrup
• oral rehydration solution or Gatorade or Pedialyte
• first aid kit
• refill all prescription drugs as soon as possible.
Other supplies and equipment:
• battery-powered or hand cranking radio
• flashlights
• extra batteries
• tissues, toilet paper, baby wipes
• trash bags
• matches or lighters for starting campfire stoves (outside), fireplaces,
candles, etc. if power is off
• wood for burning if you have a fireplace
• disposable plates, cups, spoons, forks
• disinfecting spray
Flu Care at Home
The coughing flu patient should wear a mask and be confined to an area
in the home where other family members do not go. The healthiest person
should care for the sick member. If possible, hold your breath in the sick
room while delivering food, water, medicine, etc. Wear a mask if you have
to stay in the room. Wash your hands after every contact with the sick
person. Dispose of used tissues in a covered wastebasket with a plastic
liner to keep germs/viruses from floating around in the air. Plastic bags
should also be used for soiled linens while waiting to be washed in hot
water and detergent. Use 1/4 cup bleach to one gallon of water for
cleaning surfaces that you can wipe down.
Dehydration:
Dehydration is the single greatest threat to the patient that the home
care provider can do something about! So drinking lots of fluids is most
important. Urination once an hour is a sign that a person is drinking
enough fluids.
While dehydration is a dangerous condition to all, it is most dangerous
and life-threatening to the young and the old. Dehydration can be caused
by frequent vomiting, diarrhea, high fever, rapid breathing, and prolonged
lack of fluids. Obviously, if you can lessen vomiting and diarrhea through
over-the-counter drugs, this can be helpful. There are also medications
your physician may prescribe for you to keep on hand in your home. Talk
this over with him/her before an emergency event. High fevers can cause
excessive sweating and cause the body to use more fluids. A lot of fluids
are lost through breathing, especially if breathing is more rapid.
Some signs of dehydration include drier than normal skin, skin that
stays tented when pinched, sunken eyes, extreme tiredness, dry cracked
lips, dry tongue, and dizziness. The easiest and earliest sign of
dehydration is the lack of urine. Sick family members should be carefully
observed to make sure they are passing urine at normal time intervals.
This is especially important in infants and small children. Severe
dehydration can kill, especially the young. If your infant stops wetting
diapers for several hours, be concerned! Stock up on Pedialyte or other
oral rehydrating fluids that your pediatrician recommends. If the child
refuses to drink, parents should give dropperfuls of rehydrating solution
such as Pedialyte for hours on end if that’s what it takes until the child
starts urinating again. Don’t stop there; keep on giving fluids until the
child urinates regularly. The same rules apply for adult patients. If
nausea and vomiting are present you can usually give teaspoonfuls without
triggering the vomiting response.
You can make your own oral rehydrating solution by mixing 1 cup of
orange juice (8 oz), 3 tablespoons sugar, ½ teaspoon salt, and 1 teaspoon
baking soda and then adding enough water to make 1 quart.
If the patient has diarrhea or is recovering from diarrhea and is able
to drink, give lots of clear fluids without caffeine such as broth, light
soups, jelly, ginger ale, and popsicles.
Caffeine is a diurectic which will cause more loss of fluids, so avoid it.
Cough syrup and decongestants can be purchased ahead of time and kept
in the flu survival kit. Patients will require more water intake to loosen
the phlegm and cough it up. So drink, drink, drink.
High fever:
Use the full recommended dose of acetaminophen and/or ibuprofen to
control high fevers. Fevers of 101 degrees may actually be beneficial to
help defeat the virus. Higher fevers may be detrimental. If the fever is
hard to control, it is safe to use the acetaminophen and ibuprofen at the
same time or to alternate their use. Ibuprofen will bring down a high
fever more quickly than acetaminophen.
For very high fevers, such as 103 degrees and above, sponging the
patient with a wet cloth by wiping the skin will be more effective than
immersing the patient in water. Wiping the skin with a wet cloth causes a
more effective decrease in temperature by the process of evaporation. Do
not sponge with alcohol or put the sick patient in cold water. These
techniques can cause other serious problems if the fever comes down too
fast. Stick to wiping with cool water; it’s safer and very effective.
Never attempt to “sweat” the fever out. Taking off clothing and
blankets naturally allows the body to cool. If the patient starts
shivering, cover until it stops.
Lung Care:
The flu usually attacks the lungs causing breathing difficulties. To
aid breathing and maintain lung health have the sick person sit up or prop
them up with pillows. The upright position helps the lungs expand more
easily. Have the sick person breathe deeply or pretend he is blowing up a
balloon on a regular basis. The patient should do five deep breaths in and
out every 30 minutes while awake. If the person is moderately or very ill
and sleeping, wake them up every two hours to deep-breathe. Deep breathing
keeps the tiny air sacs in the lungs clear and open rather than closing
down with sticky mucous. Crying in an infant or child has the same effect
as deep breathing in an adult. It keeps the tiny air sacs in the lungs
open. This is one instance where a moderate amount of strong crying is
music to one’s ears!
If the patient has a lot of mucous or phlegm in their lungs or airway,
you can help him by having him lie down on his stomach with head and
shoulders lower than the rest of his body and then firmly patting his back
(over the lungs) with cupped hands. If your hand is cupped, the striking
will not sting like a slap, and it will have a hollow sound. Doing this
three times a day will help the mucous in the lungs break loose, and the
patient will be able to cough it up and spit it out.
For more information try these websites at
www.pandemicflu.gov
www.cdc.gov/flu/avian/index.htm
www.health.state.ga.us
www.publichealthathens.com
www.agr.state.ga.us
www.gadnr.org
or call
Center for Disease Control (CDC) 1 800 232-4636 English
1 800 246-2857 Spanish
Georgia Division of Public Health 1 866 782-4584
Northeast Health District 1 800 473-4357
Frequently Asked Questions About
Avian (or Bird) Flu
1. What is Avian Influenza or Bird Flu?
Like humans, birds have naturally occurring influenza
(flu) viruses. There are numerous types of avian influenza viruses that are
carried by wild bird species throughout the world. Wild birds worldwide carry
the viruses in their intestines, but usually do not get sick from them.
However, bird flu is very contagious among birds and can make some
domesticated birds, including chickens, ducks and turkeys, very sick and even
kill them.
2. What is the difference between bird flu and human
flu?
There are many different types of flu viruses. Some of
these viruses infect humans, while others infect birds, pigs and other
animals. These different types of flu viruses vary in their ability to
infect animals and humans. Additionally, they vary in their ability to cause
serious illness and death.
“Bird flu” is a non-scientific term that refers to a
specific virus (H5N1) that has been present in domestic birds in Asia since
1997. The H5N1 virus has been uniquely difficult to control in Southeast Asian
poultry flocks. Despite the depopulation (slaughter) of millions of domestic
birds in affected countries, the virus continues to spread to other domestic
birds. Another unique aspect of the H5N1 (“bird flu”) virus is that it has
caused wild bird mortality. This is unprecedented, and it is not known whether
these infections are from wild bird contact with infected poultry or if it is
actually being transmitted by wild birds. Numerous studies are ongoing to help
answer this question. It has also been able to infect a number of humans.
3. Can bird flu viruses
infect humans?
Yes, bird flu viruses can infect humans, although it does
not happen frequently. Direct contact with infected poultry, including
surfaces and objects contaminated by feces, is presently considered the main
route of human infection. To date, most human cases have occurred in rural
areas in other countries where many households keep small poultry flocks.
These flocks are typically allowed to roam freely, sometimes entering homes or
sharing outdoor areas where children play. As infected birds shed virus in
their feces, there are many opportunities for human infection from infected
droppings. Also, households in many of the infected countries depend on
poultry for income and food, and many families slaughter poultry to consume it
or sell it. Exposure is most likely during slaughter,
defeathering and butchering.
4. Who is most vulnerable to bird flu?
Typically, Flu is usually most dangerous to young children and to the
elderly.
However, much depends on whether there is any immunity to the flu in some
populations. For example, the 1918 flu was more deadly to young adults than to
those over 40. It is thought that a similar virus may have circulated more
than 40 years before, giving some immunity to those who caught it before.
5. What are the symptoms of Bird Flu?
The reported symptoms of Bird Flu have ranged from
typical human flu symptoms
6. Do we have avian influenza viruses and “bird flu”
in the United States?
Yes, avian influenza viruses are found in wild bird
populations in North America and occasionally infect domestic poultry. For
example, in 2004 outbreaks of avian influenza in US poultry occurred in the
New England states and Texas, and were traced to birds from live bird markets.
These outbreaks were not caused by the same "bird flu" virus (H5N1) that is
currently circulating in Asia. The U.S. outbreaks were quickly contained
and there was no impact on human health. To date, the H5N1 “bird flu” virus
has not been detected in the U.S. or any country in the western hemisphere.
7. Do we have avian influenza and "bird flu" viruses
in Georgia?
Avian influenza viruses have occasionally been isolated
from wild birds in Georgia, but we have not had any recent outbreaks in
domestic poultry. Furthermore, Georgia does not have live bird markets like
those associated with outbreaks in other countries.
8. What is the risk of H5N1 arriving in Georgia?
The risk of H5N1 infection among birds in Georgia is very
low. No poultry or poultry products from countries affected with avian
influenza are legally allowed to enter the U.S. Travelers from affected
countries could possibly introduce the virus to the United States through
inadvertent or intentional movement of the H5N1 virus or infected birds.
9. If I see a dead bird in Georgia, is it likely to
have bird flu?
There is surveillance for avian influenza among
shorebirds, waterfowl, and poultry in the Southeast and Georgia, and this will
detect the “bird flu” virus if present. Other wild birds such as
songbirds, crows or sparrows are not generally infected with avian influenza
viruses, so it is not beneficial to include them in a surveillance program.
Plans to expand wild bird disease surveillance across the U.S. are underway.
10. What does a bird flu pandemic mean and will
it happen?
Pandemic means
epidemics or cases in more than one continent.
Pandemic flu will happen sooner or later. They happen from time to
time as new strains of flu virus emerge and because humans have little or no
immunity to these viruses. Three examples of these occurring are in 1918, 1957
and 1968. The 1918 pandemic killed around 50 million people worldwide, and
pandemics in 1957 and 1968 were milder.
11. Will the bird flu that is in the news now result in the next
pandemic?
Bird flu is still a bird disease. The H5N1 bird flu in Asia does not spread
well from person to person. It is a leading contender to be the next pandemic
flu virus because it has caused an unprecedented epidemic in poultry and wild
birds across Asia. However, nobody knows for sure whether this will be the flu
that causes the next human pandemic.
12. How does bird flu become a human flu?
Bird flu could become a human flu in two ways.
