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Risk of Bird Flu for International Travelers

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The first outbreak of the bird flu (H5N1) in humans occurred in 1997. Eighteen people in Hong Kong were infected; six died. In an effort to stop the spread of the virus, the Chinese government responded by destroying the poultry population—1.5 million birds. Since 1997, the bird flu has infected people in over 15 countries in Asia, Europe, the Near East, the Pacific, and Africa, and it remains a highly contagious and deadly virus among birds. There is a fear that the bird flu could mutate and spread more easily to humans. The fear of a pandemic is further heightened by the fact that migratory birds can continue to spread the virus to other countries.

What should you do if you have plans to travel abroad? The first step is to find out the facts.

Bird Flu Facts

The bird flu is caused by the type A strain of the influenza virus. In the wild, influenza A is easily spread among birds, but they usually do not get sick from the virus. Domestic birds, like chickens, are more susceptible, though. Among poultry populations, a highly dangerous form of the flu can cause severe sickness and death within 48 hours.

While the bird flu has infected tens of millions of poultry, H5N1 remains rare among humans. Those at the greatest risk of infection are people who have direct contact with sick or dead birds or with surfaces contaminated by the virus. While there is the potential for the virus to mutate and become more contagious, at this time, the bird flu does not spread easily from birds to people, nor does it spread easily between people.

For those that get the bird flu, symptoms range from mild to severe. Bird flu can cause fever, chills, cough, sore throat, diarrhea, and vomiting. In severe cases, H5N1 can quickly progress to respiratory distress, pneumonia, organ failure, and death.

H5N1 is treated with antiviral medications, however the infection is resistant to some of them. There is a vaccine to protect against a strain of the virus, but it is not currently available to the public. The vaccine was purchased by the government for the Strategic National Stockpile. Health officials will distribute the vaccine if a crisis arises.

Stay Informed

There are periodic reports of cases of the bird flu. The sporadic cases do not mean you have to change your travel plans. When you make your arrangements, check the Centers for Disease Control and Prevention (CDC) Travel website for updated information. Check for updates regularly and take any action recommended by the country you are visiting.

Before you travel, plan ahead for an outbreak. The local government, in an effort to contain the virus, is likely to place restrictions on where people can go. You can be prepared by having a supply of necessities, such as canned food, water, and medications. If you can, find out where to go for medical care.

Reduce Your Risk of Infection

To reduce your chance of being infected with the bird flu, follow these guidelines from the CDC and the WHO:

  • Avoid direct or indirect contact with wild and domestic birds, including feathers, feces, undercooked meat and egg products.
  • Make sure all poultry foods—including eggs—are thoroughly cooked. The heat from cooking destroys the bird flu virus.
  • Do not consume blood from poultry.
  • Beware of cross contamination. Raw poultry juices should never be near food preparation areas. Do not use the same utensils, cutting boards, or dishes for raw and cooked foods, and keep these types of food separate. Thoroughly clean any items that come into contact with poultry.
  • Wash your hands frequently or use an alcohol-based instant hand sanitizer.
  • Do not visit poultry farms or live food markets where poultry is sold.
  • Keep in mind that you are more at risk if you handle poultry, such as:
    • Plucking birds
    • Preparing birds for cooking
    • Handling fighting cocks
    • Petting birds

In addition to these tips, make sure that all of your immunizations are up-to-date before you travel. Keep in mind that none of these immunizations will protect you from bird flu. Also, research what medical facilities exist and what resources are available. Use the US Department of State website for a list of all of the US embassies. From there, you can find information on foreign hospitals and doctors.

Getting Sick Abroad

If you do get sick while abroad, contact the US consulate in the country you are in and an officer can help you locate medical care. In addition, follow these tips:

  • Find out what your health insurance will cover when you are traveling. Keep in mind that Medicare does not pay for coverage outside of the US.
  • If you have a health condition, obtain a letter from your doctor that explains your condition and your medicine.
  • Always carry your health insurance card and any other identification or proof of insurance coverage.
  • Keep identification information with you at all times while traveling. Make sure pertinent health information is included.

RESOURCES:

Traveler’s Health
Centers for Disease Control and Prevention
http://wwwn.cdc.gov

World Health Organization (WHO)
http://www.who.int

CANADIAN RESOURCES:

Health Canada
http://www.hc-sc.gc.ca

Public Health Agency of Canada
http://www.phac-aspc.gc.ca

References:

Avian influenza. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated August 12, 2013. Accessed October 3, 2013.

Information on avian influenza. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/flu/avianflu/index.htm . Updated April 12, 2013. Accessed October 3, 2013.

Avian influenza. World Health Organization website. Available at: http://www.who.int/mediacentre/factsheets/avian_influenza/en. Updated April 2011. Accessed October 3, 2013.

Avian flu travel information. Centers for Disease Control and Prevention website. Available at: http://wwwnc.cdc.gov/travel/page/avian-flu-information . Updated March 15, 2012. Accessed October 3, 2013.

Current concepts: avian influenza A (H5N1) infection in humans. N Engl J Med. 2005;353(13):1374-1385.

FDA approves first U.S. vaccine for humans against the avian influenza virus H5N1. Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/2007/ucm108892.htm. Updated April 10, 2013. Accessed October 3, 2013.

Human infection with avian influenza A (H5N1) virus: advice for travelers. Centers for Disease Control and Prevention website. Available at: http://wwwnc.cdc.gov/travel/page/human-infection-avian-flu-h5n1-advice-for-travelers-current-situation . Updated March 15, 2012. Accessed October 3, 2013.

Situation updates—avian influenza. World Health Organization website. Available at: http://www.who.int/influenza/human_animal_interface/avian_influenza/archive/en. Accessed October 3, 2013.



Last reviewed October 2013 by Michael Woods, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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