Leonard Mermel, DO, medical director of the infection control department at Rhode Island Hospital and a professor of medicine at Brown Medical School, recently answered questions about the bird flu.
Mermel is also immediate past president of the Society for Healthcare Epidemiology of America, a technical expert panel member for the United States Department of Health and Human Services' Medicare Patient Safety Task Force, and a consultant for the Center for Biodefense and Emerging Pathogens at Memorial Hospital of Rhode Island.
What is the avian (bird) flu?
There are several influenza strains that primarily infect birds and are referred to as the avian flu. H5N1 is one of the avian flu strains that has infected mammals, including humans, with a high mortality rate.
What is the difference between the flu and the avian flu?
"Regular" flu is human influenza that changes slightly from year to year. Avian flu is influenza from birds. Some avian flu strains evolve to spread to humans and some of these strains can then be spread person to person. We don't have any significant immunity to the H5N1 bird flu now spreading across Asia, whereas we do have some immunity against human strains.
How is avian influenza transmitted?
Currently, avian flu is transmitted from infected birds to humans who have had direct contact with them. To date, there have been very rare occurrences of human-to-human transmission of avian influenza.
What are the symptoms of avian influenza?
The initial symptoms are non-specific and resemble those of common viral infections. The most common avian flu symptoms include fever, muscle aches and cough. However, some patients infected with H5N1 avian flu have also presented with gastroenteritis and encephalitis. If you feel you have these symptoms, or other severe flu-like symptoms, please contact your physician.
Why is the concern currently so great?
Concern about the avian flu is increasing because of the rising incidence among birds in Asia. It has now spread to birds in Europe, and the concern is that it will spread to humans in Europe and beyond.
How could it spread to humans?
Right now, the avian flu has spread to humans as a result of contact with infected birds. Rare person-to-person spread has occurred. However, a single genetic mutation may allow it to spread more easily person-to-person, which could lead to the next pandemic.
What is the likelihood that a pandemic will occur?
The likelihood is high. It is more a question of when another influenza pandemic will occur than if it will occur.
How can we try to protect ourselves?
You can begin by getting a routine influenza vaccine. Practice good personal hygiene. Clean your hands well and often. Avoid close contact with persons with the above-noted symptoms, and practice cough etiquette (cover your mouth when you cough, then clean hands afterwards). See the Rhode Island Department of Health web site for family preparedness planning. If a pandemic occurs, other public health measures may be recommended at that time.
What is the risk for Rhode Islanders at this time?
At this moment there is no risk.
What should someone do if they become ill after traveling to an area affected by the avian flu?
If they have an illness with a fever after returning from an affected area, especially if associated with cough or shortness of breath, they should contact their doctor immediately.
How will Rhode Island Hospital treat the avian flu?
We have a very detailed plan for the hospital that's been under development for months and will continue to be refined as the need arises. We will do the best we can to care for those sick from pandemic influenza if and when it occurs.