Avian Flu Precaution*

A Message on Avian Flu to Brown Study Abroad Students, Parents, and Advisors

The Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) continue to carefully monitor avian flu. Currently, there is not a pandemic of influenza of any type, and neither health organization has issued a travel warning with regard to avian flu. As a precaution, however, the Office of International Programs is providing you below with factual information on the concerns related to avian flu, together with an overview of recommendations as we continue to monitor pandemic efforts.

The Office of International Programs' avian flu planning is and will be guided by the Center for Disease Control and World Health Organization guidelines and is part of the university's larger planning for a possible emergency. Please see:
http://www.brown.edu/Administration/EHS/emergency_preparedness/pandemic/

Information About Avian Flu

What is avian flu?

Avian Influenza, also known as H5N1 and bird flu, is a potential concern due to outbreaks originating in Asia. Avian flu is an infectious disease caused by viruses that infect birds, and less commonly, pigs. It is present in the droppings of birds, especially chickens. Sporadic human cases have occurred after direct contact with poultry. The risk to travelers is small, but it is important to avoid poultry farms and live animal markets. Well-cooked chicken is safe to eat.

What is the difference between Avian Flu, Seasonal Flu and Pandemic Flu?

Avian influenza is an infection caused by bird flu viruses. Avian influenza A (H5N1) viruses usually affect wild birds but now are infecting and causing serious and widespread disease among poultry, such as chickens, mostly in Southeast Asia and parts of Eastern Europe. Human infections with H5N1 viruses are rare, but have occurred during the last three years in Vietnam, Thailand, Cambodia, Indonesia, and China, with many cases resulting in death. Most cases of H5N1 infection in humans are thought to have occurred from direct contact with infected poultry in the affected countries in Asia. There have also been rare, isolated cases of spread from human to human.

Seasonal influenza (often called 'the flu') is a contagious respiratory illness caused by influenza viruses. Seasonal flu occurs every year and can cause mild to severe illness in people. The best protection against seasonal flu is vaccination, and hand washing.

An influenza pandemic would be a global outbreak of disease that occurs when a new 'influenza A' virus appears or emerges in the human population, causes serious illness in people, and then spreads easily from person to person worldwide. Currently, there is not a pandemic of influenza of any type. There is no pandemic of avian flu since widespread human to human spread of avian influenza has not occurred.

How is avian flu treated?

There are several different influenza antiviral drugs that can be used to treat pneumonia caused by the avian flu. They are amantadine, rimantadine, oseltamivir (“Tamiflu”) and zanamivir (“Relenza”). All four of the drugs have an effect on influenza A viruses, but some of the strains have become resistant to these drugs. Currently, oseltamivir (“Tamiflu)” is somewhat effective (though some resistance has developed in northern Vietnam). Relenza may be more effective.

Rising Concern

A rising concern is that avian and human flu viruses can exchange genes when a person is simultaneously infected with viruses from both species, which can give rise to a new subtype of the flu virus. If a new flu virus emerges, it is possible that few humans will have natural immunity and existing vaccines would not be effective against this new subtype. Preventive and preparedness measures should be continued because of a possibility of an avian flu pandemic.

Where to find information

We recommend that you visit the CDC's Web site (http://www.cdc.gov), bookmark it in your Web browser, and refer to it whenever you have a question. The site is clear, authoritative, comprehensive and current. Information is also available on the official U.S. government Web site for information on pandemic flu and avian influenza: http://www.pandemicflu.gov/.

Travel Suggestions

Listed below are recommendations from the CDC Website.

The CDC has not recommended that the general public avoid travel to any of the countries affected by H5N1. Persons visiting areas with reports of outbreaks of H5N1 among poultry or of human H5N1 cases can reduce their risk of infection by observing the following measures:

Before any international travel to an area affected by H5N1 avian influenza:

* Visit CDC's Travelers’ Health website at http://www.cdc.gov/travel to educate yourself and others who may be traveling with you about any disease risks and CDC health recommendations for international travel in areas you plan to visit. For other information about avian influenza, see CDC's Avian Influenza website: http://www.cdc.gov/flu/avian/index.htm.

* Be sure you are up to date with all your routine vaccinations, and see your doctor or health-care provider, ideally 4-6 weeks before travel, to get any additional vaccination medications or information you may need.

* Assemble a travel health kit containing basic first aid and medical supplies. Be sure to include a thermometer and alcohol-based hand gel for hand hygiene. See the Travelers Health Kit page in 'Health Information for International Travel' for other suggested items.

* Identify in-country health-care resources in advance of your trip.

* Check your health insurance plan or get additional insurance that covers medical evacuation in case you become sick. Information about medical evacuation services is provided on the U.S. Department of State web page Medical Information for Americans Traveling Abroad, at http://travel.state.gov/travel/tips/health/health_1185.html

During travel to an affected area:

* Avoid all direct contact with poultry, including touching well- appearing, sick, or dead chickens and ducks. Avoid places such as poultry farms and bird markets where live poultry are raised or kept, and avoid handling surfaces contaminated with poultry feces or secretions.

* As with other infectious illnesses, one of the most important preventive practices is careful and frequent hand washing. Cleaning your hands often with soap and water removes potentially infectious material from your skin and helps prevent disease transmission. Waterless alcohol-based hand gels may be used when soap is not available and hands are not visibly soiled.

* Influenza viruses are destroyed by heat; therefore, as a precaution, all foods from poultry, including eggs and poultry blood, should be thoroughly cooked.

* If you become sick with symptoms such as a fever accompanied by a cough, sore throat, or difficulty breathing or if you develop any illness that requires prompt medical attention, a U.S. consular officer can assist you in locating medical services and informing your family or friends. Inform your health care provider of any possible exposures to avian influenza. See Seeking Health Care Abroad in 'Health Information for International Travel' for more information about what to do if you become ill while abroad. You should defer further travel until you are free of symptoms, unless your travel is health-related.

After your return:

* Monitor your health for 10 days.

* If you become ill with a fever plus a cough, sore throat or trouble breathing during this 10-day period, consult a health-care provider. Before you visit a health-care setting, tell the provider the following: 1) your symptoms, 2) where you traveled, and 3) if you have had direct contact with poultry or close contact with a severely ill person. This way, he or she can be aware that you have traveled to an area reporting avian influenza. Do not travel while ill, unless you are seeking medical care. Limiting contact with others as much as possible can help prevent the spread of an infectious illness.

With reasonable attention to health and safety rules, your study abroad experience should be a healthy one. Should you have any questions with regard to the information provided above, please do not hesitate to contact the Office of International Programs at Brown University at 401 863.3555.

Best wishes for a rewarding and safe study abroad experience!

Sincerely,

Kendall Brostuen, Director
Office of International Programs
Associate Dean of the College

*Adapted from the School for International Training (SIT) Avian Flu Precaution.