As poultry and some people outside the United States get infected with the new strain of avian flu (H5N1), farmers, consumers, grocers, doctors and more, want to know what to expect – and when to expect it here in the United States. The Center for Community Journalism’s senior intern, Emily Tera Seymour, compiled the following report about what the disease is and how the disease has spread so far. It is our hope that this information will help our audience prepare well-informed and insightful coverage of this problem and how it is affecting or may affect their communities.

In particular, Dr. Benjamin Lucio of Cornell University, located in Ithaca, N.Y., has agreed to serve as a media source for information about avian flu. He also wants people to know that his lab accepts chickens that appear to be sick and come from growers in New York state.                                                   --E.G.

“There’s no need to panic,” says Dr. Benjamin Lucio of Cornell University in regards to the current outbreak elsewhere of influenza A (H5N1) – commonly known as the bird flu, “but we have reasons to stay alert.”

Lucio, director of the Avian Diagnostic Laboratory at Cornell, states, there has been no detection of the flu in the Americas, from Alaska to Argentina. “We will know if and when avian influenza is present” because it is very detectable, as the only nationwide known disease to kill birds in big numbers, he explains in a phone interview Feb. 28, 2006. 

“We don’t have any other disease here that will result in an outbreak of such,” he says, “and this is where we differ from other countries.”

Another difference is culture. Lucio says culture makes a “huge difference” in this sort of widespread outbreak. “Few people in America slaughter chickens to begin with. But in poor cultures if someone sees a sick chicken, it’s something to eat.” In the States, however, a sick chicken usually results in the killing and ridding of the bird, he notes.

Although there is a concern for the virus reaching the United States, Lucio says there may be an even bigger  concern. “It’s not that we shouldn’t be concerned about the virus spreading to the Americas,” he says. The virus is “detectable and the Department of Agriculture has means of control in poultry if alerted. However, there is a possibility the virus may change as it grows. This is a big concern.”

The Beginning

Nearly 10 years ago, outbreaks of highly pathogenic H5N1 were reported in poultry in Hong Kong. During 1997, 18 human cases were confirmed, six fatal. This was the first known human infection with this specific virus.

Avian (bird) influenza (flu) is a virus that occurs naturally among birds. Wild birds worldwide carry the viruses in their intestines but rarely get sick from them. It is very contagious among birds and may result in sickness and death among domesticated birds such as, chickens, ducks and turkeys.

If domestic poultry becomes infected, the disease is distinguished by low and high extremes of infection. The “low pathogenic” form may go undetected and cause only mild symptoms. The highly pathogenic form, however,  spreads rapidly, affecting multiple internal organs and can reach a mortality rate of 90 percent to 100 percent often within 48 hours, according to the Centers for Disease Control and Prevention Web site.

The CDC Web site also defines the influenza A (H5N1) virus – also known as H5N1 virus – as “an influenza A virus subtype that occurs mainly in birds, is highly contagious among birds, and can be deadly to them. H5N1 virus does not usually infect people, but infections with these viruses have occurred in humans. Most of these cases have resulted from people having direct or close contact with H5N1-infected poultry or H5N1-contaminated surfaces.”http://www.cdc.gov/flu/avian/gen-info/facts.htm

The Spread

Years passed with no reports or detection of the virus. Then, in mid-2003, sporadic cases began popping up in East Asia and the Pacific. By the beginning of 2004, Vietnam, Thailand and Japan not only reported H5N1 in poultry, but also experienced the initial effects of the first wave in human cases.

As the year progressed so did the number of countries with reports of the virus. By the end of February 2004 the virus had spread through Cambodia, Lao PDR, Indonesia and China. By the end of mid-March no more human cases were reported. In total, 12 human cases (8 fatal) occurred in Thailand and 23 cases (16 fatal) occurred in Vietnam.

Throughout the next several months, the number of fatal human cases increased for Vietnam and Thailand, and during this time Malaysia reported H5N1 in poultry, which brought the second wave of the virus into full effect. November 2004 brought the close of this second wave and no more human cases were reported.  Altogether, an additional 5 cases (4 fatal) occurred in Thailand and 4 cases (4 fatal) in Vietnam.

The third wave began to take its toll with the start of the new year. Vietnam reported sporadic cases by the end of January 2005, six fatal. These growing numbers in Vietnam over the next few months made Vietnam the country hardest hit by the flu. By June 2005, however, the World Health Organization’s investigative team found no evidence that H5N1 had improved its spread to humans in countries like Vietnam. 

Around this time, the virus spread to Europe, affecting countries such as Russia, Kazakhstan, Turkey, Romania and Croatia as last year drew to a close.

So Far This Year

At this time, the virus has spread in birds through more than 30 countries and, according to the CDC, it is “not expected to diminish significantly in the short term.” It has spread from Asia to Europe, to Africa and continues to spread to the Near East and South Asia.

The spread of H5N1 virus is rare from person-to-person, not continuing beyond one person, but remains a threat in animal-to-person contact. As of March 2006, there have been 173 laboratory-confirmed human cases, according to WHO, 93 fatal.

This “high” number of suspected human infections in a short period of time suggests that the virus “mutated” causing it to be more easily spread from poultry-to-people, according to the assessment of the current situation on the CDC Web site.

As the virus continues to spread overseas, America is staying on high alert. Currently, Asia and Europe are one-step short of declaring a pandemic.

Three things are required for a pandemic to occur: A new influenza subtype must emerge; it must infect humans and cause serious illness; and it must spread easily and among humans. Asia and Europe meet the first two requirements, but at this time the virus is spreading very mildly (if at all) from human-to-human.

As of November 2005, the virus ranked number three (out of six) on the Pandemic Alert Chart by the WHO. http://www.who.int/csr/disease/avian_influenza/phase/en/index.html

This means that the virus is on pandemic alert, but there is no or very little human-to-human transmission. Experts at WHO (and elsewhere) believe that the world is now closer to another influenza pandemic than at any time since 1968.

Dr. Lucio says the increased numbers of human cases does not constitute really “bad figures” for the state of the disease. “If you look at how widespread the disease is, it probably means thousands have been in contact with the flu.” He adds, “Then if you look at the confirmed number of human cases, it doesn’t seem like that big of a number anymore.”

At this time there is no commercially available vaccine to protect humans against the virus that is being detected across Asia and Europe. The federal government is supporting the efforts of the development and testing of possible vaccines. (For further information about vaccination: http://www.cdc.gov/flu/avian/gen-info/vaccines.htm.)

To prevent the virus from reaching the States, the U.S. has placed bans on imported poultry and bird products from infected countries at this time. Also, risks of domestic poultry being affected nationwide by wildlife are low because there is much control of their keeping –-poultry farmers use chicken coops and raise them inside for the majority of the year. Lucio says poultry in America is only outside for a few months a year and even then, for the most part, is still kept within a maintainable and enclosed farm.

Regarding how Americans may handle the disease spreading to the States some day, Lucio offers his opinion. “It’s really all a matter of psychology,” he says. “Some may handle the infection reaching America differently, if it does. But what we need to remember is to be reasonable and logical in our actions and thoughts.”