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Student Education

Things you really should know about: bird flu

BMJ 2006; 332 doi: (Published 01 April 2006) Cite this as: BMJ 2006;332:0604146
  1. Laura J L Halpin, final year medical student1,
  2. Farah Janmohamed, final year medical student1,
  3. Sanjay Patwardhan, specialist registrar2
  1. 1Barts and the London Medical and Dental School, London
  2. 2City Hospital, Birmingham

Do you know your H5N1 from your H3N2? Laura Halpin, Farah Janmohamed and Sanjay Patwardhan consider some of the commonly asked questions about bird flu

Bird flu has recently received extensive media coverage, with escalating concerns surrounding a potential influenza pandemic. Despite the availability of many information sources, ranging from newspapers to guidance from the Department of Health and the chief medical officer, medical students and junior doctors may not have a satisfactory understanding of the key facts.

What is avian influenza?

Bird flu is a highly infectious viral disease caused by influenza A viruses, which normally infect birds and, less commonly, pigs. All birds are thought to be susceptible, but some species are more resistant than others. There are 16 H-types of influenza A, two of which affect birds—the H5 and H7 subtypes. The H5N1 subtype is responsible for the current outbreak.

What is the current situation?

The current outbreak emerged in poultry in South East Asia (in Korea) in December 2003 and has been documented as the most severe. The sudden spread of avian influenza in birds, with outbreaks occurring in numerous continents simultaneously, is historically unprecedented. Despite the extermination of more than 150 million birds worldwide, 176 human cases have been recorded in Vietnam, Thailand, China, Indonesia, Cambodia, Iraq, and Turkey by the World Health Organization. As of 10 March 2006, 97 people have died.

In Turkey, there have been 12 confirmed human cases, with four deaths. This has resulted in the Turkish government launching an intensive public awareness campaign.

Has an outbreak in humans ever happened before?

Avian influenza typically only affects birds and pigs, but has been known to infect humans. Human infection with the H5N1 subtype of avian influenza was first reported in Hong Kong in 1997, when 18 cases (six fatal) were identified. Ten human cases were then reported in Vietnam and Thailand in 2004, of which eight were …

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