Avian Influenza threat, human infections and pandemic potential

1. Avian Influenza threat, human infections and pandemic potential Date : 23 \3\2012 Presentation By :- Dr. EmanDiab

2. introduction

3. Introduction • AVI is a highly contagious viral disease with up to 100 percent mortality in domestic fowl. • Caused by influenza A virus subtypes H5, H9 and H7. • All types of birds are susceptible to the virus, but outbreaks occur most often in chickens and turkeys. • The infection may be brought by migratory wild birds which can carry the virus, but show no signs of disease.

4. Electron micrograph for the influenza virus A, Ref.

5. History of infection

6. History of human infection • First avian influenza virus to infect humans occurred in Hong Kong in 1997. The epidemic was linked to chickens and classified as avian influenza A (H5N1). • More than 560 cases have been identified since then, with deaths worldwide exceeding 300. • Human cases of highly pathogenic bird flu have been largely confined to Southeast Asia and Africa.

7. Ref.

8. History of poultry infection by AI • 1878 in Italy &known as “fowl plague” • Its typed as influenza virus at 1955 . • classified to types (A , B, C ) • In the late 1990s, a new strain of bird flu arose that was remarkable for its ability to cause severe disease and death, especially in domesticated birds such as ducks, chickens, or turkeys. As a result, this strain was called highly pathogenic (meaning very severe) avian influenza. It began in Asia & China then spread world wide possibly through migratory birds • It began in Asia & China then spread world wide possibly through migratory birds..

9. History of poultry infection by AI • Since the identification of highly pathogenic influenza, infected birds have been found in Asia, Europe, the Middle East, and Africa. • Careful control measures, including destroying infected flocks and vaccinating healthy birds, have reduced the number of cases, but the virus continues to exist in poultry flocks in areas of Asia and Africa. Bird flu from the highly pathogenic strain is not found in the United States at this time

11. Cause of AI -RNA virus. -8 segments . -Enveloped virus. -Single strand . -Orthomyxoviridaefamily. -Its polymorphic shape may be circular , concave……

12. Ref. Dr. Madiha (prof. dr. of virology in Damanhur university)

13. Budding of the virus after completing Ref. (net. http//

14. Genetic classification Ref.net. http//

15. Genetic classification -according to NP :- (A, B, C ) -Type A :- in birds -Type B , C :- specific to human being (due to having specific receptors) don’t transmit for birds from . humans

16. According to surface protein -There are several subtypes, labeled according to an H number (for the type of hemagglutinin) and N number (for the type of neuraminidase). -There are 16 different H antigens  (H1 to H16) and nine different N antigens (N1 to N9). So there 144 possible combinations.

17. Ref. Dr. Madiha (prof dr. of virology)

18. Nomenclature of AI • Some variants are identified and named according to: • the isolate they resemble, thus are presumed to share lineage (example Fujian flu virus-like); • their typical host (example human flu virus); • their subtype (example H3N2); • their deadliness (example LP, low pathogenic). • So a flu from a virus similar to the isolate A/Fujian/411/2002(H3N2) is called Fujian flu, human flu, and H3N2 flu. • Variants are sometimes named according to the species (host) in which the strain is endemic or to which it is adapted. • The main variants named using this convention are: • Bird flu • Human flu • Swine influenza • Equine influenza • Canine influenza

19. Nomenclature of AI • Ex. • (A/chicken/Italy/330/97/H5N2) • A refers to type A of AI. • Chicken is the infected species. • Italy is place where it had been isolated. • 330 gene bank (inter only in zoonontic diseases). • 79 discovered at 1997. • H5N2 sub type of the virus.

20. susceptibility

21. Most susceptible animals -Chickens. (ducks &gees)-Water fowls -Birds -Swine -equines

22. The most susceptible people to AI infection .-Farmers and others who work with poultry 0Travelers visiting affected countries 0-Those who touch an infected bird -Those who eat raw or undercooked poultry 0meat, eggs, or blood from infected birds -Health care workers and household contacts of patients with avian influenza may also be at an increased risk of the bird flu.

23. Mode of transmission

24. Mode of transmission -Through inhalation of contaminated droplets. -Through ingestion of contaminated food & water or uncooked food . -Through direct contact between infected birds or between infected birds and humans.

27. Clinical signs of AI

28. Clinical signs in human Symptoms of avian flu infection in humans depend on the strain of virus. Infection with the H5N1 virus in humans causes typical flu-like symptoms, which might include: (Cough (dry or productive Diarrhea Difficulty breathing Fever greater than 100.4°F (38°C) Headache Malaise Muscle aches Runny nose Sore throat

31. Clinical signs in birds -In poultry tropism of AI is upper respiratory tract. -Signs variable , Depends on :- age , severity of virus , other infection complications ,immune status , dose of infection. Ex. Depression &decrease in feed in take Drop in egg production Discoloration in comb &wattles Subcutaneous edema in face Hemorrhage in thigh muscles &on shank bone.

32. -Nasal discharge & ocular discharge -Greenish yellowish diarrhea -Rales & coughing Cyanosis in combe Edema in face Ref. net. Sites Http//

33. PM. lesions Piticeal hemorrhages on proventriculus Ref. net sites Http//

34. Diagnosis

35. Exams &tests for humans:- -If you think you have been exposed to avian influenza, call your health care provider before your visit. This will give the staff a chance to take proper precautions that will protect them and other patients during your office visit. -Tests to identify the avian flu exist but are not widely available. -test for diagnosing strains of bird flu in people suspected of having the virus gives preliminary results within 4 hours. Older tests took 2 to 3 days. -Your doctor might also perform the following tests:- Auscultation (to detect abnormal breath sounds) Chest x-ray. Nasopharyngeal culture White blood cell differential Other tests may be done to look at the functions of your heart, kidneys, and liver.

36. Treatment

37. Treatment for human -Different types of avian flu virus may cause different symptoms. Therefore, treatment may vary. -In general, treatment with the antiviral medication oseltamivir (Tamiflu) or zanamivir (Relenza) may make the disease less severe if you start taking the medicine within 48 hours after your symptoms start. -Oseltamivir may also be prescribed for persons who live in the same house as those diagnosed with avian flu. -The virus that causes human avian flu appears to be resistant to the antiviral medicines amantadine and rimantadine. Therefore these medications should not be used if an H5N1 outbreak occurs.

38. -People with severe infection may need to be placed on a breathing machine. -Experts recommend that persons diagnosed with avian flu be put in isolation. -Doctors recommend that people get an influenza (flu) shot to reduce the chance of an avian flu virus mixing with a human flu virus, which would create a new virus that may easily spread. -The U.S. Food and Drug Administration has approved a vaccine to protect humans from the avian flu. -Experts say the vaccine could be used if the current H5N1 virus starts spreading between people.

39. Prognosis -The outlook depends on the severity of infection and the type of avian influenza Virus that caused it. Death is possible

40. When to Contact a Medical Professional;- -Call your health care provider if you develop flu-like symptoms within 10 days of handling infected birds or traveling to an area with a known avian flu outbreak.

41. Prevention &control in animals -There no treatment -Just apply biosecurity & treat secondary bacterial infections if present. -Best doing is that … if appear in a farm then close it &slaughter then well disposal to carcasses…. If after isolation we found it (LPAI) in broiler farm then do early marketing.

43. Vaccines in poultry -Vaccines generally prohibited but we can use inactivated vaccine . .While in some countries they use NA vector live vaccine

45. Biosecurity

46. Biosecurity We must take care of that :- The avian flu virus (H5N1) has been shown to survive in the environment for long periods of time. Infection may be spread simply by touching contaminated surfaces. Birds who were infected with this flu can continue to release the virus in their feces and saliva for as long as 10 days.

47. Biosecurity -Knowledge of major pathway of spread of HPAI viruses &their persistence in environment. -Wild live birds &migrated birds must be controlled. -early detect &report of out breaks . -enhanced biosecurity of poultry farms. -Hygienic disposal of litters. -Hygienic disposal of dead carcases. -Visit one farm per day . -Prevent visitors from entry except after doing decontamination & wearing sterile gloves. -Clean &disinfect vehicles. -Stay out quarantine farms.

48. Conclusions

49. Experts are worried that the virus could one day mutate and become easily-human-transmissible. If this occurred, a serious influenza pandemic could occur. Ref.net. Http//

50. Conclusion. Hmmm ….while I was talking with Japanese Drs (Dr.Suzuki (& Dr. Ikuta They told me that there a human vaccine against (H1N1) in Japan is used ..that was during the lecture they were sharing with dr. Madiha & dr . Hanyallakany.