With the media bombarding us with stories on avian influenza - including recent reports of the January 17th death of a young woman in Nigeria - is all this information wreaking havoc on your travel plans?
More importantly, should it?
The fear over avian flu is eerily familiar, since we saw the devastating effect of SARS about four years ago - not simply in terms of the actual illness, but the significant financial impact on the travel industry.
When SARS cases began cropping up in late 2002 and early 2003, the World Health Organization (WHO) and the Centers for Disease Control (CDC) issued advisories in Asia and Canada. Combined with daily media reports of SARS deaths, the travel industry in those regions took a heavy toll for several months.
But considering that the death rate of SARS was only about 15 percent of those who contracted it, overall, was it more fear than fact that affected travel so significantly?
These days, it’s avian flu that’s got travelers concerned. Although fewer than 200 cases have been reported worldwide, the potential for widespread medical disaster remains high, as this virus is thought to have a mortality rate of over 50 percent. Airports — main points of entry for world travelers — are admittedly not equipped to handle large outbreaks, and most cities don’t even have places to quarantine people if a transmissible form of bird flu were to develop. Even though neither WHO nor the CDC have issued any travel advisories in the regions affected by avian flu, it’s still hard to piece together all the information that we’re getting.
So, for the moment, here is the latest guide to the current strain of bird flu that’s been hitting the headlines, and how you can better protect yourself in your upcoming travels.
What is avian flu?
This particular strain of avian influenza is known at H5N1, which is caused by viruses that occur naturally among birds. It can be highly contagious among birds, spread through secretions like saliva, mucus and feces. There is a mild form, which causes very little damage, like ruffled feathers and lowered egg production, and a much more dangerous form that can spread very rapidly among flocks. The stronger version can affect multiple internal organs, and has a mortality rate of about 90-100 percent within 45 hours. As of now, cases of bird flu within poultry have been found in areas throughout Africa, Asia, Europe, Eurasia, and Near East countries like Egypt, Iraq, Iran and Israel. There has also been a surprising new case recently on the island of Rügen in Germany, where a deceased cat turned out to be infected with H5N1.
Can I contract bird flu?
This type of influenza generally cannot be transmitted from bird to human. However, there have been isolated cases. The first case of this was reported in 1997 in Hong Kong, and at that time, six out of the 18 victims died. More reports appeared in 2003, and since then, there have been 103 deaths out of 184 cases. Human cases of this virus have hit the hardest in Vietnam, Indonesia and Thailand, with other cases in Cambodia, China, Turkey and Iraq.
The way humans have contracted bird flu is from directly contacting infected birds or surfaces that are contaminated with secretions and/or excretions of infected birds. There have been cases of people getting infected during slaughtering, de-feathering and butchering poultry. However, recent studies show that the virus concentrates itself too deeply in the respiratory tract to be spread by coughing or sneezing, as more common forms of influenza are.
There have been rare cases of the virus spreading from one ill person to another, but so far, it hasn’t spread beyond one person. The big fear among scientists is that the more human cases that occur, the more likely it is that this flu could mutate into a strain that can spread easily between humans, in which case a worldwide epidemic is terrifyingly possible.
Is there a cure?
Right now, there is no way to cure or prevent H5N1. However, researchers are currently developing vaccines targeted at a number of different strains of the virus. None of these would be sufficient to prevent a pandemic, since no existing strain of the virus is currently capable of causing one (the fear is that the virus will mutate into a form as yet unknown to scientists). Some U.S. health organizations have suggested that Tamiflu may be an effective treatment for avian flu, although the data is not sufficient to reach a definite conclusion.
Are airports safe?
Airports are often the front lines of defense, because a contagious disease can be brought over from one country to another via aircraft. Currently, there are official CDC quarantine stations in 18 airports around the country. While that sounds reassuring, you need to put things in perspective: most of these airport quarantine facilities are not designed for large-scale or long-term outbreaks; they are offices with CDC staff and a private room for patients to get tested. They include:
Anchorage (Anchorage International Airport)
Atlanta (Hartsfield International Airport)
Boston (Terminal E, Logan International Airport)
Chicago (O’Hare International Airport)
Detroit (Detroit Metropolitan Airport)
El Paso (Center for Border Health Research)
Honolulu (Honolulu International Airport)
Houston (George Bush Intercontinental Airport)
Los Angeles (Tom Bradley International Airport)
Miami (Miami International Airport)
Minneapolis-St. Paul (Minneapolis-St. Paul International Airport)
Newark (Newark Liberty International Airport, Terminal B)
New York (JFK International Airport, Terminal 4)
San Diego (San Diego International Airport)
San Francisco (San Francisco International Airport)
San Juan (San Juan Luis Munoz Marin International Airport)
Seattle (Seattle-Tacoma International Airport, Room S)
Washington DC (Dulles International Airport)
Plans are underway for the same type of facilities in at least seven more cities, possibly including Charlotte, Dallas, Denver, New Orleans, Philadelphia and Phoenix.
Some airports have pinpointed locations where they can quarantine larger groups of people, but studies tell us that airports aren’t as prepared as they could be. In the case of LAX, for example, a vacant maintenance hangar can be used to hold large groups, but there is no plumbing or other amenities to keep people there for long stretches.
Translation: We’re not really adequately prepared.
But there has been some progress in this area. Because officials fear that a transmittable form of avian flu might first wind up on Hawaiian soil due to its proximity to Asia, procedures at the Honolulu International Airport have become a model for the rest of the United States. It is the first airport to establish a surveillance program, in conjunction with the Health Department, to test visibly ill passengers. Air staff is asked to report any passengers who exhibit signs of influenza. On the ground, a Health Department medical official will then test the passenger for all forms of influenza. Unfortunately, identifying and testing influenza on sick passengers isn’t always easy. Currently this process is entirely voluntary, so if a passenger refuses to take the test, neither the Health Department nor the airport can do anything further.
How can I avoid contracting avian flu?
Even though WHO has not issued any warnings about travel to countries affected by avian flu, there are still some steps you can take to protect yourself. The virus can be killed by heat, so make sure that any poultry or poultry-related food that you eat is properly and thoroughly cooked to at least at 158 F. If you’re into sampling local cuisine, be very aware of local dishes that may include raw or runny eggs or undercooked meat. And use common sense. Your culinary adventures don’t need to include local delicacies like raw duck blood, as was the case with three Vietnamese brothers who contracted avian flu last year.
Another thing to be aware of is cross contamination — be sure that the restaurant you’re eating at (or whoever is preparing your food) properly scrubs and disinfects its cooking surfaces with soap and hot water.
If you happen to be going abroad, then the short-term preventive solutions are relatively simple: try to avoid contact with live markets and poultry farms. Even free-range poultry is still at risk for developing bird flu. One more thing: if you’re planning to have fresh poultry for dinner, have the bird slaughtered at the market rather than doing it yourself.
Lastly, don’t forget to practice good hygiene throughout your travels. Wash your hands thoroughly with hot water and soap often, or keep a bottle of antiseptic hand rinse with you.
For more information on avian flu and how you can protect yourself in your travels, the following resources may help you:
World Health Organization: http://www.who.int/csr/disease/avian_influenza/en/
An overview with key facts, current information, breaking news, advice for travelers and links to regional offices around the world
Center for Disease Control: http://www.cdc.gov/flu/avian/index.htm
An overview with key facts, up-to-date information, breaking news and information for travelers
Department of Health and Human Services: http://www.pandemicflu.gov
A specialized website managed by the Department of Health with strategies and information on a potential pandemic outbreak
Food and Agricultural Organization: http://www.fao.org/ag/againfo/subjects/en/health/diseases-cards/special_avian.html
A comprehensive overview from the organization’s Animal Production and Health Division
U.S. Department of State: http://www.travel.state.gov/travel/tips/health/health_1181.html
Tips on traveling abroad, travel warnings and frequently asked questions
For more information on our site visit:
Travel Safety & Security
