Introduction

Avian flu (bird flu)
Avian flu (bird flu)

Bird flu, or avian flu, is an infectious type of influenza that spreads among birds. In rare cases, it can affect humans.

There are many different strains of bird flu virus, most of which don't infect humans. However, three particular strains have caused serious concern in recent years:

  • H5N1 (since 1997)
  • H7N9 (since 2013)
  • H5N6 (since 2014)

Although these viruses don't infect people easily and aren't usually transmitted from human to human, several people have been infected around the world, leading to a number of deaths.

Bird flu affects many species of birds, including chickens, ducks, turkeys and geese. It can be passed between commercial, wild and pet birds. Birds don't always get sick from infection, so seemingly healthy birds may still pose a risk to people who come into contact with them.

Bird flu in the UK

No humans have been infected with H5N1, H7N9 or H5N6 bird flu in the UK, although plans are in place to manage any suspected cases.

During 2016/17, there were several outbreaks of H5N8 bird flu in poultry flocks and wild birds in the UK and Europe. Since then, there have been further outbreaks of H5N8 across the Middle East, Africa and Asia. Worldwide, there have been no human cases of H5N8.

The last reported case of H5N1 in birds in the UK was in early 2008. H7N9 has not been detected in wild birds or poultry in the UK.

You can read reports on recent cases of bird flu in the UK on the GOV.UK website.

Signs and symptoms

Like other types of flu, bird flu symptoms often include:

  • a high temperature (fever)
  • aching muscles
  • headache
  • respiratory symptoms, such as a cough or runny nose

Diarrhoea, vomiting, abdominal (tummy) pain, chest pain, and bleeding from the nose and gums have also been reported as early symptoms in some people.

These symptoms can come on suddenly. The time from infection to the start of symptoms (incubation period) is usually three to five days, although in some cases it can be up to seven days.

Within days of symptoms appearing, potentially fatal complications such as pneumonia, acute respiratory distress syndrome and multiple organ failure may develop. Prompt treatment with antiviral medication may help prevent complications and reduce the risk of death.

Treatment

People with suspected symptoms of bird flu (avian flu) will be advised to stay at home, or will be cared for in hospital in isolation from other patients.

In addition, other recommendations are:

  • resting
  • drinking plenty of fluids and eating healthily
  • taking medication to help treat fever and pain, such as aspirin and paracetamol

Antiviral medication

In the UK, certain antiviral medications have been stockpiled for use in the event of an outbreak. These medications work by stopping the virus multiplying in your body.

Oseltamivir (Tamiflu) and zanamivir (Relenza) help reduce the severity of the condition, prevent complications and improve the chances of survival.

For regular flu, these medications are most effective if given within 48 hours of symptoms developing, but it's not clear if this is the case for bird flu. They should be given as soon as possible to people suspected or proven to be infected, sometimes even if it's more than 48 hours after symptoms started. This decision would be made by the doctor prescribing the medication.

These medications may also be given as a preventative measure to people who could have been exposed to bird flu viruses – for example, other household members, healthcare workers or people who have had close contact with infected birds, depending on the circumstances.

Treating complications

Complications such as bacterial pneumonia may develop in some people and can be treated with regular antibiotics.

People who are severely affected may need to be given extra oxygen to help them breathe – for example, through a ventilator (a machine that assists with breathing).

When to seek medical advice

You should contact your GP or call NHS Direct Wales on 0845 46 47 (or 111 Wales if available in your area) immediately if you experience these symptoms and you've visited an area affected by bird flu in the last two weeks.

An initial assessment can be made over the phone, at a GP surgery, at home, or in a side room at a hospital.

Bird flu is diagnosed based on your symptoms and the likelihood that you've been exposed to an infected bird. The doctor will ask you whether you've:

  • recently travelled to an area affected by bird flu and if you've been close (within one metre) to live or dead domestic fowl or wild birds, including those at bird markets
  • had close contact (touching or speaking distance) with anyone who has a severe respiratory illness
  • had contact with anyone who died unexpectedly and who was from an area that had an outbreak

If bird flu is suspected, the following tests will be carried out to establish whether you have the infection:

  • chest X-ray
  • virus detection using a nose and throat swab
  • blood tests

If the laboratory tests and chest X-ray results are normal, it's unlikely you have bird flu.

You can read about outbreaks of bird flu in the UK on the GOV.UK website.

How bird flu spreads to humans

Bird flu is spread through direct contact with infected birds (dead or alive), an infected bird's droppings, or secretions from their eyes or respiratory tract.

Close and prolonged contact with an infected bird is generally required for the infection to spread to humans. For example:

  • touching infected birds that are dead or alive
  • inhaling or being in contact with dried dust from the droppings or bedding of infected birds
  • inhaling or being in contact with droplets sneezed by infected birds
  • culling, slaughtering, butchering or preparing infected poultry for cooking

Another possible source of bird flu can be live markets, where birds are sold in crowded and sometimes unsanitary conditions. Avoid visiting these markets if you're travelling in countries that have had an outbreak of bird flu.

Bird flu isn't transmitted through cooked food. Poultry and eggs are safe to eat in areas that have experienced outbreaks of bird flu.

Preventing bird flu

There are a number of things you can do to reduce your risk when you visit areas where outbreaks have been reported, such as:

  • avoid visiting live animal markets and poultry farms
  • avoid contact with surfaces that are contaminated with bird droppings
  • don't pick up or touch birds (dead or alive)
  • don't eat or handle undercooked or raw poultry, egg or duck dishes
  • don't bring any live poultry products back to the UK, including feathers
  • always practise good personal hygiene, such as washing your hands regularly

There are no restrictions on travel to countries that have been or are currently affected by bird flu.

Read more about preventing bird flu.

Reporting suspected cases of bird flu

Bird flu is a notifiable disease in animals and you should report any suspected case to the Animal and Plant Health Agency (APHA), even if you're not sure.

Call the Animal and Plant Health Agency Cymru/ Wales on 0300 303 8268 if you find five or more dead birds in the same place.

Read about notifiable diseases in animals on the GOV.UK website.

Human cases

The World Health Organization (WHO) confirmed that by January 2018, 860 people had been infected with the H5N1 virus worldwide and 454 had died. Indonesia, Egypt and Vietnam experienced most cases and fatalities.

Reports of people being infected with the H7N9 virus across mainland China began in March 2013. By January 2018, there had been 1,565 confirmed cases and 612 deaths. Most cases were among middle-aged and elderly men. A small number of cases were reported in travellers from Hong Kong, Taiwan, Macao, Malaysia and Canada.

Since 2014, there have been 19 human cases of infection with H5N6, all reported in mainland China. This strain is different to the H5N6 seen in Europe – the latter has not been associated with any human cases.

There have been some reports of limited human-to-human transmission of H5N1 and H7N9 viruses, usually as a result of very close contact between family members or in hospital settings. The H5N6 virus seen in China has so far not transmitted from person to person.

People who have had bird flu generally developed the virus after coming into close and prolonged contact with infected birds. Millions of birds have been killed during outbreaks to prevent the disease spreading and being passed on to people.

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Prevention

As the bird flu (avian flu) virus is carried by birds, it's very difficult to prevent it spreading. However, there are some general measures you can take to reduce your risk of catching a viral infection.

General precautions

To reduce your risk of catching and passing on viral infections, such as flu, always ensure you:

  • wash your hands regularly, particularly before and after handling food
  • turn away from other people and cover your mouth with tissues when you cough or sneeze
  • dispose of tissues immediately after use and wash your hands with soap and warm water
  • avoid public places if you're ill
  • tell the receptionist at your GP surgery about your symptoms so you can be seated away from other people and given a surgical mask if necessary
  • make sure you maintain a good level of general health and have any recommended vaccinations, such as the pneumococcal vaccination and seasonal flu vaccine, if you're in a high-risk group – for example, if you have a long-term illness such as asthma or you're 65 or over

Contact with birds

You can feed wild birds and ducks, but it's important to wash your hands thoroughly afterwards. Don't go near sick or dead birds. Keep away from bird droppings if possible and wash your hands thoroughly if you accidentally touch any.

Call the Animal and Plant Health Agency Cymru/Wales helpline on 03459 33 55 77 and choose the Avian Influenza oprion if you find five or more dead birds in the same place

If you come across between one and four dead birds, Defra advises leaving them alone or disposing of them carefully. See the Defra website for guidelines on disposing of dead birds.

Pets

In general, you don't need to change the way you look after your pets. If you have a dog that sometimes catches wild birds, try to avoid areas where this is likely to happen. In theory, the H5N1 bird flu strain can be passed on to other animals, but it's very unlikely.

If you have a pet bird, you should avoid letting it have any contact with wild birds or wild bird droppings.

Travel

If you're travelling in a country that's had an outbreak of bird flu, don't go to live animal markets or poultry farms.

Don't go near bird droppings or dead birds, and don't bring live birds or poultry products back to the UK with you, including feathers.

The NHS has plans in place to manage a potential outbreak of bird flu in the UK, although such an outbreak is considered highly unlikely.

Preparing meat

Bird flu isn't transmitted through cooked food. It's safe to eat poultry and eggs in areas that have had outbreaks of bird flu.

As a precaution, always ensure good hygiene standards when preparing and cooking meat. For example:

  • use different utensils for cooked and raw meat
  • wash your hands thoroughly with soap and warm water before and after handling meat
  • ensure that meat is thoroughly cooked and piping hot before serving

Bird flu vaccination

A vaccine that offers protection against the H5N1 bird flu strain does exist, but supplies are limited, so it's unlikely to be widely available unless there's a serious outbreak.

The seasonal flu vaccine doesn't provide protection against the strains of bird flu that can affect humans.

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The information on this page has been adapted by NHS Wales from original content supplied by NHS Choices.
Last Updated: 14/05/2018 13:23:23