healty world

Advice for travellers

staying safe

May 2005: West Nile virus – USA, Canada and Portugal
West Nile virus (WNV) is a rare infection spread by the bite of an infected mosquito. It can infect people, horses, many types of birds and some other animals. There is no evidence to suggest that West Nile virus can be spread directly from person to person or directly from an animal to a person.
The start of the WNV season in North America is imminent. A total of 2470 human cases and 88 deaths from WNV infection were reported in the US in 2004. In Canada, there were 25 cases and no deaths in 2004. The peak transmission season was July – September. These figures represent a considerable reduction in numbers of both cases and deaths when compared to 2003. In addition, two cases of WNV infection have been identified in the Algarve region of Portugal.
As a precautionary measure, advice previously given to people travelling to the USA and Canada, which was extended in 2004 to cover Southern Europe where there is a possible low risk of WNV infection, is still applicable.
To reduce the risk of mosquito bites, the following advice should be followed for those travelling to the USA, Canada and Southern Europe:
stay indoors, or wear a long sleeved shirt and long trousers at dawn, dusk and early evening
use an insect repellent (preferably one containing DEET) on clothes and exposed skin
always follow the manufacturers' directions for use, use sparingly on children and avoid contact with mouth and eyes
indoors, mosquito bites can be reduced by air conditioning, insect-proof screens on windows and doors and spraying the room with insecticide. Bed nets and cot nets can be used if necessary.
A few cases of WNV have been reported in the USA following blood transfusion and organ transplantation. In the United Kingdom, blood, organ and tissue donors are carefully screened before donation.

West Nile Virus
West Nile virus belongs to the group of viruses known as ‘arboviruses’, so-called as they are transmitted by arthropods (insects such as mosquitoes and ticks). The mosquitoes involved in the transmission of West Nile virus usually feed on birds but will sometimes bite and infect horses or humans. West Nile virus has now been found in Africa, Europe, the Middle East, west and central Asia, and more recently, North America. Sporadic cases and outbreaks of disease in humans and horses have occurred in Europe since the 1960s.

20 April 2005: Marburg virus – Angola
As of 15 April, the World Health Organization has reported 250 cases of Marburg virus infection.
There have been 229 deaths, in seven provinces of Angola (Uige, Lunda, Cabinda, Kuanza Norte, Kuanza Sul, Malange and Zaire).
The Foreign and Commonwealth Office advise against all but essential travel to Uige Province where the majority of cases have been recorded.
Symptoms of the disease are similar to other infectious diseases such as malaria or typhoid fever. All visitors to these areas of Angola are recommended to take extra hygiene precautions and to contact a doctor at the first sign of fever or feeling unwell

Marburg haemorrhagic fever is a severe and highly fatal disease caused by a virus from the same family as the one that causes Ebola haemorrhagic fever. These viruses are among the most virulent pathogens known to infect humans. Both diseases are rare, but have a capacity to cause dramatic outbreaks with high fatality.
Illness caused by Marburg virus begins abruptly, with severe headache and severe malaise. Many patients develop severe haemorrhagic manifestations between days 5 and 7, and fatal cases usually have some form of bleeding, often from multiple sites. The disease has no vaccine and no specific treatment. Case fatality rates have varied greatly, from 25% in the initial laboratory-associated outbreak in 1967, to more than 80% in the Democratic Republic of Congo from 1998-2000, to even higher in the outbreak that began in Angola in late 2004.(WHO)

31 March 2005: Malaria increases – Dominican Republic
There has been an increase in the number of malaria cases amongst travellers returning from coastal resorts in the Dominican Republic, including from areas previously malaria-free.
Travellers to the Dominican Republic are reminded to comply with the current recommendations for anti-malaria medication and practice insect bite avoidance. Further information on precautionary measures to take against malaria can be found on this website.

Malaria
Malaria is spread by the bites of infected mosquitoes and can be fatal.
The symptoms include fever and, in some cases, complications affecting the kidneys, liver, brain and blood. People who spend a lot of time in malarial areas can develop some immunity, but this does not last long. If you are travelling or going back to a malarial region, you should take anti-malarial medication.

Planning ahead
Get advice from your doctor or a specialist travel clinic. If you have to take medication, follow the instructions carefully and remember you might need to start taking medication some time before your trip.

Precautions
Try to avoid being bitten by mosquitoes. You should:
wear clothes that cover your arms and legs
use insect repellent
sleep in a screened room, or under a mosquito net
kill any mosquitoes in the room with a 'knockdown' spray.
If you develop a fever or feel ill while you're abroad, or for up to three months after you get back, see a doctor immediately. Tell them if you've been to a country where malaria is present.

Know Before You Go

Get a good guidebook and get to know your destination. Find out about local laws and customs.
Ensure you have a valid passport that is in good condition and the necessary visas.
Make copies of your passport, insurance policy plus 24-hour emergency number, and ticket details. Leave these copies, your itinerary and contact details with family and friends.
Take enough money for your trip and some back-up funds eg travellers cheques, sterling or US dollars.

• 
  Travel Health
  Holidays are to be enjoyed, whether you are looking for fun, relaxation, action or adventure!
  For the business traveller, priorities are different, but the experience should nonetheless be comfortable and pleasant.
  Injury and illness on holiday can be a misery - from painful sunburn to the infamous dodgy tummy - and with no home comforts or familiar remedies, it really can make or break a trip.
  The information in this section is aimed at helping you stay safe and well while you are abroad.
  General tips:
  Buy adequate and appropriate Travel Insurance.
  Check the Department of Health general medical advice for travellers.
  Check what vaccinations you need with your GP at least six weeks before you travel.
  Check if your medication is legal in the country that you are visiting.
  Pack all medication in your hand luggage.
  If you are taking prescribed medication take the prescription and a doctors letter with you.
  If you are travelling within the EU, get form EHIC from the post office for reduced or free emergency care. But remember you still need travel insurance.
  Be safe in the Sun. Avoid excessive sunbathing, especially between 11am and 3pm and wear a high factor sunscreen.
  Drink plenty of water. If you drink alcohol or use some kinds of drugs your body can become dehydrated, especially in a hot climate.
  Practice safe sex - always use a condom. Ensure that you pack a supply before you go as they are not always as readily available abroad and quality can differ from country to country.
  Find out the local emergency number and the address of the nearest hospital when you arrive overseas. Your rep, local guide or accommodation manager should know.

healty & personal care

FLU DISEASES

What to Do for Colds and Flu

Is It a Cold or the Flu? For Your Safety, Know the Difference
A cold and the flu (also called influenza) are alike in many ways. But the flu can sometimes lead to more serious problems, like the lung disease pneumonia.
A stuffy nose, sore throat, and sneezing are usually signs of a cold.
Tiredness, fever, headache, and major aches and pains probably mean you have the flu.
Coughing can be a sign of either a cold or the flu. But a bad cough usually points to the flu.
Know When to Call Your Doctor
You usually do not have to call your doctor right away if you have signs of a cold or flu. But you should call your doctor in these situations:
Your symptoms get worse.
Your symptoms last a long time.
After feeling a little better, you develop signs of a more serious problem. Some of these signs are a sick-to-your-stomach feeling, vomiting, high fever, shaking chills, chest pain, or coughing with thick, yellow-green mucus.
Try to Avoid Getting a Cold
Wash your hands often. You can pick up cold germs easily, even when shaking someone's hand or touching doorknobs or handrails.
Avoid people with colds when possible.
If you sneeze or cough, do it into a tissue and then throw the tissue away.
Clean surfaces you touch with a germ-killing disinfectant.
Don't touch your nose, eyes or mouth. Germs can enter your body easily by these paths.
Try to Avoid Getting The Flu
A flu shot can greatly lower your chance of getting the flu. The best time to get the shot is from the middle of October to the middle of November, because most people get the flu in the winter.
The shot can't cause the flu. But you may feel sore or weak or have a fever for a couple of days.
Who Should Get a Flu Shot?
Almost all people who want to lower their chance of coming down with the flu can get a flu shot.
Flu shots are most important for:
people 65 or older
nursing home patients
people over 6 months old with health problems, like asthma, or with long-term diseases, like HIV or heart disease
children or teenagers who must often take aspirin
people who are often around the elderly or those with health problems
Who Might Not Be Able to Get a Flu Shot?
Some people should talk to their doctor first.
Talk to your doctor before you get the shot if you:
have certain allergies, especially to eggs
have an illness, like pneumonia
have a high fever
are pregnant
Prescription Medicine Can Prevent Flu, Too
If you are one of those who should not get the flu shot, ask your doctor about prescription medicine to help prevent flu.
And if you get the flu, taking this medicine within the first 48 hours can make your illness less serious.
But, Do Not Take Antibiotics For a Cold or Flu
Antibiotics won't work against cold and flu germs.
And, antibiotics should be taken only when really needed.
Help Yourself Feel Better While You Are Sick
A cold usually lasts only a couple of days to a week. Tiredness from the flu may continue for several weeks.
To feel better while you are sick:
Drink plenty of fluids.
Get plenty of rest.
Use a humidifier -- an electric device that puts water into the air.
A cough and cold medicine you buy without a prescription may help.
Choose Medicine With This: Choose the Right Medicines For Your Symptoms
Make sure the label states that it treats your symptoms.

If You Want to Do This: Choose Medicine With This :

Unclog a stuffy nose ---> Nasal decongestant

Quiet a cough ---> Cough suppressant

Loosen mucus so you can cough it up ---> Expectorant

Stop runny nose and sneezing ---> Antihistamine

Ease fever, headaches, minor aches and pains ---> Pain Reliever (Analgesic)

Protect Your Children From "Salicylates" In Cold Medicines
Do not give aspirin or other "salicylates" to children or teenagers with symptoms of a cold or flu.
If you aren't sure whether a product has salicylates, ask your doctor or pharmacist.
Young people can get sick or die from a rare condition called Reye syndrome if they take these medicines while they have these symptoms

Of birds and diseases
By Dr. YLMTHE
avian flu is back. Now I’m really worried my family will be exposed to avian flu. Is avian flu the only disease I can get from birds?Unfortunately, no. There are plenty of other diseases you can get from birds and other animals. Basically, these are all called zoonotic diseases, which are transmissible from animals to humans.Most bird-to-human diseases are more likely to be transmitted from poultry (like chickens) than your friendly pet birds. Nevertheless, your pet birds are also famous for transmitting several diseases, namely psittacosis.I’m still not quite sure about the avian flu. Is it spread only by chickens?All birds are susceptible to getting avian flu, which is caused by many different subtypes of the influenza virus type A.Birds that migrate, especially waterfowl such as wild ducks, are the natural reservoir of these flu viruses. These are also the most resistant to dying from the virus! That’s why they can spread the disease so well, causing problems when they fly from one place to the next.Of course, it doesn’t help when humans capture these wild ducks and put them in a live bird market next to uninfected domestic chickens.There are many diseases (zoonotic diseases, which are transmissible from animals to humans)you can get from chickens, birds and other animals.If it was only a bird disease, how do we humans get it?Throughout the years, the viruses have mutated to become stronger and more virulent. Initially, the avian flu was contained amongst birds and poultry. Then the viruses mutated and started “jumping” into humans. Initially this happened to humans who worked in close proximity with the birds, like poultry farmers.These first humans then became a “mixing vessel” for the scrambling of genetic material between avian and human flu viruses. As a result, a new “flu” subtype has emerged!How did these viruses get so smart? (Note that both the human and avian flu viruses are equally smart!) Well, they are constantly exchanging genetic material between themselves, containing the “knowledge” or “blueprints” on how to elude the human immune defences.In 1997, Hong Kong became the first victim of these “smart” types of newly mixed avian-human viruses. Luckily, the prompt culling of their entire poultry population prevented what could have been a pandemic.Okay, is psittacosis anything similar to the avian flu?Psittacosis is caused by Chlamydia psittaci, a different sort of micro-organism. It is also called Parrot disease or Bird fancier’s disease, though the type of birds which get it are not confined to parrots and other caged pet birds. Even canaries, chickens and ducks can get it.Now, when a human breathes in the Chlamydia through the infected bird’s urine or faeces droplets, or gets pecked, or if he shares food with the birds out of his own mouth (some people are so fond of feeding parrots that way!) he might get psittacosis.This initially starts off as a mild flu-like illness with fever, cough, chills and loss of appetite. Then it can progress to frank pneumonia and involve other organs like the liver, the heart cavity lining and the brain. The course of the disease varies from one patient to the next. In mild cases, you get away with a fever for three weeks. In severe cases, you die.Psittacosis is more common in people who work closely with birds and poultry, like those who keep birds as pets, poultry farmers and workers, pet shop employees, vets, bird dealers and public health inspectors!It would seem that most bird-to-human disease occur in those are in close contact with birds. So the majority of us are safe right?Not really. Some poultry, pigeons and parrots may carry salmonella, which is a bacteria. When you eat the contaminated chicken (or other poultry, assuming you don’t eat pet birds!), the salmonella can pass into you.Salmonella causes vomiting, bloody diarrhoea and fever which may last for 2 to 4 days. Unfortunately, salmonella can be transmitted from human to human, and humans back to their pet birds.Another gastrointestinal tract infection passed on by eating contaminated poultry is campylobacteriosis. The symptoms are similar to salmonellosis (except with prominent stomach cramps). You can get this by eating raw or undercooked poultry, and even from drinking unpasteurised milk. Even one drop of juice from an infected raw chicken meat can give you this disease!Then there is a disease called allergic alveolitis, which occurs in people hypersensitive to bird feathers, feather dust and bird faecal matter, especially those from pigeons and budgerigars. And in Malaysia, you get pigeons everywhere, whether you breed them or not!Allergic alveolitis is a lung disease that can take as early as four hours after inhalation of the feathers to manifest itself, or as long 20 years after continued exposure. The symptoms are that of coughing, difficulty in breathing and fever.Is there any treatment for all these bird related diseases?It all depends on the infecting organism. Certainly, chlamydia, salmonella and campylobacter can be eradicated with antibiotics. People with allergic alveolitis will get better once they are removed from their feather-laden environment. And a lifestyle, hobby or occupational change might be in place for those afflicted.The viruses are harder to eradicate. But antiviral medications like oseltamivir and amantadine are approved by the US FDA for treatment and prevention of influenza.
Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health advice, computers and entertainment. The information contained in this column is for general educational purposes only. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

What is avian influenza (bird flu)?

Bird flu is an infection caused by avian (bird) influenza (flu) viruses. These flu viruses occur naturally among birds. Wild birds worldwide carry the viruses in their intestines, but usually do not get sick from them. However, bird flu is very contagious among birds and can make some domesticated birds, including chickens, ducks, and turkeys, very sick and kill them.Do bird flu viruses infect humans?Bird flu viruses do not usually infect humans, but several cases of human infection with bird flu viruses have occurred since 1997.How are bird flu viruses different from human flu viruses? Updated March 18There are many different subtypes of type A flu viruses. These subtypes differ because of certain proteins on the surface of the flu A virus (hemagglutinin [HA] and neuraminidase [NA] proteins). There are 16 different HA subtypes and 9 different NA subtypes of flu A viruses. Many different combinations of HA and NA proteins are possible. Each combination is a different subtype. All subtypes of flu A viruses can be found in birds. However, when we talk about “bird flu” viruses, we are referring to those flu A subtypes that continue to occur mainly in birds. They do not usually infect humans, even though we know they can do so. When we talk about “human flu viruses” we are referring to those subtypes that occur widely in humans. There are only three known subtypes of human flu viruses (H1N1, H1N2, and H3N2); it is likely that some genetic parts of current human flu A viruses came from birds originally. Flu A viruses are constantly changing, and they might adapt over time to infect and spread among humans.What are the symptoms of bird flu in humans?Symptoms of bird flu in humans have ranged from typical flu-like symptoms (fever, cough, sore throat and muscle aches) to eye infections, pneumonia, severe respiratory diseases (such as acute respiratory distress), and other severe and life-threatening complications. The symptoms of bird flu may depend on which virus caused the infection.How does bird flu spread?Infected birds shed flu virus in their saliva, nasal secretions, and feces. Susceptible birds become infected when they have contact with contaminated excretions or surfaces that are contaminated with excretions. It is believed that most cases of bird flu infection in humans have resulted from contact with infected poultry or contaminated surfaces.How is bird flu in humans treated?Studies suggest that the prescription medicines approved for human flu viruses would work in preventing bird flu infection in humans. However, flu viruses can become resistant to these drugs, so these medications may not always work.What is the risk to humans from bird flu?The risk from bird flu is generally low to most people because the viruses occur mainly among birds and do not usually infect humans. However, during an outbreak of bird flu among poultry (domesticated chicken, ducks, turkeys), there is a possible risk to people who have contact with infected birds or surfaces that have been contaminated with excretions from infected birds. The current outbreak of avian influenza A (H5N1) among poultry in Asia (see below) is an example of a bird flu outbreak that has caused human infections and deaths. In such situations, people should avoid contact with infected birds or contaminated surfaces, and should be careful when handling and cooking poultry. For more information about avian influenza and food safety issues, visit the World Health Organization website.What is an avian influenza A (H5N1) virus?Influenza A (H5N1) virus – also called “H5N1 virus” – is an influenza A virus subtype that occurs mainly in birds. It was first isolated from birds (terns) in South Africa in 1961. Like all bird flu viruses, H5N1 virus circulates among birds worldwide, is very contagious among birds, and can be deadly.What is the H5N1 bird flu that has recently been reported in Asia? Updated May 09Outbreaks of influenza H5N1 occurred among poultry in eight countries in Asia (Cambodia, China, Indonesia, Japan, Laos, South Korea, Thailand, and Vietnam) during late 2003 and early 2004. At that time, more than 100 million birds in the affected countries either died from the disease or were killed in order to try to control the outbreak. By March 2004, the outbreak was reported to be under control. Beginning in late June 2004, however, new deadly outbreaks of influenza H5N1 among poultry were reported by several countries in Asia (Cambodia, China, Indonesia, Malaysia [first-time reports], Thailand, and Vietnam). It is believed that these outbreaks are ongoing. Human infections of influenza A (H5N1) have been reported in Thailand, Vietnam and Cambodia.What is the risk to humans from the H5N1 virus in Asia? Updated May 24The H5N1 virus does not usually infect humans. In 1997, however, the first case of spread from a bird to a human was seen during an outbreak of bird flu in poultry in Hong Kong. The virus caused severe respiratory illness in 18 people, 6 of whom died. Since that time, there have been other cases of H5N1 infection among humans. Most recently, human cases of H5N1 infection have occurred in Thailand, Vietnam and Cambodia during large H5N1 outbreaks in poultry. The death rate for these reported cases has been about 50 percent. Most of these cases occurred from contact with infected poultry or contaminated surfaces; however, it is thought that a few cases of human-to-human spread of H5N1 have occurred.So far, spread of H5N1 virus from person to person has been rare and spread has not continued beyond one person. However, because all influenza viruses have the ability to change, scientists are concerned that the H5N1 virus could one day be able to infect humans and spread easily from one person to another. Because these viruses do not commonly infect humans, there is little or no immune protection against them in the human population. If the H5N1 virus were able to infect people and spread easily from person to person, an “influenza pandemic” (worldwide outbreak of disease) could begin. No one can predict when a pandemic might occur. However, experts from around the world are watching the H5N1 situation in Asia very closely and are preparing for the possibility that the virus may begin to spread more easily and widely from person to person.How is infection with H5N1 virus in humans treated?The H5N1 virus currently infecting birds in Asia that has caused human illness and death is resistant to amantadine and rimantadine, two antiviral medications commonly used for influenza. Two other antiviral medications, oseltamavir and zanamavir, would probably work to treat flu caused by the H5N1 virus, though studies still need to be done to prove that they work.Is there a vaccine to protect humans from H5N1 virus? Updated May 09There currently is no vaccine to protect humans against the H5N1 virus that is being seen in Asia. However, vaccine development efforts are under way. Research studies to test a vaccine to protect humans against H5N1 virus began in April 2005. (Researchers are also working on a vaccine against H9N2, another bird flu virus subtype.) For more information about the H5N1 vaccine development process.What is the risk to people in the United States from the H5N1 bird flu outbreak in Asia?

Attack of the Bird Flu: Experts Say Pandemic Inevitable
While the deadly Avian flu spreads through Asia, Bay State health officials - who have been "vigorously" planning for a flu pandemic for six years - doubt the state could ever be completely prepared for a full-blown attack."At some point, the pandemic is going to happen. We're prepared better today than we were last week. We can only prepare so far," said Dr. Alfred DeMaria, head of communicable disease control for the state Department of Public Health.Two million people in Massachusetts alone could become ill in six to eight weeks if a flu pandemic hit, according to the state DPH. One million Bay Staters could need outpatient care; 16,800 could be hospitalized and nearly 5,000 could die.Last century saw three flu pandemics - in 1918, 1957 and 1968. The flu killed half-a-million Americans in 1918.National and local flu experts say it's inevitable that a sweeping flu pandemic - a worldwide outbreak - occurs every 20 to 50 years.The H5N1 strain has killed 64 people in Southeast Asia in two years. People have contracted the virus from birds.Health officials fear the virus eventually will spread from person to person, creating a worldwide outbreak that could kill millions."It's not a matter of if, but when we might see another pandemic," said Tom Skinner of the federal Centers for Disease Control.U.S. officials are concerned that hospitals won't be able to hold and care for a lot of patients at one time. Skinner said the technology that produces vaccines needs to be improved so vaccines can be produced more quickly. It now takes four to six months to produce a vaccine.Should there be a flu pandemic, Massachusetts is slated to get 460,000 vaccine doses a month for one to two years.State officials are working with businesses to make sure they can still operate should 30 or 40 percent of their employees call in sick, DeMaria said. The state is looking at alternative sites to house people who are ill at the same time.While a vaccine to fight the current strain of Avian flu is being made, health officials don't know if that particular strain would cause the pandemic. The strain could change over time and require a different vaccine."The picture of what the virus (H5N1) can do to humans is pretty gruesome in terms of its mortality," said Dr. Kenneth McIntosh, former chief of infectious disease at Children's Hospital in Boston."If we're really talking about that kind of pandemic, a virus that spreads efficiently from human to human," McIntosh added. "I don't think anybody can be ready for that, quite honestly. You can do everything you can but it's still going to be a disaster.
"Source: Boston Herald"

Tips
Preventing the Flu For all families, prevention is key.

Follow these 10 tips to stay healthy this winter:1. Avoid taking babies or young children into large crowds when the flu is in your area.2. Avoid close contact, such as kissing and holding, between infants and anyone who has a cold or the flu.3. Avoid close contact with people who are sick.4. Wash your hands or use alcohol-based hand sanitizers after being in public or around anyone with a cold orthe flu.5. Cover your mouth and nose with a tissue when you cough or sneeze; use a tissue only once and then throwit away. If no tissue is available, cough or sneeze into the inside of your elbow.6. Avoid touching your eyes, nose and mouth.7. Do not share things that go into the mouth, such as drinking cups, straws, spoons, etc.8. Clean common surfaces, such as doorknobs, refrigerator handles and phones, frequently if someone inyour house has a cold or the flu.9. Keep your child home or stay home yourself if you have the flu (fever, muscle aches, cough).10. Don't smoke around children, and avoid secondhand smoke.Warning Signs If your child experiences any of these symptoms, take the child to your pediatrician or to the emergency department right awayWhat is influenza (flu)?Influenza (flu) is a viral upper respiratory illness that comes on suddenly, causing symptoms such as fever, body aches, headache, fatigue, loss of appetite, a dry cough, and a sore or dry throat. The flu is not the same as the common cold; flu symptoms are usually more severe, and you will often miss more work or school than you would with a cold.Most people recover without problems, but sometimes the illness leads to a bacterial infection, such as an ear infection, sinus infection, or bronchitis. Good home treatment may help prevent these infections. More serious complications, most commonly pneumonia, may develop in some people. People at increased risk for complications that require hospitalization are young children, adults age 65 and older, and those with serious medical problems.What causes the flu?Influenza viruses A and B cause the classic flu. Type A is usually responsible for the outbreaks that occur annually.These viruses are constantly changing, producing what are called subtypes or strains that are different from the original virus but retain some of its characteristics. Strains of influenza virus that cause the flu may differ from year to year.What are the symptoms?The flu causes fever, cough, shaking chills, body aches, headache, and fatigue. These symptoms usually last for 3 to 4 days, after which you may have a dry cough, runny nose, and a sore or scratchy throat for another week or so. The incubation period—the time from exposure to the flu virus until you develop symptoms—is 1 to 4 days.Although people often use the term "flu" to describe any kind of mild illness that has flulike symptoms (such as the common cold or a stomach virus), the flu is a distinct viral illness with specific symptoms, and it tends to occur at a particular time of year—late fall and winter.How is the flu diagnosed?Health professionals usually can diagnose influenza using your symptoms alone, especially if many cases of a similar illness have occurred in the community and the local health department has confirmed a flu outbreak. Routine testing of people who have typical flu symptoms is usually not necessary. Rarely, the specific flu virus you have may be identified through a blood test or a nasal or throat swab.How is it treated?Home treatment is usually all that is needed for flu symptoms. However, antiviral medications are available to reduce the duration and severity of symptoms. These medications are especially useful for older adults and others who are at risk for developing complications from the flu. These medications need to be started within 2 days of your first symptoms.Can the flu be prevented?You can help prevent the flu by getting immunized with an influenza vaccine each year, ideally in October or November. The standard vaccine, known as the "flu shot," is given by injection. It can be given after age 6 months to anyone who wishes to help prevent the flu. The flu shot is recommended for:
1 All children age 6 months to 23 months. All adults age 50 and older. Adults and children age2 and older who have health conditions such as asthma, chronic heart or lung disorders, or an impaired immune system.
Women who will be pregnant during the flu season.
Close contacts (including household members and health care workers) of anyone in a high-risk category, which includes all children 23 months of age and younger.
FluMist, a live-virus vaccine in the form of a nasal spray, is an alternative to the flu shot that is now available for healthy children and adults between the ages of 5 and 49, except pregnant women. FluMist should not be given to close contacts of people with severely impaired immune systems (such as those who have had a recent bone marrow transplant) to avoid their transmitting the virus after being vaccinated.

Avian influenza A(H5) in rural areas in Asia:food safety considerations
12 February 2004In several countries in Asia, most rural families keep small free-range poultry* flocks, and up to 80% of poultry are raised at small-household village level. This poses a challenge for controlling outbreaks of highly pathogenic avian influenza A(H5) (HPAI) in poultry and raises concerns about handling poultry in countries currently experiencing outbreaks.In animals, HPAI is most commonly transmitted through direct contact with wild birds, especially asymptomatic waterfowl, and contacts with infected poultry and poultry products. There are also common indirect routes, e.g. through contaminated clothing, footwear, vehicles and equipment, as well as contaminated feed, water, manure and litter. Insects, rodents, cats and dogs can also act as vectors and transmit the disease.Previous outbreaks of HPAI, notably in Hong Kong Special Administrative Region of China in 1997 and in the Netherlands in 2003, have occurred in areas characterized by industrial production conditions that allowed rapid and effective implementation of recommended animal control measures (including systematic culling of infected flocks, quarantine, bans on the movement of animals, and compensation schemes for affected farmers and smaller-scale poultry owners).While efficient control measures could be rapidly implemented for the industrial production of poultry in the affected countries in Asia, the current outbreaks are happening in areas where poultry and humans often share the same environment. Poultry are present in almost all villages and are generally marketed as live animals – the “farm-to-fork” chain may be as short as a few metres. In these conditions, the disease can spread quickly between the many small flocks. The practice of home slaughtering means that human exposure to the virus can easily occur in infected areas. Applying the recommended control measures to curb the outbreaks in the animal population would be extremely difficult and would take time, thus increasing the risk of human exposure to the virus.Current guidance on the food safety aspects of the disease in poultry is valid for areas where efficient animal control measures are in place and ensure that infected animals or eggs would not enter the food-chain or be marketed. In the present outbreaks, however, until the animal control measures put in place become effective, there is a risk that infected eggs or live birds excreting viruses will be marketed or enter the food-chain, particularly in rural settings. Additional guidance is therefore needed.Investigation of previous outbreaks has established that close contact with live infected poultry has been the principal means of transmission to humans. The practice of marketing live poultry directly to consumers should therefore be discouraged in areas currently experiencing influenza outbreaks among poultry.Appropriate messages should be developed to inform the rural population about the need to restrain or stop the movement of animals, as well as the measures to be taken if a family identifies a sick or dead bird within its small flock. The importance of hygiene in reducing the mechanical spread of the disease on vehicles, equipment, footwear and clothing should be re-emphasized.It is expected that the practice of home slaughtering will not be halted completely, and advice on how to slaughter as safely as possible should be given. Sick birds, or birds from flocks in which one or more birds are sick, should never be slaughtered for consumption and their eggs should not be marketed for human or animal consumption. The slaughter should be carried out by one designated person wearing protective personal equipment. Where this is not possible, strict hygiene should be observed by the person who slaughtered the animals. The slaughter should preferably take place in a confined area away from the kitchen; children and animals should be kept away. It is important to use hot water for scalding. After slaughter, cleaning and disinfection of the area, including safe disposal of the feathers and animal remains, are equally important.Until the disease in animals is effectively contained, there is a risk of infected animals being handled for human consumption, thus increasing the risk of exposure for anyone taking part in these activities.WHO reiterates that, once poultry has entered the food-chain as a processed product (whole refrigerated or frozen carcasses and products derived from these), cooking so that the centre of the product reaches a minimum temperature of 70 °C would render it safe for human consumption. The same applies to eggs. Eggs from infected birds can harbour the virus both outside and within the shell and should therefore be cooked before consumption.(WHO)