WHO, CDC Issue Travel Warnings Over Bird Flu

According to a World Health Organization (WHO) report on 5 Aug. 2005, the Ministry of Health in Viet Nam has reported an additional 3 human cases of avian influenza A (H5N1) virus infection: one in the northern province of Ha Tay, one in the southern province of Tra Vinh, and one in Ho Chi Minh City, also in the south. The patients from Tra Vinh and Ho Chi Minh City died. These newly confirmed cases in Viet Nam bring the total reported there since mid-December 2004 to 63 cases, 20 of which have been fatal.

During December 2003 to Aug. 5, 2005, a total of 112 human cases of avian influenza A (H5N1) were reported in Viet Nam (90), Thailand (17), Cambodia (4) and Indonesia (1), resulting in 57 deaths.

Most cases of H5N1 infection in humans are thought to have occurred from direct contact with infected poultry. Therefore, care should be taken to avoid contact, when feasible, with live, well-appearing, sick or dead poultry and any surfaces that may have been contaminated by poultry or poultry feces or secretions. To date, there has been no evidence of sustained person-to-person spread of influenza A (H5N1) virus.

To reduce the risk of infection, travelers visiting areas where outbreaks of H5N1 infection among poultry or human cases of H5N1 infection have been reported should observe the following measures to help avoid illness.

Before any international travel
(1) Always educate yourself and others who may be traveling with you about any disease risks in areas you plan to visit (for information about H5N1, see this web page for more information.

(2) Be sure your vaccinations are up to date and see your doctor or health-care provider, ideally 4 to 6 weeks before travel, to get any additional vaccinations, medications, or information you may need. CDC’s health recommendations for international travel to Southeast Asia are provided on CDC’s Travelers’ Health website.

(3) Assemble a travel health kit containing basic first aid and medical supplies. Be sure to include a thermometer and alcohol-based hand rub for hand hygiene. See this page for other suggested items.

(4) Before you leave, find out how and where to get medical care in the country where you are traveling.

(5) Check your health insurance plan or get additional insurance that covers medical evacuation in case you become sick. Information about medical evacuation services is provided on the U.S. Department of State Web page titled Medical Information for Americans Traveling Abroad.

During Travel
(1) Avoid all direct contact with poultry, including touching well-appearing, sick, or dead chickens and ducks. Avoid places, such as poultry farms and bird markets, where live poultry are raised or kept, and avoid handling surfaces contaminated with poultry feces or secretions.

(2) As with other infectious illnesses, one of the most important preventive practices is careful and frequent hand-washing. Cleaning your hands often, using soap and water (or waterless alcohol-based hand rubs when soap is not available and hands are not visibly soiled), removes potentially infectious
material from your skin and helps prevent disease transmission.

(3) Hand-washing is especially important when preparing raw poultry for cooking (including during cooking classes).

(4) Influenza viruses are destroyed by heat; therefore, as a precaution, all foods from poultry, including eggs and poultry blood, should be thoroughly cooked. Seae International Food Safety Authorities Network (INFOSAN) for guidelines about food safety and H5N1 here.

(5) If you become sick with symptoms such as a fever, difficulty breathing, or cough or with any illness that requires prompt medical attention, a U.S. consular officer can assist you in locating medical services and informing your family or friends. See this page for more information about what to do if you become ill while abroad. It is advisable that you defer travel until you are free of symptoms unless your travel is health-related.

After your return
(1) Monitor your health for 10 days.

(2) If you become ill with fever and develop a cough or difficulty breathing, or if you develop any illness during this 10-day period, consult a health-care provider.

Before you visit a health-care setting, tell the provider the following: 1) your symptoms 2) where you traveled and 3) if you have had direct poultry contact or contact with a known or suspected human case of influenza A (H5N1) in an H5N1-affected country . This way he or she can be aware you have traveled to an area reporting avian influenza.

For more information about H5N1 infections in humans, visit the World Health Organization (WHO) website and the CDC Avian Influenza site.

For more information about CDC’s health recommendations for travel to Asia, go here and here.


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