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Avian influenza
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Avian influenza in birds H5N1

Avian influenza is an infection caused by avian (bird) influenza (flu) viruses. These influenza viruses occur naturally among birds. Wild birds worldwide carry the viruses in their intestines, but usually do not get sick from them. However, avian influenza is very contagious among birds and can make some domesticated birds, including chickens, ducks, and turkeys, very sick and kill them.

Avian influenza is flu infection in birds. The disease is of concern to humans, who have no immunity against it. The virus that causes this infection in birds can mutate (change) to easily infect humans. Such mutation can start a deadly worldwide epidemic.

Infected birds shed influenza virus in their saliva, nasal secretions, and feces. Susceptible birds become infected when they have contact with contaminated secretions or excretions or with surfaces that are contaminated with secretions or excretions from infected birds. Domesticated birds may become infected with avian influenza virus through direct contact with infected waterfowl or other infected poultry, or through contact with surfaces (such as dirt or cages) or materials (such as water or feed) that have been contaminated with the virus.

Historically, avian influenza viruses infected pigs and mixed with pig influenza viruses. The viruses exchanged genetic information, which led to the formation of a new virus. This new virus could then infect humans and easily spread from person to person. Previous flu pandemics (worldwide epidemics) have started this way.

The first avian influenza virus to infect humans directly occurred in Hong Kong in 1997, during an avian flu epidemic on the island. This outbreak was linked to chickens and classified as avian influenza A (H5N1).

Since the Hong Kong outbreak, the bird flu virus has spread across Asia, and in October 2005 was discovered in poultry in Turkey and Romania. So far, hundreds of people have been infected by H5N1. Many people have died.

The wider the area over which the avian flu virus spreads, the greater the chances of a worldwide outbreak. There is tremendous concern that H5N1 poses an enormous pandemic threat.

Farmers and other people working with poultry, as well as travelers visiting affected countries, have a higher risk for getting the bird flu. Handling an infected bird can cause infection. People who eat raw or undercooked poultry meat are also at an increased risk for avian influenza. Highly infective avian flu viruses, such as H5N1, have been shown to survive in the environment for long periods of time, and infection may be spread simply by touching contaminated surfaces. Birds who recover from the flu can continue to shed the virus in their feces and saliva for as long as 10 days.

Health care workers and household contacts of patients with avian influenza may also be at an increased risk of the bird flu.

Infection with avian influenza viruses in domestic poultry causes two main forms of disease that are distinguished by low and high extremes of virulence. The “low pathogenic” form may go undetected and usually causes only mild symptoms (such as ruffled feathers and a drop in egg production). However, the highly pathogenic form spreads more rapidly through flocks of poultry. This form may cause disease that affects multiple internal organs and has a mortality rate that can reach 90-100% often within 48 hours.
Human infection with avian influenza viruses

There are many different subtypes of type A influenza viruses. These subtypes differ because of changes in certain proteins on the surface of the influenza A virus (hemagglutinin [HA] and neuraminidase [NA] proteins). There are 16 known HA subtypes and 9 known NA subtypes of influenza A viruses. Many different combinations of HA and NA proteins are possible. Each combination represents a different subtype. All known subtypes of influenza A viruses can be found in birds.

Usually, “avian influenza virus” refers to influenza A viruses found chiefly in birds, but infections with these viruses can occur in humans. The risk from avian influenza is generally low to most people, because the viruses do not usually infect humans. However, confirmed cases of human infection from several subtypes of avian influenza infection have been reported since 1997. Most cases of avian influenza infection in humans have resulted from contact with infected poultry (e.g., domesticated chicken, ducks, and turkeys) or surfaces contaminated with secretion/excretions from infected birds. The spread of avian influenza viruses from one ill person to another has been reported very rarely, and has been limited, inefficient and unsustained.

“Human influenza virus” usually refers to those subtypes that spread widely among humans. There are only three known A subtypes of influenza viruses (H1N1, H1N2, and H3N2) currently circulating among humans. It is likely that some genetic parts of current human influenza A viruses came from birds originally. Influenza A viruses are constantly changing, and they might adapt over time to infect and spread among humans.

During an outbreak of avian influenza among poultry, there is a possible risk to people who have contact with infected birds or surfaces that have been contaminated with secretions or excretions from infected birds.

Avian Influenza A (H5N1)

Influenza A (H5N1) virus – also called “H5N1 virus” – is an influenza A virus subtype that occurs mainly in birds, is highly contagious among birds, and can be deadly to them. H5N1 virus does not usually infect people, but infections with these viruses have occurred in humans. Most of these cases have resulted from people having direct or close contact with H5N1-infected poultry or H5N1-contaminated surfaces.

Treatment Avian Influenza A (H5N1)

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 cannot be used if an H5N1 outbreak occurs.

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.

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