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Government has an inter-departmental surveillance programme in place for early detection of the disease in birds and humans and the management of such cases.

Avian Influenza (Bird Flu): Frequently Asked Questions

What is avian influenza (bird flu)?
  • Like humans, birds have naturally occurring influenza (flu) viruses.
  • There are numerous types of avian influenza viruses that are carried by wild bird species throughout the world, but these viruses do not cause disease in these birds.
  • Occasionally, some of these viruses can infect domestic birds such as poultry, but typically we do not see direct transmission of avian influenza viruses from birds to humans.
What kind of birds does avian influenza infect?
  • Naturally occurring avian influenza viruses in wild birds are generally associated with waterfowl (ducks and geese), and some species of shore birds and typically do not cause illness in these birds.
  • The viruses occasionally “jump” from these wild birds to domestic birds such as chickens. In some cases these viruses can cause severe disease in domestic birds, but in general this requires viral adaptations that occur over time in domestic bird populations. This is the case with the highly pathogenic H5N1 virus (“bird flu”) which has been circulating in domestic birds in Asia since at least 1997. Although this virus probably originated in wild birds, it has mutated and adapted to domestic poultry.
What are the symptoms of avian influenza?
  • The so-called "low pathogenic" form commonly causes only mild symptoms such as ruffled feathers, or a drop in egg production, and may easily go undetected.
  • The highly pathogenic form is far more dramatic. It spreads very rapidly through poultry flocks, causing disease affecting multiple internal organs, and can cause up to 100% of birds to die, often within 48 hours.
Are there avian influenza viruses in the region?
Yes, avian influenza viruses are found in wild bird populations in North America and occasionally infect domestic poultry. In 2004 outbreaks of avian influenza in US poultry occurred in the New England state and Texas, and were traced to birds from live bird markets. These outbreaks were caused by an H7 strain of virus and not by the "bird flu" virus (H5N1) that is currently circulating in Asia.
Do we have avian influenza in the Cayman Islands?
There had been no known outbreaks of any type of avian influenza in the Islands for the past two decades. Furthermore, Cayman doesn't have any live bird markets or a large poultry industry that is associated with outbreaks, as seen elsewhere. What is unique about the current outbreaks in poultry?
  • The current outbreaks of highly pathogenic avian influenza, which began in South-east Asia in mid-2003, are the largest and most severe on record.
  • The source of this, the H5N1 virus, has proved to be especially tenacious. Despite the death or destruction of an estimated 150 million birds, the virus is now considered endemic in many parts of Indonesia and Viet Nam and in some parts of Cambodia, China, Thailand, and possibly also the Lao People's Democratic Republic. Control of the disease in poultry is expected to take several years.
  • The H5N1 virus is also of particular concern for human health, as explained below.
How is H5N1 spreading in Asia?
The H5N1 virus is spread between birds through contact between an uninfected bird and an infected bird's saliva, nasal secretions, or faeces. The movement of infected poultry, contaminated poultry equipment, or people with virus-contaminated clothing or shoes results in the international movement of the H5N1 virus. Historically, the movement of poultry-adapted avian influenza strains does not involve wild birds. Recently, there has been some evidence that migratory waterfowl may have spread the Asian H5N1 “bird flu148 virus to domestic poultry across national borders, but the mechanism of this spread is not yet fully understood.
What are the implications for human health?
The widespread persistence of H5N1 in poultry populations poses two main risks for human health.
  • The first is the risk of direct infection when the virus passes from poultry to humans, resulting in very severe disease.
  • Of the few avian influenza viruses that have crossed the species barrier to infect humans, H5N1 has caused the largest number of cases of severe disease and death in humans.
  • Unlike normal seasonal influenza where infection causes only mild respiratory symptoms in most people, the disease caused by H5N1 follows an unusually aggressive clinical course, with rapid deterioration and high fatality.
  • Primary viral pneumonia and multi-organ failure are common. In the present outbreak, more than half of those infected with the virus have died.
  • Most cases have occurred in previously healthy children and young adults.
  • A second risk, of even greater concern, is that the virus - if given enough opportunity - will change into a form that is highly infectious for humans and spread easily from person to person. Such a change could mark the start of a global outbreak (a pandemic).
How do people become infected?
  • Infected birds shed large numbers of virus in their saliva, nasal secretions and faeces. Direct contact with infected poultry, or surfaces and objects contaminated by their faeces, is presently considered the main route of human infection.
  • To date, most human cases have occurred in rural areas or on the outskirts of cities where many households keep small poultry flocks, which often roam freely, sometimes entering homes or sharing outdoor areas where children play. As infected birds shed large quantities of germs in their faeces, opportunities for exposure to infected droppings or to environments contaminated by the virus are abundant under such conditions.
  • Moreover, because many households in Asia depend on poultry for income and food, many families sell or slaughter and consume birds when signs of illness appear in a flock, and this practice has proved difficult to change. Exposure is considered most likely during slaughter, de-feathering, butchering, and preparation of poultry for cooking.
As Cayman doesn't have a poultry industry as such, and people and birds don't live in close quarters, contracting bird flu from domestic poultry here is highly unlikely.
Does the virus travel easily from birds to humans?
No. Though more than 140 human cases have occurred in the current outbreak, this is a small number compared with the huge number of birds affected and the numerous associated opportunities for human exposure, especially in areas where backyard flocks are common. It is not presently understood why some people, and not others, become infected following similar exposure. How is an avian influenza outbreak among birds different than an influenza pandemic?
  • An influenza outbreak among birds occurs when the virus causes serious illness or death and is spread from bird to bird.
  • If the avian virus is contagious to people, the humans may inadvertently become infected due to exposure to sick birds.
  • An influenza pandemic can occur when the avian virus infecting humans changes and then spreads easily from person to person. This results in the spread of flu over a wide geographical area, usually over more than one continent, creating a pandemic.
What is the risk of the H5N1 virus currently circulating in Asia causing a worldwide pandemic?
Flu viruses are constantly changing over time. The H5N1 virus could become a pandemic strain in one of two ways:
  • There could be exchange of genetic material between the human influenza virus and the H5N1 virus when a person is simultaneously infected with viruses from both species. This process of gene swapping inside the human body can give rise to a completely new subtype of the influenza virus to which few if any humans have natural immunity. Transmission could also now occur from one person to another.
  • It could mutate over time and adapt to human cells. This second process may happen over the course of several years.
What is the risk of H5N1 arriving in Cayman's bird population?
  • The risk of H5N1 infection among birds in the Cayman Islands is very remote.
  • No poultry or poultry products from countries affected with avian influenza are allowed to enter the Islands.
  • The Department of Agriculture is also monitoring the importation of any exotic birds, and is strictly enforcing the necessary quarantine requirements.
  • The large migratory bird population on Cayman Brac and Little Cayman are also closely observed with the help of local bird watchers.
  • The Department of Agriculture has a thorough surveillance programme in place to test for the disease and is especially vigilant for large numbers of birds dying suddenly.
If I see a dead bird in Cayman, is it likely to have bird flu?
Not likely. Although the department asks people to report all dead birds, one dead bird doesn't necessarily signal that H5N1 is present. Birds die from many different causes. One death followed by multiple deaths in the following days usually signals something more serious. However, the department is not taking any chances and is treating every bird death, seriously.
What is the risk of H5N1 to the Cayman public?
  • Currently the world is in pandemic alert. However the risk of H5N1 being in Cayman is very remote and the chance of H5N1 entering the local bird population and causing subsequent human transmission is extremely unlikely.
  • Nonetheless, if H5N1 enters the local bird population, the surveillance programme that is in place will identify H5N1 in the early stages and appropriate control measures will be undertaken.
  • Currently the human-to-human transmission has not been fully established, so infected people coming to the Islands and transmitting the disease to locals are remote at this point.
  • Residents traveling to countries where H5N1 has been identified should exercise caution, and should avoid live bird markets and poultry farms.
What can I do to protect myself from bird flu?
  • Travelers to affected countries are advised to avoid poultry farms and live bird markets during their visit.
  • Wild waterfowl or waterfowl showing signs of disease should be avoided in these affected countries.
  • Although birds in Cayman are unlikely to be infected with bird flu, it is always a good idea to avoid contact with birds showing signs of disease.
  • People who raise poultry should immediately report any suspicious disease in their birds to the Department of Agriculture.
  • Those with pet birds should not worry about their pets getting "bird flu" if they have not been out of the country or in contact with wild birds.
Is it safe to eat poultry and poultry products?
Yes.
  • In areas free of the disease, poultry and poultry products can be prepared and consumed as usual, with no fear of acquiring infection from the H5N1 virus.
  • In areas experiencing outbreaks, poultry and poultry products can also be safely consumed provided these items are properly handled during food preparation and properly cooked. The H5N1 virus is sensitive to heat. Normal temperatures used for cooking (70 degrees Celsius for all parts of the food) will kill the virus. Consumers need to be sure that all parts of the poultry are fully cooked (no “pink” meat) and that eggs, too, are properly cooked (no “runny” yolks).
  • Consumers should also be aware of the risk of cross-contamination. Juices from raw poultry and poultry products should never be allowed, during food preparation, to touch or mix with items eaten raw.
  • When handling raw poultry or raw poultry products, persons involved in food preparation should wash their hands thoroughly and clean and disinfect surfaces that came in contact with the poultry products. Soap and hot water are sufficient for this purpose.
  • In areas experiencing outbreaks in poultry, raw eggs should not be used in foods that will not be further heat-treated as, for example by cooking or baking.
How is Cayman preparing for the bird flu and a potential pandemic?
  • Even though the chances of a bird flu outbreak in Cayman are currently remote, government has an inter-departmental surveillance programme in place for early detection of the disease in birds and humans and the management of such cases.
  • A national plan is underway to prepare the Islands to deal with an influenza pandemic. According to estimates 10 to 25 percent of the population will be affected if a pandemic develops. This will have a serious impact on national economies and essential services.
  • Because Cayman is vulnerable due to the speed of international travel, the Public Health Department is working closely with the Pan American Health Organization (PAHO) and the World Health Organization (WHO) to guarantee appropriate assistance for securing vaccine and antiviral drugs in the event of the disease reaching Cayman.