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Avian flu still a threat

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    <table><tbody><tr><td class="inside_story"> Avian flu still a threat </td> </tr> <tr> <td> <table width="509"> <tbody><tr> <td> </td> </tr> <tr> <td class="default_caption" align="right">Independent/Jon Helgason</td> </tr> <tr> <td class="default_caption"> Community Health Nurse Kelsey O╣Donnely of the Central District Health Department talks about planning and prevention of possible Avian Flu outbreaks in relation to bird migration through Nebraska.

    By Tracy Overstreet

    You may not have heard a lot about it lately, but avian flu is still a threat.

    "Worldwide, this is still very much an issue," said Kelsey O'Donnell, a community health nurse from the Central District Health Department headquartered in Grand Island.

    O'Donnell was the final speaker for Stuhr Museum's Crane Speaker Program. She spoke Sunday afternoon in the auditorium of the Grand Island museum's main building.

    The worry is that avian flu is fatal in 63 percent of human cases, she said.

    "There are already 22 confirmed cases this year," O'Donnell said.

    As of March 5, the World Health Organization reported 371 people had contracted the avian flu and 235 had died, she said.

    "It's startling those numbers. You don't really think about it because it's not happening here," O'Donnell said.

    Cases have been confirmed in Cambodia, China, Egypt, Indonesia, Pakistan, Thailand, Turkey, Vietnam and other countries. Those countries are part of the migratory flight patterns of many birds making birds the potential carrier for disease to other countries including the United States.

    O'Donnell said research shows that birds can transmit avian flu through feces, which could be passed through a shared pond, and through respiratory secretions to birds within 100 yards.

    Wild ducks are most prevalent to carry and contract the flu in the fall, while shorebirds show a prevalence in the spring, she said.
    Sandhill cranes were noted as being at "reduced risk for being a carrier," she said.

    Flu in general is a respiratory illness of which there are three types.
    Type A is common in birds, humans and other mammals and can be moderate to severe; Type B is primarily human and more mild; Type C is very sporadic and uncommon.

    Avian flu happens to be of Type A, O'Donnell said.

    Of the different types of flu, Type A is comprised of two types of antigens binders called hemagglutinin and releasers called neuraminidase. There are 16 subtypes of hemagglutinins and 9 types of neuraminidase.

    That makes for 144 different combinations of flu.
    When naming the different strains of flu, the type of flu, location of isolation and the hemagglutinin and neuraminisdase numbers are used as in the Type A, H5N2 strain isolated in Texas in 2004.

    Of the various strains, O'Donnell said, only those with the subtypes of H5 or H7 can mutate into the dangerous high-path variety. Low-path flu can go almost undetected and may cause only slight changes in the bird populations such as a decreased egg production.

    But high-path flu is always noticeable, creates rapidly spreading severe illness and is often fatal in bird populations.

    Flu can mutate quickly from low-path to high-path, O'Donnell said.
    She said several cases of the low-path variety with the H5 or H7 antigens were discovered in the United States in 2007.

    West Virginia reported a H5N2 strain in turkeys in March. Minnesota had a H7N9 strain in turkeys in April. A South Dakota goose population was discovered to have H5N2 in June.

    In June 2007, Nebraska reported an H7N9 outbreak in turkeys.
    Virginia had an H5N1 strain reported in turkeys in July, she said.

    Only three high-path strains have been found in the U.S. in the Northeastern U.S. in 1924 and H5N2 strains found in Pennsylvania in 1983 and in Texas in 2004.

    The concern is that a strain of avian flu could lead to a pandemic a fast-moving outbreak in humans worldwide.

    That has happened three times in the last century, beginning with the Spanish Flu in 1918-19. The United States had 500,000 deaths from the Spanish Flu and worldwide there were 50 million deaths.

    In 1957-58, the Asian Flu caused 70,000 deaths in the United States.
    The Hong Kong Flu struck in 1968-69 and 34,000 deaths were attributed to that strain, O'Donnell said.

    Statistics show a fourth outbreak could occur before the end of the 100-year period, she said.

    But protections are being taken.

    O'Donnell said 85,501 wild birds were sampled in 2006, including wild birds in Nebraska. Nebraska's testing has been done mostly on ducks mallards, blue-wing teal, dabbling ducks, diving ducks and also some geese.
    The Centers for Disease Control is also working on stockpiles of anti-virals should the need arise.

    But perhaps the best protection comes from individuals.
    "Stay home if you're ill," O'Donnell said.

    She also advised households to prepare for a pandemic through stockpiling for possible quarantines. Home preparedness brochures outline a cost-effective and routine way to build a stockpile, O'Donnell said.
    About 5 to 20 percent of the population gets regular seasonal flu every year, and about 36,000 people die every year in the United States from seasonal flu, which is also a respiratory illness, she said.

    "There's no hard and fast rules to flu anything can happen," O'Donnell said.

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