Bird flu no reason to cancel a trip
By Elisabeth Rosenthal
International Herald Tribune
THURSDAY, FEBRUARY 2, 2006
One hundred and fifty million birds have been killed because of avian influenza. Eighty humans have died of the disease worldwide in three years.
And yet worried travelers are flocking to doctors' offices: Is it safe to visit countries with bird flu, they ask, countries like China, Vietnam, Turkey and Croatia?
For the moment, experts agree, the answer is that bird flu is overwhelmingly an animal disease and not a problem for humans.
It infects people very rarely, and only after close contact with sick birds. The 160 humans worldwide who have been sickened by the H5N1 strain of the virus lived with birds.
So if you are going to a hotel in Istanbul, Beijing or Hanoi, relax and enjoy; it is hard to conceive how one could contract bird flu there, health experts say. Go ahead and eat boiled eggs and chicken dishes, too, because thorough cooking kills the virus.
The World Health Organization "does not recommend restrictions on travel to any areas with H5N1," said Dick Thompson, a spokesman for the WHO in Geneva.
"There seems to be a heightened sense of concern about an extraordinarily rare disease," Thompson added. "It is very, very, very difficult for humans to acquire, even with direct exposure."
A few nations, like Russia, have warned citizens not to travel to countries with bird flu, like Turkey. But the WHO and most governments advise common sense precautions.
"Basically what people should do is stay away from birds - live birds, dead birds, their excrement," said Linnie Golightly of the International Health Service at New York Hospital.
"People are scared and I try to bring them back to earth. Sure there is a risk, but there is a bigger risk every time you cross the street in Manhattan."
The British Department of Health, for example, suggests that travelers "avoid bird markets, farms or contact with live poultry." The Centers for Disease Control in the United States warn against "contact with surfaces that might be contaminated with poultry feces or secretions."
Obviously, the level of vigilance needs to increase in rural areas, where sanitary procedures are less dependable and contact with birds is harder to avoid.
Heightened awareness is also warranted in nature preserves; hikers, for example, should avoid trekking through large flocks of birds.
"People should know to avoid certain settings and then enjoy the rest of their trip," Golightly said. "It's not a big deal - the same as saying the best way to avoid rabies is to avoid contact with dogs or bats."
In practice, the various guidelines can be distilled into a few simple rules - ones that this reporter followed on a recent trip to Dogubayazit, Turkey, the epicenter of a recent bird flu outbreak:
Do not handle birds, their carcasses, feathers, raw eggs or raw meat. Make sure your children take the same precautions.
Do not eat undercooked poultry products.
Stay away from bird parks, a common tourist attraction in Asia, or at least do not touch the creatures there.
Stay away from farms, markets and other places, such as rural restaurants, where birds are slaughtered. Bird blood, which can contain the H5N1 virus if the bird was infected, is splattered.
Leave hiking shoes outside the hotel room at night and, perhaps, even disinfect the soles if you feel you walked through an area where the risk of exposure was high.
The cardinal rule of healthy travel in any developing country: Wash your hands whenever you can and carry a gel hand sanitizer for in between.
Experts emphasize that it is extremely unlikely travelers will actually encounter anyone or anything infected with the H5N1 virus, since bird flu occurs sporadically in most countries where it is a problem, and areas with outbreaks are generally rapidly quarantined.
Bird flu panic should not be a reason for canceling trips, they say.
People from all over the world still flock to the Hamptons' area on Long Island even though Lyme Disease, a serious illness carried by deer and ticks in the area, has become an ever-present threat there for 20 years. People have learned to manage that risk by checking for ticks after they walk in the woods and by fencing yards to decrease any possible contact with deer.
Then there is the vexing question of Tamiflu, the drug that may reduce the symptoms of bird flu in humans, although studies are unclear on its effects.
To treat influenza, Tamiflu is taken twice a day for five days, and must be started within the first 36 hours of symptoms.
It can also be used to prevent the development of disease in those who have had significant exposure, such as touching a sick bird; but for this purpose it must be taken every day for six weeks.
The World Health Organization does not want travelers packing the drug as they would malaria tablets.
"Taking it on a trip is certainly not recommended," said Thompson, who emphasized that the WHO's concern about H5N1 was that it might someday mutate into a form that could pass between humans, not that it was a threat to humans now.
At the New York Hospital travel clinic, doctors refuse requests for Tamiflu prescriptions on the grounds that "there are lots of other things that give you fevers in these countries." They recommend that travelers consult their embassies if they have questions.
"I don't travel with it and we don't give it out," Golightly said of Tamiflu. "A lot of people take comfort from knowing it's in their bag, but it's a false sense of control."
http://www.iht.com/articles/2006/02/02/news/flu.php
By Elisabeth Rosenthal
International Herald Tribune
THURSDAY, FEBRUARY 2, 2006
One hundred and fifty million birds have been killed because of avian influenza. Eighty humans have died of the disease worldwide in three years.
And yet worried travelers are flocking to doctors' offices: Is it safe to visit countries with bird flu, they ask, countries like China, Vietnam, Turkey and Croatia?
For the moment, experts agree, the answer is that bird flu is overwhelmingly an animal disease and not a problem for humans.
It infects people very rarely, and only after close contact with sick birds. The 160 humans worldwide who have been sickened by the H5N1 strain of the virus lived with birds.
So if you are going to a hotel in Istanbul, Beijing or Hanoi, relax and enjoy; it is hard to conceive how one could contract bird flu there, health experts say. Go ahead and eat boiled eggs and chicken dishes, too, because thorough cooking kills the virus.
The World Health Organization "does not recommend restrictions on travel to any areas with H5N1," said Dick Thompson, a spokesman for the WHO in Geneva.
"There seems to be a heightened sense of concern about an extraordinarily rare disease," Thompson added. "It is very, very, very difficult for humans to acquire, even with direct exposure."
A few nations, like Russia, have warned citizens not to travel to countries with bird flu, like Turkey. But the WHO and most governments advise common sense precautions.
"Basically what people should do is stay away from birds - live birds, dead birds, their excrement," said Linnie Golightly of the International Health Service at New York Hospital.
"People are scared and I try to bring them back to earth. Sure there is a risk, but there is a bigger risk every time you cross the street in Manhattan."
The British Department of Health, for example, suggests that travelers "avoid bird markets, farms or contact with live poultry." The Centers for Disease Control in the United States warn against "contact with surfaces that might be contaminated with poultry feces or secretions."
Obviously, the level of vigilance needs to increase in rural areas, where sanitary procedures are less dependable and contact with birds is harder to avoid.
Heightened awareness is also warranted in nature preserves; hikers, for example, should avoid trekking through large flocks of birds.
"People should know to avoid certain settings and then enjoy the rest of their trip," Golightly said. "It's not a big deal - the same as saying the best way to avoid rabies is to avoid contact with dogs or bats."
In practice, the various guidelines can be distilled into a few simple rules - ones that this reporter followed on a recent trip to Dogubayazit, Turkey, the epicenter of a recent bird flu outbreak:
Do not handle birds, their carcasses, feathers, raw eggs or raw meat. Make sure your children take the same precautions.
Do not eat undercooked poultry products.
Stay away from bird parks, a common tourist attraction in Asia, or at least do not touch the creatures there.
Stay away from farms, markets and other places, such as rural restaurants, where birds are slaughtered. Bird blood, which can contain the H5N1 virus if the bird was infected, is splattered.
Leave hiking shoes outside the hotel room at night and, perhaps, even disinfect the soles if you feel you walked through an area where the risk of exposure was high.
The cardinal rule of healthy travel in any developing country: Wash your hands whenever you can and carry a gel hand sanitizer for in between.
Experts emphasize that it is extremely unlikely travelers will actually encounter anyone or anything infected with the H5N1 virus, since bird flu occurs sporadically in most countries where it is a problem, and areas with outbreaks are generally rapidly quarantined.
Bird flu panic should not be a reason for canceling trips, they say.
People from all over the world still flock to the Hamptons' area on Long Island even though Lyme Disease, a serious illness carried by deer and ticks in the area, has become an ever-present threat there for 20 years. People have learned to manage that risk by checking for ticks after they walk in the woods and by fencing yards to decrease any possible contact with deer.
Then there is the vexing question of Tamiflu, the drug that may reduce the symptoms of bird flu in humans, although studies are unclear on its effects.
To treat influenza, Tamiflu is taken twice a day for five days, and must be started within the first 36 hours of symptoms.
It can also be used to prevent the development of disease in those who have had significant exposure, such as touching a sick bird; but for this purpose it must be taken every day for six weeks.
The World Health Organization does not want travelers packing the drug as they would malaria tablets.
"Taking it on a trip is certainly not recommended," said Thompson, who emphasized that the WHO's concern about H5N1 was that it might someday mutate into a form that could pass between humans, not that it was a threat to humans now.
At the New York Hospital travel clinic, doctors refuse requests for Tamiflu prescriptions on the grounds that "there are lots of other things that give you fevers in these countries." They recommend that travelers consult their embassies if they have questions.
"I don't travel with it and we don't give it out," Golightly said of Tamiflu. "A lot of people take comfort from knowing it's in their bag, but it's a false sense of control."
http://www.iht.com/articles/2006/02/02/news/flu.php
