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Egypt: Pandemic Plan

Sally Furniss

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Bird Flu Protection

There are certain measures that should be taken to protect oneself against the possibility of getting infected with the deadly H5N1 the virus which causes avian influenza.

In addition to destroying all infected poultry to help contain the disease, farm employees, where cases are reported, should never touch infected poultry or breathe air there besides undergoing virus test to ensure that they are free of the lethal virus. Should there be any reported cases among humans, Tamiflu may be used though it does not kill the virus, rather it slows the spread of it in human body.

" When cooking poultry, make sure that it is cooked in 80C so that virus can be killed in less than 60 seconds.

" Wash eggs very well before eating them. " Wash hands very well after slicing poultry meat. " Eat fruits and vegetables such as cauliflower, apple, pineapple, peach, onion, garlic, carrots, broccoli in addition to honey and yogurt to help strengthen one's immunity.

Two drugs (in the neuraminidase inhibitors class), oseltamivir (commercially known as Tamiflu) and zanamivir (commercially known as Relenza) can reduce the severity and duration of illness caused by seasonal influenza.

The efficacy of the neuraminidase inhibitors depends, among others, on their early administration ( within 48 hours after symptom onset). For cases of human infection with H5N1, the drugs may improve prospects of survival, if administered early, but clinical data are limited.

The H5N1 virus is expected to be susceptible to the neuraminidase inhibitors. Antiviral resistance to neuraminidase inhibitors has been clinically negligible so far but is likely to be detected during widespread use during a pandemic. An older class of antiviral drugs, the M2 inhibitors amantadine and rimantadine, could potentially be used against pandemic influenza, but resistance to these drugs can develop rapidly and this could significantly limit their effectiveness against pandemic influenza. Some currently circulating H5N1 strains are fully resistant to these the M2 inhibitors. However, should a new virus emerge through reassortment, the M2 inhibitors might be effective.

For the neuraminidase inhibitors, the main constraints - which are substantial - involve limited production capacity and a price that is prohibitively high for many countries. At present manufacturing capacity, which has recently quadrupled, it will take a decade to produce enough oseltamivir to treat 20% of the world's population. The manufacturing process for oseltamivir is complex and time-consuming, and is not easily transferred to other facilities.

So far, most fatal pneumonia seen in cases of H5N1 infection has resulted from the effects of the virus, and cannot be treated with antibiotics. Nonetheless, since influenza is often complicated by secondary bacterial infection of the lungs, antibiotics could be life-saving in the case of late-onset pneumonia. WHO regards it as prudent for countries to ensure adequate supplies of antibiotics in advance.
 
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