Recent outbreak of asian bird flu
 

Have just recently read that several cases of Bird Flu have appeared in Indonesia. Has anyone recently returned from BKK and is there any concerns. I realize that this epidemic is in the rural areas, but what about food supplies in BKK, especially chicken products. Has the Thai government taken any precautions against this disease. Any comments.

I spent almost 4 weeks in thailand in January and didn't even think about bird flu. I was nowhere near chicken farms or live chicken markets. I ate eggs, chicken and duck. I didn't give any special instructions -- like overcook it.

The only "new" news re: bird flu is that it has spread into Europe.

Take a look at the cdc website for updates. www.cdc.gov

Bird flu is not spread by eating poultry or eggs. There was one case where the believed route of transmission may have been eating a traditional VN soup that has fresh duck blood added to it just before serving. (so you are perhaps well advised not to eat fresh poultry blood)

The appropriate precautions are not to have direct contact with ill or dead birds or bird droppings.

All of the SE Asian governments have been working hard to contain the avian flu. The spread of the flu across the continent is due to migratory birds.

The avaian flu is not currently transmitted from person to person (which is what the concern is about)

I vacation in BK at least once a year and just got back from 3-weeks in BK last month. As far as all of the bird flu talk...well...among Thais I know and meet, there was none. This flu has been going on for at least three years. In summer 2004, there was a sign up at the hotel I stayed in saying that due to the bird flu, all eggs would be cooked well done. That was the end of the discussion. Summer of 2005, at the same hotel, I didn't notice any sign. At the apartment building I rented from recently, there was no sign in the restaurant as to cooking eggs well done. The worry of the bird flu is that it mutates and then gets to the point where it can be transmitted from human to human. It hasn't done that as of yet. Happy Travels!

i eat all the chicken i can here and there

If you are genuinely concerned, ask your travel clinic to give you a prescription for Tamiflu. You can always store it if you don't use it.

Please don't ask your travel clinic to give you Tamiflu. Fully 50% of the tested cases of Avian flu are already resistant to Tamiflu. The inappropriate use of Tamiflu is creating resistance in the infleunza viruses.

That last comment regarding resistance is inaccurate.

Plans to use this antiviral agent in case of an outbreak of human to human transmission of AV are progressing here in the US.

It is thought that Tamiflu did not work in some cases because it was administered too late in the disease process.

There is also no reported clinical evidence of Tamiflu creating resistant strains of flu virus.

Rather this is a lay generalization-guess based on the existence of antibiotic resistant bacteria resulting from over use of antibiotics.

It seems that every time I read or see a story about bird flu and the tamiflu vaccine, the authorities are urging people NOT to hoard it. It's very unlikely any one of us will be anywhere near a source of bird flu, and the treatment for it should be in the hands of authorities who might be called on to handle a real emergency. In my opinion.

K

We do know about viruses developing resistance to anti-viral agents both in vivo and in vitro. Consider extensive data on how the AIDS virus has sequentially developed resistance to a number of different anti-viral agents.

While I have read one article that suggested that the Avian flu did not have resistance to Tamiflu, but had been used too late (as you are suggesting) others maintain that there is clear evidence of resistance.

In any case, suggesting that someone ask for an anti-viral agent if they are worried encourages inappropriate use of anti-viral agents and therefore increases the chances of development of resistant strains of influenza viruses.

Of course inappropriate use of an antiviral may enhance the development of resistant strains of the virus.

But, having Tamiflu and using it are separate issues. Since the former, alone, is unlikely to contribute to resistance.

The conundrum: if you have the "common flu" and use Tamiflu it is likely to, at least, shorten the course of the illness. If, on the other hand, you are caught in the middle of the first outbreak of human-to-human H5N1 variant. Knowing that the current mortality rate is about 50%, should your major concern be your own/family's health or the theoretical possibility that your actions might increase the risk of antiviral resistance.

Hoarding is a non-issue for travelers to places that are deemed likely to produce the first h-t-h H5N1 outbreak. Carrying Tamiflu can be considered an extremely cautious, but not necessarily irrational act.

On the other hand, hoarding is relevant to people geographically far-removed from the most likely source of a potential outbreak. The Federal government claims that they have enough TF to "ring" several potential outbreaks. If you believe and trust the politicos, don't buy TF.

Sales of Tamiflu is strictly controlled here in Thailand. Very few people have private stockpile of the medicine but the government has claimed that they have enough for any potential outbreak. I think they are worried about misuses and resistance developing from such uses.

As a nurse, I`m with Kathy. Look at all the problems people have created by insisting on antibiotics for colds! Hoarding tamiflu isn`t the answer. So use some sense, and don`t waste precious resources unecessarliy.