Journal Mobile

KY Yuen
Journal Issue: 
Volume 35: Issue 4: 2005




Despite  control  of  the  poultry  outbreak  by  culling  and  sometimes vaccination, poultry outbreaks and sporadic cases in humans continue to occur in South East Asia and is spreading to Europe.  The human disease is characterised by a rapidly progressive community-acquired pneumonia and frequently diarrhoea with leukopenia, lymphopenia and impaired liver functions. Virus can be detected in  the  intestine, spleen, serum, cerebrospinal  fluid, in  addition  to  the  respiratory secretions. Acute encephalitis or acute gastroenteritis were occasionally reported as  early  manifestations.   Most  of  the  cases  are  caused  by  poultry-to-human transmission.  Human-to-human transmission is still inefficient but has occurred in health care workers and family contact.  In endemic areas, patients presenting as community-acquired pneumonia with a history of contact with sick or dead birds should  be  isolated,  investigated  and  empirically  treated  for  H5N1  infection. Infection  control  measures  should  include  contact,  droplet  and  airborne precautions.  The globalisation of this avian epidemic by migratory birds and the crude  fatality  rate  of  50%  in  humans  have  triggered  a  global  response  of preparedness  for  a  coming  influenza  pandemic  which  may  occur  with  genetic reassortment or mutations conferring the virus the capability of efficient human to human transmission.