FACT SHEET: AVIAN INFLUENZA A (H5N1) and PANDEMIC INFLUENZA
Also see: PANDEMIC
INFLUENZA FAMILY GUIDE
This fact sheet alerts
Americans to the Department of State's preparedness efforts
with respect to a possible influenza pandemic. The Department
of State emphasizes that, in the event of a pandemic, its
ability to assist Americans traveling and residing abroad
may be severely limited by restrictions on local and international
movement imposed for public health reasons, either by foreign
governments and/or the United States. Furthermore, American
citizens should take note that the Department of State cannot
provide Americans traveling or living abroad with medications
or supplies even in the event of a pandemic.
Background - H5N1 Avian
Influenza A
Countries continue to
report cases of avian influenza A (H5N1), commonly referred
to as "bird flu" in their domestic and wild bird
populations. In addition, countries are reporting H5N1 in
other wild and domestic animal populations. A small number
of confirmed cases of H5N1 among humans have been reported,
some of which have resulted in death. More information is
available on the World Health Organization (WHO) website,
http://www.who.int/csr/disease/avian_influenza/country/en/
Please refer to this website for the most up to date information
on the countries affected by H5N1 and the number of deaths.
The vast majority of the reported human cases have resulted
from direct contact with H5N1-infected poultry. Although
there is evidence to suggest very limited, human- to-human
transmission in family groups involving close exposure to
a critically ill member, there is no evidence that the virus
can be easily or sustainably transmitted from human-to-human.
The U.S. Department of Health and Human Services, Centers
for Disease Control and Prevention (DHHS/CDC), the WHO,
and the Department of State are nonetheless concerned about
the potential for the virus to adapt or mutate into a strain
that can be easily transmitted in a sustained manner among
humans, a characteristic that could result in a human influenza
pandemic, and are working closely with other partners to
prepare for the possibility of pandemic influenza. Information
on the U.S. Government's overall response and efforts is
available at http://www.pandemicflu.gov.
Travel and Avian Influenza
A
The Department of State,
the DHHS/CDC and the WHO have not issued any health precautions,
travel alerts or warnings for H5N1 infected areas. However,
the DHHS/CDC advises travelers to H5N1 affected countries
to avoid poultry farms, contact with animals in live food
markets, and any surfaces that appear to be contaminated
with feces or fluids from poultry or other animals, and
to eat only thoroughly cooked poultry products. American
citizens traveling to or living in H5N1 affected countries
should consider the potential risks and keep informed of
the latest medical guidance and information in order to
make appropriate plans. Specific DHHS/CDC travel information
relating to H5N1, including preventive measures, is available
at http://www.cdc.gov/flu/avian/index.htm
and http://www.cdc.gov/travel.
WHO guidance related to
avian influenza is available at http://www.who.int/csr/disease/avian_influenza/en/.
Additional general country
information can be obtained from the Department of State's
Consular Information Sheets at http://travel.state.gov
and embassy
and consulate websites. You may also call the Department
of State's toll-free number, 1-888-407-4747, or if calling
from overseas, 202-501-4444.
Prevention, Response and
Treatment - Take Charge of Your Plans
A vaccine for humans that
is effective in preventing infection with the avian influenza
A (H5N1) virus is not yet available. Based upon limited
data, the DHHS/CDC has suggested that the anti-viral medication
Oseltamivir (brand name- Tamiflu) may be effective in treating
avian influenza A. U.S. embassies and consulates do not
have supplies of this drug for use by private American citizens
abroad. The Department of State has pre-positioned supplies
of the drug Tamiflu at its embassies and consulates worldwide,
for eligible U.S. Government employees and their families
serving abroad. Americans should also be aware of the potential
health risk posed by counterfeit drugs, including those
represented as Tamiflu, by scam artists who sell products
on the internet or in countries with lax regulations governing
the production and distribution of pharmaceuticals. For
more information on counterfeit drugs please visit the Food
and Drug Administrations (FDA) questions and answers for
counterfeit drugs at http://www.fda.gov/oc/initiatives/counterfeit/qa.html
In addition, the Department
of State has asked its embassies and consulates to consider
preparedness measures that take into consideration the fact
that travel into or out of a country may not be possible,
safe, or medically advisable during a pandemic. Guidance
on how private citizens can prepare to shelter in place,
including stocking food, water, and medical supplies, is
available at the www.pandemicflu.gov
website. Embassy stocks cannot be made available to private
American citizens abroad and we encourage people living
in an area with outbreaks of H5N1 to prepare appropriately.
It is also likely that
governments will respond to a pandemic by imposing public
health measures that restrict domestic and international
movement, further limiting the U.S. government's ability
to assist Americans in these countries. These measures can
be implemented very quickly. Areas of known H5N1 outbreaks
in poultry have been quarantined by governments within 24
hours, restricting (if not preventing) movement into and
out of the affected area.
Americans who are planning
travel to a country that has reported the virus or who are
concerned about avian influenza are advised to monitor the
DHHS/CDC and the WHO websites for the latest information.
CDC Contact Information
Public Inquiries:
English (888) 246-2675
Spanish (888) 246-2857
TTY (866) 874-2646
Mon-Fri 8am-11pm EST
Sat-Sun 10am-8pm EST
Address:
Centers for Disease Control and Prevention
1600 Clifton Rd.
Atlanta, GA 30333
USA (404) 639-3311
Traveler's Website: http://www.cdc.gov/travel
WHO Liaison Office in Washington,
DC
Contact Information:
Telephone: (202) 974-3787
Facsimile: (202) 974-3789
Address:
WHO Liaison Office
1889 F Street, N.W., Suite 369
Washington, D.C. 20006 USA
[July 2006]
Frequently Asked Questions
about Avian Influenza A (H5N1) and Pandemic Influenza
- Where can I find
up-to-date medical and planning information on avian influenza
A (H5N1) and pandemic influenza?
- Why is the U.S. government
not providing Tamiflu) to private Americans overseas?
- What if I get sick
when I am in another country? I have a pre-existing medical
condition, is there anything different I should do? How
do I locate a doctor in the country I am traveling to?
- Will the U.S. government
evacuate Americans in a foreign country in the event of
a pandemic?
- As a private American
citizen living overseas, what can I do today to help prepare
myself and my family for possible bird flu pandemic?
- What precautions
should I take if I live in or visit an area affected by
H5N1 "bird flu"?
- Can my domestic animals
get H5N1 "bird flu"?
- Where can I find
up-to-date medical and planning information on avian influenza
A (H5N1) and pandemic influenza?
Current information about
avian influenza A (H5N1) and pandemic influenza can be found
at:
• http://www.cdc.gov/flu/avian/gen-info/qa.htm
• http://www.cdc.gov/travel
• http://www.who.int
• http://www.pandemicflu.gov
• http://www.travel.state.gov
- Why isn't the U.
S. Government providing Tamiflu) to private Americans overseas?
The Department of State
lacks the legal authority to provide any type of medication,
including Tamiflu, to private American citizens. State Department
physicians and medical staff have authorization to treat
only those official employees, and their families, who are
under Chief of Mission (the principal officer in charge
of a diplomatic facility of the United States) authority.
- What if I get sick
when I am outside the U.S.? If I have a pre existing medical
condition, is there anything different I should do? How
do I locate a local doctor when I am in another country?
Please see the Department's
travel tips brochure on health issues, including the importance
of obtaining adequate medical insurance to cover overseas
medical emergencies: http://www.travel.state.gov/travel/tips/health/health_1185
.html
If you have preexisting
medical problems you should carry a letter from your physician,
describing the medical condition and any prescription medications,
including the generic name of prescribed drugs.
For a current list of doctors/hospitals
in the country to which you are traveling, please visit
the embassy or consulate website, which can be accessed
through http://usembassy.state.gov/.
The list is generally found under the Embassy or Consulate's
link for Consular Services or American citizen services.
- Will the U. S. government
evacuate Americans from a foreign country in the event of
a pandemic?
Current medical thinking
suggests that sheltering in place may be the appropriate
response to the start of an influenza pandemic in certain
countries or regions. In this scenario, people would be
advised to exercise "social distancing" and avoid
any form of public gathering where transmission of the disease
could occur. Mass transit, including air travel, is a common
venue for human-to-human transmission of viral infections
due to the proximity of travelers to each other.
Whether the U.S. government
evacuates anyone will depend on a variety of country-specific
factors. Each U.S. embassy and consulate has been asked
to develop a contingency plan in the event of a pandemic,
and to identify events that might prompt them to send employees
and/or their dependents out of the country, assuming such
travel is possible. Should this decision be made, the Department
of State will communicate this to the private American community
so that people can plan accordingly. As in any other crisis,
the Department of State will assess the availability of
commercial transportation, the ability of people to travel
to the United States or a third country, and other related
factors in deciding on appropriate actions to assist official
and private Americans.
- As a private American
citizen living overseas, what can I do today to help prepare
myself and my family for a possible influenza pandemic?
Several simple measures
can be taken now that will put you and your family in a
better state of readiness should such a pandemic occur.
These measures are outlined at http://www.pandemicflu.gov/planguide/.
If you are living overseas for work or education, contact
your sponsors and find out what plans they have regarding
repatriation or evacuation; they may also have advice for
you about obtaining an influenza vaccination (if and when
a vaccine becomes available), anti-viral medication, and
employing other suggested preventive measures as the need
arises.
- What precautions
should I take if I live in or visit an area affected by
H5N1 "bird flu"?
Avoid contact with live
birds, chickens, ducks, turkeys and geese and their feces,
feathers and pens if at all possible. Children, in particular,
should be taught these precautions, and small children may
need to be supervised for their protection. Do not purchase
or agree to adopt new pet birds from an area in which H5N1
influenza has been reported. Avoid poultry products from
areas with H5N1-infected birds. Do not transport live or
dead poultry even if it appears to be healthy.
All foods from poultry,
including eggs and poultry blood should be cooked thoroughly.
Egg yolks should not be runny or liquid. Because influenza
viruses are destroyed by heat, the cooking temperature for
poultry meat should be 74 C (165 F).
Avoid cross contamination
of other foods by use of separate kitchen utensils and surfaces
exposed to raw poultry. Wash hands with soap and water after
any poultry contact. For more information on food handling
and safety please visit the United States Department of
Agriculture (USDA) website at http://www.fsis.usda.gov/Fact_Sheets/index.asp.
Sanitary professionals,
health-care workers and others who must travel to H5N1-infected
areas and work directly with infected birds, poultry and
humans should follow approved precautions for reducing the
risk for infection with H5N1 virus. See DHHS/CDC guidance
at http://cdc.gov/flu/avian/professional.
- Can my domestic animals
get bird flu?
There have been reports
of H5N1 infection in domestic cats, pigs, tigers, leopards,
ferrets, and stone martens. The domestic cats are believed
to have been infected by eating raw, H5N1-infected birds.
Although no human cases of avian influenza A have been associated
with contact with infected cats, you should keep your cats
inside if there has been a verified outbreak of H5N1 in
your area. In addition, avoid contact with stray cats, and
inform your local veterinarian if your cat becomes sick
after having had contact with birds. You should always follow
strict hygiene rules when disposing of animal waste or caring
for your pets.
At this time, there is
not enough information to determine if dogs can become infected
with H5N1 virus. For more information about H5N1 infection
in domestic animals, see the DHHS/CDC website at http://www.cdc.gov/flu/avian/gen-
info/qa.htm.
[Posted: July 19, 2006]
