Public Health Agency of Canada Recommendations for Avian Flu
At least one Canadian group formed after SARS hit Toronto is
working with the World Health Organization (WHO), Centers for
Disease Control and Prevention (CDCP) and other organizations to
help boost public safety.
That group is the Public Health Agency of Canada (PHAC), which
was formed in 2004. It acts independently but is responsible to
Canada's health minister. PHAC is in the midst of creating a
pandemic plan for Canada, said Aggie Adamczyk, media relations
officer with the agency.
The plan is not being formulated just for the Avian Flu but for
any disease that could reach pandemic proportions, although PHAC
is monitoring the Bird Flu situation. The agency recommends
"good respiratory etiquette," she said, which includes using a
tissue or sleeve when a sneeze comes upon you. Plenty of hand
washing is also a PHAC suggestion.
Where the regular Influenza A symptoms include aching muscles,
sore nose, high fever and coughing, people wary of the Bird Flu
should be on the watch for symptoms pinpointed in a 1997 Hong
Kong outbreak. In that outbreak, people "developed symptoms of
fever, sore throat, cough and, in several of the fatal cases,
severe respiratory distress secondary to viral pneumonia.
Previously healthy adults and children, and some with chronic
medical conditions, were affected," according to WHO Web
information.
As with the WHO, PHAC isn't rushing to recommend the use of
SARS-style face masks to ward off the Avian Flu, Adamczyk said,
although that could change depending on the course the H5N1
virus takes. "It's a little bit early (for masks or antiviral
drugs) at this point," she said. Even so, global health
officials need to be ready for whatever new infectious disease
comes their way, she said. "No one really knows if it will be
Avian Flu or something like SARS. You have to be ready for (any
disease)," Adamczyk said.
It is possible to create a vaccine for a pandemic flu, although
making it ahead of time is risky because the flu could mutate,
limiting the vaccine's effectiveness. The amount of vaccine that
would be needed for a pandemic could also prove to be a problem,
although research is underway to find technologies to streamline
the vaccine production process.
In the event of a pandemic, public health officials could ask
people to remain in their homes and refrain from gathering in
public places. Other viral outbreaks have led to similar
scenarios in North America in the past.
The WHO recommends the following to public health groups dealing
with cases of Avian Flu:
* Co-ordinate services: Agricultural, veterinary and health
services (along with other sector services deemed as
appropriate) should exchange lab information and other data.
* Vaccination for public health reasons: Health authorities may
consider vaccination against more common, seasonal influenza for
persons at risk of occupational exposure to the H5N1 virus.
Vaccination against seasonal influenza is a public health
measure aimed at slashing the progression of HN51 along with the
seasonal flu. Even so, vaccination against seasonal influenza
will not protect people against infection with the H5N1 virus.
* Protection of persons at risk of occupational exposure: This
is aimed at helping protect people who work on farms or other
businesses wherein contact with fowl is common. Such people
should wear personal protective equipment as follows:
1. Protective clothing, preferably coveralls plus an impermeable
apron or surgical gown with long-cuffed sleeves plus an
impermeable apron.
2. Heavy-duty rubber work gloves that can be disinfected.
3. Standard well-fitted surgical masks should be used if
high-efficiency respiratory masks are not available. Masks
should be fit-tested and training in their use should be
provided.
4. Goggles.
5. Rubber or polyurethane boots that can be disinfected or
protective foot covers that can be discarded.
Tamiflu should be made available to people who work in at-risk
conditions, the WHO recommends. In addition, people in such
occupations should be aware of the early clinical signs of H5N1
infection and check for them daily (as well as for two weeks
after the last exposure to potentially-dangerous conditions),
with the caveat that many of those signs are also apparent in
more common diseases.
The following symptoms should be reported to a doctor, according
to the WHO: "Most patients infected with the H5N1 virus show
initial symptoms of fever (38 C or higher) followed by
influenza-like respiratory symptoms, including cough,
rhinorrhea, sore throat, and (less frequently) shortness of
breath. Watery diarrhea is often present in the early stages of
illness, and may precede respiratory symptoms by up to one week.
Gastrointestinal symptoms (abdominal pain, vomiting) may occur
and headache has also been reported. To date, one report has
described two patients who presented with an encephalopathic
illness and diarrhea without apparent respiratory symptoms."
People suspected of carrying the virus should be put in
isolation and virus samples should be sent to WHO laboratories,
the group said.