The re-appearance of iodine deficiency and hypothyroidism in developed countries is caused by a trend towards low salt consumption. In a bid to reduce the risk factor for hypertension and edema, most people in affluent nations are taking the widely publicized health advice to drop salt from their diet.

Unfortunately, iodized salt has been the most used and the most effective public health initiative to reduce iodine deficiency and prevent goiter, cretinism, and hypothyroidism.

Adding iodine to salt is a very cheap means of eradicating iodine deficiency. Experts estimate that it costs only a few cents for every ton of salt produced.

However, care should be taking with treating iodine deficiency with iodized salt.

Where the deficiency is severe and met with high intake of iodized salt, hyperthyroidism may result. In addition, people who are older than 40 years have a greater risk of developing hyperthyroidism from taking iron-fortified food products.

Where salt consumption is heavily restricted, iodine can still be obtained from the diet by eating more saltwater fish and sea vegetables such as kelp.

With swine flu claiming so many lives across the nation it is little tricky to give a straight answer to such a simple question. However, there is a fair amount of chance to recover from the flu if tr

With swine flu claiming so many lives across the nation it is little tricky to give a straight answer to such a simple question. However, there is a fair amount of chance to recover from the flu if treatment and care can be provided on time and during the initial phase soon after contracting the viral infection.

‘One must realise that unlike other viral diseases like leptospirosis, malaria, dengue where the entire immune system and all major organs have to face the wrath of the virus, in case of swine flu, the immunity of a person is suppressed and only the lung function is affected, although to a great extent. So, recovery of a patient from swine flu largely depends on the extent of lung damage one has faced due to the virus,’ says Dr Prakash Jiandani, director of critical care unit, Wockhardt Hospital, South Mumbai. In some rare cases of swine flu, it can also lead to cardiac arrest and brain damage. But most of the time, a life is lost battling a respiratory infection because of swine flu and it doesn’t reach to that extreme. Here is all that you need to know about the treatment and medication of swine flu.

Lines of treatment

In case of swine flu, the first line of treatment is antiviral therapy given either by oral suspension or in capsule form. If a patient fails to recover with oral medications the second line of treatment would be to start on ventilation. ‘The idea of starting a patient suffering with moderate to severe symptoms of swine flu on ventilation, is done to restore oxygen supply in the blood and revive lung function. However, one must realise that even best ventilation mechanisms can help patients only to a certain extent. If the damage done to the lungs is beyond any repair, then even the best of supportive care provided would fail to help one survive any longer,’ informs Dr Jiandani. Here are the symptoms of swine flu you should know about.

Prevention is better than cure

This is the reason why preventing a bout of swine flu is more important than treating it. ‘It is necessary to take steps early and visit the doctor if you develop any symptoms of the seasonal flu. However, not all the healthy individual with cold and cough needs to be treated for swine flu. One should be diagnosed carefully for the symptoms, especially those who fall under the risk group, like people suffering from High BP, diabetes or the elderly,’ says Dr Jiandani. Here are 15 tips for everyone to prevent a bout of swine flu.

Oral antiviral medication, when given within 48 hours after experiencing the symptoms can help one recover fast. However, if it delays recovery then oxygen therapy with proper ventilation goes in long way to resurrect lung function. ‘High frequency ventilation or extracorporeal membrane oxygenation (ECMO) can help patients recover from the symptoms of flu,’ says Dr Jiandani. (Read: IMA guidelines to tackle swine flu (H1N1 influenza) in India)

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Fluzone Quadrivalent, Fluzone Intradermal Quadrivalent, and Fluzone
High-Dose vaccines are given to help prevent influenza disease caused by influenza A and B strains contained in each vaccine. Fluzone Quadrivalent vaccine is given to people 6 months of age and older. Fluzone Intradermal Quadrivalent vaccine is given to people 18 through 64 years of age. Fluzone High-Dose vaccine is given to people 65 years of age and older.

For more information about Fluzone Quadrivalent, Fluzone Intradermal Quadrivalent, or Fluzone High-Dose vaccine, talk to your health care professional and see complete Patient Information.

IMPORTANT SAFETY INFORMATION

Fluzone Quadrivalent, Fluzone Intradermal Quadrivalent, and Fluzone
High-Dose vaccines should not be administered to anyone with a severe allergic reaction (eg, anaphylaxis) to any vaccine component, including eggs, egg products, or thimerosal (the multidose vial is the only presentation containing thimerosal), or to a previous dose of any influenza vaccine.

  • 1.CDC. How flu spreads. http://www.cdc.gov/flu/about/disease/spread.htm. Accessed October 12, 2017.
  • 2.CDC. Vaccine effectiveness - how well does the flu vaccine work? http://www.cdc.gov/flu/about/qa/vaccineeffect.htm. Accessed October 12, 2017.
  • 3.CDC. Children, the flu, and the flu vaccine. http://www.cdc.gov/flu/protect/children.htm. Accessed October 12, 2017.
  • 4.CDC. Misconceptions about seasonal flu and flu vaccines. http://www.cdc.gov/flu/about/qa/misconceptions.htm. Accessed October 12, 2017.
  • 5.CDC. Flu symptoms and complications. http://www.cdc.gov/flu/consumer/symptoms.htm. Accessed October 12, 2017.
  • 6.Affronti M, Mansueto P, Soresi M, et al. Low-grade fever: how to
    distinguish organic from nonorganic forms. J Clin Pract.
    2010;64(3):316-321.
  • 7.Hamborsky J, Kroger A, Wolfe C. Influenza. In: Hamborsky J, Kroger A,
    Wolfe C, eds. Epidemiology and Prevention of Vaccine-Preventable Diseases (The Pink Book). 13th ed. Washington, DC: Public Health Foundation; 2015:187-208.
  • 8.Treanor JJ. Influenza viruses, including avian influenza and swine
    influenza. In: Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas,
    and Bennett's Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, PA: Churchill Livingstone Elsevier; 2010:2265-2288.
  • 9.CDC. Prevention and control of influenza with vaccines:
    Recommendations of the Advisory Committee on Immunization
    Practices (ACIP), 2010. MMWR.2010;59(RR08):1-62.
  • 10.CDC. The flu: A guide for parents. http://www.cdc.gov/flu/pdf/freeresources/updated/a-flu-guide-for-parents.pdf. Accessed October 12, 2017.
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The flu spreads very easily from person to person. Even before you notice symptoms, you may spread the virus to others. If you have the virus, you can spread it to others by:

These actions release tiny droplets containing the flu virus into the air.

You can become infected if these droplets land on your:

Infection can also happen if you touch any of these body parts after touching objects contaminated by infected droplets. Common contaminated objects include:

  • doorknobs
  • phones
  • television remotes
  • someone's hands

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Influenza: Types, Causes, Symptoms, Transmission & Prevention

Influenza: Index

What is Influenza?

Influenza, more commonly known as flu is a medical condition that results from infection of influenza viruses (RNA virus of an orthomyxoviridae family).Influenza mainly affects respiratory tract, nose and the throat, which may spread to the lungs and bronchi.

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A team led by Dr. Russell Stothard, head of the Schistosomiasis Control Initiative at the Natural History Museum, London, recently conducted a field evaluation, which reported that even if stool or urine examinations are negative, a tissue biopsy might reveal eggs. Detection of antibody might as well be useful for epidemiological surveys as well as clinical research and management.

Schistosomiasis can be successfully treated using an oral drug Praziquantel. Though a single dose of this drug can cure the infection, it is not effective in preventing re-infection of the patient, which is highly probable in an affected area. Researches are presently being carried on to develop a vaccine for this disease.

The toxic metalloid, antimony was initially used in low doses to treat schistosomiasis, but this is not used in present days. Another drug called Oxamniquine is used outside the U.S to treat Schistosoma mansoni.

Investigations are being carried on a new Egyptian drug, Mirazid for the treatment of this disease.

Other forms of oral medication that are being experimented with are medicinal castor oil, Gopo Berry (by Dr Chidzere of Zimbabwe in 1980s), etc.

Acrolein, copper sulfate, and niclosamide can be used to eliminate the fresh-water snails that cause the disease.

Crayfish breeding can also be helpful for the purpose though it must be done with caution.

Avoiding water bodies previously detected with snails.

Use of sapindus plant(Phytolacca dodecandra) to prevent the disease by controlling snails. Aklilu Lemma and Legesse Wolde-Yohannes received the Right Livelihood Award in 1989 for their research.

Better plans and designs while creating dams and irrigation schemes can prevent this disease from spreading among the nearby population.

Influenza B: Cause, Symptom, Treatment and Prevention

Influenza B can cause respiratory and stomach symptoms. It can be easily treated. Vaccine and staying away from virus can prevent it.

Influenza or the flu refers to a respiratory infection that can be caused by a variety of viruses. The virus will move through the air and become inhaled through the mouth or nose. Approximately 5-20 percent of people catch the flu each year in the United States. Influenza can cause a serious infection or death in newborns, the elderly and people with some chronic illnesses. The viruses that cause influenza are classified as A, B or C types, depending on how their proteins are composed. Type B viruses are the most common in humans.

All flu viruses travel in the air as droplets of moisture. It spreads when people talk, cough or sneeze, releasing this moisture. Some people inhale this moisture in the air while others touch objects like a keyboard or telephone that are covered in the virus and then transfer them to the eyes, mouth or nose by touching these areas.

The influenza virus alters and creates new strains constantly so those that have already been affected by the flu may have developed antibodies to ward of a specific type of flu virus. If you are exposed to a virus in the future that is similar to those you have experienced before or you have been given a vaccination against a certain type of flu, it will be easier for the body to fight off the infection.

The antibodies a person has developed will not be able to prevent an infection caused by new strains of the virus or subtypes of the virus that are different than those you have already been exposed to.

1. Body Symptoms

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Mononucleosis can remain for years and years if it is not treated with the right mononucleosis treatment.

Mononucleosis is an infectious disease and is more commonly known as mono. There are a number of mono symptoms. Some of the common mono symptoms are:

  • Sore Throat
  • Swollen Glands
  • Fever
  • Cough
  • Fatigue
  • Headache
  • Loss of Appetite
  • Swollen Spleen
  • Swollen Lymph Nodes
  • Skin Rash

Symptoms of Mononucleosis:
Mononucleosis has various symptoms. Although mild mononucleosis symptoms are light and similar to that of a common cold, acute mononucleosis has distinct symptoms and can be recognized easily.

Some of the most common acute mononucleosis symptoms are the followings:

Sore Throat – When a person is infected with the Epstein Barr virus he will experience a sore throat and this is the first sign that a person can know in advance that he is infected with mononucleosis. The throat becomes red and inflammation occurs, for the blood vessels in the infected area are widen and becomes permeable allowing the immune proteins, white blood cells to flood into the cell tissue. When someone experiences a sore throat the best thing one can do is to consult a doctor and give complete rest to the body and avoid overuse of voice.

Swollen Glands – This is a distinctive symptom of the contagious mononucleosis. Sore and swollen glands are commonly experienced by mononucleosis victims. Normally, swollen glands are felt in the neck but they can also occur in the armpits and in the groin area.

Fever – Of all the symptoms of mononucleosis, fever is the most common symptoms that are experienced by mononucleosis patients. Sometimes fever rises to high levels, above 40 degree C or 104 degree F and this can be dangerous for children by causing fit or seizure in them.

Respiratory Problems – Mononucleosis patients also experience difficulties while breathing. The inflamed glands and swollen throat can create respiratory problems and cause difficulty in breathing. Some of the respiratory mononucleosis symptoms are coughing, cold, sneezing and nasal discharge.

Ruptured Spleen – An enlarged and ruptured spleen occurs rarely in about 2 or 3 of every mononucleosis victims. Here the spleen ruptures causing internal bleeding and arise complicated situations in the blood pressure. A ruptured spleen requires emergency hospitalization or it may make the situation more complicate and even result in sudden death.

These symptoms are a warning signs and can be fatal. If they are not checked in the right time, it can raise complications in making recovery from this contagious disease.

Mono Symptoms can begin to appear four to six weeks after the first infection of the EVB virus. People infected by this virus, might have some or all of these symptoms of mono. It is also possible to have mild symptoms and will not be substantially affected by them. Due to the variety of symptoms, quite possibly the group of symptoms could be incorrectly diagnosed as another infection, such as flu or strep throat.

The symptoms of acute infectious mononucleosis is a sore red throat, swollen lymph nodes, fever and relieve shortness of breath. Although these infectious symptoms of mononucleosis can be annoying and uncomfortable, but this is how the body eliminate the EBV virus from the system. Read about mononucleosis causes.

For more information about symptoms of mono, please see:

See this YouTube video for more details and learn what are the symptoms of mono?

If you liked this article, please share it on Facebook and Google+. You can also follow our Facebook page here: Mono Symptoms.

Typical Signs of Sleep Deprivation and Insomnia.

Irritability. This isn't your typical "I just don't want to be bothered right now". This is a growing anger and near hatred of everything and everyone around you. This symptom of sleep deprivation will cause you to snap at the littlest things and boil over in anger at the most trivial of mistakes. You'll quickly know whether or not this level of "intolerance" is normal for you.

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Iodine deficiency is most common in parts of the world farther from large water bodies. Therefore, people living in inland areas and those in arid regions are usually iodine deficient because they do not eat marine foods.

According to a WHO (World Health Organization) statement made in 2007, about 2 billion of the world’s population do not get sufficient iodine from their diets. The WHO called iodine deficiency the single, most important but preventable cause of mental retardation.

Besides those who live too far away from marine life and so do not get enough iodine in their diet, other groups of people who are prone to iodine deficiency include:

  • Pregnant women
  • People exposed to radiation
  • People with selenium deficiency

Iodine deficiency can also be caused by chemicals such as perchlorates, thiocyanates and also goitrogens such as calcium. In addition, tobacco and alcohol intake may increase the risk of this deficiency.

In addition, women are more likely than men to develop iodine deficiency.

A 24-hour urine iodine collection is the most common medical test for diagnosing iodine deficiency. The body eliminates 90% of the iodine ingested daily in the urine, therefore, the level of iodine in urine is a good indication of the amount of iodine found in the body.

Iodine deficiency causes a number of medical disorders including goiter and cretinism.

Other symptoms of iodine deficiency include depression, fatigue, hair loss, weight gain, impaired memory and mental abilities, slow heartbeats and increased sensitivity to cold.

Goiter is the medical term for the enlargement of the thyroid gland. When this gland swells, it can also cause the swelling of the larynx and neck.

Goiter can form when the production of T4 falls sharply. To renew the production, TSH is secreted in large amounts from the pituitary gland.

However, if the low production of T4 is caused by iodine deficiency, the increased secretion of TSH does not translate into an increased synthesis of T4. Instead, TSH needlessly stimulates the growth of new cells in the thyroid gland, and this causes the enlargement of the gland.

In mild cases, which are the most common, a mild iodine deficiency may lead to increased production of T3 in the thyroid gland. However, since most of the body’s store of T3 is made from the available T4 which are not being replenished, T4 is rapidly depleted.

Goiter is a big public health problem not only in poor countries but in some affluent nations of Europe and in Australia and New Zealand. The treatment is, however, simple. By supplying iodine supplements, goiter cases can be quickly resolved.

The easiest way to provide iodine supplementation to any population is by mandating that sale of only iodized salts.

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Kaposi's Sarcoma — This is the most common AIDS-related cancer. It causes reddish-purple lesions that usually appear on the skin. They also can appear on the lymph nodes, mouth, gastrointestinal tract and lungs.

Shingles — Shingles are caused by a reactivation of the chicken pox virus. It may cause a painful rash or blisters that follow the path of nerves.

Reviewed by health care specialists at UCSF Medical Center.

As pancreatic cancer develops in the body, it may cause some of the following symptoms. The symptoms and severity can vary for each person but it’s important that if you are experiencing any, which are persistent and not normal for you, that you visit your GP or call NHS 111.

  • Depression
  • Diabetes – new on-set and not associated with weight gain
  • Nausea and vomiting
  • Loss appetite
  • Pain when eating

Not everyone will have all of these symptoms. For example, those who have a tumour in the body or tail of the pancreas are unlikely to have painless jaundice. All of these symptoms can have other causes, and there is not yet a reliable and easy test for pancreatic cancer.

However, if you regularly experience ONE OR MORE of these symptoms which are NOT NORMAL FOR YOU, DO NOT IGNORE THEM, contact your GP straight away.

Keeping track of any symptoms you may be experiencing can be useful when discussing them with your GP. Click here for the Pancreatic Cancer Action symptoms diary.

30% of patients will have yellowing of the skin and whites of the eyes, jaundice, when they first go to the doctors. This is related to the tumour blocking the bile duct which leads to a build-up of bile in the liver.

Jaundice may be more obvious in the whites of the eyes and bad jaundice can cause itching of the skin. For more information on jaundice click here.

Approximately 70 per cent of patients with pancreatic cancer go to the doctor initially due to pain. This pain is often described as beginning in the stomach area and radiating around to the upper back (just above where a woman’s bra strap would be).

Generally the reason for the pain is because of the tumour pressing against your abdomen and spine.

A tumour in the pancreas can cause bowel disturbances which means you do not absorb your food properly. This will result in regular, large bowel movements of pale and smelly stool. This can also cause weight loss.

Many of our patients or relatives have said that they have experienced mood changes before being diagnosed.

Mild to severe depression can often present itself in the early stages of pancreatic cancer. This is why if someone who has never suffered from a severe bout of depression before should express their concerns to their GP. It can often highlight a medical problem in the very early stages.

Pancreatic cancer can cause diabetes. A pancreatic tumour can interfere with insulin production in the pancreas which can lead to new onset diabetes.

You may have diabetes if you have low energy, pass more urine than normal and feel extremely thirsty.

For general health information including information on pancreatic cancer

The information provided in this site, or through links to other websites, is not a substitute for medical or professional care and should not be relied upon as such. Read our disclaimer.

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    Have other people told you that your voice is very soft or that you sound hoarse? If there has been a change in your voice you should see your doctor about whether it could be Parkinson's disease. Sometimes you might think other people are losing their hearing, when really you are speaking more softly.

    What is normal?
    A chest cold or other virus can cause your voice to sound different, but you should go back to sounding the same when you get over your cough or cold.

    Masked Face

    Have you been told that you have a serious, depressed or mad look on your face, even when you are not in a bad mood? This is often called facial masking. If so, you should ask your doctor about Parkinson's disease.

    What is normal?
    Some medicines can cause you to have the same type of serious or staring look, but you would go back to the way you were after you stopped the medication.

    Dizziness or Fainting

    Do you notice that you often feel dizzy when you stand up out of a chair? Feeling dizzy or fainting can be a sign of low blood pressure and can be linked to Parkinson's disease (PD).

    What is normal?
    Everyone has had a time when they stood up and felt dizzy, but if it happens on a regular basis you should see your doctor.

    Stooping or Hunching Over

    Are you not standing up as straight as you used to? If you or your family or friends notice that you seem to be stooping, leaning or slouching when you stand, it could be a sign of Parkinson's disease (PD).

    What is normal?
    If you have pain from an injury or if you are sick, it might cause you to stand crookedly. Also, a problem with your bones can make you hunch over.

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    In some cases, myositis is a short-term problem that goes away after a few days or weeks. In other cases, it is part of a chronic (long-term) condition. Chronic forms of myositis can lead to muscle atrophy (wasting and shrinking) and severe disability.

    There are many different types of myositis, including:

    Idiopathic inflammatory myopathies. In this rare group of muscle diseases, the cause of the muscle inflammation is unknown (idiopathic). There are three major types: dermatomyositis, polymyositis and inclusion body myositis.

    Infectious myositis. Myositis sometimes occurs as part of a systemic (whole body) infection, especially a viral infection. It is especially common among people who have the flu (influenza). Myositis also can be caused by trichinosis, an infection in which tiny parasites invade the muscles. People can develop this infection by eating meat that has not been cooked enough. One type of infectious myositis is called pyomyositis, a bacterial infection that causes one or more pockets of pus (abscesses) inside a muscle. It usually is caused by Staphylococcus ("staph") bacteria. Pyomyositis is a relatively common infection in developing countries in tropical climates, especially where sanitation and health care are poor. However, it sometimes occurs in the United States, primarily in people who inject illegal drugs and in people infected with HIV.

    Benign acute myositis. In benign acute myositis, a young child suddenly develops severe leg pain and cannot walk normally. These symptoms are dramatic and frightening, but they usually disappear within a few days. Benign acute myositis usually occurs in children who are recovering from the flu or some other respiratory infection caused by a virus. Doctors are not sure whether the child's muscle symptoms are caused by the virus itself or by the body's immune reaction to the virus.

    Myositis ossificans. In myositis ossificans, a lump of bony material forms inside a muscle. This usually happens after a muscle injury, especially a deep bruise.

    Drug-induced myositis. In drug-induced myositis, muscle inflammation occurs as a side effect of a medication or a combination of medicines. Although this is rare, the most common medications that can cause myositis are the cholesterol-lowering drugs called statins, including atorvastatin (Lipitor), lovastatin (Mevacor) and simvastatin (Zocor) and zidovudine (Retrovir), also called AZT, a drug used to treat HIV/AIDS.

    Symptoms of myositis can include muscle weakness, muscle pain and muscle tenderness. Other symptoms vary, depending on the specific cause of myositis:

    Idiopathic inflammatory myopathies. These conditions typically cause painless muscle weakness that develops slowly over weeks, months or years. Although up to 40% of people with 1 of these conditions have muscle pain, the weakness is usually worse than the pain.

    Infectious myositis. When infectious myositis is caused by the flu, symptoms include not only muscle aches and muscle weakness, but also high fever, chills, sore throat, cough, fatigue and runny nose. When caused by trichinosis, symptoms in the early stages include diarrhea and vomiting. Later, as the parasites invade the muscles, symptoms can include fever, eye redness with swelling in the lids and muscle pain. Patients with pyomyositis usually have a fever, and the abscessed muscle is painful, tender and slightly swollen. Skin over the muscle may be red and hot.

    Benign acute myositis. A child suddenly has trouble walking and complains of severe leg pain. This pain is often worst in the calf muscles. In most cases, the child also has a history of recent fever, runny nose, sore throat and other upper respiratory symptoms.

    Myositis ossificans. A lump appears in the affected muscle, and this lump may hurt when you press it. These symptoms usually begin several weeks after a muscle injury, especially a bruise.

    Drug-induced myositis. Symptoms include muscle soreness, pain and weakness. These symptoms usually begin soon after a person starts taking a new drug or a combination of drugs. Myositis is more common when a person is taking a combination of lipid-lowering medications, such as gemfibrozil (Lopid) and lovastatin (Mevacor), than when a single medication is used.

    Your doctor will ask you to describe your symptoms. It is especially important to describe the exact location of any weakness or muscle pain and how long you have had it. The doctor also will review your medical history and current medications.

    Next, your doctor will examine you, paying special attention to your muscles and nerves. Depending on what your doctor finds, he or she may order diagnostic tests. Common tests used to diagnose muscle problems include:

    Blood tests to measure levels of muscle enzymes, auto-antibodies (antibodies directed against one's own cells or organs) and antibodies to infectious agents

    An electromyogram, a test that measures the electrical activity of muscles

    Magnetic resonance imaging (MRI), a painless scan that can identify abnormal muscle and can be used to locate the best site for a biopsy to establish the diagnosis or to monitor the progress of a known type of myositis

    A standard X-ray or a bone scan if your doctor suspects you have myositis ossificans

    An ultrasound, computed tomography (CT) scan or MRI if pyomyositis is suspected

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    Avian influenza (bird flu) is a notifiable disease in the UK and is listed in section 88 of the Animal Health Act 1981. Section 15 (1) of the Act says:

    “Any person having in their possession or under their charge an animal affected or suspected of having one of these diseases must, with all practicable speed, notify that fact to a police constable.”

    Loosely translated this means that if you suspect or are aware of the presence of a notifiable disease there is a legal obligation to notify a DEFRA Divisional Veterinary Manager immediately. DEFRA is the Department of the Environment, Food and Rural Affairs and is responsible for overseeing animal health in the UK.

    Avian influenza in birds is spread via secretions from the eyes, respiratory tract and from faecal matter, with droplets of liquid sneezed by infected birds spreading the disease extremely rapidly in environments where large numbers of birds are housed. In wild birds the situation is different with many migratory birds (including waterfowl, sea birds and shore birds) carrying the virus for long distances and being implicated in the international spread of the disease. Migratory waterfowl - most notably wild ducks - are the natural reservoir of bird flu viruses and these birds are also the most resistant to infection. They can carry the virus over great distances and excrete it in their droppings, yet develop only mild and short-lived illness themselves. There is a great deal of speculation about the importance of this very large reservoir of influenza viruses in wild birds as it is a source of viruses for other species, including humans, lower mammals, and birds. The high rate of infection allows for the maintenance and emergence of new and potentially highly dangerous strains by means of mutation and/or genetic reassortment.

    Some strains of avian influenza can be transmitted to humans and other animals but this is normally only the case following high levels of exposure to infected birds and/or their faecal matter. People most at risk would be those involved in intensive farming, in particular the poultry industry. These strains will normally only cause mild symptoms in humans but a current south-east Asian strain has caused a number of deaths. Although humans can be infected from birds the current highly pathogenic H5N1 strain does not readily infect people and there is very little chance, if any, for human-to-human spread of the disease.

    The main significance for human health is that birds could be the source of new strains of influenza virus. Existing bird strains could mutate to form a new strain, which could, in turn, readily infect humans. Likewise, if mammals are infected with both human and avian strains of the disease at the same time the mixing of genetic material from the two viruses might produce new strains. These strains would have the potential to spread readily between humans. If a new strain of avian flu was to mutate, humans would have little or no immunity to it and a serious worldwide epidemic could occur.

    Although avian influenza has hit the headlines on numerous occasions over the last few years the disease is yet to have a major impact in the UK, with only minor outbreaks which have been confined to poultry production units. The most recent outbreaks of avian influenza have been the low pathogenic strain with an outbreak of H7N2 in Conwy, North Wales in May 2007 and more recently an outbreak of the H7 strain in St Helens, Merseyside in June 2007. In both cases restrictions that were imposed on the sites concerned were removed promptly, in the case of Conwy within 5/6 weeks of investigation and in the case of St Helens within a day of investigation. The most recent outbreak of highly pathogenic avian flu was the strain H5N1 identified on a poultry unit in Holton, Suffolk in February 2007. Amongst restrictions imposed on the facility were a 3 km Protection Zone and a 10 km Surveillance Zone along with a much wider Restriction Zone. All restrictions were removed from the farm just over one month later.

    Although avian influenza has been restricted, in the main, to the mass production of poultry, the feral pigeon has inevitably been identified as one species that has the potential to carry and pass the disease onto humans based on the birds’ close association with man. The main focus of attention has been the racing pigeon industry due to the fact that it involves the transportation of pigeons across international borders. Clearly, if pigeons are released in EU countries where avian influenza is active, when they return to lofts in the UK there is clear potential for those birds to carry and transmit the disease to other domesticated birds, wild birds and animals and indeed humans. As it is migratory birds that are considered to be the main carriers of avian influenza, racing pigeons must also fall into this category as they are frequently required to cross international borders.

    Much research has been carried out to better understand the threat posed by the pigeon (feral and domesticated) and research is ongoing in many parts of the world, particularly in those countries worst affected. A thorough scientific research programme was undertaken following the outbreak of the highly pathogenic strain H5N2 in the north-eastern United States (in 1983/4) to assess the potential for wild birds to spread disease amongst local farms. The following species were included in this survey:

    • Wild and free-flying domestic ducks and geese
    • Wild or free-flying domestic birds (including pigeons)
    • Rodents
    • Dead or sick birds within the quarantine area

    Attempts to isolate the virus were conducted on a sample of 4,132 birds, of which 473 were pigeons, and of this number 92.6% were collected from infected farms. A further 81 feet, taken from dead pigeons, were also assessed for the purposes of the research - this is because pigeons commonly feed on agricultural sites and by walking in infected faecal matter the birds could potentially pass on the disease. In order to assess the sample, tracheal (throat) and vent (anus) swabs were taken from each bird. None of the 4,132 birds collected tested positive for the H5N2 strain. Blood samples taken from 383 pigeons were also negative for antibodies (antibodies are protective substances that are produced by the defensive network of the body in response to an infection) to avian influenza, an indication that infection by this virus had not occurred in these birds. An additional 50 pigeons, collected from within the quarantine zone, were also negative for the influenza virus. Experimental attempts made to infect pigeons with the highly pathogenic H5N2 strain of avian influenza did not result in either multiplication of the virus or any evidence of antibodies in the blood. The results of all of these studies indicated that pigeons were not infected with avian influenza and did not spread it.

    In another outbreak of avian influenza in the USA in 1993 (in the period February to May) blood samples were collected from 17 flocks of pigeons located within the quarantine area for evidence of antibodies to avian influenza. Flock sizes varied from 2000 - 3000 birds and represented a total of between 34,000 and 51,000 birds. Approximately 10 birds per flock were sampled (a total of 160 birds) and in every instance all pigeons tested were negative for antibodies to this avian influenza.

    Another study published in 1996 on the susceptibility of pigeons to avian influenza found that groups of pigeons inoculated with two strains of highly pathogenic influenza virus, or two strains of non-pathogenic virus, remained healthy during the 21-day trial period. The sample did not shed virus and did not develop antibodies to this disease - further evidence that pigeons are not a factor in the spread of avian influenza. More recent scientific evidence, from experimental work in 2001/2002, has shown that pigeons infected with the highly pathogenic form of the virus (designated H5N1 of Hong Kong origin) did not develop signs of this disease and did not have detectable changes to the disease in their tissues. Neither was the virus found in their tissues and nor was it re-isolated from swabs of tissues. These findings indicated once again that pigeons (along with starlings, rats and rabbits used in these studies) are largely resistant to infection with this highly pathogenic strain of the virus.

    It is quite clear from all the information available that avian influenza continues to be a threat to both humans and birds, but the likelihood of its transmission to humans as a result of contact with the feral pigeon or its faeces is virtually nil. The feral pigeon is reputed to be the ultimate disease-carrier, harbouring the capability to spread a huge variety of diseases to both humans and other birds and animals, but in reality this is a myth. As can be seen from the findings of several research programmes, the feral pigeon is at the bottom of the list of those species that have the potential to spread avian influenza and it is likely that this is the case with most of the other diseases that are commonly associated with the pigeon.

    PCRC, Unit 4, Sabre Buildings, Sabre Close, Newton Abbot, Devon, TQ12 6TW

    Aide-mémoire N°211
    Janvier 2018

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    Influenza is transmitted to a healthy person from an infected person through tiny droplets expelled from a runny nose or during sneezing, breathing or coughing.

    People with weak immune systems are more prone to getting infected. Once the virus attaches itself to cell receptors, it replicates in large quantities and invades the entire body.

    Influenza: phases of viral replication

    The first signs of influenza are felt after round 48 hours (incubation period) of the viral infection. The influenza virus originates and infects the human body in 4 phases. They are:

    a) Attachment: The virus binds to a respiratory epithelial cell membrane.

    b) Endocytosis: The virus wraps in an endocytic vesicle and releases mucleocapsides into the cytoplasm of the cell.

    c) Replication: Genome of influenza virus serves as a template using which each infected cell produces virus in large number

    d) Protein synthesis: The virus starts using the energy released from cellular metabolism to synthesize its own proteins.


    Vaccination for Influenza

    Vaccination is perhaps the best guard against influenza infection. Prophylaxis is the most commonly administered vaccination for influenza. However the kind of vaccination administered depends on the epidemiological context.
    The effectiveness of Influenza vaccination lasts for around a year, after which fresh vaccination is required. The body develops immunity after round two weeks of vaccination. In addition, the vaccination is effective only against certain strains of influenza and may fail as new strains originate.

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