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How is it diagnosed?
The gold standard in laboratory diagnosis is virus isolation. Rapid laboratory verification of suspected human cases is usually performed by immunochromatographic or immunofluorescent detection of influenza virus antigens or by real-time detection of H5 specific RNA polymerase chain reaction (RT-PCR) in respiratory samples. In addition, commercial ELISA kits are available which detect antibodies to viral antigens such as nucleoproteins.
Laboratory criteria for diagnosis: at least one of the following must be positive.
a) avian influenza A isolated from a clinical specimen,
b) Detection of avian influenza nucleic acid A in a clinical specimen,
c) Avian influenza A specific antibody response (four-fold or greater increase or a single high titer).
Case classification
Possible case: person meeting the clinical and epidemiological criteria.
Highly probable case: person whose test for influenza A / H5 or A / H5N1 was positive for human influenza in a national reference laboratory not participating in the reference laboratories of the European network
Nationally confirmed case: Person tested positive for influenza A / H5 or A / H5N1 in a national reference laboratory with participation in the reference laboratories of the European network for human influenza.
Case confirmed by the World Health Organization: Person confirmed for H5 in a laboratory collaborating with WHO
Who should sample:
With a history of contact with sick or dead poultry and fever above 38 ° C
Cough
Sore throat
Break
Shortness of breath
Diarrhea
Appropriate samples will be taken from the nasopharyngeal swab or aspirate, nasal aspirate, BAL, tissue samples (biopsy / autopsy) from patients with one or more of their complaints.
How is it treated?
Antivirals (neuraminidase inhibitors: oseltamivir and zanamivir) are used in the treatment of the disease. These drugs should be started within the first 48 hours of starting symptoms. Supportive therapy with oxygen and ventilator support is the basis of treatment.
People with unprotected risky contacts will receive prophylaxis. In case of unprotected contacts, prophylaxis is initiated in coordination with the infectious disease specialist. Prophylaxis will be initiated by the Community Health Center where the contact is registered and will be followed for 10 days.
Prophylaxis should be started as early as possible, within the first 48 hours of initial contact with the confirmed or probable case. If this is not possible, prophylaxis can be started within 7 days of the last contact.
For chemoprophylaxis, oseltamivir should be administered instead of standard influenza prophylaxis (1×75 mg) at the therapeutic dose (2×75 mg) for a short period of 5 days if contact does not continue and for 10 days in intensive and continuous contact.
Antivirals (neuraminidase inhibitors: oseltamivir and zanamivir) are used in the treatment of pediatric patients and adult patients. These drugs should be started within the first 48 hours of starting symptoms. Supportive therapy with oxygen and ventilator support is the basis of treatment.
The dose of oseltamivir in children is calculated as follows;
From 2 weeks to 1 year of age 6 mg / kg / day in two doses,
Children from 1 year to 12 years (per kilogram)
2 x 30 mg for 15 kg and less,
2 x 45 mg between 15.1 and 23 kg,
2 x 60 mg between 23.1 and 40 kg,
40.1 kg and over 2 x 75 mg,
Personnel involved in the killing of avian influenza birds should receive prophylaxis during killing and for 5 days after the last known contact, due to intense exposure during killing.
What are the ways of protection?
If a person is definitively diagnosed or suspected of having bird flu infection and does not need hospitalization;
People with avian flu infection risk contacts should follow up for 10 days after their last contact for other initial symptoms such as fever, cough, difficulty breathing and headache, sore throat, nausea-vomiting and diarrhea.
Due to the risk of infecting other people in the home and community, they should live in a different room than other people in their home,
When coughing or sneezing, they should cover their mouths with a tissue (preferably with tissue paper), used tissues should be placed in closed, non-perforated nylon bags and thrown into a second plastic bag,
He should wash his hands frequently;
Wear a face mask when sharing the same environment with another person (home, street, public transport, hospital, etc.),
Do not share personal belongings with others and do not use household items such as cups, plates, towels; If he needs to use it, he should thoroughly wash these items with soap and water.
She should also monitor her symptoms and seek emergency medical help if her illness gets worse.
Necessary contact precautions (gloves and masks) should be taken prior to contact with live or dead poultry with suspected disease.
When suspicious material is touched with bare hands, wash them with soap and consume inspected products.
Poultry must be cooked well (60-70 degrees) under suitable conditions and should not be eaten raw.
People with suspected illness should go to health centers immediately Family members and health care workers who come into contact with people who are sick or suspected of being sick should wear protective masks and gowns.
The composition of the flu vaccine changes every year due to major or minor antigenic changes in the circulating viruses. Current influenza vaccines are protective against human-specific strains of influenza viruses and do not protect against the avian influenza virus. However, the use of this vaccine is still recommended for people at high contact risk in countries with a highly pathogenic avian flu outbreak among poultry. Therefore, the possibility of any gene exchange during a coinfection with the human influenza virus and the bird-specific influenza virus, thus the emergence of a strain with pandemic potential can be reduced.
Who is part of the risk group?
People who have direct contact with live or dead sick animals or animal waste are at increased risk. In addition, health workers who come into contact with sick people are also at risk.
Pregnancy aggravates the course of avian flu like other types of flu.
No special application is required for pregnant and lactating people, and it is the same as the recommendations made for other patients. The mother is recommended to wear a face mask only when approaching her baby.
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