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Case Definitions of Avian Influenza
1. Suspect Case

A suspect case is a person suffering from an upper respiratory tract infection with symptoms of fever (temp > 38°C), cough, and/or sore throat and/or runny nose, coupled with one of the following circumstances:
• Having visited a poultry farm where avian influenza occurred in the last one week;
• Having been in contact with confirmed avian influenza case during transmission period
• Working in a laboratory that is handling avian influenza-suspect human or animal specimen

2. Probable Case

A probable case is similar to a suspect case with one of the following conditions:
• Limited laboratory evidence suggesting the presence of Influenza A virus (H5N1), for example: Hemagglutination Inhibitation (HI) test using H5N1 antigen.
• Within a short period the disease turns into pneumonial infection/respiratory failure/death.
• There is no evidence suggesting other causes of death

3. Confirmed Case

A confirmed case is a suspect case or probable case coupled with the presence of one of the following laboratory test results:
• Positive culture for H5N1 influenza virus
• Positive PCR assay for influenza (H5)
• Four-fold increase of H5 antibody titer

Source : Komnas FBPI
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Frequently Asked Questions about Avian Flu
1. What is Avian Flu?

Avian influenza (bird flu) is an infectious disease caused by the type A strains of the influenza virus. These are mainly found in birds and poultry.

2. Has bird flu reached Indonesia?

Avian influenza was first detected in August 2003 in Indonesia. As of early December 2006, the virus has been detected in birds in 30 provinces in Indonesia.

3. I have domestic birds. How would I know if my domestic birds have bird flu?

The Food and Agriculture Organization of the United Nations (FAO) website (http://www.fao.org/ag/againfo/subjects/en/health/diseases-cards/special_avian.html) provides information about how to assess whether a bird may be infected with bird flu. You can also visit the Department of Agriculture for general information on Avian Influenza (http://www.deptan.go.id/) or the Directorate General of Animal Health of the Department of Agriculture at (http://keswan.ditjennak.go.id/).

4. Can humans catch bird flu, and are the effects fatal for humans?

Yes, bird flu can infect humans and the disease can be fatal. Keep in mind that at this stage the disease remains a rare event.

5. How long is the incubation period?

The incubation period for bird flu is 2-10 days after exposure to the virus. However, most cases become symptomatic after 3-5 days of exposure to the virus.

6. What are the symptoms of bird flu?

Early signs of bird flu are often similar to seasonal human influenza (cough, sore throat, high fever, headache, muscle ache, etc). The disease can progress into pneumonia where there might be shortness of breath, difficulty breathing and respiratory failure.

7. What should I do if I think I have bird flu?

If you think you have been exposed to bird flu and have influenza-like symptoms, seek medical advice.

8. How is the virus transmitted to humans?

The virus is found in bird and poultry faeces and respiratory secretions. Most cases have contracted the virus directly from infected birds, although environmental contamination with the virus can also be a source of infection.

9. Is there a cure for the bird flu?

Besides intensive medical attention, Oseltamivir (registered as Tamiflu) is the main anti-viral treatment for bird flu. It is most effective when administered early in the disease. Tamiflu in Indonesia is available at all Avian Influenza Referral Hospital. (see AI Hospital Referral list)

10. Are there any vaccines for the virus?

There are currently no human vaccines available for bird flu. Researchers are carefully monitoring the situation to ensure that if the virus changes into a strain that is more infective for humans, they can then start to develop a vaccine specifically for that strain.

11. What can we do to prevent bird flu in our homes?

• Maintain a healthy environment and sanitary surrounding (especially if there are bird/poultry pens and cages).
• Maintain self sanitation (frequently wash hands with soap and antiseptic solution)
• Always place bird/poultry pens and cages as far away from the house as
possible.
• Use protection (masks and gloves) when handling organic poultry fertilizers.
• Don’t throw bird/poultry innards and feathers recklessly, always place them in a plastic bag and dispose properly.
• Always clean excess bird/poultry and animal feed, to prevent attracting wild
birds.

12. How do we protect ourselves from bird flu infection?

• Wash your hands with soap or other antiseptic solutions after handling
poultry/birds.
• Disinfect surfaces with simple detergents, alcohol solutions (70%) or chlorine
(0.5%).
• Wear masks, gloves and boots if entering areas with recent bird flu infection.
• Closely observe your health if you have close contact with birds/poultry. Seek medical advice if you develop fever, eye infections, and/or respiratory problems.

Also:
1. Do not touch sick or dying birds; if you do, immediately wash your hands and report to local authorities.
2. Wash your hands and utensils with soap and water before you eat or cook.
Cook all poultry and eggs well.
3. Separate your birds and separate all new flocks for two weeks.
4. Go immediately to a health clinic if you have a fever with flu-like symptoms and have had contact with birds.

13. What occupations are high risk for bird flu infection?

1. poultry farmers and farm workers
2. poultry slaughterers and slaughterhouse workers
3. sellers of poultry products (meat, eggs, etc.)
4. bird / poultry owners
5. lab staff and workers processing samples
6. people who live in areas where recent poultry deaths have been attributed to bird flu infection
7. people who had direct, close and unprotected contact with confirmed bird flu
cases.

14. Is it safe to each chicken meat and other poultry products?

Yes, it is safe to eat chicken and other poultry products that have been fully-cooked (fried, boiled or grilled). Do not eat poultry meat that is still pink or half-cooked/half-boiled eggs.


Source: World Health Organization
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