Bird Flu Symptoms: What To Look Out For
By Grace Jiu

Bandar Seri Begawan - With mounting concerns of an impending pandemic looming, a seminar was held to update health care workers - particularly doctors - on the current situation of the avian flu epidemic in Southeast Asia regions and its threat to Brunei - focusing on the management of suspect or confirmed cases and maximising preparations with regard to facilities, medications, awareness among health care workers and public education.

Speaking to doctors at the seminar was Dr Chong Vui Heng from the Department of Internal Medicine, RIPAS Hospital.

An influenza pandemic averages one per 30 years, and the last pandemic was the Hong Kong flu in 1968, which saw one million deaths.

H5N 1 of bird flu is the likely candidate virus of the next influenza pandemic, he said.

He specified to the audience of health care workers that testing for Influenza A (H5Nl) should be considered for patients suffering all of the following - documented temperature of 38 degrees Celcius, cough, sore throat, or shortness of breath, and most importantly, history of contact with poultry or domestic birds, or suspected patient with Influenza A (H5N1) or was in a H5N 1-affected country.

He categorised case definitions of the avian flu into `possible,' `probable' and `confirmed' cases.

The characteristics of a possible case is a fever over 38 degrees Celsius, and one or more of the following conditions - cough, sore throat and dyspnoea and have been in a lab test for Influenza

A (no sub-typing), contact with confirmed case of Influenza A, poultry contact in an area with known outbreak of Influenza A and worked in a lab that processed samples from persons or animals that are suspect for highly pathogenic avian influenza A (HPAI).

A probable case would be any individual with features of possible case, with a lab testing positive for H5.

A confirmed case would be an individual with acute respiratory illness, with a lab test showing one or more of the following - positive Polymerase Chain Reaction (PCR) for H5 or H5N1, positive viral culture, positive immunoflourescence antibodies for H5 and positive fourfold rise of specific antibodies.

Dr Chong Vui Heng noted that if Brunei is affected, it might be a long stretch based on previous influenza pandemics, and the toll would likely be very high.

The Tutong Hospital - designated to manage any avian flu or pandemic influenza cases - has a maximum capacity of 200 patients and if necessary it will be closed to routine cases.

He also pointed out that ventilation and all essential facilities for containing and treating infectious diseases will be made available.

According to Dr Chong Vui Heng, the next pandemic influenza could see 400 - 800 million cases, and 280,000 to 650,000 deaths.

The speaker also said that an Influenza Pandemic Plan 2005 should be available soon. It will consist of a plan of action by the various sub-committees including surveillance issues by Public Health, case managements from suspicion to referral and diagnostics.

He urged health care workers to read and digest it once available.  -- Courtesy of Borneo Bulletin

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