Avian Influenza Frequently Asked Questions

Why isn’t the USG providing Tamiflu to private Americans overseas?

The Department of State lacks the legal authority to provide any type of medication, including Tamiflu, to private American citizens. State Department physicians and medical staff have authorization to treat only those official employees, and their families, who are under Chief of Mission authority.

Will you evacuate Americans in the event of a pandemic?

Current medical thinking suggests that a “stay in place” response to a pandemic may be appropriate in certain countries or regions. In this scenario, people would be advised to exercise “social distancing” and avoid any form of public gathering where transmission of the disease could occur. Airplanes are a common venue for human-to-human transmission of viral infections due to proximity of travelers and recycling of air within the cabin. People who are not comfortable with this scenario should consider these factors when making their plans.

Whether the U.S. Government evacuates anyone will depend on a variety of factors specific to individual countries.  The Embassy is developing a contingency plan in the event of a pandemic, and to identify events that might prompt them to send employees and/or their dependents out of the country, assuming such travel is possible. Should the decision be made to send Embassy employees and/or their dependents out of a country, we will communicate this to the private American community so that people can plan accordingly. As in any other crisis, we will assess the availability of commercial transportation, the ability of people to travel to the United States or a third country, and other related factors in deciding on appropriate actions to assist Americans.

Should I begin taking antiviral medications such as Tamiflu if I'm planning a visit to another country?

No, the CDC specifically states at this time persons traveling to countries with Avian Influenza cases in birds, poultry or humans do not need to take Tamiflu prophylactically. If you become ill in any way while in the country, you should seek medical advice immediately. Travelers to any country that has reported cases of H5N1 among birds or humans should consider scheduling an appointment with their health care provider before traveling to discuss risks for potential exposure to H5N1. Only you and your health care provider can determine that risk and what the most appropriate precautions are for you.

Is it safe to eat poultry and eggs?
Proper cooking of poultry will destroy the virus. There have been no reported human cases of avian influenza contracted from consumption of well-cooked poultry or eggs. Both humans and animals have contracted avian influenza from eating undercooked poultry products. Best practices during handling of raw poultry meat and usual recommended cooking practices for poultry products should be followed to lower the risk of common bacterial diseases spread by poor handling and cooking techniques. Eggs from infected poultry could also be contaminated with the virus and therefore care should be taken in handling eggs or raw egg products.  Guidance on handling food to avoid spreading the virus is available on the websites for the Centers for Disease Control, the U.S. Department of Agriculture, and the World Health Organization.

What are the travel recommendations regarding the H5N1 bird flu outbreak in Asia and parts of Europe?

The U.S. Centers for Disease Control in Atlanta currently advises that travelers to countries with known outbreaks of influenza A (H5N1) avoid poultry farms, contact with animals in live food markets, and any surfaces that appear to be contaminated with feces from poultry or other animals. For more information about travel recommendations, visit the Centers for Disease Control website at http://www.cdc.gov/travel/seasia.htm#country.

Do High Efficiency Particulate Air (HEPA) filters on airplanes offer protection?
Yes, if they are true HEPA filters, but many planes are not equipped with them. Airplanes are a common venue for human-to-human transmission of viral infections due to proximity of travelers and recycling of air within the cabin. You should not travel if you are ill or have a fever. If a neighbor is coughing or appears ill near you, move and tell the flight attendant. This is particularly important if you are flying from a country that has documented avian influenza cases in humans.

If you develop influenza symptoms and are in a country known to have H5N1 among birds and/or humans, it is important to get immediate medical care. For this reason, you should visit your local doctor for treatment.

Are children more susceptible?

The World Health Organization and the Centers for Disease Control believe that children may be more susceptible due to their increased proximity socializing at schools and day care centers, as well as being more likely to come into contact with poultry or bird fecal matter during their play habits. It is unknown whether immunity differences in children have any significance, since we presume that the vast majority of humans have no immunity against the H5N1 virus.

As a private American citizen living overseas, what can I do today to help prepare myself and my family for possible bird flu pandemic?

Several simple measures can be taken now that will put you in a better state of readiness should such a pandemic occur. First of all, as suggested for reasons other than just bird flu, purchase enough non-perishable food, water, and personal supplies for your family to last 7 days. Store it in a place where you will not be tempted to break into it for everyday use; if you are asked to "shelter in place" or remain in quarantine, these supplies will be vital. Along with those supplies, buy several boxes of tissues (preferably a version with an "anti-viral layer") for use should someone come down with a respiratory virus. Also, purchase a personal thermometer or two. If you are living overseas due to work or education, contact your sponsor and find out what plans they may have regarding repatriation or evacuation; they may also have advice for you about procuring influenza immunization, avian influenza immunization (if and when available), anti-viral medication, and other suggested measures as they arise. Encourage regular hand-washing among family members; discourage touching the eyes/nose/mouth. Personal hygiene measures to minimize the impact of sneezes and coughs will go a long way in lessening your risk of catching many viruses, not just the bird flu virus.

Has a vaccine been developed against the virus yet?

Yes, clinical trials of a Vietnam strain of H5N1 human vaccine have demonstrated safety and efficacy. Further work is required to determine the proper dosing and potential boosting of adjuvants. The US Department of Health and Human Services (HHS) has placed an initial order for this vaccine and stands ready to order more once it is available. It remains to be seen, however, whether this vaccine will be effective against other H5N1 strains currently circulating, let alone against a pandemic strain that has undergone genetic change from the currently circulating virus. Once a new pandemic virus has emerged, large-scale production can begin of a more specific pandemic vaccine. Supplies sufficient to significantly impact a rolling pandemic may not be available for at least six months. Although the current global production capacity is inadequate for the expected vaccine needs, alternate and more efficient technologies for vaccine development are being vigorously pursued.

Will getting a flu shot this year afford any protection against a future pandemic avian influenza virus?

No. The annual influenza vaccine is targeted against specific influenza strains predicted from the previous year. Yearly seasonal flu shots are not even effective against next year's influenza strains, let alone against a future emerging pandemic strain. Of course medical authorities encourage everyone to have the seasonal vaccine every year to prevent flu.

What precautions should I take if I live or visit in an area affected by bird flu?

Avoid contact with live birds, chickens, ducks, turkeys and geese and their feces, feathers and pens if at all possible. Children, in particular, should be warned and precautions enforced. Pet birds should not be kept. If preparing poultry, cook it well done before eating. Avoid cross contamination of other foods by use of separate kitchen utensils and surfaces exposed to raw poultry. Wash hands with soap and water after any poultry contact. Be sure, if possible, that poultry does not live near your housing area. Do not transport live or dead poultry even if it appears to be healthy. Avoid poultry products from areas of infected birds. If you must travel to infected areas and work directly with infected birds, poultry or humans, hand washing and shoe and clothing cleaning should be an immediate priority. Be sure to wear gloves, a special N-95 mask, goggles and a disposable gown if you must be in contact with the birds/poultry in enclosed environments where aerosolization of the small virus particles may occur. Observe yourself for the development of any respiratory or gastrointestinal symptoms after the visit and check your temperature for a week afterwards, and contact a physician if you have any questions.