Us State Dept/cdc Notice

[sbk]

The following information is from the

Centers for Disease Control and Prevention (CDC).

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GUIDELINES AND RECOMMENDATIONS

Interim Guidance about Avian Influenza for Americans Living Abroad

(Released February 18, 2004)

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Since December 2003, outbreaks of highly pathogenic avian

influenza - mostly influenza A (H5N1) - among chickens and ducks

have been reported in several countries in Asia. Human cases also

have been reported. No evidence for sustained person-to-person

transmission of influenza A (H5N1) has been identified; however,

influenza A viruses can change rapidly, and therefore the situation

in these countries is being monitored carefully. The Centers for

Disease Control and Prevention (CDC), the World Health Organization

(WHO), and national authorities in Asia are working to assess the

outbreak, provide support, and assist with control efforts.

At this time, WHO and CDC do not recommend that the general public

avoid travel to countries with reported avian flu cases in birds

and humans. CDC will provide updates on its avian flu website

CDC and Traveler's Health

website (travel site) as further information becomes

available. Information also is available on the WHO website

(WHO).

BACKGROUND

Avian influenza viruses usually do not infect humans. The ability

of avian viruses to spread from person to person appears limited.

Rare person-to-person infection was noted in the influenza A (H5N1)

outbreak in Hong Kong in 1997 and in the Netherlands in 2003,

but these secondary cases did not result in sustained chains of

transmission or communitywide outbreaks. These previous experiences

with avian influenza viruses suggest that limited person-to-person

transmission of the current H5N1 viruses could occur.

Infected birds shed virus in saliva, nasal secretions and feces.

Avian influenza viruses spread among susceptible birds when they

have contact with contaminated nasal, respiratory, and fecal

material from infected birds; however, fecal-to-oral transmission

is the most common mode of spread.

All influenza viruses can change, and therefore it is possible

that an avian influenza virus could change so that it could infect

humans and spread easily from person to person. Because these

viruses do not commonly infect humans, there is little or no

immune protection against them in the human population.

RECOMMENDATIONS FOR AMERICANS LIVING ABROAD

The following recommendations are directed to embassies and

Americans living abroad in areas where avian influenza cases

have been reported. These recommendations are based on experience

to date and may be revised as more information becomes available.

Embassies should recommend the following precautions to

U.S. expatriates living in an area with avian influenza:

-- As with other infectious illnesses, one of the most important and

appropriate preventive practices is careful and frequent

hand washing. Cleaning your hands often using either soap and water

or waterless, alcohol-based hand rubs removes potentially infectious

materials from your skin and helps prevent disease transmission.

-- To minimize the possibility of infection, observe precautions to

safeguard your health. This includes avoiding settings where avian

influenza is most likely to be transmitted, such as bird markets

and poultry yards.

-- Influenza viruses are destroyed by adequate heating; therefore,

as a precaution, all foods from poultry, including eggs, should be

thoroughly cooked.

-- CDC does not recommend the routine use of masks or other

personal protective equipment while in public areas.

At this time, there is no U.S. Department of State (DOS) travel

warning related to influenza. For a list of DOS travel warnings,

see the DOS website (http://travel.state.gov/travel_warnings.html).

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Further information about avian flu may be obtained

from the CDC website at www.cdc.gov.

The Department of State continues to monitor security

conditions overseas and, as always, will promptly

disseminate information affecting the safety of Americans

abroad through its consular information program. These

documents are available on the Department's Internet website

at www.travel.state.gov. The Department's website contains

further information about avian flu, as well as a link to the

CDC website.

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