The New England Journal of Medicine has an article on the state of play with Avian Influenza (H5N1).
The report begins: “The unprecedented epizootic of avian influenza A (H5N1) viruses among birds continues to cause human disease with high mortality and to pose the threat of a pandemic.”
It is quite a technical (at least for me) report, but in a nutshell:
- Despite widespread exposures to poultry infected with avian influenza A (H5N1) viruses, influenza A (H5N1) disease in humans remains very rare, with 340 cases as of December 14, 2007.
- Influenza A/H5N1 is now well established amongst the poultry of large parts of Asia, Africa and the Middle East.
- 90% of infected patients are 40 years or younger with the highest incidence occurring between 10 & 19 years of age.
Most of those affected were previously healthy.
Of the 6 pregnant women who were affected, 4 died, with the survivors suffering spontaneous abortions.
- Most transmission of the virus to humans originates from birds… although human-to-human transmission has probably occurred during very close, unprotected contact with a severely ill patient.
Important nursing implications are that respiratory secretions and all bodily fluids, including feces, from an infected patient should be considered potentially infectious.
- The incubation period appears to be between 2 and 7 days.
Patients typically develop a severe pneumonia that progresses rapidly to an acute respiratory distress syndrome (ARDS). If a patient is going to die, time from onset of the disease to death is around 10 days.
- Rapid diagnostic tests to see if a patient has “influenza” have been found to be insensitive and produce many false negatives.
- The overall mortality rate is around 61%.
Most hopeful scenario; animal to human transmission remains rare.
Worst case scenario; hospitals overwhelmed with really sick, really infectious patients requiring high and complex levels of care. Screw up and catch it….61% kill rate.
Be afraid nurses. Be very afraid.