Risk of Bird Flu for International TravelersEn Español (Spanish Version)
The first outbreak of the
(H5N1) in humans occurred in 1997. Eighteen people in Hong Kong were infected; six died. In an effort to stop the spread of the virus, the Chinese government responded by destroying the poultry population—1.5 million birds. Since 1997, the bird flu has infected people in over 15 countries in Asia, Europe, the Near East, the Pacific, and Africa, and it remains a highly contagious and deadly virus among birds. There is a fear that the bird flu could mutate and spread more easily to humans. The fear of a pandemic is further heightened by the fact that migratory birds can continue to spread the virus to other countries.
What should you do if you have plans to travel abroad? The first step is to find out the facts.
The bird flu is caused by the type A strain of the influenza virus. In the wild, influenza A is easily spread among birds, but they usually do not get sick from the virus. Domestic birds, like chickens, are more susceptible, though. Among poultry populations, a highly dangerous form of the flu can cause severe sickness and death within 48 hours.
While the bird flu has infected tens of millions of poultry, H5N1 remains rare among humans.
Those at the greatest risk of infection are people who have direct contact with sick or dead birds or with surfaces contaminated by the virus. While there is the potential for the virus to mutate and become more contagious, at this time, the bird flu does not spread easily from birds to people, nor does it spread easily between people.
Symptoms can range from mild to severe. A person with the virus may have an eye infection, flu-like symptoms (eg, fever, chills,
), and gastrointestinal problems (
, vomiting). In severe cases, H5N1 can quickly progress to respiratory distress,
, organ failure, and death.
The H5N1 is resistant to two commonly used antiviral medications,
(Flumadine). Because of this, the WHO and the US Centers for Disease Control and Prevention (CDC) recommends
oseltamivir for the treatment and prevention of H5N1. However, there have been cases where the virus is resistant to this medication.
In April 2007, the US Food and Drug Administration (FDA) approved the first US vaccine to protect against a strain of the virus. Not available to the general public, the vaccine was purchased by the government for the Strategic National Stockpile. Health officials will distribute the vaccine if a crisis arises.
If you are traveling to a country that has reported cases of the bird flu in the past, you do not necessarily need to change your plans. The CDC does recommend that you get the latest information on your destination and continue to check for updates. In the event of an outbreak, the local government, in an effort to contain the virus, is likely to place restrictions on where people can go. You can be prepared by having a supply of necessities (eg, canned food, water, medicine) and knowing where to go for medical care.
To reduce your chance of being infected with the bird flu, follow these guidelines from the CDC and the WHO:
- Avoid direct or indirect contact with wild and domestic birds, including feathers, feces, undercooked meat and egg products.
- Make sure all poultry foods—including eggs—are thoroughly cooked. The heat from cooking destroys the bird flu virus.
- Do not consume blood from poultry (eg, duck blood).
- Beware of cross contamination. Raw poultry juices should never be near food preparation areas. Do not use the same utensils, cutting boards, or dishes for raw and cooked foods, and keep these types of food separate. Thoroughly clean any items that come into contact with poultry.
- Wash your hands frequently or use an alcohol-based instant hand sanitizer.
- Do not visit poultry farms or live food markets where poultry is sold.
Keep in mind that you are more at risk if you handle poultry, such as:
- Plucking birds
- Preparing birds for cooking
- Handling fighting cocks
- Petting birds
In addition to these tips, make sure that all of your immunizations are up-to-date before you travel. Keep in mind, though, that none of these immunizations will protect your from bird flu. Also, research what medical facilities exist and what resources are available. The US Department of State (
) has a list of all of the US embassies; from there, you can find information on foreign hospitals and doctors.
If you do become ill while abroad, contact the US consulate in the country you are in and an officer can help you locate medical care. In addition, follow these tips:
Find out what your health insurance will cover when you are traveling. Keep in mind that
does not pay for coverage outside of the US.
- If you have a health condition, obtain a letter from your doctor that explains your condition and your medicine.
- Always carry your health insurance card and any other identification or proof of insurance coverage.
- Keep identification information with you at all times while traveling. Make sure pertinent health information is included.
Centers for Disease Control and Prevention (CDC)
World Health Organization (WHO)
Public Health Agency of Canada
Avian influenza. United States Army Public Health Command website. Available at: http://phc.amedd.army.mil/topics/discond/inf/Pages/AvianFlu.aspx. Accessed July 20, 2011.
Avian influenza. EBSCO DynaMed website. Available at:
. Updated July 2009. Accessed July 27, 2009.
Avian influenza. EBSCO Health Library website. Available at:
. Updated January 2009. Accessed December 1, 2008.
Avian influenza A virus infections of humans. Centers for Disease Control and Prevention website. Available at:
. Updated May 23, 2008. Accessed July 20, 2011.
Avian influenza. World Health Organization website. Available at:
http://www.who.int/mediacentre/factsheets/avian_influenza/en/. Accessed July 20, 2011.
Avian flu travel information. Centers for Disease Control and Prevention website. Available at:
. Updated July 2008. Accessed July 27, 2009.
BioSante Pharmaceuticals reports 100% protection from H1N1 challenge when using BioVant adjuvanted vaccine. Business Wire website. Available at:
. Published August 17, 2009. Accessed August 20, 2009.
Current concepts: avian influenza A (H5N1) infection in humans.
N Engl J Med.
FDA approves first U.S. vaccine for humans against the avian influenza virus H5N1. Food and Drug Administration website. Available at:
. Published April 17, 2007. Accessed July 27, 2009.
Guidelines and recommendations: interim guidance about avian influenza (H5N1) for U.S. citizens living abroad. Centers for Disease Control and Prevention website. Available at:
. Updated November 2008. Accessed July 27, 2009.
Human infection with avian influenza A (H5N1) virus: advice for travelers. Centers for Disease Control and Prevention website. Available at:
. Updated November 2008. Accessed July 27, 2009.
Key facts about avian influenza (bird flu) and avian influenza A (H5N1) virus. Centers for Disease Control and Prevention website. Available at:
. Updated May 2008. Accessed July 27, 2009.
Novartis MF59-adjuvanted vaccine rapidly induces protective antibody levels against diverse strains of avian flu. Norvartis website. Available at:
. Published September 19, 2009. Accessed August 20, 2009.
Novartis investigational adjuvanted (MF59) pre-pandemic avian influenza vaccine Aflunov shows long lasting, broadly cross protective immune response. Norvartis website. Available at:
. Published April 30, 2009. Accessed August 20, 2009.
Questions and answers about avian influenza (bird flu) and avian influenza A (H5N1) virus. Centers for Disease Control and Prevention website. Available at:
http://www.cdc.gov/flu/avian/gen-info/qa.htm. Updated May 2008. Accessed July 20, 2011.
Last Reviewed July 2011