Yes, the virus that wreaked havoc on the poultry industry in two provinces is the AH5N6. And yes, it can be transmitted to humans. But that has not happened, yet, the Department of Health has confirmed.

As a precaution, all identified suspected cases - 30 from Pampanga and four from Nueva Ecija - have been placed in isolation to prevent possible human-to-human transmission of the infection.

These individuals suspected of being infected were those exposed during the culling operation that involved 258 people.

Of the number, 32 percent (38) were farm workers, while majority (68 percent) were from the Armed Forces, who assisted in the operations.

Suspected cases received oseltamivir, an antiviral.

In a press conference, Health Secretary Paulyn Ubial said 34 of those exposed exhibited symptoms but as of August 24, none was confirmed to have been infected.

Australian tests confirmed that H5N6 strain as the virus that affected San Luis, Pampanga initially that caused the bird flu outbreak, according to the Department of Agriculture.

The outbreak prompted culling of hundreds of thousands of birds to contain the flu. At the same time, deliveries have been barred to keep the infection from spreading. The towns of Jaen and San Isidro in Nueva Ecija soon reported similar suspected cases for both human and fowls.

The Department of Health stepped in response and deployed epidemiologic surveillance teams to monitor any human cases.

Specimens from suspected cases are sent to the Research Institute for Tropical Medicine (RITM) with a turn around time of 24 to 48 hours.

“We are working closely together with the DA to ensure that poultry and poultry by-products are safe for consumption,” Secretary Ubial said, and added that the department is actively disseminating public health advisories on the prevention of transmission of bird flu to the human population.

Safe to eat

To assuage public fears that poultry products were not safe for consumption, Secretary Ubial, Dr Socorro Lupisan, director of RITM, and veterinarian Jor Lagayn from the DA’s Bureau of Animal Industry ate fried chicken and boiled egg at a recent press conference.

It is safe to eat chicken and its by-products as long as these are cooked properly, the Health chief stressed.

President Rodrigo Duterte participated in another public event with Pampanga officials where they also partook of poultry products to demonstrate there was no harm in consuming these.

Assurances notwithstanding, the public was reminded to practice proper hygiene including regular hand washing after meals and using the toilet, as well as proper cooking to avoid eating raw chicken-based food.

In farms, personal protective equipment must be used at all times, while disinfection through bleach and water must be practiced. Further, workers must avoid using materials used in the arm while outside of farms within the premises.

“We are [also] advising them to avoid contact with (birds’) foecal matter,” Secretary Ubial said.

Symptomatic treatment

While the objective is to avoid even one human from being infected by the virus, health officials nonetheless want people to be aware of how infection will be managed.

“Our treatment is usually symptomatic, not curative as in ‘here’s the problem, here’s the cure’ but focus on alleviating the symptoms,” Secretary Ubial explained.

For instance, if a patient is dehydrated, health professionals will give electrolytes. If the patient needs respiratory support, they will put the patient on respirators.

Dr Socorro Lupisan of the Research Institute for Tropical Medicine on the Influenza A H5N6 virus: Transmission from bird to human is very, very rare. But if you get the disease, you will likely die.
Dr Socorro Lupisan of the Research Institute for Tropical Medicine on the Influenza A H5N6 virus: Transmission from bird to human is very, very rare. But if you get the disease, you will likely die.

“We also do antivirals to fight the virus, and weaken it until the patient can overcome it,” Secretary Ubial added.

Regarding the strain, Dr Luisan of the RITM noted that while the transmission from birds to humans is very low, the mortality rate is high in case of infection.

Secretary Ubial pointed out that the H5N6 strain was a fairly new strain affecting humans, that was only reported in 2014. She also clarified that there is no statement yet that this strain is worse than the H5N1.

Health response

The DOH has designated Jose B. Lingad Memorial Medical Center is San Fernando, Pampanga and the Paulino Garcia Memorial and Research medical Center in Cabanatuan as referral hospitals for suspect cases and specimen collection.

In Metro Manila, RITM, San Lazaro Hospital and the Lung Center of the Philippines are on heightened alert as referral hospitals.

“I call on everyone to be vigilant, follow the advisories issued by concerned government agencies and be equipped with the right information about the disease.”

As a precautionary measure for those who had direct contact with infected poultry and developed flu symptoms, these individuals are urged to report to the Regional Epidemiology and Surveillance Units if the DOH Regional Offices for testing. MIMS

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