Q. Hello Dr. C. My name is Mary, I am 62 years old, and have been in good health in recent years. Three years ago, I came down with the flu and developed pneumonia. I had to be hospitalized for five days and was very ill for a time. I recovered completely but am now very nervous about all the information in the papers and on TV about a possible bird flu epidemic. Am I protected from this type of flu because of my prior history? Am I at higher risk than others to get bird flu? What should I do to protect myself from this and other types of flu? A. Mary, I can certainly understand your concerns given the rather scary things we have all heard about this new and worrisome viral illness. First and foremost, you are at a very, very low risk of getting bird flu. There have no cases of this type of flu reported in the United States. The disease is principally an illness of birds, infecting domestic fowl including ducks, chickens, and turkeys. The disease has infected tens of millions of birds worldwide and caused millions of deaths. The sheer magnitude of the number of birds infected in Cambodia, China, Indonesia, Japan, Laos, South Korea, Thailand, Vietnam, Russia, Turkey, and Mongolia has led to the mounting concerns because they know possibly that a virus of this type (strains of Influenza A) can infect humans. The specific bird flu viruses (H5, H7, and H9) have been found in twenty humans. At least six have died from the disease. The H5N1 form of the virus is the most common strain of bird flu virus. Most of the cases have occurred from contact with infected poultry or contaminated surfaces. Why then is there a concern about a bird flu epidemic? Viruses have a way of changing in such a way as to make person-to-person more likely. While that has not occurred yet, public health officials fear that it is only a matter of time before this type of transmission becomes a reality. In case of this development, the disease could spread very quickly among humans because we possess no immunity to variant strains of bird influenza A. In addition, there is as of now no commercially available vaccine and the virus is resistant to several anti-viral drugs. It is hoped that a vaccine against the H5N1 strain will be available in 12-18 months. As the flu season comes upon us, it is highly recommended that adults, particularly the elderly, those with chronic illnesses, and healthcare workers, take the currently available vaccine. This will reduce the risk of being infected with the human forms of several influenza viral strains. Since there have been no human cases of bird flu in the US, this vaccine preparation is not able to protect and is not designed to protect you from bird flu. To additionally protect yourself from the flu, it is advised that you avoid persons with obvious flu symptoms, stay home a few days rather than try to work if you come down with the flu, and wash your hands frequently during the day. If you were to travel to areas of the world where bird flu has been found in domestic fowl, you should avoid visiting poultry farms and open air markets where you may risk being exposed to the bird flu virus. I hope this summary will give you reassurance and guidance to keep you healthy during this flu season.

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