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The frst peak in mortality is expected to medications used for anxiety purchase atrovent without a prescription be approximately 1 month after the peak in illness symptoms thyroid purchase atrovent 20 mcg line. Based on past pandemics treatment 5ths disease discount atrovent master card, when the pandemic virus arrives close to medicine zetia purchase generic atrovent on-line the usual annual infuenza season in temperate climates (November to April), the interval from the arrival of the virus to the height of the epidemic can be very short. This is based on analysis of the spread of past pandemics including the 1918 pandemic. The pandemic will last 12 to 18 months and more than one wave may occur within a 12 month period. Historical evidence suggests that in an entirely susceptible population the average number of secondary cases generated by a typical case of infuenza is 1. Interventions such as immunization, antiviral use, infection control measures and public health measures can affect this number. The population will be less susceptible overall if the new virus has circulated previously. For example, the H2N2 virus which caused the 1957 pandemic circulated widely up until 1968, therefore the population born prior to 1968 is expected to have some residual immunity to this particular strain. Background 5 fi the majority of the population (over 70%) will be infected over the course of the pandemic, but only 15-35% of the population will become clinically ill. The health care industry could expect to experience peak absenteeism at the top of this range the highest of all industries (see Table 1 below). Small work units in which employees engage in a high degree of social interaction could expect higher peak absenteeism than larger work units with less social interaction. They refect normal absenteeism, peak illness and caregiving absenteeism and a prudent planning buffer to account for heterogeneous effects across work units, possible workplace-avoidance absenteeism and possible absenteeism stemming from public health measures such as school closures. Estimates of peak illness absenteeism are based on evidence from past pandemics and consistent with a cumulative attack rate of 35%. Estimates of caregiving absenteeism are based on the historical relationship between sick leave and family leave. Industry variations in peak illness absenteeism are estimated using the historical relationship between total economy and individual industry absenteeism. This relationship is explained by industry variations in social density (the degree to which employees engage in social interaction as part of their work) and in the availability of leave. Below-average morbidity peaks could be expected in relatively low- social-density industries like goods and transportation and warehousing, while above-average 6 the Canadian Pandemic Infuenza Plan for the Health Sector peaks could be expected in many services industries, and, in particular, education, health care and social assistance. Nevertheless, it might be prudent for those engaged in business continuity planning to consider the possibility that some workplace-avoidance absenteeism might occur. Possible peak workplace-avoidance absenteeism in individual industries is estimated using a framework in which employees balance the perceived relative risk of the workplace with the cost of an absence. The perceived relative risk of the workplace is determined by the overall morbidity rate and whether an employee or his or her immediate family has already contracted the disease. If workplace-avoidance absenteeism occurs, it could be highest in education services, health care and social assistance and public administration, refecting a combination of high social density and leave availability in these industries. All British Columbia public schools and kindergartens were closed for a 2-week period in October 2005 as a result of a teachers strike. There is no evidence that this caused a reduction in hours worked in the rest of the British Columbia economy. The British Columbia experience suggests that many in this group had access to alternative arrangements that did not require them to miss work. While the experience with the British Columbia teachers strike suggests limited effects, pandemic-related school closings might require part of the affected workforce to be absent from work. Table 1 Daily Peak All-Cause Absenteeism by Industry in a Single City Prudent Planning Assumption (per cent) Normal Illness and (February) Care of Sick Prudence* Total All Industries 8. The use of this strategy will be limited to cases identifed early in the Pandemic Alert Period in Canada. During the Pandemic Period, this strategy will change to the nationally agreed upon strategy for the pandemic period. Estimates of health and economic impacts are important to guide public health policy decisions and to guiding pandemic planning in the health and emergency sectors. During normal infuenza epidemics that occur almost every winter in North America, an average of 10% to 25% of the population becomes ill resulting in an average of 4,000 deaths and 20,000 hospitalizations. During severe infuenza A epidemics, 30% to 50% of the population may become ill resulting in 6,000 to 8,000 deaths and 30,000 to 40,000 hospitalizations. The highest rates of infection and clinical illness occur in children but serious complications and death occur mainly in the elderly. During a pandemic, historic data shows that over 70% of a population may become infected with the novel virus and the age-specifc morbidity and mortality may be quite different from the annual epidemics. During the 1918-1919 pandemic, young adults had the highest mortality rates, with nearly half of the infuenza-related deaths occurring among persons 20 to 40 years of age. During the 1957-1958 and 1968-1969 pandemics in the United States, persons over 65 years of age accounted for 36% and 48% of infuenza-related deaths respectively. An estimate of the health and economic impacts of a pandemic in Canada was performed in 1999 using a model developed by Meltzer and colleagues, United States Centers for Disease Control and Prevention, Atlanta, Georgia, (available at. The assumptions in this model are based on American epidemiologic data on various mutually exclusive population health outcomes (death, hospitalization, outpatient treatment, and ill but with no formal care) for severe annual infuenza A epidemics and data from the most recent pandemics. For planning purposes we consider the estimates from this model to refect a mild to moderate scenario in terms of severity of illness. In the severe 8 the Canadian Pandemic Infuenza Plan for the Health Sector scenario it is estimated that 2% of clinical cases will die and 10% will require hospitalization for management of their illness. While these higher estimates, which are considered to be more consistent with the outcomes of the 1918-1919 pandemic have been used to describe potential impact of a severe pandemic, to date the emphasis has been on national planning for a pandemic of moderate severity. The Meltzer model does not include the potential impact of antivirals drugs, public health measures, or an effective vaccine. These estimates, therefore, may over-estimate the potential impact in Canada; they are provided here for planning purposes only and to raise awareness regarding potential health impacts. It is also important to recognize that as the age distribution of the Canadian population changes over time the potential health impacts will also vary. If the age- specifc mortality rates remain highest for the age groups on either end of the age spectrum with the elderly having a higher rate than young children. Based on the 1999 analysis using the Meltzer model, during a pandemic of mild to moderate severity an estimated 4. This proportion, which represents 15% to 35% of the population, does not include individuals who contract the virus and feel ill but continue their usual activities. It is important to note that since these are discrete outcomes the number of people hospitalized during the pandemic will include the entire hospitalized and recovered group and those that died in hospital which is expected to be a large proportion of the fatal cases. Moreover, these outcomes would occur as a result of relatively short (6-8 week) pandemic waves, highlighting the intense impact of pandemic infuenza compared to other illnesses. These numbers are estimates and do not take into account the differences in the health care systems, practice patterns and health care-seeking behaviour in Canada as compared to the United States or changes in the age-distribution within Canada since 1999; nonetheless, they provide a picture of the magnitude and potential impact of the next infuenza pandemic. Canadian estimates of resource use for patients with these health outcomes and Canadian resource unit costs were applied to provide an estimate of Canadian costs based on this American model. This estimate does not include other societal impacts such as those on trade and tourism. It is proposed that these levels be classifed as follows: 0 No activity observed in Canada, 1 Single case(s) observed in Canada. Localized and widespread activity have been combined in one level since the response activities associated with these two categories are not suffciently different to warrant distinguishing between them. The Pandemic Alert Period (Phases 3 to 5) now addresses the situation of evolution or adaptation of a novel animal infuenza virus with pandemic potential. It places greater emphasis on rapid intervention in an attempt to contain or delay the spread of a new infuenza virus subtype in humans. Although it is uncertain if such containment measures would be effective or feasible, it is still useful to consider potential early interventions for planning purposes. Note: the phase terminology used refects the epidemiological situation and the key objectives of the pandemic response but does not necessarily refect the level of activation of emergency operations within Canada. An infuenza detected in poultry Global: Phase 0, Level 0 virus subtype that has caused outside of Canada human infection may be present in animals located outside of Canada. If present in animals, the risk of human infection and/or disease is considered to be low. An infuenza detected in a poultry Global: Phase 0, Level 0 virus subtype that has caused human fock in Canada infection is present in animals in Canada but the risk of human infection and/or disease is considered to be low. However, an detected in poultry focks Global: Phase 0, Level 0 animal infuenza virus subtype that outside of Canada poses substantial risk to humans is circulating in animals located outside of Canada.
If we have a major event 97140 treatment code buy atrovent 20 mcg cheap, it would be prudent to medicine 4h2 pill 20 mcg atrovent with mastercard plan to 2 medications that help control bleeding purchase 20 mcg atrovent visa be self- reliant for about three months medications pregnancy purchase online atrovent. Get Your Will in Order Lets face it; you might not make it through a major pandemic. You may wish to consider buying a life insurance policy for your spouse and children. It would be prudent to select only the bluest of blue chip insurers, as the economic impact of a major pandemic will not be predictable. Also, if a pandemic happens and a lot of folks die, the cost of life insurance in the future will be higher. Get a Flu Shot and a Pneumovax Vaccination Even though the recipe for the 2005-6-flu season does not include protection against the avian flu, be sure to get one anyway. The reason for this is that many experts predict that the most likely time for the pandemic to begin is during the regular flu season. If you have the flu shot, it will protect you against the seasonal flu and prevent you from developing it during the same time that pandemic flu is circulating in your community. Since pandemic flu is so different antigenically than seasonal flu, this could happen and if it does, your chances of surviving the second infection are not very good especially if you are still weakened by the first one. You can protect yourself from pneumococcal pneumonia by getting a Pneumovax vaccination. Food Security Food supplies are likely to become limited in the event of a major pandemic. Storing a supply of canned meat and fish, dried beans, and rice is a prudent consideration. If food shipments are interrupted to the urban centers, it wont be very long before food is gone from the grocery shelves. If you have any doubt about this, think back to what happens when there is a threat of an ice or snowstorm. Despite the brown and black outs of 2003, not much has been done to improve the vulnerability of the power grid, the energy bill passage in July 2005 notwithstanding. The grid is literally interconnected such that what happens in one part has an impact in another. While the grid has some built-in automatic circuit breakers designed to isolate a power overload condition before it spreads and causes a widespread blackout. Power industry guidelines call for the plants to keep at least a 25-day coal stockpile to ensure uninterrupted power production in the event of a coal supply disruption. If a critical number of system engineers employed by the plant, the railroad, or the coalmine become ill, die, or are otherwise absent as a result of the pandemic; this would result in the shutting down of that plant if coal supplies run out. Nuclear plants could be shut down if the number of plant personnel fell below a predefined threshold for safe operation of the plant. Since plant and grid repair and restart crews would also be affected in a similar manner to the engineers, the time to bring the shutdown system back up will also be more prolonged than under normal conditions. One way to cope with this is by having a small number of key battery operated devices like lighting, flashlights, and a radio. Good selections of excellent battery chargers that use solar power for energy are now available. Water Service Public water systems employ a host of professional and operational staff that would be expected to experience illness at the average rate of the community as a whole. So, absenteeism could affect service reliability as would loss of power due to a brown or blackout as these utilities use electric pumps to pressurize their systems. If water service is interrupted for a time, remember to wait a while before drinking the water once service is restored because it may be contaminated with bacteria initially. You might also consider how you could divert rainwater from your downspouts for storage and drinking. Water collected from the roof will need to be purified before drinking because it could be contaminated. Landline telephone systems have an excellent record of remaining operational even during power failures. In the event of a widespread prolonged blackout, they will not be able to continue to function for very long. Even if there are no operative local or regional news broadcasts, someone somewhere will be on the air reporting the news and providing information of interest to flu survivors. It will be comforting having access to this information should a major pandemic come to pass. Find a Rural Refuge During the Spanish Flu pandemic being away from centers of population was safer but even small communities were hit hard so it was no guarantee. There was some flu in just about every community so living in a rural area is not going to be enough. Reverse quarantines, where the community kept outsiders from entering and bringing the fly with them did work occasionally in 1918. Some small communities might try this approach but for there to be any hope of success, it will need to be very strict and be started at the beginning of a pandemic or it will not work. One lesson from major epidemics with high death rates is that these events almost always lead to civil disorder. In the event of a major pandemic, it would be wise to ride out the storm away from cities or other major population centers. It is probable that food and water will be easier to obtain in the country and people less likely to be hostile compared with what can be imagined to occur in the major metropolitan areas under similar circumstances. If you plan to leave the city for the country, you may want to do so early in the pandemic. In the event that your city has the misfortune to be one of the first areas affected by the pandemic and the federal government elects to impose quarantines as a means of containing the spread of the pandemic (a strategy sure to fail), then you might find the road out of town blocked if you wait too long before decamping. It is likely that the healthcare system will be the first societal institution to collapse under the strain with recovery not expected until after the return of other essential utilities and services. While it is true that the first victims of the flu will get excellent treatment including hospitalization and even ventilators if required. In order to reduce healthcare costs, hospitals have significantly reduced the number of available patient beds and nursing staff. In fact it is a common occurrence today for hospitals to be on bypass when it comes to accepting critically ill patients in their emergency rooms via ambulance. Once the pandemic settles in, the hospitals will be full including waiting rooms and hallways. So, in my opinion, it would be unwise to remain in the city so you can take advantage of the healthcare system in case you become ill. The Flu Survival Kit Under the circumstances, having a supply of over-the-counter products and select prescription drugs on hand useful for the home treatment of cases of severe influenza is prudent. For instance, simple household items that will be very useful include ibuprofen, acetaminophen, table sugar, and table salt. It will also be helpful to have on hand, and know how to use a thermometer, an automatic blood pressure and pulse monitor. In the following discussion I will provide you with advice on how these simple items can be used very effectively for the home care of flu sufferers. In order to obtain the prescription drugs needed for the home care of the flu, please call the office at 404. The kit includes a list of useful items included in this monograph and a prescription in your name with medication for treatment of one person. Simple Medical Skills Required Caregivers need to learn how to obtain vital signs like pulse, blood pressure, temperature and respiratory rate. It will also be very useful to be able to use an automated blood pressure monitor to measure blood pressure. If you need help learning how to do these, my staff will be happy to help you develop these simple skills. Prescription products for home treatment of one person with severe influenza 11 Tamiflu 75mg # 20: take two tablets daily for 5 (or 10) days for flu Promethazine (Phenergan) 25mg tablets # 60: take fi to 1 tablet every 4 hrs as needed for nausea Hydrocodone with acetaminophen (Lortab-5) # 60 (5mg/325mg): fi to 1 tablet every 4 hrs as needed for cough or pain Diazepam (Valium) 5mg # 60: fi to 1 tablet twice daily as needed for anxiety, muscle aches, or insomnia Symptoms of Influenza the influenza virus usually enters the body through the respiratory tract but can also gain access through the intestinal tract. The virus causes a variety of symptoms with fever, sore throat, cough, runny nose and general aches and pains as the leading ones. In addition to these principal symptoms many also experience headache, nausea, abdominal cramps and diarrhea. In fact, this scenario is what looks to be the most likely time for the pandemic to begin. The best guess for the start of the pandemic at this point is between December 2005 and April 2006. There are several ways to tell the difference between the flu and less severe illnesses.
Job modifcation treatment 4 ulcer cheap atrovent 20mcg amex, extensive physical therapy symptoms 3dp5dt cheap atrovent 20 mcg with visa, and multiple cortisone shots have failed to symptoms of diabetes purchase atrovent 20mcg provide much relief medicine 369 discount atrovent online master card. According to the Joint Commission patient safety guidelines for abbreviations, which order is written appropriatelyfi The long-term consequences of high bladder outlet resistance in children with myelomeningocele include A. A 30-year-old man presents with low back, knee, and ankle pain of two months duration. Which type of aphasia is characterized by nonfuency, an intact ability to repeat, and intact comprehensionfi Which class of medication is the frst choice for the treatment of Raynaud phenomenonfi After Alzheimer disease, the most frequent dementia in the elderly is secondary to A. The increase in peristalsis in the large and small intestines in response to a meal is called the A. Prevalence of impairments, disabilities, handicaps and quality of life in the general population: a review of recent literature. Motor cortex plasticity during costraint- induced movement therapy in stroke patients. Test-enhanced learning Try breaking up study Forgetting is a After using repeated research has shown sessions into small chunks surprisingly big part of testing and studying that rather than reading and review just a little learning new information. Spread out learning something this helps connect information retention these shorter sessions new, you retain a greater your new knowledge and retreival. Its over several months to percentage of new with established especially efective if get all the clinical topic knowlege. Continue knowledge and you study from test areas covered in repeating these self-tests has been shown to questions provided small bites. References: Repeated testing produces superior transfer of learning relative to repeated studying. Proceedings of the National Academy of Sciences of the United States of America, 2012, Mar. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author, except in the case of brief quotations embodied in critical reviews and certain other non- commercial uses permitted by copyright law. Instead, students read them in advance and during class apply their content to professional practice. The lectures are introductory for a student of speech-language pathology who is learning to provide health care for those who stutter. That being said, perhaps they will be of interest to a broader audience within the speech-language pathology discipline. This text is freely downloadable from the website of the Australian Stuttering Research Centre at sydney. The year and month of the last update appears on the cover and at the top right of alternate pages. The writing of this material would not have been possible without the bristling intellectual climate in which I have thrived for past decades. Many have influenced the present work, but most directly I am indebted to Ann Packman, Sue OBrian, Ross Menzies, and Robyn Lowe. Apart from those broad influences, however, I alone am responsible for the content and structure of these lectures. They constitute a personal view about the course content that students of speech-language pathology need during professional preparation to provide health care for stuttering. That personal view includes judgements about the topics and research publications that students need to be aware of, and judgements about those that are beyond the scope of an introductory course. Mark Onslow Australian Stuttering Research Centre the University of Sydney April 2018 Citations added to this Edition the December 2017 edition has been revised to include the following publications. Transcranial direct current stimulation over left inferior frontal cortex improves speech fluency in adults who stutter. White matter tractography of the neural network for speech-motor control in children who stutter. Retrospective experiences of cyberbullying and emotional outcomes on young adults who stutter. Executive function and childhood stuttering: Parent ratings and evidence from a behavioral task. Comparison of percentage of syllables stuttered with parent-reported severity ratings as a primary outcome measure in clinical trials of early stuttering treatment. Potential confusion 1 According to the American Speech-Language-Hearing Association the disorder is plagued with inconsistent, confusing terminology. These terms sometimes are used to refer to stuttering: dysfluency, disfluency, and nonfluency. Direct and person-first terms Historically, someone who has the disorder was referred to directly as a stutterer, and those with the disorder as stutterers. Person-first terminology is a different and more recent approach, intended to avoid any negative connotation from labelling someone with a disorder. Accordingly, preferred terms would be a person who stutters, someone who stutters, or those who stutter. Making a choice When making a choice about how to refer to those who have the disorder, clinicians may be influenced by the views of clients. A useful rule of thumb is to err on the side of caution, and to use person first terms if there is any uncertainty. When writing a formal report about clients, clinicians may prefer person-first terms. Some scientific speech-language pathology journals require the use of person-first terms for stuttering. Potential limitations of person-first terms For all its potential benefits, there are potential limitations with person-first terms for stuttering. Two 2,3 research publications raise doubt about whether person-first terminology for stuttering alters negative perceptions about the disorder. It is also the case that person-first terms invoke present tense, and this can cause awkward expression when writing with past tense. For example, the tense in neither of these wordings is completely satisfactory: the research participants were people who stutter and the 4 research participants were people who stuttered. Additionally, it might be argued that the semantics of person-first terminology is misleading about the nature of the disorder. It might imply that stuttering is something that speakers do when speaking, rather than something that happens to them when they speak. Stuttering and stuttering behaviour As well as being a term to refer to the disorder, stuttering can be used to refer to someones speech being affected by it. For example, she was stuttering a lot yesterday, and stuttering on the telephone is a problem for him. The term behaviour to describe stuttering is a little different from the everyday use of the term. The only way to know that people are angry is for them to tell you, or to infer that they are angry from their behaviour. Researchers sometimes use the term stuttering behaviour in scientific publications. For example, the observers were instructed to push a button for every stuttering behaviour, and the stuttering behaviours reportedly began suddenly. It is possible for researchers to use sophisticated instruments to measure stuttering behaviour. For example, kinematic (movement) measures of lip variability during speech have been shown to 5 6 distinguish children and adults who stutter from those who dont. However, clinicians use more convenient verbal descriptions of stuttering behavior, as described shortly. Dysfluency and dysfluent Dysfluency and its adjective dysfluent are often used to describe when people stutter. For example, his speech has been dysfluent for the past week, and dysfluency in the workplace is a problem for her.
Antigenic shift and drift in influenza A viruses Influenza A viruses are very diverse symptoms constipation order cheapest atrovent and atrovent, and two viruses that share a subtype may be only distantly related medicine 831 purchase generic atrovent line. Some variability results from the gradual accumulation of mutations administering medications 7th edition ebook purchase atrovent 20 mcg mastercard, a process called antigenic drift medicine 751 m buy atrovent 20 mcg with visa. More rapid changes can occur when two different influenza viruses infect the same cell. In this situation, gene segments from both viruses may be packaged into a single, novel virion, a process called genetic reassortment. Genetic reassortment can occur between any two influenza A viruses, whether they are adapted to circulate in birds or mammals. Antigenic shifts may be sufficient for the reassortant virus to completely evade existing immunity. After a subtype has circulated in a species for a while, genetic reassortments and antigenic drift can produce numerous viral variants, which may differ in their virulence for birds and/or mammals. Infections are particularly common among members of the order Anseriformes (waterfowl, such as ducks, geese and swans) and two families within the order Charadriiformes, the Laridae (gulls and terns) and Scolopacidae (shorebirds). Whether wild birds play any found in wild birds, although a few subtypes have been role in spreading this virus is uncertain. Viruses that have adapted to Other avian influenza viruses reported in poultry rarely become re-established in wild birds, although mammals they may infect them transiently. Many different viruses In addition to H5N1 and H9N2 viruses, diverse can cause disease in chickens and turkeys, but three viral subtypes. In addition to domesticated birds, these viruses H3N8 virus affected horses in China for a short time. Cats have been found in a large number of wild or captive avian and dogs can also be infected experimentally with some species. To date, studies have investigated wild animals; however, antibodies they have been found in pigs, housecats, several species of to a few subtypes have been found in raccoons, and large felids in zoos, dogs, donkeys, stone martens (Mustela experimental infections were established in raccoons, skunks and wild mice (Mus musculus). Serological Although clinical cases are usually uncommon in evidence of infection or exposure has been reported in people, they have been caused by multiple avian influenza horses and raccoons. Other rodents, cynomolgus macaques (Macaca fascicularis) and subtypes that have caused illnesses in people include H9N2, rabbits. Cattle could be experimentally infected with viruses H6N1 and various H7 and H10 viruses. These viruses have been found occasionally in viral lineages circulate in North America and Eurasia, pigs and dogs. Serological evidence of infection was although reassortment occurs between these lineages at detected in performing macaques in Bangladesh, and in some locations. The H9N2 viruses Zoonotic H7N9 avian influenza viruses in China circulating in poultry are currently limited to Eurasia. Evidence of infection has also been reported in a except as imported cases in travelers. Person-to-person transmission of these H5N1 Asian or Middle Eastern countries, with outbreaks viruses seems to be rare, and appears to require close, occurring at times in other parts of the Eastern Hemisphere. Fecal-oral transmission is the infected people did not seem to transmit this virus to others. Survival of influenza viruses in the environment Respiratory transmission is thought to be unimportant in most wild birds, but it can occur with a few viruses or in Avian influenza viruses can remain viable for a time in some hosts, particularly those that live on land. Once an in distilled water or sterilized environmental water, some avian influenza virus has entered a poultry flock, it can laboratory experiments suggest that the presence of natural spread on the farm by both the fecaloral route and aerosols, microbial flora can greatly reduce their survival period. At colder temperatures (4C; 39F), Fomites can be important in transmission, and flies may act virus survival in feces ranged from less than 4 days to at as mechanical vectors. When protected under certain conditions, airborne spread might be possible from sunlight, virus persistence on various surfaces, or in between farms. Two studies suggested that virus avian influenza viruses during close contact with birds or survival might be particularly prolonged on feathers. In their tissues, although indirect contact via fomites or other poultry meat (pH 7), a virus survived for 6 months at 4C. Most viruses are Environmental sampling in Cambodia suggested that avian probably acquired via the respiratory tract, but the eye may influenza viruses might not survive long in tropical also act as an entry point. Infected animals and people shed avian influenza viruses Disinfection mainly in respiratory secretions. Fecal shedding has been Influenza A viruses are susceptible to a wide variety of reported occasionally, but its significance is still uncertain. Transplacental transmission may be (glutaraldehyde, formaldehyde), phenols, acids, povidone- possible with certain viruses. Influenza A viruses can also be viruses) that can spread beyond the respiratory tract. These viruses were transmitted the incubation period in poultry can be a few hours to a few days in individual birds, and up to 2 weeks in the between zoo tigers in one outbreak, and experimentally Last Updated: September 2014 2006-2014 page 3 of 24 Avian Influenza flock. The incubation period for avian influenza viruses in have been reports of sporadic deaths and rare outbreaks. Illnesses exacerbated by factors such with high mortality) to diarrhea, respiratory distress and/or as concurrent infections or young age can be more severe. One group of infected housecats elevated mortality in guinea fowl infected with an H7N1 remained asymptomatic, but a few other cats were found virus. Conjunctivitis and fatal respiratory High mortality has been seen in young ostriches during signs were described in experimentally infected cats. Experimental infections Decreased feed and water intake, with other nonspecific in pigs, as well as reports of infected herds, suggest that systemic, respiratory and/ or neurological signs. An influenza virus was also isolated from a Such viruses may have been isolated when they were diseased pilot whale with nonspecific signs, although evolving to become more virulent. A small number of birds may have signs of acute renal failure and visceral urate deposition. However, some lesions seen in chickens and There is no specific treatment for influenza virus turkeys, such as cyanosis and hemorrhagic lesions in infections in animals. Disease reporting Avian H5N1 influenza viruses in mammals A quick response is vital for containing avian influenza outbreaks. Veterinarians who encounter or included pulmonary consolidation and/or edema, suspect a reportable disease should follow their country- pneumonia; hemorrhagic lesions in various internal specific guidelines for informing the proper authorities organs; and in some cases, other lesions such as multifocal (state or federal veterinary authorities in the U. Pulmonary lesions including interstitial Prevention pneumonia have been noted in some experimentally the risk of introducing a virus to poultry or other birds infected pigs, while other pigs had mild to minimal gross can be reduced by good biosecurity and hygiene, which lesions. Overall prevent reassortment between human and avian influenza susceptibility to illness may differ between species. Experimentally infected cats became severely In different countries, vaccines may be used routinely ill, but dogs had only mild signs except when the to protect poultry flocks, as an adjunct control measure inoculation method bypassed normal upper respiratory during an outbreak, or to protect valuable species such as defense mechanisms. There is also serological evidence of zoo birds from highly virulent viruses such as H5N1. H10N8) and the isolation of H9N2 viruses from both sick Thus, vaccination can mask infections if good surveillance and healthy dogs in China raise questions about the effects programs. Insect and rodent viruses might be as long as 8-17 days, but most cases ] control, disposal of contaminated material, and thorough become apparent within 5 days. Keeping Clinical Signs susceptible animals indoors may be helpful in areas where outbreaks are occurring. Lower respiratory signs tend backyard flocks, live poultry markets and similar sources. These cases were usually in chicken and turkey flocks, with cumulative morbidity mild and very similar to human influenza, with upper and mortality rates that may approach 90-100%. While respiratory signs, fever, and in some cases, gastrointestinal similar high morbidity and mortality rates can sometimes be signs (mainly vomiting and abdominal pain) and mild seen in other birds, susceptibility may vary greatly, and dehydration. All of these patients, including a 3-month-old certain species such as waterfowl tend not to be severely infant with acute lymphoblastic lymphoma, made an affected. Acute, influenza-like upper respiratory illness even in waterfowl, and the introduction of these signs were also reported in two adults, a 35-year-old viruses may be heralded by unusual deaths among wild woman and a 75-year-old man. Currently, surveillance suggests that carriage of in a 47-year-old woman, who had chronic graft vs. Last Updated: September 2014 2006-2014 page 6 of 24 Avian Influenza Although she recovered, she required long term oxygen virus in China, even when adults with severe illnesses supplementation. Diarrhea Commercial rapid diagnostic test kits used to detect and vomiting were sometimes reported, but conjunctivitis seasonal human influenza virus infections may not was uncommon, and most patients did not have nasal recognize avian influenza viruses. A few uncomplicated cases were characterized by mild Treatment upper respiratory signs or fever alone, especially in Treatment for avian influenza may vary, depending on children. At least one asymptomatic infection has been the severity of the case, and can include various drugs, reported in an adult.
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