University of California Education Abroad Program

Pandemic Planning

Updated May 2007

EAP has been closely monitoring Avian Influenza A (H5N1), or "bird flu," since late 2003 through CDC (U.S. Centers for Disease Control and Prevention), the WHO (World Health Organization), the U.S. Department of State, and worldwide health agencies, in addition to host university, UC Study Centers, and host country resources. We also work closely with the University of California Student Health Services and the Office of the President to provide current information to students, as conditions require.

All EAP programs are proceeding normally, with the expectation that the current Avian Flu situation will remain contained. Since January 2004, outbreaks of H5N1 (Avian Flu or bird flu) in animals have been confirmed in Africa, Asia, and Europe. Avian Flu among humans, who were in close and direct contact with sick or dying animals, has been confirmed in Azerbaijan, Cambodia, China, Djibouti, Egypt, Indonesia, Iraq, Lao People’s Democratic Republic, Nigeria, Thailand, Turkey and Vietnam.

Currently, it is not known if Avian Flu, or any other infectious disease, will become a significant world health threat. CDC remains in communication with WHO and local health agencies and ministries and monitors the disease worldwide. According to the World Health Organization, while the number of outbreaks in birds continues to increase, the transmission of H5N1 to humans remains sporadic and there is currently no evidence of efficient human-to-human transmission. At present, the CDC has not recommended that the general public avoid travel to any of the countries affected by H5N1.

Please do not hesitate to contact the EAP Universitywide Office, if you have any questions or concerns.

Fact Sheet:

The U.S. Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) have not recommended that the general public avoid travel to any of the countries affected by H5N1. The following information is intended to clarify the threat posed to humans by avian flu (H5N1) in Asia.

EAP has been closely monitoring avian flu since February 2003.
Avian influenza viruses do not normally infect species other than birds and pigs. The first documented infection of humans with H5N1 happened in Hong Kong in 1997 but did not appear again until early 2003. Then, toward the end of 2003, H5N1 suddenly became highly and widely visible.
Outbreaks of H5N1 virus in poultry and wild birds have caused widespread public concern due to fears that a pandemic may happen as widely reported by the media. Part of the concern is the mistaken assumption that the geographical spread of the H5N1 virus in bird populations signals the start of an influenza pandemic. All countries are working actively to clarify that the spread of avian influenza in birds does not constitute an influenza pandemic in humans. Even though, in some few cases, limited human-to-human transmission within the family cannot be ruled out the majority of confirmed human Avian Flu cases were in direct and close contact with infected poultry, their blood or surfaces and objects contaminated by their feces or saliva. Exposure is considered most likely during slaughter, de-feathering, butchering, and preparation of poultry for cooking. There is no evidence that properly cooked poultry or eggs can be a source of infection.
Compared to the large number of birds affected, only a small number of human cases have occurred. It is not presently understood why some people, and not others, become infected following similar exposures.
Suspicions that sustained human-to-human transmission may have taken place will occur when cases are observed that happen close together in time and place among persons, such as family members or health care workers, known to have had close contact with an infected person. These clusters have been detected on some occasions during the 2004 outbreaks. All such instances involved family members. To date, no H5N1 cases have been detected in health care workers despite many instances of close, unprotected contact with severely ill patients.
The most vulnerable population has turned out to be rural subsistence farmers and their families, and these people constitute the true risk group.
There currently is no commercially available vaccine to protect humans against H5N1 virus that is being seen in Asia and Europe. However, vaccine development efforts are taking place. The seasonal flu vaccine does not protect people from the deadly H5N1 virus, but health experts hope that fewer flu cases would reduce the chance of human flu mixing with H5N1 to produce a pandemic strain.
WHO works closely with ministries of health and various public health organizations, which include CDC, to support surveillance.
Out of the six preparedness phases described by WHO, we are now in phase three. Phase six is full pandemic. In phase three a virus new to humans is causing infections, but that virus does not spread easily among humans.
Countries around the world have been developing plans on how to deal with an outbreak of bird flu and the possibility of it spreading between humans. A global meeting opened today in Geneva to develop a common approach on avian influenza and a possible human pandemic influenza.
Travelers to areas affected by avian influenza in birds are not considered to be at elevated risk of infection unless direct and un-protected exposure to infected birds (including feathers, faeces and under-cooked meat and egg products) occurs.
WHO and CDC continue to recommend that travelers to affected areas should avoid contact with live animal markets and poultry farms, and any free-ranging or caged poultry. Large amounts of the virus are known to be excreted in the droppings from infected birds.

Information from the World Health Organization

Advice for Travelers

WHO and CDC continue to recommend that travelers to areas experiencing outbreaks of highly pathogenic H5N1 in poultry should avoid contact with live animal markets and poultry farms. Large amounts of the virus are known to be excreted in the droppings from infected birds. Populations in affected countries are advised to avoid contact with dead migratory birds or wild birds showing signs of disease.

Direct contact with infected poultry, or surfaces and objects contaminated by their droppings, is considered the main route of human infection. Exposure risk is considered highest during slaughter, defeathering, butchering, and preparation of poultry for cooking. There is no evidence that properly cooked poultry or poultry products can be a source of infection.

U.S. Centers for Disease Control (CDC)

The CDC Travel Health Precautions outline specific measures for travelers to take before, during, and after travel. Suggested actions include:

Before any international travel to an area affected by H5N1 avian influenza:

Visit CDC's Travelers’ Health in Southeast Asia to educate yourself and others who may be traveling with you about any disease risks and CDC health recommendations for international travel in areas you plan to visit. For a list of affected areas and other information about avian influenza, see the CDC website.
Be sure you are up to date with all your vaccinations, and see your doctor or health-care provider, ideally 4–6 weeks before travel, to get any additional vaccination medications or information you may need. Currently there is no inoculation or vaccination to prevent contracting H5N1 avian influenza.
Assemble a travel health kit containing basic first aid and medical supplies. Be sure to include a thermometer and alcohol-based hand gel for hand hygiene. See the Travelers Health Kit in "Health Information for International Travel" for other suggested items.
Identify in-country health-care resources in advance of your trip.

During travel to an affected area

Read CDC's Guidance for U.S. Citizens Living Abroad.
Avoid all direct contact with poultry, including touching well-appearing, sick, or dead chickens and ducks. Avoid places such as poultry farms and bird markets where live poultry are raised or kept, and avoid handling surfaces contaminated with poultry feces or secretions.
As with other infectious illnesses, one of the most important preventive practices is careful and frequent hand washing. Cleaning your hands often with soap and water removes potentially infectious material from your skin and helps prevent disease transmission. Waterless alcohol-based hand gels may be used when soap is not available and hands are not visibly soiled.
Influenza viruses are destroyed by heat; therefore, as a precaution, all foods from poultry, including eggs and poultry blood, should be thoroughly cooked.
If you become sick with symptoms such as a fever, difficulty breathing, or cough, or with any illness that requires prompt medical attention, the Study Center staff can assist you in locating medical services and informing your family as requested.

After your return

Monitor your health for 10 days.
If you become ill with fever and develop a cough or difficulty breathing or if you develop any illness during this 10-day period, consult a health-care provider. Before you visit a health-care setting, tell the provider the following:
1) your symptoms
2) where you traveled
3) if you have had direct contact with poultry.
This way, he or she can be aware that you have traveled to an area reporting avian influenza.

For more information about H5N1 infections in humans, visit the World Health Organization avian influenza website and the CDC avian influenza site.

The CDC’s health recommendations for international travel to Southeast Asia, including Vietnam, are provided on the Travelers’ Health website.

Web Resources