Pustaka Ilmiah Universitas Padjadjaran

Abstrak

Management of Avian Influenza

To challenge the epizootic of avian influenza A (H5N1) viruses among birds continues to cause human disease with high mortality and threat of a pandemic, an updates 2005 report was reviewed recently by World Health Organization (WHO) including Highly pathogenic avian influenza A (H5N1) viruses that evolve into many phylogenetically among poultry in parts of Asia, Africa, and the Middle East, incidence and demographic characteristics, surveillance for cases (focused on patients illnesses, villagers living with backyard poultry, markets, and health care workers) and transmission of H5N1 virus direct from avian-to-human or other domestic mammals. More than 90% of case clusters have occurred among bloodrelated family members, suggesting possible genetic susceptibility..Incubation period generally appears to be 2-9 days in variety. Bronchiolar and alveolar cells, but not epithelia from the trachea or upper respiratory tract, express detectable 2,3-linked sialic acidreceptors. The detection of viral RNA by means of conventional or real-time reverse-transcriptase polymerase chain reaction remains the best method for the initial diagnosis of influenza A (H5N1). Clinical manifestations as severe pneumonia is often progresses rapidly to the acute respiratory distress syndrome. Less frequent gastrointestinal symptoms have been reported since 2005, Manifestations of each clade may differ. Treatment and hospitalisation for patients with suspected or proven influenza A (H5N1) should be done for isolation due to clinical monitoring, diagnostic testing, and antiviral therapy; is based on supportive care with supplementary oxygen and mechanical ventilation. Early treatment with oseltamivir is recommended and late initiation of therapy appears to be a major factor for the mortality. The oral bioavailability of oseltamivir in patients with severe diarrhea or gastrointestinal dysfunction related to influenza A (H5N1) virus infection or those in whom the drug has been administered extemporaneously (e.g., by means of a nasogastric tube) is uncertain. A higher dose of oseltamivir (e.g., 150 mg twice daily in adults) and an increased duration of therapy, for a total of 10 days, may be reasonable especially if there is pneumonic disease at presentation or evidence of clinical progression. Other treatments are for nosocomial complications. Using corticosteroids shown no effective and can result in serious adverse events. Antiviral prophylaxasis and immunization is proposed to complete the strategies .Healthcare worker should protected by high-efficiency masks (NIOSH-certified N- 95 or equivalent), long-sleeved cuffed gowns, face shield or eye goggles, and gloves. Prevention should be done because Avian influenza A viruses are readily inactivated by a variety of chemical agents and physical conditions. Guidelines for the prevention of infection with influenza A (H5N1) virus in various risk groups, including poultry workers, travelers, and health care workers are managed by U.S. Centers for Disease Control and Prevention. Some influenza A (H5N1) viruses isolated from humans have acquired mutations that permit binding to both 2,3-linked sialic acid receptors and 2,6-linked sialic acid receptors. The changes in multiple viral genes are generate a potentially pandemic influenza A (H5N1) virus.. The world is presently (January 2006) in phase 3 and WHO Global Influenza Preparedness Plan (WHO 2005) in different phases are made in order to face pandemic influenza A (H5N1). The International co-operation are needed. General measures should accessible to everyone and risk of communication develop generation of fear and panic should be avoided. Five essential action strategies to reduce the risk of a pandemic outlined by the WHO fare should start as soon as possible.