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Dominic B. Hermano
DrPH 205 - Applications of Epidemiological Methods and Principles
Avian Flu
 

and
 

Cholera
Energizer
•Avian Fl
u

•In
fl
uenza Fact
s

•Cholera
 

•Public Health Intervention
Presentation Outline
Avian Flu
Flu
In
fl
uenza
Zoonotic
Spread between animal and
peopl
e

A Viral Infectio
n

Viral Infection that Attacks the
Respiratory Syste
m
fl
Zoonotic
Spread between animal and
peopl
e

Swin
e

Equin
e

Avia
n
INFLUENZA
FACTS
 

from
Avian Flu
INFLUENZA TYPE A VIRUSE
S

Most signi
fi
cant to public health due to their potential to cause an
in
fl
uenza pandemic.
Subtypes
:

18 known HA subtypes (hemagglutinin
)

11 known NA subtypes (neuraminidase)
Example combinations
:

H7N2 (HA7 protein + NA2 protein
)

H5N1.
Avian Flu
INFLUENZA TYPE A VIRUSE
S

All known subtypes of in
fl
uenza A viruses can infect birds,
 

except subtypes H17N10 and H18N11,
Avian Flu
Avian Flu
Incubation period
:

A(H5N1) virus infections in humans, current data indicate an  incubation
period averaging 2 to 5 days and ranging up to 17 days.
Avian Flu
Symptoms
:

illustration from: who.int
Avian Flu
the primary risk factor for human infection
appears to be direct or indirect exposure to
i n f e c t e d l i v e o r d e a d p o u l t r y o r
contaminated environments, such as live
bird markets.
Avian Flu
Slaughtering, defeathering, handling
carcasses of infected poultry, and preparing
poultry for consumption, especially in
household settings, are also likely to be risk
factors.
Avian Flu
There is no evidence to suggest that the
A(H5), A(H7N9) or other avian in
fl
uenza
viruses can be transmitted to humans
through properly prepared poultry or eggs.
Avian Flu
A few in
fl
uenza A(H5N1) human cases have been
linked to consumption of dishes made with raw,
contaminated poultry blood. Controlling the
circulation of avian in
fl
uenza viruses in poultry
is essential to reducing the risk of human
infection.
Avian Flu
Given the persistence of the A(H5) and
A ( H 7 N 9 ) v i r u s e s i n s o m e p o u l t r y
populations, control will require long-term
commitments from countries and strong
coordination between animal and public
health authorities.
Treatment:
• Neuraminidase Inhibitors:
 

e.g. oseltamivir, zanamivir are effective against H7N9
.

• Adamantane
:

e.g. amantadine, rimantadine for type A in
fl
uenzas
.
Available Vaccines:
DrPH 205 - Applications of Epidemiological Methods and Principles
Public Healt
h

Interventions
DrPH 205 - Applications of Epidemiological Methods and Principles
Health
Education
MODES OF
TRANSMISSION
Contact Transmission
Droplet Airborne
illustration from: npr.org
Fomite Transmission
ASYMPTOMATIC
photo credits: reuters.com
Teach the public
about:
Droplet
Transmission Face Mask
Contact
Transmission
Physical
Distancing
Fomite
Transmission
Regular Cleaning of
Surfaces
CHOLERA
Cholera
is an acute diarrheal
disease that can, in a
matter of hours, result
in profound, rapidly
progressive
dehydration and death.
Cholera gravis
 

(the severe form) is a much-
feared disease, particularly in
its epidemic presentation.
Fortunately, prompt
aggressive
fl
uid repletion and
supportive care can obviate
the high mortality that is
historically associated with
cholera.
Vibrio Cholerae
About Vibrio Cholerae
• Gram-negativ
e

• Non-spore formin
g

• Serogroups O1 (classical and El Tor biotype
)

• O139 are primarily responsible for cholera outbreaks
.

• Host Range: Humans, water birds, shell
fi
sh,
fi
sh, and
herbivores.
 

• Incubation Period: Few hours to 5 Days post infection
.

• Mode of Transmission: fecal-oral route
.

• Reservoir: Humans, Animals around aquatic environment.
Cholera is native to the Ganges delta in the Indian subcontinent.
The
fi
rst cholera pandemic due to the El Tor biotype began in Indonesia in
1961 and spread in serial waves throughout Asia (Philippines and Thailand)
as V. cholerae
.
In the early 1970s, El Tor cholera erupted in Africa, causing major epidemics before
becoming a persistent endemic problem.
Currently, >90% of cholera cases reported annually to the World Health Organization
(WHO) are from Africa.
Clinical Manifestations
:

Asymptomati
c

Mild Diarrhe
a

Explosive
Diarrhe
a

😵
😓
😐
After 24-48 hours incubation period the patient
may experience the following:
😓
• Rice Watery Stoo
l

• Painless watery diarrhea
 

• Nausea and Vomitin
g

• Muscle Cramp
s

• Weaknes
s

• Tachycardi
a

• Decrease Skin Turgo
r

• Weak or Absent Puls
e

• Hypovolemic Shock
Management:
IS TO PREVENT HYPOVOLEMIC SHOCK
Treatment of Cholera is Based on Degree of Dehydration. Mild,
Moderate or Severe.
Pharmacological Management:
Macrolide
s

Tetracyclin
e

Fluoroquinolone
s

🤰
Note: increasing reports of widespread resistance
.
Pharmacological Management:
Although not necessary for cure, the use of an antibiotic to which the organism
is susceptible, diminishes the duration and volume of
fl
uid loss and hastens
clearance of the organism from the stool.

Boiling Water is a traditional yet effective way of
eliminating microorganisms
Water Filters is a good investment to
ensure safe drinking water.
Solar Disinfection˝
(SODIS)
Use of sun rays to
eliminate
microorganisms. (Glass
bottles are more
recommended than
PET bottles)
•Harrison's principles of internal medicine, 19th ed. 

•https://www.msdsonline.com/resources/sds-resources/
free-safety-data-sheet-index/vibrio-cholerae/

•https://www.cdc.gov/
fl
u/avian
fl
u/h7n9-images.htm

•https://www.cdc.gov/safewater/solardisinfection.html

•https://www.who.int/in
fl
uenza/human_animal_interface/
faq_H7N9/en/

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