By Prathiba Raju and Abhijit Singh

New Delhi: After witnessing the horror, devastation and massive human suffering caused by a once-in-a-generation global pandemic, it seemed like things were getting back on track and the Indian healthcare ecosystem was in recovery mode. However, the recent bird flu cases in India are a reminder of the persistent threat posed by zoonotic disease evolution. From the Nipah virus outbreak to the recent bird flu cases, the management underlines the need for robust surveillance and preventive measures. Zoonotic Diseases Effectively, informed experts.

Last week World Health Organization (WHO) The first human death due to bird flu has been confirmed in Mexico, while in India, the issue came into the limelight after the World Health body confirmed the second case of bird flu in the country and the first human infection since 2019. Avian Influenza A The (H9N2) virus, commonly known as bird flu, was detected in a four-year-old child in West Bengal.

ET HealthWorld spoke to several experts to understand the gravity of the problem and analyse its overlooked aspects

Dr. Mohan Kumar Singh, Senior Consultant, giving the basic details of the problem internal MedicineDr. of Marengo Asia Hospital, Gurugram. …

When asked about disease prevention and precautions, Dr Singh suggested, “To prevent H9N2 infection, it is important to avoid visiting live poultry and bird markets as such environments can serve as hotspots for viral infection. After handling birds or their environments, it is very important to maintain good hygiene by washing hands frequently. Wearing protective gear such as gloves and masks while working with birds can reduce direct contact with potential viral sources. Also, getting an annual flu shot may provide some cross-protection against H9N2, even though there is no specific vaccine for it.” Talking about its management, the expert suggested, “Antiviral medications like zanamivir (Relenza) or oseltamivir (Tamiflu) should be used as early as possible to reduce the frequency and severity of your symptoms. Supportive care is equally important, which includes staying well hydrated, taking adequate rest, and using fever-reducing medications to effectively manage the symptoms. Consult a doctor immediately if you experience difficulty in breathing as it may require hospitalization.”

Expressing his views on the problem, Dr Naseeruddin G, Consultant-Internal Medicine, Fortis Hospital, said, “WHO has confirmed that a 4-year-old child in India tested positive for H9N2 bird flu, the second such case in the country. This strain usually causes mild illness, but this child required hospitalisation. The infection was probably through contact with poultry, as there were no reports of the child’s close contact with other cases. H9N2 rarely spreads between people, but health officials monitor these cases as flu viruses can mutate.”

“As a precaution, people in India, especially those living near poultry farms, should practice good hygiene, avoid close contact with sick birds and cook poultry products thoroughly,” Dr Naseeruddin said.

Dr Praveen Gupta, head and principal director of the neurology department at Fortis Hospital, also expressed similar views and urged for extensive surveillance at various hotspots. He said, “The recent reports of bird flu cases in India are alarming and require immediate action. Forest officials and wildlife personnel must adopt strict safety protocols like wearing gloves and protective gear while handling dead birds.”

“Along with this, there should be increased surveillance and preventive measures to identify and prevent new cases. This includes setting up checkpoints for wildlife health, increasing testing in previously reported outbreak areas, and educating the public about the symptoms of bird flu and the importance of avoiding contact with wild birds. Proactive steps in surveillance and hygiene can help reduce the spread of this potentially dangerous virus,” Dr Gupta said.

Commenting on the potential diagnostic strategies to detect the rare disease, Dr Manish Mannan, HoD – Pediatrics and Neonatology, Paras Health, Gurugram, said, “Diagnosing H9N2 requires a combination of clinical suspicion and laboratory testing. If a child comes in with symptoms of bird flu and has a history of exposure to birds, a respiratory sample (swab or wash) will be collected and tested for the specific influenza virus strain. Early diagnosis is crucial for prompt treatment and isolation to prevent further spread.”

Adding to the management aspect, Dr Mannan said, “The infection primarily involves supportive care to manage symptoms such as fever and dehydration. Antiviral drugs are usually used to shorten the duration of the illness and reduce the risk of complications. In severe cases, additional supportive measures such as oxygen therapy or respiratory support may be required.

Sharing her opinion on minimising the risk at an early stage, Dr Neha Rastogi Panda, Infectious Disease Consultant, Fortis Gurugram, suggested, “Make sure the internal temperature of poultry reaches 165°F (74°C) to kill any virus; avoid transporting live birds to the market: if possible, buy poultry from reputable sources.”

Dr Sushila Kataria, Senior Director, Internal Medicine, Medanta, explained that the disease in humans is mild, and the treatment is the same as for other influenza viruses, including antiviral drugs like Tamiflu. She said, “H9N2 bird flu is a type of influenza A virus that is primarily found in birds. Human Transmission This is possible due to the same, which usually occurs through close contact with infected birds. This includes individuals handling poultry, such as those working in hatcheries, who are at a higher risk of infection. H9N2 bird flu is not highly contagious and does not have the potential to become a pandemic, as its R0 (basic reproduction number) is very low. Therefore, there is no cause for widespread concern. But, people with comorbid conditions, children, and the elderly with low immunity are more susceptible to infection and should take extra precautions. By following these preventive measures, Risk of infection can be reduced to a large extent.”

Elaborating on the epidemiology of bird flu, Dr Akshay Budhraja, Senior Consultant and HOD- Respiratory and Sleep Medicine, Aakash Healthcare, New Delhi said, “H9N2 is a subtype of avian influenza that spreads through direct contact with infectious animals, mainly birds. The pathogen is very virulent and the virus rarely infects humans. Sporadic cases of infection with avian viruses are seen worldwide, mainly in Asia, Europe, Africa and the Middle East. However, its symptoms are similar to flu: cough, fever, sore throat, headache, body pain and rarely leads to severe lung infection.

Experts voiced the unpredictable nature of infectious diseases and the continued threat they pose, even as the world recovers from COVID-19. It was reported that cases are increasing rapidly Mutation Rate Demand for avian influenza-like viruses Strong and active Global approach to public health Health Community Remain alert and adaptive, and be prepared to react quickly Emerging threats To prevent another crisis on the scale of COVID-19.