Updated Information for Travelers about Avian Influenza
(Updated August 14, 2004; Updated July 14, 2004; Released April 23, 2004)

According to the World Health Organization (WHO), the Vietnamese Ministry of Health has reported 3 human deaths from confirmed avian influenza H5 infection. Further testing is needed to determine whether the virus is the same strain that caused human illnesses and deaths in Thailand and Vietnam in early 2004.

Avian influenza A (H5N1) is a serious viral infection that occurs primarily among poultry and other birds. While it is unusual for humans to get influenza virus infections directly from poultry or birds, rarely human infections and outbreaks caused by certain avian influenza A viruses have been documented since 1997. During mid-January 2004 through March 2004, widespread H5N1 outbreaks among poultry were reported from Cambodia , China, Indonesia, Japan, Laos, South Korea, Thailand, and Vietnam . Efforts to contain the outbreaks included culling millions of birds. At that time, Thailand and Vietnam also reported human infections and deaths caused by H5N1 viruses (for details, see http://www.who.int/csr/disease/avian_influenza/en/). All patients with confirmed H5N1 were severely ill, and many had a history of exposure to sick or dead poultry. Field investigations at that time showed no conclusive evidence of human-to-human transmission of the disease.

Beginning late June 2004, renewed outbreaks of H5N1 among poultry were reported in Indonesia, Vietnam and Thailand . Although the previous H5N1 poultry outbreaks in Japan and South Korea have been controlled, the degree to which outbreaks in Cambodia, China, Indonesia, Laos, Thailand, and Vietnam have been controlled is uncertain. For this reason, CDC continues to recommend the measures that were detailed in a health update on August 12, 2004, which specifies enhanced surveillance for suspected H5N1 cases among travelers with severe unexplained respiratory illness returning from H5N1-affected countries. CDC also remains in communication with WHO about the avian influenza outbreaks.

Travelers to Cambodia, China, Indonesia, Laos, Thailand, and Vietnam are advised to follow standard health recommendations for that region and, as a precaution, avoid places such as poultry farms and bird markets where live poultry are raised or kept, and avoid contact with sick or dead poultry. As with other infectious illnesses, one of the most important and appropriate preventive practices is careful and frequent hand washing. Cleaning your hands often using either soap and water or waterless, alcohol-based hand rubs removes potentially infectious materials from your skin and helps prevent disease transmission.  Travelers returning with an illness from any area of the world are reminded to seek prompt medical attention. For more information about CDC´s health recommendations for travel to Asia, see http://www.cdc.gov/travel/seasia.htm and http://www.cdc.gov/travel/eastasia.htm.

For information about avian influenza health updates, see

http://www.cdc.gov/flu/avian/professional/han081304.htm

http://www.phppo.cdc.gov/HAN/ArchiveSys/ViewMsgV.asp?AlertNum=00204

For information about previous avian influenza outbreaks see http://www.cdc.gov/flu/about/avianflu.htm.

For more information on recent studies about avian influenza, see http://www.who.int/csr/don/2004_07_08/en/.

For information about the embargo on the importation of birds from specified Southeast Asian countries, see http://www.cdc.gov/flu/avian/outbreaks/embargo.htm.

For information on influenza, see http://www.cdc.gov/flu/.