There has been a great deal of media coverage in recent years about bird flu and the risk of human infection. There has also been speculation about the risk of a worldwide flu pandemic. Dr Jace Clarke sorts out the facts from the fiction and provides some clear guidance to help expats understand the different forms of flu, the risks of contracting the virus, its symptoms and treatment.

Let’s start by getting bird flu into perspective. In the last five years there have been less than 400 confirmed human cases of the H5N1 strain of bird flu and fewer than 250 deaths. The risk of contracting bird flu as an expat is quite remarkably low, even in those countries of the Pacific Rim where the outbreaks have been most numerous. The greatest risk is of catching the human strain of the virus but here, unless you are elderly or in poor health, it is very unlikely that the infection will cause you any more inconvenience than a few days in bed with a temperature.

Flu is caused by the influenza virus. The viruses that cause bird flu and flu in humans are similar – but while the human version is easily transmitted from person to person, the variety that causes bird flu is extremely hard for humans to catch and is not infectious between people. In fact you have to be working with infected birds and handling them on a daily basis to have any real risk of contracting the virus.

The Influenza virus is capable of mutating, so most years a different strain of the human virus emerges, causing an outbreak of flu which can affect many people. It is most common in the winter in the northern and southern hemispheres, but can occur all year round in tropical regions. Very severe flu epidemics or pandemics only occur when a completely new strain of the virus emerges. This is the reason why there has been so much concern about bird flu, in case the H5N1 bird flu virus mutates in the future into a version which can be transmitted between humans. While this is not impossible, it has not happened yet and the only concern for expats today is the risk of contracting one of the common strains of human flu.

Human flu is most commonly transmitted by coughs and sneezes; it takes a couple of days to incubate and the symptoms are typically a high temperature, sweats, muscle aches, a dry cough, sore throat, sneezing and headaches. Symptoms peak after a couple of days and most people recover completely within 1-2 weeks. The immune system usually clears the viruses that cause flu and treatment aims to ease the symptoms until the infection goes. The best treatment is to take paracetamol or ibuprofen to lower temperature and ease aches, combined with plenty to drink to prevent dehydration. Antibiotics are not effective on viruses and will not be prescribed for flu unless the patient subsequently develops a complication such as a bacterial chest infection.

While flu is no more than an inconvenience to most people it can develop into more serious illness in the elderly, frail or those with some chronic conditions, diabetes or poor immune systems. Expats living in countries where malaria is prevalent should also be aware that the early symptoms of malaria can be very similar to flu and they should seek early medical advice and intervention if there is any risk that they have contracted malaria instead. Flu is also similar to the early stages of meningitis and pneumonia, so if in doubt, consult your doctor promptly, it is far better to be safe than sorry.

Expats in high risk groups of developing complications should make sure that they have an annual flu jab, generally these are people over the age of 65, or those with heart, lung, diabetes or other chronic conditions. A flu jab works by providing the body’s immune system with a weakened form of the current human viral strains, antibodies are then produced which will help reduce the severity and duration of the symptoms should there be further infection. Your doctor will be able to advise if you are likely to benefit from immunisation.

A final word about bird flu if you are living in or travelling to an affected area. The risks of contracting the disease are very low, but it is still wise to take sensible precautions, such as avoiding bird or poultry farms or markets, avoiding close contact with live or dead poultry and making sure that any poultry products are well cooked – this includes avoiding soft or runny eggs.