Season 5 | Episode 9
Joe McIntyre (Host): Welcome to the Merck Manuals Medical Myths Podcast. On this show, we set the record straight on today's most talked about medical topics and questions. I'm your host, Joe McIntyre, and on this episode, we will zoom in on a virus that impacts wild birds and domestic poultry. The episode will explore the background, symptoms, and treatments surrounding bird flu. To provide expert insight, I'm joined by Laurie Hess Doctor of Veterinary Medicine and the new Editor in Chief of the Merck Veterinary Manual. After graduating with a BA in Biology from Yale University, Dr. Hess earned her veterinary degree at Tufts University. She then completed an internship and a two-year residency in avian and exotic animal medicine and surgery at Schwarzman Animal Medical Center in New York City. Dr Hess co-headed the avian and exotic pet service at the Schwarzman Animal Medical Center for nearly a decade, and she subsequently established the Veterinary Center for Birds and Exotics in Westchester County, New York in 2010. All right, so Dr. Hess, let's focus on a topic that's been in a lot of headlines lately, the avian flu. For our audience who may not be familiar with the virus, can you explain, I think what it's called is highly pathogenic avian influenza. HPAI, is that right?
Dr. Laurie Hess: Yes, absolutely. So avian flu, like any other flu virus, like we get flu, it's been around for years and years and years. There are different variants, as we call them. The one that you'll hear about now is HPAI, as you mentioned, highly pathogenic avian influenza, or H5N1, and the H and the N refer to proteins on the surface of the viruses, and there's different variants, but that's the one you're probably going to hear about in the news. And the reason that it's so significant now is that this particular strain of the virus is very virulent to poultry, so to chickens and turkeys, and you know guinea fowl, and birds like that and it's really kind of sweeping the nation. It's been around for years in other countries, we've seen small outbreaks in the US, but this form is very, very dangerous to chickens and turkeys. Something like 100 million poultry have been affected and, unfortunately, had to be euthanized in the past couple of years from this disease. It is something of concern because we now know that it can spread to mammals. So recently, it's been seen in cows and goats. It's been seen even in some house pets. We know that cats are susceptible to it. It is transmittable to people, but there have only been five cases, and those are cases that have occurred in dairy farm workers who are in close contact with cows who were in close contact with infected poultry. So, while we want to be vigilant about not touching infected animals, we don't have to all freak out there's been no human-to-human transmission. So again, it's something to be aware of, but not something to be extremely alarmed of right now.
Host: Okay, that's probably a relief for myself also, but I'm sure plenty of our listeners as well. So are there any signs or symptoms? I know there have only been five cases, but people should look out for in birds or in other poultry if they want to avoid avian flu, whether they're working on a farm or otherwise.
Dr. Hess: Yeah, I think the most important thing to remember is that it can affect all birds, and the way that it's spread is through wild birds like water fowl in particular, because they travel and migrate long distances, so they're not typically affected. I mean, there are some wildlife that are affected, some wild birds are affected, and there's other wildlife like skunks and foxes and things that can become affected. So if you see wild birds, in particular, that are sick. If you own chickens, if you have chickens, I know I have chickens. I have poultry. If you have turkeys or ducks or anything like that, if you see sick birds, don't handle them. If you have a sick pet chicken and you have to take it to the veterinarian, for example, wear masks, wear gloves. But if you see sick wild birds in your yard, alert your state veterinarian or your local authorities. Every state has a veterinarian or animal control, and they'll know what to do. You don't want to expose yourself unnecessarily. Ideally, you try to keep your pet birds that live outside, like your chickens, turkeys, ducks, or whatever, as separate as you can from wild migrating birds. It can be tough. I just built a big chicken coop, as I mentioned, I have a farm in Connecticut, and I really enclosed it so that wild birds can't land on the areas where my chickens are walking around. So you just want to be safe. And again, if you feel like you've been exposed to anything, certainly you want to talk to your physician, but just be smart and be safe and stay away from wild birds that are sick, wild birds in particular.
Host: I’m going to spread this out just a little bit. Is there anything that bird owners, whether those birds or pets or farm animals, should do when handling their avian friends who are sick, generally, versus anyone who has a sick dog or a cat or some other animal. Is there anything differently that bird owners should do? Just generally speaking.
Dr. Hess: Yeah, I mean, birds who are inside like parrots. I treat lots and lots of parrots. That's probably what I see most, all day long. You know, many people are not comfortable handling their parrots. I mean, we all pick up our cats and dogs. We pet rabbits, you know, all kinds of animals we handle all the time. Most people don't routinely handle their birds. Some do. But I would say it is a skill to work on with your parrots, because if you have to take them to the vet, you don't want it to be the very first time you pick up your bird and try to get that bird into a carrier. So having a carrier at home, keeping it open and maybe feeding some treats in there and teaching your pet birds to go in there, that it's not a big deal and that it's okay to get in there to travel, you know, it's something you should practice. I would say not to be crazy. You don't have to mask up and gown up to touch your pet birds inside. I would try to keep your pet birds inside. Some people like to take their birds out on their porches and hang out outside. I'd say, for right now, I might avoid that, because if you have your bird walking around on your picnic table, and there's been a wild bird who's passed over that picnic table before, you don't really want to risk unnecessary exposure. But I think all bird owners, whether you have chickens outside or parrots inside, or finches or canaries or whatever you have, should have a relationship with a local vet, because there are going to be times when your bird is sick and you don't want to be crazily searching the internet for a vet to go to, you should have someone, just like you have a dog or a cat vet available. And that bird should get an annual checkup, most people don't do that. It is very important, because, again, you're not handling that bird routinely. You might miss things, you can't tell if a bird has lost a lot of weight, because they're fluffy and they fluff up, and you can't tell what's under those feathers. So those are my general recommendations for people who have pet birds.
Host: Good to know. And I know this episode is not centered around myths, and you were pretty clear earlier, but I just want to make sure that our listeners are aware, is bird flu transmittable to humans by eating eggs or eating poultry in any way?
Dr. Hess: So, bird flu is not transmittable by eating cooked eggs, cooked poultry. We would never eat raw poultry and raw eggs, hopefully. There are a lot of diseases, including salmonella, bacteria that live in poultry and eggs that you can get if you eat them raw. And again, we would not ever encourage anyone to do that. And we don't know 100% that you can't get avian influenza from eating raw poultry products. We know that raw milk now contains avian influenza if it's come from an infected cow. So again, now we're strongly recommending that people do not drink raw milk. Pasteurization eliminates avian influenza, as does cooking eggs and chicken meat. So just cook your products and buy pasteurized milk in the store.
Host: Now, there can be so many sources of misinformation on many things, but also including bird flu. Where should people go to find the correct information that's sourced vetted by the people who know what they're talking about?
Dr. Hess: Well, to get the most updated information on bird flu, I would definitely recommend checking out the Center for Disease Control's website, the CDC. They put up new information every day, statistics, new findings. It's very current. It's a great, reliable source of information. And of course, the Merck Veterinary Manual and the Merck Manual that covers human health, those are both sites that are reviewed by medical professionals. So, we know that the information there is trustworthy and up to date and reliable.
Host: Are there any best practices, Dr Hess, for people to use to avoid avian flu or other sorts of infectious diseases that may come from birds?
Dr. Hess: Absolutely, I think the most important thing that people who have birds who live outside, or even any other animals, even if you have indoor pets, is to practice really good biosecurity. And that's kind of a buzzword in the veterinary industry. And really what it means is, you know, it's a closed flock system. So if you have a chicken flock or a duck flock, or turkeys or whatever, that live outside, you don't bring in new birds all the time. If you're bringing in new birds, you keep them separate from your existing birds for at least a month. You want to monitor them to make sure they're not incubating anything. If you have friends come over who have their own pets, their own farm, you want them not to wear clothes that they've worn on their farm. You want them to change their shoes, or at least have, you know, like I have a foot bath, which is like a big tub of soapy disinfectant that I make people step in when they come on and off my farm so that they're not bringing things in. Veterinarians are notorious for going from place to place to place, and you know, so if you have a local vet who's coming over and doing a farm call or a house call, you want to make sure that they've changed their clothes and their shoes before they trek onto your property. And, you know, again, these are all things we have to think about. But the idea is that you don't want to serve as a source of infection on your clothes, on your hands, on your shoes. And practicing this way is really important. Even if you have a new puppy, you don't really want to bring that puppy to the park and have it play with everybody else, because that puppy's immune system is not up to date. So just smart practice don't be fearful, but just be smart and think about the action before it happens because you can't take it back.
Host: Dr. Hess, thank you so much for joining us on this podcast. It was a pleasure to talk to you, and also learn more about the avian flu. On our next episode, Dr Hess, will sit down with us again and chat about her background and her decision to join the Merck Veterinary Manual. As we close out, Dr Hess, I'll let you leave our listeners with the final word.
Dr. Hess: I really enjoyed being here, thank you so much for having me. And in the spirit of the Merck Veterinary Manual, we hope to relay education and keep everybody current on animal disease. I'd like to leave you with a thought that medical knowledge is power, so pass it on.
