Avian Influenza Epidemiology in Queen’s County

Introduction

Influenza pandemics have traditionally taken the global populace by astonishes allowing health care practitioners with inadequate time for preparedness for the rapid increases in cases and deaths that characterize these events making them considerably upsetting.
The peril of human influenza has significantly escalated over the past decades following the surfacing of highly vituperative avian influenza viruses, more principally the H5N1 viruses that has infected human populations in several Counties in the US

While previous influenza pandemics have confronted populations without admonition, the widespread circulation of H5N1 viruses among avian populations in the recent past as well as their potential for amplified transmission to humans and other mammalian species has compelled the health sector to unmatched opportunities to get ready for response in the event of another epidemic threat in the future.

Avian Influenza Outbreak

The few human influenza incidences in Queens County have been corresponding to large outbreaks of Avian Influenza. The medical gamut of avian influenza in humans is subject to descriptions of the hospitalized patients.
There has not been a determination to date of the frequencies of milder infirmity, and nonconforming presentations, and subclinical infections, even though case reports are available.
It is reported that the incubation phase of avian influenza may be longer than any other acknowledged human influenzas. It is noted that the case-to-case intervals in household huddles have commonly been reported to be between 2 to 5 days with an upper limit of between 8 and 17 days, a fact attributable to unrecognizable contact to infected animals as well as ecological and environmental underpinnings (Morse, 2007).

The number of recorded outbreaks of HPAI has increased globally in the past 10 years culminating in 2004 with the unprecedented outbreaks of H5N1 HPAI involving at least nine countries in East and South-East Asia, Europe and North America.
Apart from the geographical extent of these outbreaks and apparent rapid spread, this epidemic has a number of unique features, among which is the role that asymptomatic domestic waterfowl and more particularly free-ranging ducks play in the transmission of highly pathogenic H5N1.

Queens County Demographic Data

Population

Population estimates, July 1, 2014, (V2014) 2,321,580
Population estimates base, April 1, 2010, (V2014) 2,230,539
Population, percent change – April 1, 2010 to July 1, 2014, (V2014) 4.1%
Population, Census, April 1, 2010 2,230,722

Age and Sex

Persons under 5 years, percent, July 1, 2014, (V2014) 6.3%
Persons under 5 years, percent, April 1, 2010 5.9%
Persons under 18 years, percent, July 1, 2014, (V2014) 20.4%
Persons under 18 years, percent, April 1, 2010 20.7%
Persons 65 years and over, percent, July 1, 2014, (V2014) 13.6%
Persons 65 years and over, percent, April 1, 2010 12.8%
Female persons, percent, July 1, 2014, (V2014) 51.5%
Female persons, percent, April 1, 2010 51.6%

Poultry in Queens County

There are three major poultry farms in Queens County, NY
- RD’s Live Poultry Market
- ZamZam Live Poultry II Corp
- Jeuri Live Poultry Inc.
State Agricultural Department inspectors make quarterly visits to check that birds are healthy, and drop in unannounced at least once a month to see that strict rules about cleanliness are followed in slaughter rooms

Avian Influenza Symptoms

The largest part of avian influenza patients develops early symptoms of high fever and an influenza-like illness accompanied with lower respiratory track symptoms.
In little cases, symptoms of upper respiratory tract are reported. Additionally, in the early course of the illness, some patients have been reported to have diarrhea, vomiting, pleuritic pain, abdominal pain, and bleeding from gums and nose (Bresse & Hayden, 2013).

Epidemiological Indicators Associated with Avian Influenza

Subject to the nature of the examination employed in assessing avian influenza separating what is evaluated, it is considered virulence rather than pathogenicity. Virulence is amorphous to the degree of pathogenicity, which is the disease inducing power of a micro-organism in a particular host.
This can be articulated mathematically as the ration of the number of cases of overt infection to the total number infected (Bresse & Hayden, 2013).
On the other hand, pathogenicity is considered to be the possession of an organism that determines the extent to which explicit disease is produced in an infected population or the might of an organism to produce diseases. On this basis, the strains ought to be notable as either high or low virulence on the basis of characteristic intravenous pathogenicity test (Fineberg, 2014).
There has been a variance in both virulence and contagion of H5N1 strains over the past decade since when the first isolates were established in the mid-1990s to early 2005 due to the emergence of new genotypes and owing to the fact that each overriding genotype has been swapped with others possessing dissimilar distinctiveness.

Avian Influenza Mode of Transmission

The human influenza is spread through inhalation of communicable droplet nuclei, either direct or by contact, and at times through fomite (indirect) contact, with self-inoculation onto the upper respiratory tract or conjunctival mucosa.
Conversely, the comparative efficiency of the assortment of routes of transmission has not been fully defined. With the human avian influenza infections, there has been unswerving evidence with bird-to-human, doubtless environment-to human, and limited with non-sustained human-to-human transmission (Suri, 2007).
As early as 1997, exposure to live poultry 7 days prior to the inception of the epidemic was linked with the disease in humans while there was no momentous hazard attributable to preparing or eating poultry foodstuffs.
Recently however, most patients have had a history of direct contact with poultry (Morse, 2007). Some these infections have been reported to be instigated by pharyngeal or gastrointestinal injection of the virus.

Human to Human Transmission

Human-to human transmission of avian influenza has also been reported in a number of domestic clusters and some have been cases of child-to mother transmission which is connected with personal contact devoid of pertinent safety measures.
Additionally, owing to the endurance of avian influenza in the environment, several other forms of transmission has been postulated including oral ingestion of contaminated water as well as undeviating intranasal and conjunctival inoculation through contact to water and other potential modes. Another probable risk aspect in the environment has been related to untreated poultry manure as fertilizer (Fineberg, 2014).

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