How to Survive H5N1 Avian/Bird Flu and/or H1N1 Swine Flu

Have you ever been in a situation where an ordinary common cold has been passed among members of an office or social group or family? Such things are regrettably commonplace.

But a cold is a passing inconvenience. Now imagine if instead of a common cold, the problem is H5N1 Bird Flu or H1N1 Swine Flu, evolved into a form transferable between people.

Your chances of infection are probably similar to catching a cold. But your chance of surviving an infection have just dropped from the 99.99% certainty of surviving a cold down to as low as 50% (with H5N1) or perhaps 1% - 10% (it is early days yet with Swine Flu and its mortality rate remains unclear). To put that another way, if there are four members of your family, and you all get infected with Bird Flu, the chances are two of you will die from it.

Unless you're keen for this to occur, you need to read the following material and urgently act on it.

Important Disclaimer

I have no medical qualifications and this article is not intended as medical advice. Although I've had physicians check the medical aspects of this article for gross errors and inaccuracies, they too would not want you solely relying on this article, and we all urge you to check with your personal health care provider and prepare a strategy best suited for your situation.

The best 'cure' for influenza is simply not to get it in the first place. This may be difficult to arrange if you have a job that places you in close contact with lots of other people all day every day, but in any environment, there are prudent steps you can take to reduce your exposure and risk.

In order to avoid infection, you need to understand how you could be infected, and then ensure such actions do not occur.

The influenza virus needs to be introduced in to your body through a wet surface such as your nose or mouth (either by breathing in or eating something containing the virus), or, less likely, through your eyes, any cuts, or, ahem, sexual organs.

Human flu is primarily spread when a person coughs, ejecting a fine mist of infected droplets of moisture into the air around them. These gradually settle and contaminate surfaces in the general area where the person coughed.

Victims either inhale the droplets or transfer the virus from a contaminated surface and become infected themselves.

Think carefully about all the ways this can happen. For example, maybe you get these droplets on your hands and then rub your eyes with your hands. Or maybe a person with contaminated hands then passes you a pen, transferring some infection onto the pen, which is then transferred to your hand (a physician I know always uses his own pen, everywhere, for signing credit card forms and everything else, never accepting someone else's pen for this purpose). You next reach for a piece of food, eat it, and ingest the virus.

Another often overlooked source of potential contamination is money - paper money and coins, all of which may be handled by very many people.

People are generally contagious from about one day before displaying obvious symptoms through to three to seven days after becoming sick. Children can sometimes remain contagious for more than a week.

A person can start to exhibit symptoms of the flu between one and four days after being exposed to it. Usually the flu appears after about two days.

Bird flu is passed between birds in additional ways. Contamination is present in their feces and other excretions, and is extremely virulent. There is enough virus in a single gram (1/28th of an ounce) of contaminated manure to infect one million birds, and it will survive in contaminated manure for at least three months.

The virus can survive at room temperature in water for up to four days, and more than 30 days at or below freezing (one source suggests it survives years at -70°C). Another source, referring to H5N2 viruses, says they can live for weeks on surfaces such as clothing, vehicles, and equipment.

The virus can be killed by heat - 56°C for three hours or 60°C for half an hour. Strong disinfectants such as fomalin and iodine based compounds will also kill it.

If an epidemic or pandemic does materialize, then you need to consider the following cautionary steps.

Try to avoid being anywhere with high concentrations of other people. As much as possible, keep off public transport, avoid sports and other events where large groups are brought together, and consider taking your children out of school.

Schools may promise, as my daughter's school is currently (30 April 2009) to keep a careful watch on the situation and to send students and staff home if they appear unwell, but when you keep in mind that people are infectious for a day or so before they start to exhibit symptoms, by the time a school sends one person home, he/she has already infected maybe ten or twenty or more other students, and by the time those 10 - 20 or more students have exhibited symptoms, they have infected 100 - 400 other students.

Avoid contact with surfaces that might have been contaminated - which means just about everything outside of your own controlled environment (ie house). When you must have contact with potentially contaminated surfaces, you should be fastidious about washing your hands.

Consider also carrying some alcoholic type hand wet-wipes and hand sanitizers. Look for sanitizers that are about 65% or more alcohol, anything less than that may be ineffective against bacteria, and it seems viruses require a stronger concentration.

In general, never put your hands in your mouth, or touch anything that is going into your mouth, unless you've recently (ie immediately previously) washed them.

And, talking about eating, you should avoid eating any food you haven't prepared yourself. You have no way of knowing what has happened in the kitchen of a restaurant to the food you're being served, and if a Flu outbreak occurs, the chance of the food being infected and the virus not being killed in the cooking process becomes measurably significant.

You might also want to be careful about eating cold fruits, salads, and other foods that aren't thoroughly washed prior to eating. Who knows what might have happened to that head of lettuce prior to it being served on your plate. Poultry manure is widely used as a fertilizer - your nice fresh lettuce may have been lightly dusted with contaminated poultry manure.

When cooking poultry products, wash them thoroughly before preparation, and cook them thoroughly. The recommended 'doneness' temperature for poultry is about 82°C/180°F, and for safety, you should ensure the entire poultry pieces reach this temperature and hold it for 5 - 10 minutes.

At some point, it may be necessary to start to worry about water supplies, too. If a bird should defecate into a water reservoir while flying overhead, and remembering that a single gram of contaminated feces has enough virus to infect a million birds, there may be a chance of viral contamination entering the drinking water. Check with your water supplier to see what steps they take to eliminate all viruses from their water supply.

A slightly more publicly obvious measure is to wear a respiratory mask while out in public. This was made compulsory in some areas during the Spanish Flu pandemic, and is a sensible if slightly embarrassing precaution.

Our projection is that respiratory masks will quickly become in very short supply. For that reason, and because they have a very long shelf life, why not buy some now.

You might also wish to stop shaking people's hands - this too became normal behavior during the Spanish Flu pandemic.

If you're unable to avoid crowded locations, consider putting on a pair of neutral glasses. They won't affect your vision, but will give you discreet protection against infection entering your eyes.

One last suggestion. Be healthy. Exercise more, eat well, get enough sleep, and try and maintain a good healthy lifestyle. Healthy people have more natural resistance to infection than unhealthy people.

A regular Flu shot at present won't protect you against either H1N1 Swine Flu or H5N1 Avian Flu, but it will protect you against this season's regular flu and by reducing the risk of you getting regular flu, helps you to stay healthy and less vulnerable to these special Flus.

Similarly, a pneumonia immunization (Pneumovax) won't reduce your chance of getting Flu at all, but this vaccination may help reduce the possibility of pneumonia type complications if you do get Flu. A pneumonia immunization gives you protection for ten years, so it is probably a good thing to do anyway.

So you've got the snuffles. Is it Flu, or merely a common cold? It is important to quickly understand which virus you have, because if it is the flu you have only a very limited time period to start a course of Tamiflu to combat the infection.

Here's a helpful page that compares and contrasts the sometimes similar and sometimes different symptoms of the two viruses, and here's a slightly different list of comparative symptoms.

If the worst comes to worst and you do come down with Bird or Swine Flu, you'll want to urgently take a ten tablet (two a day for five days is the recommended dose, although some studies suggest stronger doses or for longer time) course of Tamiflu.

Tamiflu is presently the best choice of drug to take to combat Swine Flu, and somewhat less so for Bird Flu, and to be effective, you must start taking the pills within two days of symptoms appearing.

Some recent studies are suggesting Tamiflu is less than 100% effective, but, perfect or not, it is the best and only course of action open to you. Update 2009 : Tamiflu's general effectiveness has massively diminished in the last four years, but it is still of some use with some Flu strains.

If you do have Flu, people around you should also consider taking courses of Tamiflu to protect against being similarly infected. When taking Tamiflu to protect against an infection rather than to fight a current infection, the dosage reduces to only one tablet a day, for a minimum of seven days, and in general beyond that for as long as you wish to protect yourself against the possibility of infection.

So why not simply start taking a Tamiflu tablet every day during any outbreak that might occur? Because the drug is expensive, and it might not be covered by your health insurance. But, more importantly, because there probably won't be enough available for everyone to do this.

Tamiflu can only be sold (in the US) with a doctor's prescription. Go see your friendly family doctor and see how much Tamiflu he is willing to prescribe to you now.

You might care to suggest to him he prescribes each of the people in your family a 42 pill course (and because the medicine comes in strips of ten, he might therefore choose to round up the quantity to 50 each) as a prophylaxis (preventative). This might be something your health insurer might okay, but even if you have to pay for the Tamiflu out of pocket, it may be money very well spent.

Tamiflu pills cost slightly more than $8 each in local pharmacies in the Seattle area, and about $6 each mail order.

Don't use them as a preventative, but keep them for if they're needed. A 42 pill per person supply would give you a generous quantity to use if any of your family did get infected, and leave you with extra in case of reinfection (it is not known if a Tamiflu defeated infection gives you immunity against reinfection or not).

Get these pills now. Not tomorrow. Ring for an appointment with your doctor today. Two local pharmacies told me yesterday and today (28/29 Sept 05) that they are now out of Tamiflu stocks, although both hope to get more in soon. Plainly, supplies are becoming hard to obtain.

And there are various mutterings being made in some countries to make it illegal for ordinary citizens to buy and stockpile Tamiflu, because if everyone tried to do this, there'd be insufficient to go around.

There absolutely is insufficient Tamiflu, already. Your choice is either to be optimistically noble, and hope that, if/when you need some, you'll be able to quickly get a supply, or to be selfish and get an adequate supply for yourself now, while you know you can.

Without a doubt, if everyone rushed to order Tamiflu today, there'd be none left for genuinely needy cases. On the other hand, no-one will thank you for your selflessness, least of all your family and dependents, if you don't get a supply now, subsequently get infected and die.

So you're faced with a difficult decision. On the one hand, if you hoard a supply of Tamiflu, you might subsequently never need it, and deprive someone else of the vital medicine. On the other hand, if you don't stockpile a quantity for yourself, then you in turn might fall victim to a shortage of supply in the future. For sure, if you're in a 'higher risk group' of people more susceptible to the flu, you could be understood for choosing to be prudent now.

Tamiflu has up to a five year shelf life - recent stocks (Sept 05) have an expiry date of May 2010, so there's no reason to delay the purchase of the product. Buy some now. Store the Tamiflu at warm room temperature to give it the longest shelf life. The manufacturer recommends storing it as close to 77°F/25°C as possible.

Chances are there might even be some Google ads on this page from internet sites offering to sell you Tamiflu. Some may be reputable, and some will probably require you to provide a prescription. A reputable mail order/internet store that requires a prescription may be a bona fide way to save money on buying the drug.

But others, in third world countries, are very much an unknown quantity. If you buy Tamiflu from such sites, you really have no way of knowing what you'll be getting. You don't know if it is truly Tamiflu or not, you don't know if it is previously expired Tamiflu or still current, and just because it is delivered in what seems to be an official Tamiflu package doesn't mean anything.

Desperate people will try anything in an attempt to survive a life-threatening illness, and there are always plenty of people eager to take advantage of such people and their unfortunate situations.

We can expect to see an upsurge in patent medicines being offered for sale, complete with extravagant pseudo-scientific claims. This happened during the Spanish Flu epidemic and will almost surely happen this time around, too.

Here's an example of a medication we view with extreme suspicion. There are of course many more websites selling many more questionable products out there. Steer well clear of them.

The medical community is slowly (some might say reluctantly) accepting that some alternative medicines can indeed provide cures for some ailments. Homeopathy and acupuncture in particular are becoming more mainstream.

But the key 'benefit' of mainstream medication is the rigorous testing and evaluation process it goes through. All cynical comments about multi-national drug companies to one side, the reality is that most medicines have been rigorously trialed and are closely regulated by national health bodies such as the FDA. You can close to 100% accept the claims of such medicines as being accurate and fair.

The same is not true of alternative medicines. There is no clear procedure to validate alternative medicines and the claims they make. If you can research and confirm that a specific homeopathic remedy, for example, is generally considered by a range of advocates to address a certain ailment, and if these claims have been extant for extended periods of time, maybe that is of some reassurance, but be very wary of claims that you can't find copious additional confirmation for.

Here's an example of a mix of science, pseudo-science, and ideas which, if not nonsense, should at least be kindly described as 'outside the mainstream of medical thought'. But is the product this page advocates - Sambucol - of any value? Who only knows. In its favor, this product seems to be inexpensive, and so you might decide to get some 'just in case' on the basis that it almost certainly won't do any harm, and might possibly do some good.

The bad news is that Bird and Swine Flu can kill sizeable percentages of the people who catch these ailments. The good news is that, even if it spreads to be a pandemic, not everyone will be infected, and obviously not everyone who is infected will die.

Follow the steps above to reduce your chance of becoming infected, and to increase your chance of surviving if you do become infected.

In Part 1 we explain what Bird Flu is and what the risks are. Part 3 will discuss the social problems that may occur during any type of Flu pandemic and offers some suggestions about how to survive in a potentially hostile, foodless and lawless world.

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