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Birds can be affected by flu, just like humans. When birds get flu it's called avian flu. There are several types of avian flu. Some types don't harm birds that much. Others types kill whole flocks in just a few days.

A severe strain of avian flu emerged in 2003, called H5N1. It has spread widely among birds in several Asian countries. There have been more limited outbreaks in flocks of birds in some European countries.

H5N1 sometimes passes to humans who have very close contact with infected birds. For example, some poultry workers have caught avian flu. But HN51 doesn't pass easily from birds to humans.

Many millions of birds have been affected by H5N1, but there have been only 385 confirmed human cases worldwide.¹ Although this is worrying, it's a small number of people overall, considering how many people across the world come into contact with birds.

Most human cases of H5N1 have happened in countries where people are in regular contact with birds and keep small flocks close to their homes. The biggest risk comes from contact with bird droppings.

Although H5N1 is hard for people to catch, if someone does get it, the virus can make them dangerously sick.

Of the 385 people confirmed to have been infected by H5N1, 243 people have died.² But this only includes people who have been confirmed to have avian flu by laboratory tests. Some scientists think that more people might have caught avian flu, but not seen a doctor because they didn't get seriously sick.³ If this is true, it could mean that avian flu isn't quite as dangerous for humans as doctors first thought.

It's impossible to rule out one-off cases of H5N1 being passed from person to person. However, H5N1 can't pass easily between humans. For most people, this limits the danger, as the infection almost always comes from direct contact with infected birds.

H5N1 isn't a big danger for most people at the moment, but scientists are worried because flu viruses can easily change. If someone caught avian flu at the same time as having human flu, the two viruses could mix. This might create a new strain of flu that spreads easily from person to person.

A new strain of human flu could be dangerous, because people's immune systems wouldn't have had time to learn how to fight it. It could quickly infect millions of people around the world (this is called a pandemic).

Drugs that fight viruses can be used to treat avian flu in humans. They may increase people's chance of survival if given quickly.

Scientists have also developed a vaccine to prevent H5N1.⁴ It's not known whether this vaccine would help if H5N1 changed into a form that passed easily between humans. It would depend on how similar the new, human flu virus was to the avian flu virus.

If a flu pandemic happened, vaccines could be developed to treat the virus, but it would take time.

Some companies have advertised vitamin pills or food supplements that they claim will help to prevent or treat avian flu. The Food and Drug Administration says it's extremely unlikely that these products work.⁵

According to the Centers for Disease Control and Prevention, in the United States, there's no danger from eating turkey, chicken or other poultry.⁶ Importing most bird products from countries affected by avian flu has been banned.

Even if infected birds did enter the food supply, cooking would kill the virus. You should cook poultry thoroughly, until there's no pink visible and the juices run clear. Eggs should be cooked until the white is solid.

The U.S. Department of State says there's no need to avoid traveling to countries with an avian flu outbreak.⁷ But you should:

• Avoid live animal markets and poultry farms
• Avoid eating or handling raw or undercooked poultry
• Avoid areas contaminated with animal droppings
• Wash your hands regularly.

Even in a country reporting cases of avian flu, no danger comes from eating thoroughly cooked poultry or eggs. Raw or undercooked poultry is risky. But heat kills the virus.²

There's little reason to worry about any immediate danger from avian flu. But if you want to avoid normal, human flu, talk with your doctor about a flu vaccine.

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment. ©BMJ Publishing Group Limited 2008. All rights reserved.