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Differences in the Epidemiological of H5n1, Covid-19 and Other Global Zoonosis Flu

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Differences in the Epidemiological of H5n1, Covid-19 and Other Global Zoonosis Flu DIFFERENCES IN THE EPIDEMIOLOGICAL OF H5N1, COVID-19 AND OTHER GLOBAL ZOONOSIS FLU Zata Ismah 1, Saidah Fatimah Sari Simanjuntak2, Bebby Alfiera Riyandina Hardja3, Nur Fadhilah Hasanah4, Rani Elviyanti Siregar5, Apriliani6 1,2,3,4,5,6Health Faculty At State Islamic University Of North Sumatera. Email : [email protected] ABSTRAC Human avian influenza has caused serious outbreaks in several countries, especially in Asia, one of which is Indonesia. Human avian influenza has become an important public health problem because of the high mortality rates and because of the possibility of causing a global pandemic. The source of the virus is thought to come from bird migration and transport of infected birds. Laboratory tests can be done by examining leukocytes, platelets in suspected cases. Clinically suspicious of AI testing can be done simultaneously, which is taking blood for serology, throat swabs, nasopharynx, and oropharynx for RT-PCR examination and viral culture gold test as confirmation. Until now it is known that there have been five zoonotic flu diseases that cause a global pandemic and have taken many casualties in the world including SARS, MERS, H1N1, H5N1, and new diseases namely COVID-19. The method to be used for this review is literature study. The data obtained were compiled, analyzed, and concluded in order to get conclusions about the literature study. The five zoonotic flu diseases have differences from one another. So the classification of differences between H5N1 with each of the zoonotic flu diseases above needs to be done. Keywords: Avian influenza (AI) H5N1 virus, Covid19, Epidemiology, Global pandemic, Zoonotic flu 1. INTRODUCTION Human avian influenza is an infection that occurs in humans caused by the influenza A virus subtype H5N1. Avian influenza was discovered to attack in Italy about 100 years ago. This outbreak virus struck humans in Hong Kong in 1997 with 18 victims and six of them dead. Avian influenza (H5N1) or highly pathogenic avian influenza (HPAI) has caused serious outbreaks in several countries, especially in Asia. Since May 2005 the number of confirmed cases of avian influenza A (H5N1) has expanded to various countries in the world. Human avian influenza (H5N1) has become an important public health problem because it has a high mortality rate and 67 likely to cause an influenza pandemic.1 Avian Influenza (AI) is a contagious avian disease caused by influenza type A viruses from the family of Orthomyxoviridae. This virus most commonly affects birds (for example domestic chickens, turkeys, ducks, quails, and geese) as well as various wild birds. Some bird flu viruses are also known to attack mammals, including humans.2 Based on data from the Ministry of Research and Development of the Ministry of Health (2005), avian influenza transmitted by Avian Influenza type H5N1 viruses in poultry has been confirmed to have occurred in the Republic of Korea, Vietnam, Japan, Thailand, Komboja, Taiwan, Laos, China, Indonesia, and Pakistan. The source of the virus is thought to come from bird migration and transport of infected birds.3 Until now the AI pandemics still occur in both developing and developed countries, the possibility of transmission from the movement of birds from endemic to non-endemic countries. Although AI disease attacks poultry, or other livestock, but can transmit to humans. Transmitted between humans, can not be proven. The laboratory tests can be carried out by examining leukocytes, platelets carried out in suspected cases. A suspicious clinical examination of AI can be done simultaneously, namely taking blood for serology, throat swabs, nasopharynx, and oropharynx for RT-PCR examination as well for viral culture gold test as confirmation. Weaknesses in laboratory examinations, not all referral laboratories can perform RT-PCR examinations.4 The Ministry of Health of the Republic of Indonesia said that as of 30 December 2005, 142 cases of poultry influenza infections in humans had been reported from various regions. At that time human transmission was still limited in Cambodia, Indonesia, Thailand, with epicenter in Vietnam (65.5% of all cases), 72 people (50.7%) had died. This number has now increased again, especially with the widespread and increasing deaths in Indonesia. Also from several other countries (Turkey, Iraq), there have been reports of cases of this avian influenza in humans. Cumulative cases of H5N1 since 2014-2018 were 860 cases with 454 deaths (CFR 53%). Based on data from the Indonesian Ministry of Health (2019), in 2018 there were no H5N1 cases reported yet. Cases in Indonesia from 2005 to 27 October 2018 were 200 cases with 168 deaths (CFR 84%).5 68 Until now it has been known that there have been five zoonotic flu diseases that cause a global pandemic and have taken many casualties in the world including SARS, MERS, H1N1, H5N1, and new diseases namely COVID-19. The five zoonotic flu diseases have differences from one another. 2. METHODS The data collection method is literature study. The method to be used for this review is literature study. The data obtained were compiled, analyzed, and concluded in order to get conclusions about the literature study. Research with literature studies is a study whose preparation is the same as other research, but the sources and methods of data collection are by taking data from libraries, reading, taking notes, and processing research materials. Research with literature studies is also a study and can be categorized as a scientific work because data collection is carried out with a strategy in the form of a research methodology. 3. RESULT AND DISCUSSION EPIDEMIOLOGY 1. Agent The virus that causes bird flu is classified as family orthomyxoviridae. Viruses consist of 3 different antigenic types, namely A, B, and C. Influenza A viruses can be found in poultry, humans, pigs, horses, and sometimes other mammals, such as mink, seals, and whales. However, natural horpes are wild birds. In contrast, influenza B and C viruses are only found in humans (shown in fig.1). Avian influenza also called avian influenza, is caused by influenza A virus. This virus is an RNA virus and has haemagglutinin (HA) and neuraminidase (NA) activity. The division of virus subtypes is based on the surface of the antigen, the surface of the hemagglutinin, and the neuraminidase they have.6 2. Clinical Symptoms According to Vascellari (2007), the symptoms of bird flu are highly variable and depend on the infected bird species. The incubation period of this virus for poultry ranges from a few hours to 3 days, sometimes 7 days depending on the dose of the virus, the route of contact, and the species of poultry attacked. Whereas in humans 1-3 days, the infection period is 1 day before until 3-5 69 days after symptoms appear. In children for up to 21 days. Avian influenza in poultry can be found in two forms, namely mild form an acute form (highly pathogenic avian influenza, HPAI.7 The symptoms of ducks/poultry attacked by bird flu include such as neck twisted, convulsions, difficulty standing, lack of appetite, vaginal discharge, for laying ducks egg production suddenly decreases (weakness, flaccid eggshell), and widespread bleeding or spots are often found in the trachea mucosa, proventriculus, intestine, fat layer, chest muscles, and legs.7 According to Damayanti (2004), human symptoms of bird flu that is, the majority of sufferers of AI (H5N1) symptoms are the same as another influenza early fever over 38°C and lower respiratory tract symptoms. Diarrhea, vomiting, abdominal pain, chest pain (pleuritic), and bleeding from the nose and gums. The resulting sputum varies sometimes with blood, respiratory distress, tachypnea, and cracked inspiration. Diffuse progressive respiratory failure, bilateral, infiltration, and display of acute respiratory symptoms (ARDS = Acute Respiratory Distress Syndrome).8 Failure of many organs of the kidney, heart dysfunction including dilation and supraventricular arrhythmias. Other complications associated with ventilation are pneumonia, pulmonary bleeding, pneumothorax, pancytopenia, symptoms of Reye, and sepsis without bacteremia. Early- onset of a sudden and rapidly worsening disease, high fever, muscle aches, and dry cough are often found in AI infections (H5N1). Differential diagnoses of AI (H5N1) include respiratory syncytial virus (RSV), adenovirus, parainfluenzavirus, rhinovirus, Mycoplasma pneumonia, Chlamydia.8 3. Chain Of Infection According to Ong (2008), the influenza A / H5N1 virus is very virulent and contagious, at first, transmission only occurred between wild birds and then spread among poultry through livestock, equipment, transportation equipment, food, pens, and clothing. After an outbreak of avian influenza infection in poultry, this virus can spread from birds to humans. This influenza A virus can cause a pandemic because it is easily mutated, either in the form of antigenic drift or antigenic shift to form new variants that are more pathogenic.9 WHO (2008) states that the exact time when exposure is difficult is determined because in many cases the exposure is repeated many times, but the estimated incubation period for H5N1 virus infection in humans after exposure to sick poultry is generally between 2-7 days, and in one cluster case it is estimated reach 8-9 days.10 70 Transmission can also occur indirectly, for example through air polluted by material/dust containing influenza viruses (aerosols); food/beverage, livestock equipment/supplies, cages, chicken cages, clothing, vehicles, egg trays, birds; mammals and insects that contain or are contaminated with influenza viruses. In connection with the mode of transmission, the influenza virus can be spread easily to various regions by people or equipment/equipment and vehicles used to market poultry products.8 4. Natural History Of Disease A. Prepathogenesis According to Ririh (2006), the susceptible phase (pre-pathogenesis) is the stage of the etiological process, in which the first causative factor meets the host for the first time (Host). This first causative factor has not yet caused the illness but has begun to lay the foundations for future disease development.
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