There are three types of influenza viruses - A, B, and C. Only types A and B cause significant human disease. Influenza A viruses are further classified according to the type of haemagglutinin (H) and neuraminidase (N) proteins on its outer layer, hence the different influenza A subtypes, such as A/H5N1 or A/H1N1.

Avian influenza (AI) viruses affect poultry (e.g. domesticated chicken, ducks, and turkeys). Most AI viruses are low pathogenic (LPAI) viruses that can cause mild disease in poultry. In contrast, highly pathogenic (HPAI) viruses, such as A/H5N1, are highly contagious and can cause severe illness and high mortality in poultry.

Avian influenza viruses do not typically cause disease in humans, but from time to time, some of these viruses can mutate to become virulent and cause disease in humans. However, AI virus subtypes A/H5N1, A/H7N2, A/H7N3, A/H7N7, and A/H9N2, have been documented to cause mild to severe human infections.

Avian influenza infection in humans results from contact (e.g. touching) with infected live or dead poultry, or environments contaminated with secretions/excretions from infected poultry. There is limited, inefficient, and very rare human-to-human transmission of AI viruses. There is no evidence to suggest that the disease can be spread to humans through properly cooked food.

The reported symptoms of AI in humans are: a high fever (usually > 38 degree Celsius) and influenza-like symptoms such as cough, sore throat, and difficulty in breathing. Runny nose and production of phlegm, which may at times be bloody, may occasionally be present. Diarrhoea, vomiting, abdominal pain, chest pain, and bleeding from the nose and gums have also been reported.

At present, AI viruses are only capable of limited and inefficient human-to-human spread. However, through a series of mutations, these viruses can cross the species barrier and become more transmissible and/or virulent in humans. This may result in an influenza pandemic.  It is therefore important to continuously monitor the AI situation, to forewarn and prevent an influenza pandemic from occurring.

No. The seasonal influenza vaccine protects against the circulating influenza subtypes but does not provide cross-protection against AI viruses.

The most effective way to prevent AI in humans is to avoid contact with infected poultry. Persons travelling to areas reporting outbreaks of highly pathogenic A/H5N1 in poultry should avoid contact with live animal markets and poultry farms. Currently, A/H5N1 vaccine is not commercially available. However, the Singapore Government carries a stockpile of the vaccine for emergency purposes. Post-exposure prophylaxis may also be prescribed if clinically appropriate.

There are currently two classes of drugs that can be used to prevent or treat influenza in humans:  neuraminidase inhibitors (Oseltamivir and Zanamivir) and adamantane derivatives (Amantadine and Rimantadine). Treatment may vary depending on the person’s symptoms. People with severe infection may require treatment in hospitals. Your doctor will be able to advise on the most appropriate and effective course of treatment.

There have been no cases of A/H5N1 avian influenza detected in Singapore, either in humans or poultry.

In Singapore, the National Influenza Centre at the National Public Health Laboratory (NPHL) carries out sentinel surveillance for influenza and acute respiratory illnesses on samples sent from participating GPs and polyclinics. The NPHL also serves as a reference laboratory for influenza subtyping in Singapore and is able to detect novel influenza strains that emerge from time to time. In addition, Restructured Hospital (RH) laboratories regularly update MOH with influenza and influenza-like-illness (ILI) data. Influenza A and B viruses have been the usual viruses detected in Singapore over the years. The influenza A viruses isolated have been the A/H3N2 and A/H1N1 subtypes. Surveillance results show no unusual pattern of influenza or virus isolated recently.

The Ministry of Health (MOH) wishes to assure the public that there is at present no cause for alarm. We have a robust public health surveillance system in place to closely monitor the situation for any changes.

The risk of an AI outbreak in Singapore’s domestic and imported poultry is also very low. The Agri-Food and Veterinary Authority (AVA) has in place a multi-layered risk mitigation approach to prevent the incursion of AI into Singapore. This includes import conditions for live birds coming into Singapore, and maintaining tight biosecurity on our local poultry farms with a contingency plan to deal with any AI outbreak. These, along with other measures such as collaborations with overseas counterparts, help reduce the risk of introduction of AI into Singapore.

MOH has a comprehensive public health surveillance network to detect changes in infectious disease landscapes both locally and overseas. It has enhanced its influenza disease surveillance system so that human cases of AI can be detected early. If necessary, MOH will step up its public health measures (e.g. isolation of cases and quarantine of contacts, temperature screening at borders and issue of travel and public health advisories) commensurate to the public health risk involved.

As of 27 January 2012, the World Health Organisation (WHO) has not issued any travel advisories restricting travel to countries with reported cases of AI. Persons who have travelled to a country with reported cases of AI will not be quarantined upon return to Singapore.
However, the following measures are recommended to minimise one’s risk of acquiring AI:

• Avoid contact with live poultry and birds;
• Avoid handling or eating raw or undercooked poultry or foods containing uncooked poultry (including eggs);
• Avoid commercial or backyard poultry farms and markets selling live poultry and/or birds;
• Avoid crowded areas with poor ventilation;
• Practise hand hygiene by washing hands thoroughly with soap and water, especially when dirtied by respiratory secretions e.g. after sneezing;
• Observe good personal and environmental hygiene;
• Wear a mask when displaying respiratory symptoms or feeling unwell;
• Maintain good body resistance through a balanced diet, regular exercise, having adequate rest, reducing stress, and not smoking.

You should seek medical attention as soon as possible and inform your doctor if you have had contact with live and/or dead poultry and/or have recently travelled to a country with reported cases of AI. You are also encouraged to exercise social responsibility by putting on a surgical mask on your way to the clinic and avoid taking public transport if possible.

There is currently no evidence to suggest that AI can be transmitted to humans from eating chicken, poultry or eggs that have been thoroughly cooked.

The Agri-Food and Veterinary Authority (AVA) has imposed high standards for the import of poultry into Singapore through pre-border (approval of overseas establishments), border and local control.  AVA carries out inspection and sampling of imported live poultry and poultry products to assure safety. 

Local poultry farms and poultry slaughterhouses are also under regular surveillance and monitoring. Imports of poultry from countries/regions with cases of AI are not permitted. As such, it is highly unlikely for one to get infected with AI by handling chickens, eggs and other poultry bought from the market or supermarket. However, general hygiene practices, such as thorough washing of hands with soap and water before and after handling and preparation of such food products are encouraged.

Currently, there are no known cases of AI in Singapore. However, proper hygiene practices, such as thorough washing of hands with soap and water after handling birds and poultry, especially when dirtied by respiratory secretions e.g. after sneezing, are encouraged.

AVA regularly monitors poultry in local farms and migratory birds in the Sungei Buloh Nature Reserve for AI. So far, there have been no known cases of AI in Singapore. However, proper hygiene practices, such as thorough washing of hands with soap and water after contact with birds and poultry, especially when dirtied by respiratory secretions e.g. after sneezing, are encouraged.

No AI viruses have been detected in migratory and common birds in Singapore. AVA works closely with the National Parks Board (NParks) to conduct regular checks on wild birds.  AVA and the National Environment Agency (NEA) work together to conduct surveillance of common birds in Singapore, such as NEA submitting dead crows to AVA laboratories for AI testing.

Proper hygiene practices, such as thorough washing of hands with soap and water after contact with dead or live poultry, are encouraged. If you come across any stray poultry in your estate, you may call the National Environment Agency (NEA) at 1800-225 5632.