CHAPTER I INTRODUCTION

Influenza disease in fact have there is since former epoch. Because this disease is very easy to spread, it have been happened pandemic influenza for several times that cause by the virus of different influenza A subtype, which is Spanish Flu which became of year 1918 where its cause is virus of influenza of A Subtype H1N1 and defeat 40-50 million people. Asian Flu which because of virus of influenza of A Subtype H2N2 happened in the year 1957 also swallow a lot of sacrifice. Later, in the year 1968 arising pandemic influenza which because of H3N2 with death amount about 1 million people. Epidemic of avian influenza which because of virus of influenza of A Subtype H5N1 start recognized in the year 1997 in Hongkong, with source of infection and spreading coming from poultry ranch. Here in after that way contagiously to whole world so that become global problem. Growth of avian influenza that happened in Indonesia also very quickly since finding of this virus in the year 2004, namely later poultry disseminate swiftly at human being. With height of mortality of effect of of avian influenza, we the need allert in order to this disease do not round into pandemic. For That, need taken by an amount of preventive action in individual human and also environmental.

CHAPTER II THEORETICAL REVIEW

What is avian influenza? Disease of avian influenza or flu Poultry ( bird flu or avian influenza) is a disease which because of influenza virus which ditularkan by poultry, in this case the chicken, parroting, bird, goose, turkey, or the poultry of a kind. In fact disease of avian influenza is disease of at animal ( zoonis). However, in growth the virus of this disease cause experience of change at the structure genetic ( mutation) resulting this virus earn influezed to human being. avian influenza earn to groan entire/all nation or continent and generate pandemi during 2-3 year. At poultry of livestock or concubine, infection by virus of avian influenza cause incidence of two forming disease, that is form which patogenising lower or less raise hell ( low pathogenic). The form of diseases which patogenesing lower or less raise hell and do not kill often be referred as with Low Pathoghenic Avian Influenza Viruses/LPAIV, what only cause light symptom and generally is not detected. This disease is infected from poultry of carrier of virus of avian influenza to livestock poultry which easy to influenze. Meanwhile, very form raise hell / killing recognized with Highly Pathogenic Avian Influenza Viruses. HPAIV generate very symptom of excitement, catching easy, and cause disease of at organs of poultry body. Mount tired death 100% only in range of time 48 hours ( at poultry). Follow the example of virus which the included in HPAIV is H5N1. What causing avian influenza? Cause of avian influenza is virus of influenza of A Subtype H5N1. Virus Influenza is included in Familia Orthomyxoviridae Composed for human being, that is type A, B, and C. virus of influenza A in form of symmetrical spiral and own shroud wrapping items genetic which in the form of RNA ( Ribonucleic Acid)

enchain single of polarity negative. This Virus have two kinds of gibbosity, namely hemaglutinin (H) and neuraminidase ( N),H2N2, H3N2,or H5N1. And there are 16 subtype H(H1-H16) and 9 subtype N ( N1-N9) In virus of influenza A earn happened the big change at composition antigenic is so-called antigenic shift or happened the change minimize composition antigenic of is so-called as antigenic drift. This changes trigger incidence of epidemic or even pandemic. Wave of epidemic because of influenza virus take place in periodic every 2-3 year, while period the happening of interepidemi to influenza B is longer that is 3-6 year. Each 10-40 year, if emerging subtype of virus of new influenza A, will arise a pandemi such as that happened in the year 1018 (H1N1), 1957 ( H2N2), and 1968 (H3N2). In the year 1997 have emerged new subtype H5N1.Although until in this time not yet resulted pandemic. At human being only there are virus of influenza A from subtype H1N1, H2N2, H3N3, H5N1, H9N2, H1N2, and H7N7, while at animal is subtype H1 until H5 and N1 until N9. From of all the subtype, only virus of influenza of A Subtipe H5 And H7 which have been known to earn to cause very disease raise hell. Still do not all virus of influenza of subtype H5 and H7 have the character of to raise hell, and nor altogether cause disease at poultry. How the characteristic of virus of avian influenza (H5N1)? Important presumably we know the characteristic of virus of avian influenza ( H5N1), since thereby we earn to know the way of virus of H5N1 be infected and way of preventing infection. As for characteristic of virus of avian influenza ( H5N1) is: Form and have the mutation Underwater living on until 4 day at temperature 22C and more than 30 day at temperature 0C Living on longer in faeces or ill poultry body.

 Die at warm-up 80C during 1 minute, or with temperature 60C during 30 minutes and at temperature 56C during 3 hours. Die with detergen, disinfectant ( such as formalin), dilution containing iodine ( such as Betadine) and also natrium of hypochlorite potassium ( the example whitening of clothes).

Symptom Symptom of avian influenza between poultry and human being: A. Symptom at Poultry Jengger and blue pial chromatic Expenditure of blood flatten at foot which in the form of red fleck or often there are ulcer in foot is so-called with "kaki kerokan" Existence dilution at eye and nose so that be happened by the respiration trouble Go out clear dilution jell from mouth cavity Diarrhoea Starve for abundant and flabby hust egg Very high and Sudden death sum up come near 100% during 2 maximal day 1 week. Incubation period about one week

B. Symptom at The Human Preceded with incubation period (a period to entry of virus up to incidence with ill symptom) that goes on few days generally 1-3 day, at ordinary children until 21 day. Initially patient show fever symptom ( above body temperature 38C) and the symptom loo like influenza (flu-like syndrome), such as headache, cough, head cold, pain in bone muscle, and the red lane pain. Sometimes be

found a diarrhoea symptom, vomit, pain in bone stomach, pain in bone chest, and nosebleed or expenditure of blood at gum. At children frequently be met symptom of otitis media ( infection of middle shares ear) Few days later then arise asphyxia, representing one of sign of the happening infection in lung ( pneumonia). Complication will be happened if patient lost time to be brought to hospital to get treatment. As for complication is failing breath and fail multiorgan marked with symptom do not function kidney and heart, up to sepsis and even death.

Preventive Prevention of spreading of disease of avian influenza earn conducted by applying action preventif / prevention to poultry of itself and also human being. A. The Poultry Elementary principle of precaution, operation and eradication of avian influenza of at poultry is by applying the the following things. Preventing contact between poultry which rentan with virus H5N1 Omitting of Virus H5N1 with decontamination / disinfektan. Improving of Body impenetrability with vaccination Improving awareness socialize ( public awareness) for the importance of life make healthy and clean and care of existence of disease of avian influenza around we. Execution action which can be conducted is : 1. Improving biosekuriti, an action of observation and tight security to poultry of concubine and livestock which infection of avian influenza 2. Vaccination for poultry make healthy with vaccine produce local and import which have got registration number from Departement Agriculture

3. Depopulasi / destruction of poultry of animal of carrier of virus H5N1 in radius three kilometre. Government chosen selective destruction step or limited contagious district because of fund limitation 4. Operation of traffic of Exit enter livestock of poultry and poultry product 5. Observation (surveillance) case of avian influenza 6. Admission filling Cage return (restocking) 7. Destruction totally ( stamping out) for all poultry in contagious district newly 8. Make-Up of awareness socialize (public awareness) 9. Monitoring or evaluate Things which must be conducted for poultry ranch (especially which have the small scale) moment is not happened by epidemic of avian influenza: 1. Taking care of good poultry livestock in a condition by having to access clean water, free and adequate food and free of worm, and also give vaccination 2. Keep cleaning and health of cage of livestock of poultry or Concubine always clean cage from dirt with disinfectant which contains klor, such as dilution of whitening clothes 3. Checking goods which come into ranch in order to free from virus H5N1. Things which must be done to protect poultry ranch (specially which have the scale minimize) at the time of happened by epidemic of avian influenza of around ranch: 1. Poultry which infection of virus H5N1 have to be annihilated by burned then be buried in dig hole which have scattered by petrify calcify, in order to the virus which there are in poultry body is not permeated by ground.

2. Looking after poultry livestock in place protected, such as in cage which is separated from a house, do not let the poultry gallivante in environment of house or lawn. 3. Limiting of People who step into ranch 4. Always clean cage, equipments ( place eat /drink, lorry, worker shoe, dll.), and kendaraan conveyor by using periodical disinfectant. Cleaning also lawn by sweeping 5. Keep fertilize cage of far from pool, well,etc B. Socialize For high group have risk ( worker of poultry ranch, merchant, or which dealt only with the poultry product) needed by a actions : Always clean hand with soap or disinfectant after working and also before touching of food and beverage Take a bath at work after finishing to work Avoiding direct contact with ill poultry or infection of avian influenza. Using protector appliance, such as masker, overalls, eyeglasses google, galoshoes, and or gauntlet of rubber of thick. Leaving of overalls in workplace Immunize / vaccination For society generally, what need conducted is taking care of environmental and personal hygiene, and also obtain vaccination. Hygiene Pribadi and Environmental For take care of hygiene of ownself and environmental, which can be conducted:

Do not touch poultry live or dirt which possible contain virus of avian influenza H5N1 Always clean hand After contact with poultry live or the crosscut livestock chicken / egg After process of poultry or product, such as egg.

Managing and process poultry by real correct, that is: Chosening healthy poultry (do not there are disease symptoms of body) Cooking chicken flesh/ bird / duck and egg until really ripe If there are dilution is red such as blood emiting a stream of from ripe by poultry flesh or middle at share of bone marrow still red chromatic, flesh shall be cooked by the ripe return until. Turn yellow and the ripe protein have to really ripe (no halfdone new shares) If buying chicken live, strive in order not to touch it. If buying flesh chicken / duck, clean beforehand with water emit a stream of before kept in refrigerator. Afterwards clean hand with soap Bought New egg chicken / duck have to be cleaned first with water emit a stream of to clean it from dirt which generally patch at eggshell, then that egg dried with clean mop or the tissue, new kept in refrigerator. After finishing to clean hand with soap. Taking care of endurance of body with healthy life, consuming well-balanced and nutritious food, enough the rest, regular athletics and also avoid stress and smoke.

If ill medium is we which must conduct " Crowded avoiding places and which have the ugly air-refreshing " use Masker for prevent in order to we is not be contagious and or contagious disease which we suffer " Don't go to place or to district which is being attacked by epidemic of avian influenza Don't consume product containing raw egg halfdone atrau.

The example, strong jamu with halfdone egg. Taking care of environmental and individual hygiene remain to be awaked goodness by : Remain to take care of clean hand always and do not forget to clean hand. Closing nose and trap if medium sneeze or cough. If wishing throwing away phlegm, shall throw away at tissue paper before hand thrown into ash Always clean hand after sneezing, cough, or touch tissue of place phlegm / ripples.

Vaccination Until in this time not yet there is vaccine capable to prevent growth of avian influenza at human being. Vaccine for the influenza which in this time have circulating in society is to the influenza disease which because of virus influenza A subtype H1N1, H3N2, and also virus of Inveterate influenza B groan human being. This vaccine is effective giving protection to ordinary influenza until 70-90% at healthy adult. Better the gift of influenza vaccine as according to type and subtype virus, in consequence this vaccine cannot giving protection or body impenetrability to H5N1. Usage accination at human being have to take a care to prevent the happening of virus mutation. Nevertheless, vaccine earn to assist to lessen complications and support treatment at home the pain. Vaccination to ordinary influenza of suggested for those who more have risk incured more complication of risk incured by complication from influenza

Old Age > 50 year Age children 6-24 year Somebody have Age > 24 month having chronic disease, such as asthma, diabetes, disease of paru kronis,etc

Children and young adult getting therapy of old meter aspirin and have risk incured by]syndrome Reye after influenza

Health worker Pregnant woman ( trisemester II and III) Vaccine may not be passed to a acute fever patient, pregnant mother at

trisemester I, and the age baby 0-6 month. For medical obtaining advice whether somebody need vaccination, socialize have to go to discover to the doctor. Vaccine which opponent of virus of H5N1 Medium checked in some countries and not yet there is readily vaccine to be produced commercially during near by this. In this time the vaccination destined for poultry. Indonesia have able to make vaccine of avian influenza for the poultry which called bird close 5.1 which is made by Institute of Agriculture Bogor ( IPB) working equal to a company from Japan. This Diharapakan vaccination earn effective prevent spreading his expected of disease of avian influenza, since making use virus H5N1 from galur in Indonesia. What is vitamin or suplemen nutritions earn to improve system of body impenetrability? Normally vitamin or suplemen of dissimilar is not needed. Way of best to increase system of body impenetrability by answering the demand nutritious and well-balanced food or 4 health 5 perfection, regular athletics, enough take a rest, and the healthy life

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Medication Managery of medication for patient of avian influenza is taking care of to stay with pain at insulation space to get medication and appropriate treatment, since nature of ferocious disease. Patient have to get oxygen for asphyxia, dilution perenteral (infuse), medicinize antivirus, and the dissimilar medication that is needed by patient. Medicinize antivirus There four type medicinize which can be used as drug of antivirus of influenza A, namely amantadin, rimantadin, osetamivir (what commercially be recognized with Tamiflu), and Zanamivir ( commercially be recognized with Relenza) To four medicinize this influenza medication applicable to be ordinary we recognize (seasonal influenza). However, do not all this drug antivirus applicable to cure disease of caused by flu bird of virus of influenza of A Subtype H5N1. According research which have been conducted by all expert, virus H5N have resisten or tie to amantadin and rimantadin. Given Oseltamivir in oral and zanamivir in inhalasi ( breathed in) melawan of virus H5N1.Other used in pngobatan, oseltamivir also earn exploited as profilaksis or preventive to avian influenza. Use Oseltamivir observed in tighten by related/relevant department utilize to prevent unjustified usage and in order to is not happened by resistensi to the drug. In Consequence, when natural medium of influenza, you may not promiscuously drink oseltamivir as drug and or profilaksis, oseltamivir have to diresepkan by doctor of if diagnosed to instruct at avian influenza.

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What us may drink oseltamivir as profilaksis? Efektifity oseltamivir as profilaksis to virus of avian influenza H5N1 of depend on level of health and somebody age. In this time oseltamivir as profilaksis only be given to them which incured by high berisiko of avian influenza. The Example, all worker of health and worker of poultry ranch which ever for virus H5N1. Take medicine antivirus byself, without reciven by doctor, very is not suggested by and shall not be done by since potency of side effects and opportunity incidence of resistensi will very high.

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CHAPTER III CONCLUSION

Avian influenza or flu Poultry ( bird flu or avian influenza) is a disease which because of influenza virus which ditularkan by poultry, in this case the chicken, parroting, bird, goose, turkey, or the poultry of a kind. Important presumably we know the characteristic of virus of avian influenza ( H5N1), since thereby we earn to know the way of virus of H5N1 be infected and way of preventing infection. As for characteristic of virus of avian influenza ( H5N1) is: Form and have the mutation Underwater living on until 4 day at temperature 22C and more than 30 day at temperature 0C Living on longer in faeces or ill poultry body. Die at warm-up 80C during 1 minute, or with temperature 60C during 30 minutes and at temperature 56C during 3 hours. Die with detergen, disinfectant ( such as formalin), dilution containing iodine ( such as Betadine) and also natrium of hypochlorite potassium ( the example whitening of clothes).

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BIBLIOGRAPHY

World Health Organization (WHO). 2006. Ten Things You Need To Know About Pandemic Influenza. http://www.who/int/crs/disease/influenza/pandemic10things/en/index.html//

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