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Avian influenza

Children and bird flu

© UNICEF/2008/ Purnomo
Children read a newspaper while wearing masks during a massive simulated bird flu pandemic in Bali, Indonesia.

A direct risk to children’s health

Avian influenza is already affecting the lives and livelihoods of families and children in affected areas.  The bird virus has so far disproportionately affected children’s health and survival.

The avian influenza outbreak in Asia between 2005 and 2006 has been characterized by a preponderance of severe illness in children (1). Children account for about half of all reported human cases and a third of deaths from avian influenza to date. (2) While it is not known why so many children are being infected by the virus, one potential explanation may be that children, especially girls, often care for domestic poultry by feeding them, cleaning pens and gathering eggs. Children may also have closer contact with poultry as they often treat them as pets.

If the virus adapts to humans and passes easily between people there is likely to be a massive human outbreak affecting every country in the world.  Children’s life and family security will be seriously threatened since a pandemic would disrupt every aspect of normal life. These children have likely been infected by domestic birds during close contact. The mortality rate in all infected persons has been high. Unusual disease patterns have been observed in children, such as predominately gastrointestinal or central nervous system illness, in addition to presentations with respiratory signs and symptoms. While the clinical manifestations of the influenza virus strain that causes the pandemic cannot be predicted, influenza-like respiratory illness is likely to be part of the clinical spectrum.

Secondary risk factors for children

The destructive impact of avian flu on children goes well beyond the immediate risk to their health. Outbreaks of avian flu among domestic birds mean that families lose an important source of food and income. This can affect children’s health and threaten their access to education. When income drops dramatically, families sometimes can’t afford to send their children to school or pay for essential health services.


  1. Nicoll A, Children, Avian influenza H5N1 and preparing for the next pandemic. Archives of Disease in Childhood 2008;93:433-438[BMJ]
  2. WHO-confirmed human cases of avian influenza A(H5N1) infection, 25 November 2003– 24 November 2006. Weekly Epidemiological Record, WHO, 2007:82:41–48 [PDF]
  3. Webster RG, Guan Y, Poon L, et al. The spread of the H5N1 bird flu epidemic in Asia in 2004. Arch Virol Suppl 2005:117-29. [PubMed].
  4. Olsen SJ, Laosiritaworn Y, Pattanasin S, Prapasiri P, Dowell SF. Poultry-handling practices during avian influenza outbreak, Thailand. Emerg Infect Dis [serial on the Internet]. 2005 Oct [date cited]. Available from the CDC website.



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