Tuesday 9 September 2014

Veterinary School

Veterinary school

From Wikipedia, the free encyclopedia
The Norwegian School of Veterinary Science(Norges veterinærhøgskole), a veterinary school inOsloNorway.
veterinary school is a tertiary educational institution, or part of such an institution, which is involved in the education ofveterinarians. To become a veterinarian one must first complete a veterinary degree (i.e.: DVM, VMD, BVS, BVSc, BVMS, BVM, BVS, cand.med.vet, etc.)
A veterinary school should not be confused with a department of animal science. A department of animal science usually offers a pre-veterinary school curriculum, teaches the biomedical sciences (usually resulting in a Bachelor of Science degree or the equivalent), and provides graduate veterinary education in disciplines such as microbiologyvirology, and molecular biology. The terminology can be confusing, as many veterinary schools outside North America use the title "Faculty of Veterinary Science" rather than "college of veterinary medicine" or "school of veterinary medicine," and some veterinary schools (particularly those in ChinaJapan and South Korea) use the term "department" rather than college or school.[1][2]

Degrees[edit]

The College of Veterinary Medicine & Biomedical Sciences at Texas A&M University, a veterinary school in the United States.
There are several types of degrees that aspiring vets can earn; these differ according to country and may involve undergraduate or graduate education.[1] For example, in the United States, schools award the Doctor of Veterinary Medicine degree (DVM),[3]and the same degree is awarded in BangladeshCanadaEthiopiaHungaryIranMalaysiaNigeriaPakistanPhilippines,South KoreaThailandTobago and Trinidad.[1] Many countries offer a degree equivalent to the North American DVM. In theUnited Kingdom, and in many countries which have adopted the undergraduate system of higher education in which a bachelor's degree is equivalent to a DVM (albeit after five or six years of study, not four. In the United States the 4 year DVM degree is earned following a 4 year undergraduate degree totalling 8 years of study after high school), an appropriate degree is conferred ( Bachelor of Veterinary Science, Bachelor of Veterinary Medicine, Bachelor of Veterinary Medicine and Surgery etc.).[4] In Ireland, the Veterinary Medicine Programme at the University College Dublin awards the Bachelor of Veterinary Medicine (MVB)[5] At the University of Edinburgh, the degree is the Bachelor's of Veterinary Medicine & Surgery (BVM&S).[6]Some veterinary schools, however, offer a degree which enables the recipient to practice veterinary medicine in the home country but which does not permit the individual to even sit for a licensure exam in another nation. For example, veterinary schools in Afghanistan only offer the Bachelor of Science (BS) degree.[4] Ethiopia awards the Doctor of Veterinary Medicine degree, but the degree is not recognized in the US or Western Europe due to the low quality of education provided by Ethiopian veterinary schools.[7]
About 50% of Veterinarians own their own business as soon as they graduate from school. Nearly every country in the world requires an individual with a veterinary degree to belicensed prior to practicing in the profession. Most countries require a non-national who holds a veterinary degree to pass a separate licensure exam for foreign graduates prior to practicing veterinary medicine. In the US, for example, the Educational Commission for Foreign Veterinary Graduates (ECFVG) administers a four-step examination which is accepted by all American state and territorial veterinary licensing boards, the US federal government, and the District of Columbia.[8] In Europe, the European Parliament, which has some jurisdiction over the member states of the European Union (EU), issued a directive on September 30, 2005, which provides for EU-wide standards for veterinary medical education and mutual recognition of veterinary degrees between member states meeting these standards.[9] Licensure requirements are diverse, however. In South Africa, theVeterinary and Para-Veterinary Professions Act, Act 19 of 1982 provides for automatic licensure if an individual has graduated from one of several universities in South Africa, New Zealand, or the United Kingdom (as of 2008, these include the University of PretoriaMedical University of South AfricaMassey UniversityUniversity of BristolUniversity of CambridgeUniversity of EdinburghUniversity of GlasgowUniversity of Liverpool, and the University of London) or has passed the veterinary licensure examination administered by the Royal College of Veterinary Surgeons. All other persons are required to pass an examination and register with the South African Veterinary Council.[10] India has a similar system in which degrees awarded by certain schools are "deemed" to automatically qualify an individual to practice veterinary medicine, but has forgone an exam in favor of state tribunals which investigate credentials and can add a veterinarian to the register of licensed practitioners.[11]

Accreditation[edit]

Not all nations accredit veterinary schools, but all developed countries and most newly industrialized and developing countries do.[12] Few failed states have any accreditation system, however. In the United States, the American Veterinary Medical Association (AVMA) Council on Education (COE)[13] accredits veterinary schools.[14] Accreditation systems and standards vary widely, however, AustraliaNew Zealand and the United Kingdom all have vet programs that hold similar standards as those in the United States and Canada.[citation needed] The European Union is developing a common accreditation standard, but as of 2008 accreditation was most often provided by the European Association of Establishments for Veterinary Education (EAEVE).[15][16][17]
Accreditation systems vary widely in developing nations. In Mexico, El Consejo Nacional de Educación de la Medicina Veterinaria y Zootecnia (CONEVET) accredits veterinary medical colleges, although few schools are accredited.[18] The accreditation system is poor or nonexistent in other developing nations. Ethiopia, for example, has focused on building veterinary medical colleges rather than accrediting existing schools to ensure quality. Subsequently, there is almost no accreditation system and the quality of veterinary education in the country is poor.[7]

Admissions and costs[edit]

Proportion of students enrolling in each faculty at the University of Sydney from 1900 to 2000. The proportion of veterinary students is the thin pink line near the top, demonstrating the small number of places open to applicants.
Admissions practices, requirements and difficulty vary widely among veterinary schools, and from nation to nation. Generally speaking, gaining admission to a veterinary school is highly competitive, due to the small number of places available.[19] Most AVMA-accredited institutions in Australia, Canada, Ireland, New Zealand, the United Kingdom, and the United States share a common, online application system, known as the Veterinary Medical College Application Service (VMCAS).[19] Many colleges belonging to VMCAS have additional, individualized application requirements as well, and admissions standards are quite high.[19][20] Admissions standards in Europe, South America, Asia, and Africa also vary widely. Many veterinary schools limit admission to students from their area, state or country. For example, 25 of the 28 veterinary schools in the US are public universities, and by law may set aside relatively few places for out-of-state residents.[19] Other countries have similar schemes. For example, in India, federal law requires that each veterinary college set aside 15 percent of its places for students coming from other parts of India. The Veterinary Council of India (a body of the federal government), conducts the All India Common Entrance Examination, and the top scorers on the exam are placed throughout India.[21]
US Vet school costs 99-07.GIF
The cost of attending veterinary school also varies tremendously. The value of the national currency, the cost of veterinary school relative to the cost of living or median national income, the existence and amount of governmental education subsidies, the existence and amount of financial aid to students (from public or private sources), and a number of other factors combine to influence the cost of attending veterinary school. In countries where a veterinary degree is a professional degree taken as a second degree, governments may not subsidize veterinary school attendance to the degree that they do an undergraduate college education. In the United States, the average tuition was US$15,676 for residents in the 2006-2007 school year, and $28,861 a year for non-residents.[22] Average cost during the same period of fees was $3,482 (residents) and $4,452 (non-residents), room and board $8,964 (residents and non-residents), and books and equipment $2,043 (residents and non-residents).[22] In Canada during the same time period, average resident tuition wasC$5,651 and average non-resident tuition $32,942.[22] Resident and non-resident fees were C$719, resident and non-resident room and board C$6,493, and resident and non-resident books and equipment C$1,712.[22]

Curriculum[edit]

A veterinary student at the Virginia-Maryland Regional College of Veterinary Medicine receives clinical training in bovinehealth under the watchful eye of a faculty member.
Veterinary medical school curricula are not standardized. Programs may last anywhere from three to six years. In the United States and Canada, for example, the program is generally four years long. In the first three years, students are taught basic science (such asanatomyphysiologyhistologyneuroanatomypharmacologyimmunologybacteriologyvirologypathologyparasitologytoxicology) in the classroom, as well as other basic courses such as herd health (also called population health), nutritionradiography, andepidemiology. During the third year, students are exposed to clinical topics like anesthesiologydiagnosticssurgeryophthalmology,orthopedics, and dentistry. The fourth year is often 12 (not nine) months long, during which students work in a clinical setting delivering care to a wide range of animals.[23] A focus on clinical education is an aspect of most veterinary school curricula worldwide. In 2005, for the first time in its 104-year-history, the Veterinary Medicine Programme at the University College Dublin instituted a lecture-free final year focusing on clinical training.[24] The Institute of Veterinary Pathology at the University of Zurich recently developed and implemented a new curriculum for teaching pathology which includes an extensive clinical component.[25] Veterinary schools inIsrael,[26] Spain,[27] the Czech Republic,[28] and Slovakia[29] also focus heavily on clinical training.
The level of participation in clinical training can be quite limited in some schools and countries, however. In Japan, students are not permitted to engage in clinical education until they have studied for six years.[30] For example, in Sri Lanka, until recently the public owned relatively few companion animals, and veterinary medical education focused on herd health—with the result that veterinary schools focused little attention on clinical skills. As recently as 2004, this had not changed.[31] In Ethiopia, few schools have clinical training facilities, and the government has placed a priority on opening more schools rather than improving the existing colleges.[7] Even in the United States, there is some concern that clinical training may suffer because many veterinary teaching hospitals are in deep financial trouble.[32]
Veterinary students at the School of Veterinary Medicine at the University of Wisconsin–Madisontake notes during classroom lecture in June 2005.
Most veterinary schools do not permit students to engage in "species specialization"; that is, students must be expert in veterinary medicine covering a wide range of species rather than just one or two (such as dogs, cows, or reptiles).[33] Most veterinary programs do, however, allow students to take electives which will permit them to specialize upon graduation. Many veterinary schools in Australia, Canada, the United Kingdom and the United States do engage in "tracking," whereby students are asked which branch of veterinary medicine they intend to practice (companion animal, bovine, equine, food supply, avian, wildlife, public health, etc.).[34] Although tracking has proven to be contentious among some educators, about 60 percent of US and Canadian veterinary schools engage in full or partial tracking of students—and there are increased calls for full tracking by some North American veterinary medical education organizations.[35][36] Some scholars and thinkers have argued that enhanced tracking should be linked to "limited licensure," or granting veterinarians to practice veterinary medicine only in the species or specialty in which they were trained.[35][37]
Unlike human medicine, almost no veterinary medical education regimes require students to enroll in an internship and/or residency upon graduation. However, internships and residencies are often required for veterinarians seeking board certification in Canada, Europe and the US.[38]
Lecture and rote learning are two of the most common teaching methods used in veterinary medical education.[39] To a lesser degree, outcome-based education[40] and discovery learning are also common pedagogical approaches. Inquiry-based learning is also sometimes used.[41] In the last two decades, problem-based learning has been adopted in most veterinary schools in developed countries, especially those in Australia, Canada, New Zealand, the United States, and Western Europe.[42]

Monday 8 September 2014

Avian influenza

Source: http://en.wikipedia.org/wiki/Avian_influenza
Avian influenza — known informally as avian flu or bird flu — refers to "influenza caused by viruses adapted to birds."[1][2][3][4][5][6][7]The version with the greatest concern is highly pathogenic avian influenza (HPAI).
"Bird flu" is a phrase similar to "swine flu," "dog flu," "horse flu," or "human flu" in that it refers to an illness caused by any of many different strains of influenza viruses that have adapted to a specific host. All known viruses that cause influenza in birds belong to the species influenza A virus. All subtypes (but not all strains of all subtypes) of influenza A virus are adapted to birds, which is why for many purposes avian flu virus is the influenza A virus. (Note, however, that the "A" does not stand for "avian").
Adaptation is not exclusive. Being adapted toward a particular species does not preclude adaptations, or partial adaptations, toward infecting different species. In this way, strains of influenza viruses are adapted to multiple species, though may be preferential toward a particular host. For example, viruses responsible for influenza pandemics are adapted to both humans and birds. Recent influenza research into the genes of the Spanish flu virus shows it to have genes adapted to both birds and humans, with more of its genes from birds than less deadly later pandemic strains.
While its most highly pathogenic strain (H5N1) had been spreading throughout Asia since 2003, avian influenza reached Europe in 2005, and the Middle East, as well as Africa, the following year.[8] On January 22, 2012, China reported its second human death due to bird flu in a month following other fatalities in Vietnam and Cambodia.[9] Companion birds in captivity and parrots are highly unlikely to contract the virus, and there has been no report of a companion bird with avian influenza since 2003. Pigeons do not contract or spread the virus.[10][11][12] 84% of affected bird populations are composed of chicken and farm birds, while the 15% is madeup of wild birds according to capture-and-release operations in the 2000s, during the SARs pandemic. The first deadly Canadian case was confirmed on January 3, 2014.[13]

Genetics[edit]

Genetic factors in distinguishing between "human flu viruses" and "avian flu viruses" include:
PB2: (RNA polymerase): Amino acid (or residue) position 627 in the PB2 protein encoded by the PB2 RNA gene. Until H5N1, all known avian influenza viruses had a Glu at position 627, while all human influenza viruses had a Lys.[citation needed]
HA: (hemagglutinin): Avian influenza HA viruses bind alpha 2-3 sialic acid receptors, while human influenza HA viruses bind alpha 2-6 sialic acid receptors. Swine influenzaviruses have the ability to bind both types of sialic acid receptors. Hemagglutinin is the major antigen of the virus against which neutralizing antibodies are produced, and influenza virus epidemics are associated with changes in its antigenic structure. This was originally derived from pigs, and should technically be referred to as "pig flu" [14]

Subtypes[edit]

There are many subtypes of avian influenza viruses, but only some strains of four subtypes have been highly pathogenic in humans. These are types H5N1, H7N3, H7N7, H7N9, and H9N2.[15] At least one person, an elderly woman in Jiangxi ProvinceChina, died of pneumonia in December 2013 from the H10N8 strain, the first human fatality confirmed to be caused by that strain.[16]

Contraction/spreading of avian influenza[edit]

Most human contractions of the avian flu are a result of either handling dead infected birds or from contact with infected fluids. While most wild birds mainly have only a mild form of the H5N1 strain, once domesticated birds such as chickens or turkeys are infected, it could become much more deadly because the birds are often within close contact of one another. There is currently a large threat of this in Asia with infected poultry due to low hygiene conditions and close quarters. Although it is easy for humans to become infected from birds, it's much more difficult to do so from human to human without close and lasting contact.
Spreading of H5N1 from Asia to Europe is much more likely caused by both legal and illegal poultry trades than dispersing through wild bird migrations, being that in recent studies, there were no secondary rises in infection in Asia when wild birds migrate south again from their breeding grounds. Instead, the infection patterns followed transportation such as railroads, roads, and country borders, suggesting poultry trade as being much more likely. While there have been strains of avian flu to exist in the United States, such as Texas in 2004, they have been extinguished and have not been known to infect humans.
Examples of avian influenza A virus strains:[17]
HA subtype
designation
NA subtype
designation
Avian influenza A viruses
H1N1A/duck/Alberta/35/76(H1N1)
H1N8A/duck/Alberta/97/77(H1N8)
H2N9A/duck/Germany/1/72(H2N9)
H3N8A/duck/Ukraine/63(H3N8)
H3N8A/duck/England/62(H3N8)
H3N2A/turkey/England/69(H3N2)
H4N6A/duck/Czechoslovakia/56(H4N6)
H4N3A/duck/Alberta/300/77(H4N3)
H5N3A/tern/South Africa/300/77(H4N3)
H5N4A/Ethiopia/300/77(H6N6)
H5N9A/turkey/Ontario/7732/66(H5N9)
H5N1A/chick/Scotland/59(H5N1)
H6N2A/turkey/Massachusetts/3740/65(H6N2)
H6N8A/turkey/Canada/63(H6N8)
H6N5A/shearwater/Australia/72(H6N5)
H6N6A/jyotichinara/Ehiopia/73(H6N6)
H6N1A/duck/Germany/1868/68(H6N1)
H7N7A/fowl plague virus/Dutch/27(H7N7)
H7N1A/chick/Brescia/1902(H7N1)
H7N9A/chick/China/2013(H7N9)
H7N3A/turkey/England/639H7N3)
H7N1A/fowl plague virus/Rostock/34(H7N1)
H8N4A/turkey/Ontario/6118/68(H8N4)
H9N2A/turkey/Wisconsin/1/66(H9N2)
H9N6A/duck/Hong Kong/147/77(H9N6)
H9N6A/duck/Hong Kong/147/77(H9N6)
H9N8A/manishsurpur/Malawi/149/77(H9N8)
H9N7A/turkey/Scotland/70(H9N7)
H10N8A/quail/Italy/1117/65(H10N8)
H11N6A/duck/England/56(H11N6)
H11N9A/duck/Memphis/546/74(H11N9)
H12N5A/duck/Alberta/60/76/(H12N5)
H13N6A/gull/Maryland/704/77(H13N6)
H14N4A/duck/Gurjev/263/83(H14N4)
H15N9A/shearwater/Australia/2576/83(H15N9)

Influenza pandemic[edit]

Further information: Influenza pandemic
Pandemic flu viruses have some avian flu virus genes and usually some human flu virus genes. Both the H2N2 and H3N2 pandemic strains contained genes from avian influenza viruses. The new subtypes arose in pigs coinfected with avian and human viruses, and were soon transferred to humans. Swine were considered the original "intermediate host" for influenza, because they supported reassortment of divergent subtypes. However, other hosts appear capable of similar coinfection (e.g., many poultry species), and direct transmission of avian viruses to humans is possible.[18] The Spanish flu virus strain may have been transmitted directly from birds to humans.[19]
In spite of their pandemic connection, avian influenza viruses are noninfectious for most species. When they are infectious, they are usually asymptomatic, so the carrier does not have any disease from it. Thus, while infected with an avian flu virus, the animal does not have a "flu". Typically, when illness (called "flu") from an avian flu virus does occur, it is the result of an avian flu virus strain adapted to one species spreading to another species (usually from one bird species to another bird species). So far as is known, the most common result of this is an illness so minor as to be not worth noticing (and thus little studied). But with the domestication of chickens and turkeys, humans have created species subtypes (domesticated poultry) that can catch an avian flu virus adapted to waterfowl and have it rapidly mutate into a form that kills over 90% of an entire flock in days, can spread to other flocks and kill 90% of them, and can only be stopped by killing every domestic bird in the area. Until H5N1 infected humans in the 1990s, this was the only reason avian flu was considered important. Since then, avian flu viruses have been intensively studied; resulting in changes in what is believed about flu pandemics, changes in poultry farming, changes in flu vaccination research, and changes in flu pandemic planning.
Influenza A/H5N1 has evolved into a flu virus strain that infects more species than any previously known strain, is deadlier than any previously known strain, and continues to evolve, becoming both more widespread and more deadly. This caused Robert G. Webster, a leading expert on avian flu, to publish an article titled "The world is teetering on the edge of a pandemic that could kill a large fraction of the human population" in American Scientist. He called for adequate resources to fight what he sees as a major world threat to possibly billions of lives.[20]
Vaccines for poultry have been formulated against several of the avian H5N1 influenza varieties. Vaccination of poultry against the ongoing H5N1 epizootic is widespread in certain countries. Some vaccines also exist for use in humans, and others are in testing, but none have been made available to civilian populations, nor are produced in quantities sufficient to protect more than a tiny fraction of the Earth's population in the event of an H5N1 pandemic outbreak. The World Health Organization has compiled a list of known clinical trials of pandemic influenza prototype vaccines, including those against H5N1.

H5N1[edit]

The highly pathogenic influenza A virus subtype H5N1 is an emerging avian influenza virus that has been causing global concern as a potential pandemicthreat. It is often referred to simply as "bird flu" or "avian influenza", even though it is only one subtype of avian influenza-causing virus.
H5N1 has killed millions of poultry in a growing number of countries throughout Asia, Europe, and Africa. Health experts are concerned that the coexistence of human flu viruses and avian flu viruses (especially H5N1) will provide an opportunity for genetic material to be exchanged between species-specific viruses, possibly creating a new virulent influenza strain that is easily transmissible and lethal to humans. The mortality rate for humans with H5N1 is 60%.
Since the first H5N1 outbreak occurred in 1987, there has been an increasing number of HPAI H5N1 bird-to-human transmissions, leading to clinically severe and fatal human infections. Because a significant species barrier exists between birds and humans, though, the virus does not easily cross over to humans, though some cases of infection are being researched to discern whether human to human transmission is occurring.[18] More research is necessary to understand the pathogenesis and epidemiology of the H5N1 virus in humans. Exposure routes and other disease transmission characteristics, such as genetic and immunological factors that may increase the likelihood of infection, are not clearly understood.[21]
On January 18, 2009, a 27-year-old woman from eastern China died of bird flu, Chinese authorities said, making her the second person to die from the deadly virus at that time. Two tests on the woman were positive for H5N1 avian influenza, said the ministry, which did not say how she might have contracted the virus.[22]
Although millions of birds have become infected with the virus since its discovery, 359 humans have died from the H5N1 in twelve countries according toWHO data as of August 10, 2012.[23]
The avian flu claimed at least 300 humans in Azerbaijan, Cambodia, China, Egypt, Indonesia, Iraq, Laos, Nigeria, Pakistan, Thailand, Turkey, and Vietnam. Epidemiologists are afraid the next time such a virus mutates, it could pass from human to human; however, the current A/H5N1 virus does not transmit easily from human to human. If this form of transmission occurs, another pandemic could result. Thus, disease-control centers around the world are making avian flu a top priority. These organizations encourage poultry-related operations to develop a preemptive plan to prevent the spread of H5N1 and its potentially pandemic strains. The recommended plans center on providing protective clothing for workers and isolating flocks to prevent the spread of the virus.[24]
The Thailand outbreak of avian flu caused massive economic losses, especially among poultry workers. Infected birds were culled and slaughtered. The public lost confidence with the poultry products, thus decreasing the consumption of chicken products. This also elicited a ban from importing countries. There were, however, factors which aggravated the spread of the virus, including bird migration, cool temperature (increases virus survival) and several festivals at that time.[25]

H7N9[edit]

Further information: Influenza A virus subtype H7N9
Influenza A virus subtype H7N9 is a novel avian influenza virus first reported to have infected humans in 2013 in China.[26] Most of the reported cases of human infection have resulted in severe respiratory illness.[27] In the month following the report of the first case, more than 100 people had been infected, an unusually high rate for a new infection; a fifth of those patients had died, a fifth had recovered, and the rest remained critically ill.[28] The World Health Organization (WHO) has identified H7N9 as "...an unusually dangerous virus for humans."[29] As of June 30, 133 cases have been reported, resulting in the deaths of 43.
Research regarding background and transmission is ongoing.[30] It has been established that many of the human cases of H7N9 appear to have a link to live bird markets.[31] As of July, there has been no evidence of sustained human-to-human transmission, however a study group headed by one of the world’s leading experts on avian flu reported that several instances of human-to-human infection are suspected.[32] It has been reported that H7N9 virus does not kill poultry, which will make surveillance much more difficult. Researchers have commented on the unusual prevalence of older males among H7N9-infected patients.[33] While several environmental, behavioral, and biological explanations for this pattern have been proposed,[34] as yet, the reason is unknown.[35] Currently no vaccine exists, but the use of influenza antiviral drugs known as neuraminidase inhibitors in cases of early infection may be effective.[36]
The number of cases detected after April fell abruptly. The decrease in the number of new human H7N9 cases may have resulted from containment measures taken by Chinese authorities, including closing live bird markets, or from a change in seasons, or possibly a combination of both factors. Studies indicate that avian influenza viruses have a seasonal pattern, thus it is thought that infections may pick up again when the weather turns cooler in China.[37]

In domestic animals[edit]

Several domestic species have been infected with and shown symptoms of H5N1 viral infection, including cats, dogs, ferrets, pigs, and birds.[38]

Birds[edit]

Attempts are made in the United States to minimize the presence of HPAI in poultry thorough routine surveillance of poultry flocks in commercial poultry operations. Detection of a HPAI virus may result in immediate culling of the flock. Less pathogenic viruses are controlled by vaccination, which is done primarily in turkey flocks (ATCvet codes: QI01AA23 for the inactivated fowl vaccine, QI01CL01 for the inactivated turkey combination vaccine).[39]

Seals[edit]

A recent strain of the virus is able to infect the lungs of seals.[40]

Cats[edit]

Avian influenza in cats can show a variety of symptoms and usually lead to death. Cats are able to get infected by either consuming an infected bird or by passing it to other cats.

Influenza Prevention[edit]

People who have fewer chances to contact with birds do not belong to the high-risk group of HPAI. If people take precautions correctly and be more careful, the chance of infection will be very low, even among farmers.
In the aware of bird flu pandemic, people should have careful thought to adopt suitable Infection Control Procedures. Try to avoid flu infection in any situation will be necessary. Protecting eyes, nose, mouth and hands from virus particles will be a major priority because these are the most common passageways for a flu virus to transfer into the body.[41] Bird flu virus particles may also be transferred through clothing or even shoes. The final step is people should always have sanitized hands in order to further reduce the chances of cross-contamination. Any unprotected clothing or footwear should be disinfected. Avoid contact with poultry, and maintaining good personal hygiene is very important, too. Someone who has normal flu should be more careful in avoiding contact with fowl because the epidemic situation will become even more serious if the receptor protein of normal flu and the genes of Avian Flu combine with each other.[41]