The Ministry of Health has advised Rwandans to avoid direct contact with domestic animals in the wake of avian influenza, which has hit China and put other countries in Asia and the Middle East on alert.Dr. Thierry Nyatanyi, the head of Disease Prevention and Control of Epidemic Infectious diseases at Rwanda Biomedical Centre (RBC), observed that though there wasn’t any threat of the bird flu in the country, it was imperative that people avoid with direct contact with birds."We have a routine surveillance system and people should be aware that it’s not advisable to get in touch with domestic animals to avoid such diseases,” Dr Nyatanyi, said.Other regional countries are also on alert. In Uganda, the Health minister, Dr Christine Ondoa, pointed out that that her country had joined other East African Community (EAC) states to increase surveillance at entry points."We are on alert. We are aware of the outbreak and are working together to ensure we can act swiftly in case of emergency,” she was quoted in media.  On Sunday, authorities raised the total death toll by two to 14 and said two new cases of H7N9 bird flu infections were found in central China, in Henan province.Most cases of bird flu spread in humans are the result of direct or close contact with infected poultry or with surfaces contaminated by the secretions and excretions from infected birds (domesticated chickens, ducks, and turkeys).In the latest outbreak, there have been no reports of human to human transmission. The H7N9 virus may infect humans more easily, virologists say. Tracking the disease is proving difficult according to scientists. Other forms of avian flu can sicken and kill birds, but the H7N9 strain has no visible effect, meaning health authorities are forced to rely on random biological sampling at markets and farms.People who are most likely to be affected are poultry keepers, travelers visiting affected countries, those who touch an infected bird and those who eat raw or undercooked poultry meat, eggs, or blood from infected birds.Common symptoms of avian infection include cough, diarrhoea, respiratory failure and high fever.