WORLD / Asia-Pacific
Human-to-human bird flu transmission probed
(AP)
Updated: 2006-05-24 14:01
JAKARTA, Indonesia - The U.N. health agency is investigating whether bird
flu was passed from human-to-human among members of an Indonesian family,
but said Wednesday there is no evidence the virus has mutated or spread
beyond the family.
"We're not surprised that there is possible human-to-human transmission,"
said Steven Bjorge, a World Health Organization epidemiologist based in
Jakarta. "The thing we're looking for is whether it's sustained beyond
the immediate cluster."
Six of the seven people in the family in northern Sumatra who caught the
disease have died, the most recent on Monday. It is one of the largest
human clusters ever reported.
Person-to-person transmission of bird flu is rare, but it is one of the
biggest concerns about the disease. Scientists say that if the virus
mutates into a form easily passed between people, it could cause a
pandemic that could kill millions.
Bjorge, the WHO team leader at the village in Kubu Sembelang, said none
of the poultry in the area had tested positive for the H5N1 virus,
leading international experts to explore whether the virus spread among
the family members.
Isolated cases of very limited human-to-human transmission have been
documented - including one in Thailand involving a mother and child - but
such cases do not mean a pandemic flu strain has emerged.
Bjorge said the virus found in Kubu Sembelang is genetically the same as
the one found circulating in the area earlier.
"That, for me, is the most significant piece of evidence," he said.
"Despite some weeks now in following up, we cannot find any evidence of
any other cases beyond this cluster. If either of those two things
changed, then I would be talking very differently."
Indonesia and other countries like Vietnam have experienced similar
family clusters in the past, but none as large as the Indonesian one.
"We are worried for two reasons," said Peter Cordingley, spokesman for
the WHO regional office for the Western Pacific in Manila. "One is we've
never seen a cluster this size before. And the second reason is that we
have a team down there, they are examining what is going on and they
can't find an animal source of this infection, and that worries us."
Bjorge said the woman first believed to be infected by the virus worked
as a vegetable vendor in a market where live poultry was sold. Experts
are trying to determine if that's where she became infected. The woman,
who died May 4, was never tested for the H5N1 virus, but WHO considers
her part of the family cluster. The woman's 25-year-old brother is the
only family member still living after being infected.
"All confirmed cases in the cluster can be directly linked to close and
prolonged exposure to a patient during a phase of severe illness," the
WHO said in a statement on its Web site.
Bjorge said some samples have been taken from villagers, but that local
authorities have resisted working with outside health experts. WHO has
enlisted local villagers to help monitor the village for anyone
experiencing flu-like symptoms.
If anyone is found to have even mild symptoms, they will be quarantined
and given the anti-bird flu drug Tamiflu, he said.
Bird flu has killed 124 people worldwide, more than a quarter of them in
Indonesia. So far, most human cases have been traced to contact with
infected poultry.
"Indonesia at the moment has very, very serious problems with this
virus," Cordingley said. "(It's had) lots of cases this year and it
doesn't seem to be any closer to control."
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