WHO Probes Family That Died of Bird Flu

http://www.washingtonpost.com/wp-dyn/content/article/2006/05/23/AR2006052301912.html
http://tinyurl.com/hpzfb

By MARGIE MASON
The Associated Press
Tuesday, May 23, 2006; 10:19 PM

HANOI, Vietnam -- The U.N. health agency is looking closely at possible
limited human-to-human transmission of bird flu between members of an
Indonesian family, but said there was no evidence indicating the virus
had mutated or that it had spread beyond the relatives.

"We're not surprised that there is possible human-to-human
transmission," said Steven Bjorge, a World Health Organization
epidemiologist in Jakarta, Indonesia. "The thing we're looking for is
whether it's sustained beyond the immediate cluster."

Six of the seven people in the family from northern Sumatra who have
caught the deadly disease have died, the most recent on Monday. It is
one of the largest human clusters ever reported.

Bjorge, who is the team leader at the village in Kubu Sembelang, said
none of the poultry in the area tested positive for the H5N1 bird flu
virus, which has led a team of international experts to explore whether
the virus spread among the relatives.

He warned, however, that such isolated cases of very limited
human-to-human transmission have been documented _ including a case in
Thailand involving a mother and child _ and that it does not mean a
pandemic flu strain has emerged.

Bjorge said the virus has not altered its form in any way and is
genetically the same as the virus 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."

Bjorge said some samples have been taken from villagers, but
cooperation has been limited. If anyone outside the family is found to
have even mild flu symptoms, he said they would be quarantined and
given the anti-bird flu drug Tamiflu.

Earlier in a statement on its Web site, the WHO in Geneva said it was
still investigating the cluster, but experts were looking closely at
the possibility of limited human-to-human transmission. Scientists from
the WHO and the U.S. Centers for Disease Control and Prevention are
investigating.

"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 statement said. "Although human-to-human transmission cannot be
ruled out, the search for a possible alternative source of exposure is
continuing."

Health experts are concerned that if the virus mutates to a form that
is easily transmissible between people, it could lead to a pandemic. So
far, most human cases have been traced to contact with infected
poultry.

Bird flu has killed 123 people worldwide, nearly a quarter of them in
Indonesia.

The spread of bird flu from one person to another is very rare, and it
has always faded out after that. The start of a flu pandemic would
require the virus to be easily spread among people.
___

Associated Press writer Alexander G. Higgins in Geneva contributed to
this report.