Close contact could see humans spread bird flu: WHO

By Dan Eaton and Achmad Sukarsono

JAKARTA (Reuters) – The growing number of people with bird
flu-like symptoms in Indonesia does not mean the outbreak is
becoming worse, and there is no sign the virus can be passed
easily among people, top U.N. health experts said on Thursday.

Alarm has spread in populous Indonesia after four people
died and with now 10 are under observation in the capital.

But there is no evidence the H5N1 virus has mutated into a
form that could trigger a pandemic, said Georg Petersen, the
World Health Organization’s Indonesia representative.

Nevertheless, he pointed to the possibility of transmission
through very close contact with an infected person.

“I think very close contact with a sick person might infect
that caretaker. That is why in hospitals we need to take all
precautions … That would be in a way a human-to-human
transmission, but that demands close, close contact,” he said.

“Anytime someone coughs and you get it … that would be
much more what we would call transmission from human to human.”

Petersen said the case of a father and his two daughters
who died in the Tangerang suburb of Jakarta in July might have
involved “within-family transmission.”

Thailand had reported a probable case of human-to-human
transmission in September 2004, when a 26-year-old woman died
of bird flu after “prolonged face-to-face exposure” with her
daughter, who was hospitalized with the virus.

Dr Margaret Chan, the WHO’s global special representative
on avian flu, also said on Thursday there was no sign the virus
had mutated into a form that could easily spread among people.

“So far there is no evidence for increased chance of
human-to-human transmission,” Chan told Reuters by telephone
from Sydney after attending a WHO conference in Noumea, capital
of New Caledonia in the South Pacific.

The rise in the number of suspected cases did not point to
an epidemic, she said.

“With increased surveillance it’s not unusual that you
would pick up more cases,” Chan said.

Bird flu has killed 64 people in Asia since 2003 and has
since been found in birds in Russia and Europe.

HIGH ALERT

Petersen said laboratory tests on people killed by bird flu
in Indonesia showed they had the same or a similar virus that
has killed millions of poultry in Asia.

“The tests from the 37-year-old woman … so far that looks
like the bird virus. So there is no reason to believe there has
been any mutation so far,” Petersen said of the fourth
confirmed bird flu death in the country.

“In the context of bird flu … we have transmission from
an avian epidemic to humans in a few cases. And so far the
virus we have found in the people who have died of this is the
same virus or similar to the virus circulating in the chicken
population. There is no sort of epidemic amongst humans.”

I Nyoman Kandun, the head of disease control at Indonesia’s
health ministry, said tests so far showed there was only one
patient out of those being observed who was positive for the
H5N1 virus. That patient is related to the Jakarta woman who
died of bird flu almost two weeks ago.

He said initial testing showed that a girl who died on
Wednesday did not die of bird flu, but further blood samples
have been sent to a Hong Kong laboratory.

The WHO last week warned bird flu was moving toward a form
that could be passed between humans and the world had no time
to waste to prevent a pandemic. Past pandemics have killed
millions.

The U.N. health agency was also working with Jakarta to
source new stocks of the anti-viral drug Tamiflu to bolster
local stocks. Tamiflu is a tablet that can help against
infection. Several companies are working on a vaccine, but
tests are not expected to begin until later this year.

The government has appealed for public calm over the virus,
which has dominated local media reports in recent days. On
Monday, it imposed a state of high alert, giving authorities
power to order people with symptoms of the virus into
hospitals.

Besides Indonesia, bird flu has killed 44 people in
Vietnam, 12 people in Thailand and four in Cambodia.

Australia said on Thursday it would pay A$30,000 for 10,000
doses of anti-viral bird flu medicine for Indonesia aimed at
protecting health workers in the event of a pandemic.

(Additional reporting by Michelle Nichols in Canberra)