Close Contact Could See Humans Spread Bird Flu

JAKARTA — 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)