WHO probes possible human-to-human bird flu spread

By Richard Waddington

GENEVA (Reuters) – The World Health Organization (WHO) said
on Tuesday human-to-human transmission of bird flu could not be
ruled out in the deaths of six Indonesians.

The virus has not mutated to become more dangerous, the WHO
emphasized. So far, virtually all of the 124 people killed by
bird flu, most of them in Asia, have caught it from poultry.

Another suspected outbreak was denied on Tuesday when
Iran’s health minister said two dead siblings who had
reportedly tested positive for H5N1 had not had the virus.

Despite the denials, international health bodies are likely
to press Iran for more information on the cases, which would be
the country’s first if confirmed.

The deaths of the Indonesian family group, one of the
largest clusters seen since the disease re-emerged in 2003,
triggered fears the virus could be evolving into a type that
could easily jump from person to person.

Scientists say millions of people could die if the virus
acquires this ability, perhaps by hooking up with a common flu
strain.

But the WHO said in the Indonesian cases there was no sign
of mutation of the virus or rapid spread of the disease across
a community that could indicate a pandemic was in the making.

“Sequencing … found no evidence of genetic reassortment
… and no evidence of significant mutations,” the United
Nations health agency said in its statement.

However, given that those infected lived in close proximity
in a village in North Sumatra and that some had cared for sick
relatives before falling ill themselves, it was possible that
humans were the source of infection at least in some instances.

“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.

“Although human-to-human transmission cannot be ruled out,
the search for a possible alternative source of exposure is
continuing,” said a statement on its Web site, which made clear
there had been no “efficient” human-to-human transmission.

The agency believes some human-to-human transmission has
occurred before in other countries, but as in the Indonesian
case, laboratory tests have given no indication of the feared
mutation that would make the virus easier to catch and spread.

Indonesia — which has seen 33 human deaths, second highest
after Vietnam — has struggled with a lack of trained personnel
and equipment, public ignorance and suspicion of government
workers while investigating the Sumatra case.

IRANIAN DENIAL

Health experts had been on alert after an Iranian medical
official told Reuters on Monday that a 41-year-old man and his
26-year-old sister from the northwestern city of Kermanshah had
tested positive for bird flu.

On Tuesday, Health Minister Kamran Lankarani denied this.

“Fortunately, these two cases were negative for avian flu.
There is no confirmed case until now,” Lankarani told Reuters
on the sidelines of the WHO annual meeting in Geneva.

The two siblings were among five members of a family who
became sick. Surviving relatives were in hospital and one was
dangerously ill.

Iran first detected the virus in birds in February. Bird
flu has killed people in neighboring Turkey, Iraq and
Azerbaijan.

H5N1 re-emerged in late 2003 and spread to many parts of
Asia. It picked up speed this year, moving into parts of
Africa, the Middle East and Europe. In the past five months,
more than 30 countries have reported outbreaks in poultry or
wild birds.

A top virologist urged the United States, on a shrinking
list of places still untouched by the disease, to watch out for
sick poultry and people, rather than migratory birds.

“I think it is more likely that it could be smuggled in
some poultry or … an infected person could bring it in to the
United States,” Robert Webster of St. Jude Children’s Research
Hospital in the United States told Reuters in Hong Kong.

While increasing numbers of human cases are worrying health
experts, the poultry industry has also suffered badly.

“I have never seen such widespread (financial) losses
around the world,” Gordon Butland, president of Global Poultry
Strategies, told a conference in London.