Bird Flu Appears to Spread West

By Alan Sipress
Washington Post Foreign Service
Monday, January 9, 2006

JAKARTA, Indonesia, Jan. 9 -- Two children and an adult from a town near the Turkish capital tested positive Sunday for a lethal strain of bird flu as the virus continued to spread west from its source in East Asia toward Europe.

The preliminary test results, which must still be confirmed by the World Health Organization, came days after a teenage brother and sister from a village in the far east of Turkey died from the H5N1 strain of bird flu in the first confirmed human cases of the disease outside Southeast Asia and China. Bird flu was also suspected in the death of a third sibling, but test results remain inconclusive.

Turkish medical authorities reported Sunday that as many as 10 Turks have been infected.

Some of these cases have appeared in family clusters, raising concern that the disease might have begun spreading more easily among people. But international health experts said they find it more likely that the human cases in Turkey were caused by contact with infected birds, when children were playing with slaughtered chickens or crawling into henhouses, for example.

Influenza experts have said they suspect that in Thailand, Indonesia and Vietnam, the virus has already demonstrated the ability to be transmitted among humans. In each of these instances, however, the disease only infected members of an immediate family and did not spread further. That would indicate that the ability of the virus to spread among people remains limited.

If it develops into a form easily transmitted from one person to another, international experts warn the virus could spark a global pandemic and kill tens of millions of people.

Turkish doctors reported that two of the newest cases were in children, ages 5 and 2, who had been playing with dead wild birds near their home in Beypazari, about 60 miles west of Ankara, the capital. Tests on their parents were negative. A 60-year-old man had also been diagnosed with the disease.

All three are now being treated in an Ankara hospital. Turkish officials said they have ordered a mass slaughter of birds in the capital region to stem the further spread of the disease.

Turkey's Anatolia news agency reported Sunday that the epidemic in birds had already reached the west of the country, where infected chickens had been found in the area of Bursa, about 200 miles from Ankara. Sick poultry have now been identified in 15 locations, including Istanbul, agriculture officials said.

Initial tests conducted at a British laboratory on samples taken from infected poultry in Turkey indicated that the strain of bird flu remains similar to the one that infected birds last year across a broad swath of Eurasia running from western China and Mongolia across Russia to Ukraine and Romania, said Maria Cheng, a WHO spokeswoman.

Experts are awaiting results from additional tests at a separate British laboratory on human samples from Turkey, she added. Scientists are eager to see the outcome of detailed genetic sequencing that could show how the highly changeable bird flu virus has evolved since it spread from East Asia, where it has infected more than 140 people since 2003.

WHO has dispatched two teams to investigative the Turkish outbreak, Cheng said. After delays caused by poor weather, one arrived Sunday in the eastern Van region, where the initial cases were identified, more than 500 miles from Ankara. A second team remains in the capital.

Iran, which borders eastern Turkey, has closed its frontier in response to the outbreak, turning back Turks who had hoped to visit this week for a major Muslim festival.

Russia's chief state epidemiologist, Gennady Onishchenko, was quoted by the Interfax news agency as urging Russians to refrain from traveling to Turkey, especially the eastern region hardest hit by the outbreak. Eastern Turkey is a popular tourist destination for Russians.

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