Bird Flu in Indonesian Family May Raise Global Alert Level

By Alan Sipress
Washington Post Foreign Service
Thursday, May 25, 2006

JAKARTA, Indonesia, May 24 -- The World Health Organization might soon convene an expert panel to decide whether an unprecedented human outbreak of bird flu in Indonesia should trigger a higher global alert for a possible pandemic, health officials said Wednesday.

If the global alert status were increased, international stockpiles of antiviral drugs would probably be shipped to Indonesia and travel from the country would be monitored in an attempt to contain the outbreak.

Indonesian health authorities this week confirmed that the virus had killed at least six members from one extended family on Sumatra island, including a 32-year-old man Monday. A seventh family member also died from what investigators suspect was bird flu, but she was buried before samples could be taken. Another relative is hospitalized with a confirmed case and is recovering.

Maria Cheng, a WHO spokeswoman in Geneva, said the outbreak in the North Sumatran village of Kubu Sembilang, was not only the largest bird flu cluster in the world but also the first in which investigators believe the virus was passed from one person to another and then to a third.

I Nyoman Kandun, Indonesia's director of disease control, said this week that the evidence from Sumatra was "suggestive of a third generation" of infection because of the long intervals between the earliest, middle and most recent cases. The timing of the infections makes it unlikely that the family members contracted bird flu from the same source, such as sick chickens.

While the outbreak is exceptional, international and Indonesian health officials in Jakarta stressed that the virus appears unchanged. Laboratory analysis of virus samples shows that it has not mutated or developed into a form more easily passed among people.

Top international health investigators dispatched to Sumatra have not uncovered any signs that the disease has spread beyond the one extended family, indicating that broader transmission of bird flu remains difficult. Several epidemiologists, including two from WHO's global headquarters in Geneva and the Centers for Disease Control and Prevention in Atlanta, remain on the scene, tracking people who were in contact with the most recent victim and checking for illness.

Any decision to convene the expert panel, Cheng said, "depends on what we see in Indonesia. Our investigation is still incomplete." Moreover, she said, "convening the panel does not necessarily mean we're going to go up an alert level."

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