Saturday, June 24, 2006

WHO finds son gave father bird flu

WHO finds son gave father bird flu
By Elisabeth Rosenthal and Peter Gelling
Copyright by The International Herald Tribune
Published: June 23, 2006

JAKARTA An Indonesian man who died after catching H5N1 bird flu from his 10-year-old son represents the first laboratory confirmed case of human- to-human transmission of the disease, World Health Organization officials said Friday.

The WHO investigators also discovered that the virus had mutated slightly when the son contracted the disease, although not in any way that would allow it to pass more easily among people. Flu viruses like H5N1 mutate constantly and most of the mutations are insignificant biologically, as appears to have been the case in the Indonesian cluster.

"Yes it is slightly altered, but in a way that viruses commonly mutate," said Dick Thompson, a spokesman for the UN health agency in Geneva, describing the findings of the investigation, which has not yet been released, into a cluster of bird flu deaths within a family in North Sumatra.

"But that didn't make it more transmissible or cause more severe disease."

The findings came as the UN agency, along with the Food and Agriculture Organization and the Indonesian government, concluded a three-day conference in Jakarta to review Indonesia's progress in fighting the disease, which has now killed 39 people here.

Although Vietnam has recorded the highest number of bird-flu related deaths at 42, Indonesia has recorded deaths at a much faster rate in the last year than any other country, and is expected to soon surpass Vietnam.

Officials at the conference cited a lack of coordination between animal health agencies and human health agencies, as well as a lack of funding and public education, for Indonesia's faltering progress against the disease.

"We know things still need to be done, we know we need to push on," said Keiji Fukuda, coordinator for the World Health Organization's global influenza program, who was in Jakarta for the meeting. "This is a long-term fight."

Representatives at the conference said avian flu was widespread and "well established" among poultry in Indonesia, and that large numbers of animal infections still went unreported, increasing the risk to humans.

Indonesia has 1.3 billion chickens, which often roam freely in both urban and rural areas. Sick chickens often go unnoticed as many families keep only a few.

The group of experts played down the significance of the cluster of bird-flu deaths among the family in North Sumatra, saying the virus had not mutated into a more dangerous form and had not spread beyond the family.

They also pointed to similar clusters that occurred as far back as 1997 in Thailand, in Hong Kong in 2004 and last year in Azerbaijan.

The overriding importance of the slightly modified virus in North Sumatra, Thompson said, is that it allowed researchers flown in from the WHO and the U.S. Centers for Disease Control and Prevention to document for the first time that the virus has almost certainly been passed from person to person.

In previous cases in which human-to-human transmission was suspected there was not the ability to test samples from the patients, or the virus in the patients was the same as that in poultry in the area.

Scientists have long said that the H5N1 virus, which has killed hundreds of millions of birds worldwide, does not spread easily to humans or among them. But they have worried that it might acquire that ability though normal biological processes that involve genetic rearrangement, setting off a devastating human pandemic of the disease.

About 200 people have contracted bird flu around the world, almost all of them after exceedingly close contact with ill birds.
International health officials have been in Indonesia for much of the past month, investigating the family outbreak that affected seven relatives in the Karo highlands, a remote region in Sumatra. Six of the seven died.

Although Indonesia has been struggling all year to control a series of bird flu outbreaks among poultry, the family on Sumatra had no direct contact with sick birds, though the first death in the family was a woman who sold vegetables in a market that also sold birds.

The family members in the cluster had a feast together in late April when the woman was already ill and coughing heavily. Some spent the night in the same small room with her. Also, some of the family members took care of others when they were sick, before going to the hospital.

The first five family members to fall ill had identical strains of H5N1, one that is common in animals in Indonesia. But that virus had mutated slightly in the sixth victim, a child.

Still, Thompson said there was no evidence that the mutated germ was better adapted to human infection. The UN health agency has for a month been following 54 neighbors and other family members who lived near the affected family and none have contracted the virus.

Peter Gelling reported from Jakarta and Elisabeth Rosenthal from Rome.


Post a Comment

<< Home