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Family's Bird Flu Deaths Stump Experts

Bird Flu Caused 6 Deaths in Family in Indonesia; Flu's Spread Under Investigation
By
WebMD Health News
Reviewed by Louise Chang, MD

May 24, 2006 -- A cluster of bird flubird flu deaths in a family in Indonesia is getting intense scrutiny from the World Health Organization (WHO) and Indonesia's Ministry of Health -- and it is raising concerns about human-to-human transmission of the virus.

The WHO reports that as of May 23, six members of a family from the Kubu Sembelang village in Indonesia's Karo District have died of bird fluflu and a seventh family member is known to be infected with bird flu.

Another woman in the same family died on May 4 after an unnamed respiratory illness that was "consistent with H5N1 infection," states the WHO's web site. The H5N1 virus causes bird flu.

That woman was the first in the Indonesian family to fall ill. Her relatives -- who were later stricken -- helped care for her. Some also shared a small room with the woman during her illness, which included frequent coughing.

No other cases have been seen in the local community and the H5N1 virus doesn't seem to have changed, states the WHO. Still, health experts are working hard to figure out how the family fell ill and what those cases may reveal about bird flu in humans.

Human-to-Human Transmission?

It's possible, but not certain, that bird flu may have spread between the woman's relatives as they cared for her, notes the WHO.

It wouldn't be the first time that bird flu has spread between people. But such cases have been "rare" and required "very close contact" with someone sick with bird flu, states the WHO's background information on bird flu.

The WHO is posting updates on its web site about its investigation of the cluster of bird flu cases in the Indonesian family.

"All confirmed cases in the cluster can be directly linked to close and prolonged exposure to a patient during a phase of severe illness," states the WHO's update for May 23. "Although human-to-human transmission cannot be ruled out, the search for a possible alternative source of exposure is continuing."

Search for a Source

Health experts from Indonesia and the WHO are investigating the family's bird flubird flu cases.

Around the world, 124 people have died of bird fluflu since 2003, and almost all human cases have been linked to direct contact with infected birds.

The Indonesian family may be an exception to that pattern. The WHO hasn't yet found the first source of the family's exposure to bird flu.

According to the Associated Press, the woman who first fell ill reportedly worked at a vegetable stand in a market where live poultry was also sold, but it's not clear if the poultry at that market harbored the H5N1 virus. The WHO's statement doesn't mention the woman's job or the market.

No Changes Seen in Virus

Scientists have taken a close look at the H5N1 virus from the Indonesian family and found "no evidence of significant mutations," states the WHO.

Historically, the H5N1 virus hasn't spread easily among people. Gene mutations could change that, but no one knows when, where, or if that will happen.

As of May 23, the WHO had reports of 218 human confirmed cases (including 124 deaths) of bird flu worldwide since 2003. Vietnam has had the most confirmed human cases (93) and deaths (42). Indonesia is second, with 42 confirmed human cases and 33 deaths, according to the WHO.

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