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    Bird Flu: Mild to Fatal in 2 Countries

    Studies of Turkish and Indonesian Patients Find Half Die
    WebMD Health News
    Reviewed by Louise Chang, MD

    Nov. 22, 2006 – A 50% death rate was seen in bird flu cases in a sample of Turkish and Indonesian patients, with symptoms ranging from mild to fatal.

    That's according to two studies in The New England Journal of Medicine.

    The studies don't describe new cases of bird flu, but rather cases already documented in 2005 and 2006.

    As of Nov. 13, the World Health Organization (WHO) had reports of 111 confirmed human cases of bird flu worldwide for 2006, including 75 deaths.

    Those cases were in 9 countries: Azerbaijan, Cambodia, China, Djibouti, Egypt, Indonesia, Iraq, Thailand, and Turkey.

    Bird flu has not been reported in humans or birds in the U.S.

    Turkish Cases

    One of the two studies focuses on eight patients in eastern Turkey who fell ill between Dec. 31, 2005 and Jan. 10, 2006. Lab tests confirmed the H5N1 bird flu virus.

    All the patients were aged 5 to 15 who had had direct contact with sick or dead poultry.

    All had fever; all but one had pneumonia.

    Half of these patients died, report Ahmet Faik Oner, MD, and colleagues.

    Oner is on the medical staff of Turkey's Yuzuncu Yil University, where the patients were treated.

    Indonesian Cases

    The other bird flu study comes from Indonesia.

    Researchers including I. Nyoman Kandun, MD, MPH, tracked eight patients with confirmed bird flu in three areas, two of which were suburbs of Jakarta, Indonesia's capital.

    The patients ranged in age from 1 to 38 (average age: 8.5 years).

    Half of those Indonesian patients died.

    In each of these three Indonesian locations, infected patients were related to each other, and most lived together.

    For example, one boy got sick after an aunt he was living with fell ill.

    One patient had direct contact with dead birds, and two relatives became infected too.

    The source of bird flu infection in the other five patients in the study wasn't immediately known.

    Noting the "wide range" of patient outcomes, Kandun's team speculates genes might affect how vulnerable a person is to this flu.

    More Bird Flu in Cooler Months?

    A journal editorial notes that the H5N1 virus appears to spread more easily "among chickens, and consequently to humans, during the cooler months."

    The editorialists include Robert Webster, PhD, of the virology department at St. Jude's Children's Research Hospital in Memphis.

    They say "there is no question that there will be another influenza pandemic someday. We simply don't know when it will occur or whether it will be caused by the H5N1 avian influenza virus."

    "It would be prudent to develop robust plans for dealing with such a pandemic," the editorialists write.

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