Bird Flu: Mild to Fatal in 2 Countries
Studies of Turkish and Indonesian Patients Find Half Die
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
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.
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
All the patients were aged 5 to 15 who had had direct contact with sick or
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.
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,
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
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
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
"It would be prudent to develop robust plans for dealing with such a
pandemic," the editorialists write.