WHO: Bird flu spread among family members

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WHO: Bird flu spread among family members By MARGIE MASON, AP Medical

Writer

JAKARTA, Indonesia - The World Health Organization has

concluded that human-to-human transmission likely occurred among

seven relatives who developed bird flu in Indonesia.

In a report obtained Wednesday by The Associated Press, WHO experts

said the cluster's index case was probably infected by sick birds and

spread the disease to six family members. One of those cases, a boy,

then likely infected his father, it said.

The U.N. agency stressed the virus has not mutated and that no cases

were detected beyond the family.

Seven of the eight relatives died last month, but one was buried

before samples could be taken to confirm bird flu infection.

" Six confirmed H5N1 cases likely acquired (the) H5N1 virus through

human-to-human transmission from the index case ... during close

prolonged contact with her during the late stages of her illness, "

the report said.

The report was distributed at a closed meeting in Jakarta attended by

some of the world's top bird flu experts. The three-day session was

convened after Indonesia asked for international help. The country

has recorded the world's highest number of human bird flu cases this

year, and 39 of those infected have died.

" What is happening in Indonesia? That is the No. 1 question, " said

Bayu Krishnamurthi, Indonesia's national bird flu coordinator. " With

all of these limited resources — human, financial, institutional —

what should we do? "

The experts were expected to discuss the large family cluster during

the session. One of the remaining mysteries is why only blood

relatives — not spouses — became infected.

The WHO report theorizes the family shared a " common genetic

predisposition to infection with H5N1 virus with severe and fatal

outcomes. " However, there is no evidence to support that.

Keiji Fukuda, WHO's coordinator for the Global Influenza Program in

Geneva, said the Indonesian case appears to resemble other family

clusters where limited human-to-human transmission occurred following

close contact. He said scientists must find out whether anything is

different about the way the virus is behaving.

" The really critical factor is why did that cluster develop? " he

said. " What's the reason why people in a cluster got infected? "

Fukuda said that although the cluster in the farming village on

Sumatra island grabbed world attention, no country — including

Vietnam and Thailand, which have largely controlled the virus — is

safe from bird flu.

" This is a virus that you both have to respect a lot and (you) have

to be concerned about the overall situation, even in areas in which

it looks like control has been achieved, " he said on the meeting's

sidelines. " The real question is: Can you sustain that control for a

virus which is really able to persist this way? "

Bird flu has killed at least 130 people worldwide since it

began ravaging Asian poultry stocks in late 2003. Experts fear the

virus will mutate into a form that spreads easily among people,

potentially sparking a pandemic. So far, it remains hard for people

to catch, and most human cases have been traced to contact with

infected birds.

Indonesian officials said the country lacks manpower and money to

battle the H5N1 virus alone. The government has been saddled with a

series of natural disasters, including the 2004 tsunami and an

earthquake last month on Java Island.

Indonesia needs $50 million from donors in the next three years to

establish a system to help fight bird flu in poultry, according to

Roeder of the U.N. Food and Agriculture Organization.

Indonesia has said it needs $900 million over the next three years

for its overall battle against the H5N1 virus but has only budgeted

$59 million.

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