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Ciptapangan Visitor
Officials Study Indonesia Bird-Flu Cluster
posted by admin on 16/05/06

A Family's Cases Put Scientists On Guard for Virus Mutations 

An unusually big cluster of suspected bird-flu cases involving eight members of an extended family in Indonesia is attracting attention from local and international health officials on guard against any sign the virus may have evolved to spread easily among humans. 

After attending a recent family gathering, the eight people living in the northern part of Sumatra island fell ill. Six of them have died in the past week or so, according to Nyoman Kandun, director general of disease control and environmental health at the Indonesian Ministry of Health in Jakarta. 

Local tests, which have proved highly reliable, have shown that five of those family members were infected with the H5N1 virus, a deadly bird-flu strain, although a laboratory in Hong Kong is in the process of confirming those results. Specimens from one of the six people who died weren't available. 

With most similar, albeit smaller, human clusters in the past, health officials have presumed that the family members all fell ill after contracting the virus from the same sick birds -- perhaps during the slaughter or preparation of infected poultry prior to a meal -- rather than inferring human-to-human transmission. 

It wasn't immediately clear whether the family members had been exposed to infected poultry. Dr. Kandun said that the family had at least a few chickens, two of which died recently, although birds often die in small numbers for reasons other than avian influenza. He said barbecued pig had been served at the family gathering. 

The World Health Organization has sent an official to the family's village to investigate. "The investigation is still ongoing. It's still too early to say at this point," Sari Setiogi, a spokeswoman in Jakarta for the agency said last night, adding that this was the largest cluster she has seen. "It's a huge number of people that are living in the same place. But the possibility of environmental exposure is also there." 

A nurse who attended to some of the patients also came down with an influenza-like illness, although she seems to have shown symptoms prior to treating the patients, according to Dr. Kandun. She and others in the family's village are currently being tested for the virus. 

While there have been no obvious signs of poultry infected with bird flu in the area where the people died, according to Dr. Kandun, the virus has been widespread among the country's birds. Many human cases of bird flu have been confirmed in places where there have been no reported infections among poultry. Birds are known to harbor the virus without showing symptoms, and cases of the disease in birds might go undetected. 

Since last year, the WHO has confirmed 33 human cases of bird flu in Indonesia. Of those, 25 have been fatal. Globally since late 2003, a total of 208 people in 10 countries have been infected, of whom 115 have died. 

Transmission among people has been suspected in several cases. An investigation into one of those clusters from 2004 in Thailand led scientists to conclude that an 11-year-old girl who caught the virus and eventually died likely passed it directly to both her mother and her aunt while the two cared for her. 

In that cluster, however, there was no sign that a fundamental shift in the virus's genetic code had allowed it to pass easily between humans, leading scientists to believe this was a rare, isolated case. 

Write to Nicholas Zamiska at nicholas.zamiska@wsj.com

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