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Indonesia - New Suspected
Human Bird Flu Case

From Patricia Doyle, PhD
dr_p_doyle@hotmail.com
1-8-6

Hello, Jeff - Turkey is the big story re bird flu. Dogs dying in the outbreak area? This is novel:
 
In nearby Bozkurt village, local administrator Ahmet Koylu said chickens and dogs were dying but that no one had come to investigate. On Saturday [7 Jan 2006], officials reported a new bird flu case in poultry in a village near Bursa, in western Turkey, the Anatolia news agency reported.
 
From ProMed Mail
 
 
5 People Test Positive For H5N1 In Ankara And Van
1-8-6
 
ANKARA (Reuters) -- 3 patients in the Turkish capital Ankara and 2 in the eastern town of Van have tested positive for the most pathogenic strain [?] of bird flu, H5N1, the state Anatolian news agency reported on Sunday [8 Jan 2006]. It quoted senior health ministry official Turan Buzgan as saying that out of 28 samples diagnosed on Sunday [8 Jan 2006], 5 had tested positive for H5N1.
 
 
3 People Found With (Suspected)
Avian Influenza In Turkish Capital
1-8-6
 
(Reuters) -- Turkey announced on Sunday [8 Jan 2006] that 3 people had tested positive for bird flu in the Turkish capital, Ankara, marking a further westward advance of the infection towards the frontiers of Europe. Ankara Governor Kemal Onal told the state-run Anatolia news agency that 2 children and one adult had been diagnosed with the infection; but it was not clear whether they were suffering from the H5N1 avian virus that has killed 3 people in the remote east of the country.
 
The agency said a 5-year old boy had been admitted to the hospital with suspected avian influenza in Corum in central Turkey. The virus has been spreading since October 2005 among [poultry] flocks in Turkey, having advanced from Southeast Asia, but no people in Turkey had been reported infected until last week [1st week January 2006]. The emergence of human cases of the flu in the Van area, near the borders with Iran and Armenia, raised fears that the disease might advance to major Turkish population centers and to Europe.
 
It seems highly likely that the children who died in the Van region caught the virus directly from chickens. But world health authorities are concerned that human exposure to avian influenza could lead to the emergence of a mutation, allowing easier transmission between humans and raising the prospect of a pandemic.
 
 
Turkey - 30 Suspected Bird Flu Cases,
Mostly Children, Now Under Observation
 
By Alexander G. Higgins, Benjamin Harvey,
Selcan Hacaoglu and Suzan Fraser]
1-8-6
 
(AP) -- Teenage siblings who died of avian influenza in Turkey were the 1st humans outside East Asia to succumb to the deadly H5N1 strain that has apparently been spread by migratory birds, WHO stated on Saturday 7 Jan 2006. A British laboratory confirmed on Saturday that a 15-year-old girl and her 14-year-old brother were infected with the virus, said Maria Cheng, spokeswoman for the World Health Organization.
 
Testing is continuing on an 11-year-old sister who died Friday [6 Jan 2006]. "She had similar symptoms, and the clinical course of her illness was the same," Cheng said. "So it would be very probable that she died of H5N1, but right now, we don't have the laboratory test to prove that."
 
5 WHO experts were to travel Sunday [8 Jan 2006] to the city of Van, near the border with Iran, not far from the village where the 3 children died, to try to determine whether the disease was spread from animals or other humans. Iran has restricted movement along its border to prevent the disease from spreading into that country. Cheng said Turkish laboratories have so far found that 2 other children in a Turkish hospital are infected with H5N1. The British lab Saturday [7 Jan 2006] confirmed one of the cases and may be about to confirm the other, she said.
 
Altogether, Turkish officials are testing about 30 patients -- most of them children -- for [suspected] avian influenza, she said. The spread of the disease from East Asia, where it has killed more than 70 people, was "a concern," but the global risk assessment of a human pandemic was unchanged, she said. "Right now, these new cases in Turkey don't elevate the global risk assessment, so we're still in the same pandemic alert phase that we've been in for the last couple of years," said Cheng. "But it's something that needs to be monitored very closely."
 
Turkish Health Minister Recep Akdag said Saturday [7 Jan 2006] there was no reason to suspect human-to-human transmission, and he urged calm, saying there was no risk of a pandemic. But Dr. Gencay Gursoy, head of the Istanbul Physicians Association, said the situation was grave. "Turkey and the world are facing the threat of a serious infection," he said.
 
So far, the H5N1 virus has been capable in rare cases of transmitting from poultry to humans in close contact with them. Experts fear that if the virus should mutate to a strain that passes easily among people, it could set off a human flu pandemic. "At the moment, we don't know enough about the situation to tell whether or not the virus has changed in some way," said Cheng.
 
The doctor of the 3 siblings who died said they probably contracted the illness by playing with dead chickens. Cheng said the area is rural with a lot of poultry farming and that residents tend to live in close proximity to their birds. She said the cases were worrying in part because of the distance from East Asia. "It is a jump," she said. "And if you look at how H5N1 has spread in animals, it sort of follows that pattern and implicates the role of migratory birds, because we started seeing last year [2005] H5N1 being detected in the Ural mountains, in Siberia, Mongolia, Turkey, Romania."
 
Authorities have culled thousands of fowl in the affected regions, but in the village of Dagdelen, on the outskirts of Dogubayazit -- the hometown of the 3 children who died -- villagers gathered outside an Agriculture Ministry building to complain that no one had come to cull their fowl. In nearby Bozkurt village, local administrator Ahmet Koylu said chickens and dogs were dying but that no one had come to investigate. On Saturday [7 Jan 2006], officials reported a new bird flu case in poultry in a village near Bursa, in western Turkey, the Anatolia news agency reported.
 
 
Human Avian Influenza Cases Spread West In Turkey
 
(Reuters) -- Turkey reported 3 people infected with a deadly strain of bird flu in the capital Ankara on Sunday [8 Jan 2006], marking a further westward advance of human infection towards the fringes of Europe. The 1st case outside eastern Asia of the virus jumping from birds to humans emerged in Turkey last Wednesday [4 Jan 2006]. 3 children in the remote eastern Van region died of the highly potent H5N1 strain that has killed some 70 people in Asia.
 
Ankara Governor Kemal Onal told the state-run Anatolia news agency on Sunday [8 Jan 2006] that 2 children and one adult had been diagnosed with the infection in the capital, about 400 km (250 miles) from Turkey's densely populated largest city, Istanbul, Europe and the Mediterranean area. The agency said a 5-year-old boy had also been admitted to the hospital with suspected bird flu in Corum in central Turkey. CNN Turk television said 2 of the 3 infected Ankara children had been brought to Ankara from nearby Beypazari after contact with dead wild birds.
 
It seems highly likely the children who died in the Van region also caught the virus directly from chickens. But world health authorities are concerned human exposure to the bird flu could lead to the emergence of a mutation, allowing easier transmission between humans and raising the prospect of a global pandemic. A team of World Health Organization doctors is in Turkey to help investigate the deaths and look for any signs of transmission between humans. Russia has warned against travel to Turkey. Moscow raised the early prospect of economic damage to Turkey's vital tourist industry, warning Russians against traveling to Turkey after the human infections.
 
Prime Minister Tayyip Erdogan has appealed to Turks to help in a mass cull aimed at stemming the advance of the virus and promised adequate compensation to farmers and families who rely on poultry for their living. But in the Dogubayazit district hit by the virus, local people have accused the authorities of being slow in acting. A Reuters reporter saw chickens still walking on the streets and some escaping as they were about to be carried in large bags to be buried alive in pits.
 
Erdogan said the government was taking all necessary measures and allocating funds to combat the spread of the disease. The virus spreads quickly among chickens, killing them in a day, and the best way to control it is to quickly slaughter all poultry in an affected area. But this can be difficult in countries where, as is common in eastern Turkey, people keep small backyard flocks.
 
_____
 
ProMED-mail
promed@promedmail.org
 
The death of dogs in an outbreak area is a novel observation, but not necessarily related to avian influenza infection. The high frequency of children among confirmed and suspected human cases of H5N1 avian influenza is a continuing feature of the disease situation in Turkey. The number of human cases confirmed by the WHO-reference laboratory in the UK appears to have risen to 3 (possibly 4), but this has not yet been publicly acknowledged by WHO. - Mod.CP
 
 
Patricia A. Doyle, DVM, PhD- Bus Admin, Tropical Agricultural Economics
Please visit my "Emerging Diseases" message board at:
http://www.clickitnews.com/ubbthreads/postlist.php?Cat=&Board=emergingdiseases
Also my new website:
http://drpdoyle.tripod.com/
Zhan le Devlesa tai sastimasa
Go with God and in Good Health

 
 
 
Patricia A. Doyle, DVM, PhD- Bus Admin, Tropical Agricultural Economics
Please visit my "Emerging Diseases" message board at:
 
http://www.clickitnews.com/ubbthreads/postlist.php?
Cat=&Board=emergingdiseases
Also my new website:
 
http://drpdoyle.tripod.com/
Zhan le Devlesa tai sastimasa
Go with God and in Good Health
 

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