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Spread of Turkish birdflu no surprise, experts say

By Maggie Fox, Health and Science Correspondent

WASHINGTON, Jan 7 (Reuters) – The latest human cases of bird flu in Turkey are not unexpected, given the intense contact between the human victims and infected birds there, infectious disease experts say.

The World Health Organization said on Saturday it had confirmed that two children hospitalized in Turkey were infected with the H5N1 strain of avian influenza.

That makes four confirmed human cases in Turkey, the sixth country where the bird flu strain has jumped from poultry to people. A fifth child who died also tested positive for bird flu but the WHO has not yet confirmed the result.

“I think it is the same thing as is going on in Southeast Asia,” said National Institute for Allergy and Infectious Diseases Director Dr. Tony Fauci.

The virus infected 142 people in east Asia and killed 74 before it killed the three children from the same family in eastern Turkey this week.

A WHO spokeswoman said the two newly diagnosed children, a 5-year-old and an 8-year-old, were from the same rural region where the other three died this week.

WHO labs will test the virus to make sure it was transmitted directly from infected chickens to the children, and not from one child to another.

H5N1 remains mostly a disease of birds but scientists say it is mutating and has the ability to evolve into a human influenza, which would pass rapidly from person to person and could spark a pandemic — a global epidemic.

In Asia most cases have occurred in one or two people together at the most, and experts were concerned by the reported numbers coming in clusters in Turkey. When it became clear the cases were among families, they relaxed.

“From the first appearance of H5N1 influenza in migrating birds in Asia, we have recognized — and called attention to — the possibility that they could carry the virus to other continents,” Health and Human Services Secretary Mike Leavitt said in a statement earlier this week.

NOT A PANDEMIC YET

“While we are concerned about (the) report of human cases of H5N1 influenza in Eastern Turkey, there is no evidence of sustained human-to-human transmission, which is the hallmark of a potential pandemic.”

Turkish officials said that in the family where three children died, they had been playing with the severed heads of chickens slaughtered after they became ill.

“It is inevitable when you have kids playing with (infected) chicken parts that you are going to have transmission,” Fauci said in a telephone interview.

“You will have to assume that the chickens are pooping around outside the house, if not in the house,” he said. “The children will be playing around that, getting it on their feet, under their fingernails, and then they will be bringing it in the house, hugging their mother and father,” he said.

Even the infection of whole families was not surprising, Fauci said. The birds could be shedding, or excreting, large amounts of virus and all members of a family could be infected directly or indirectly.

“Sooner or later if you get infected flocks in a country you are going to get infected people,” Fauci said.

The big risk comes when the virus evolves just enough to transmit easily from one person to another. Then the greatest danger to people will be other people — not infected birds.

“What you will see with human-to-human transmission of the virus — you will see infections in people who had no exposure to something infectious like feces,” Fauci said.

Children might infect other children at school or hospital workers would be getting infected.

“What we have not seen is health-care providers getting infected,” Fauci said.

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