Case numbers rising

Human Bird Flu Cases Found This Year Equal 2005 Level (Update2)

By Jason Gale and Karima Anjani

Aug. 21 (Bloomberg) -- Bird flu killed a 35-year-old woman in Indonesia, raising the number of cases worldwide this year to 95, the same number reported in the whole of 2005, as health authorities study whether the virus is spreading between humans.

Tests on the woman were positive for the H5N1 strain of avian influenza, I Nyoman Kandun, a director general at the Ministry of Health, said late yesterday. Indonesia, with the most H5N1 deaths, confirmed two other cases from the village where the woman lived. No signs of human-to-human transmission have been found, health officials said today.

``The cases have occurred in a remote, mountainous area where there are a lot of other diseases,'' Georg Petersen, the World Health Organization's Indonesia representative, said in a telephone interview today. ``It's important to identify illnesses caused by bird flu and illnesses caused by the other diseases.''

The death toll from H5N1 has tripled this year as the virus spread in wild birds and domestic poultry to at least 38 countries. It may kill millions of people should it change into a pandemic form and spread easily among people.

An average of three new human cases a week have been reported this year as the virus became entrenched in Indonesia and China, and infected people for the first time in Turkey, Iraq, Azerbaijan, Egypt and Djibouti. It claimed more lives in Thailand and Cambodia, where fresh outbreaks killed fowl in the past month.

Death Tally

Since 2003, H5N1 is known to have infected 240 people in 10 countries, killing 141 of them, the WHO said today. The virus has killed 64 people this year, compared with 22 in the first eight months of 2005.

The spread of the virus is slowing worldwide as efforts to contain the illness partially succeed, the Food and Agriculture Organization of the United Nations said. Among the areas where migratory birds and poultry remain at risk are Asia, including Indonesia where 46 people have died; some African countries such as the Ivory Coast; and the southern Balkan and Caucasus regions in Europe, the organization said.

Almost all human H5N1 cases have been linked to close contact with sick or dead birds, such as children playing with them or adults butchering them, according to the WHO.

Doctors from the Geneva-based health agency joined a team of local medical and veterinary officials last week to identify the cause of the cases in West Java's Garut district, where the 35- year-old woman lived. Deaths from established infectious diseases are common in the area and public-health resources are minimal, the WHO said today.

Human-To-Human Transmission

While deaths from respiratory disease are known to have occurred there in late July and early August, no samples were taken, the United Nations health agency said on its Web site.

``Though some of these undiagnosed deaths occurred in family members of confirmed cases, the investigation has found no evidence of human-to-human transmission and no evidence that the virus is spreading more easily from birds to humans,'' the agency said in the statement.

Large numbers of poultry began dying in Garut after live chickens were purchased from outside the area in late June and integrated into local flocks, WHO said. Many chicken carcasses were eaten without proper preparation or were incorrectly disposed of, the agency said.

``These exposures are, at present, thought to be the source of infection for most confirmed or suspected cases,'' the agency said.

Testing

Samples have been sent for testing and some patients and their close contacts are taking antiviral drugs. Residents are cooperating with the investigation and treatment efforts, the WHO said.

At least 16 other people are undergoing testing for the virus, Agence France-Presse reported yesterday. Clusters of cases may signal the virus is becoming more adept at infecting humans, not just birds.

A pandemic can start when a novel influenza A-type virus, to which almost no one has natural immunity, emerges and begins spreading. Experts believe that a pandemic in 1918, which may have killed as many as 50 million people, began when an avian flu virus jumped to people from birds.

A flu outbreak killing 70 million people worldwide may cause global economic losses of as much as $2 trillion, Milan Brahmbhatt, a World Bank lead adviser in the East Asia region, said in June.

Indonesia, the world's fourth-most-populous country, attracted international attention in May when seven members of a family from the island of Sumatra contracted H5N1, six of them fatally. The cases represented the largest reported cluster of infections and the first laboratory-proven instance of human-to- human transmission.

To contact the reporters on this story: Jason Gale in Singapore at j.gale@bloomberg.net ; Karima Anjani in Jakarta at kanjani@bloomberg.net

Last Updated: August 21, 2006 14:18 EDT