Pakistan - BF Suspected Human Cases December 18, 2007 to Feb 2, 2008

[Theresa42]

Re: Pakistan: December 18+, WHO Begins Investigations

Hat-tip, unpathedhaunts!

Bird flu claims first two lives in Pakistan
Dec 21, 2007

By our correspondent

PESHAWAR: The administration of Khyber Teaching Hospital on Thursday confirmed that two brothers Mohammad Ilyas and Tariq, who were brought to the hospital from Mansehra on suspicion of carrying H5N1, died of bird flu Monday last.

"The two brothers have been confirmed as bird flu victims and are the first human sufferers of the disease in our country," Dr Siddiqur Rahman, Acting Chief Executive of KTH, told The News on Thursday.

Mohammad Ilyas and Tariq were working at a poultry farm in Mansehra and were brought to KTH in a serious condition. They were suffering from pneumonia and were kept in the isolation ward, said Dr Rahman.

One of them was in critical condition at the time of arrival, Dr Rahman said. He added that the Ministry of Health after their expiry took blood samples and sent them to Islamabad to verify if they were carrying Bird Flu virus (H5N1). "Then I don't know what happened to the test," he added.

Meanwhile, some reports on Thursday suggested that the laboratory test conducted in Islamabad confirmed Bird Flu influenza. A spokesman of Health Ministry in Islamabad said that they had died of bird flu, adding both the brothers were working in a poultry farm in Mansehra and had direct link with the chickens that resulted in the transfer of the virus (H5N1) into them.

http://www.thenews.com.pk/top_story_detail.asp?Id=11716

[Laidback Al]

Re: Pakistan: December 18+, WHO Begins Investigations

Bird flu claims first two lives in Pakistan
Dec 21, 2007

By our correspondent

PESHAWAR: The administration of Khyber Teaching Hospital on Thursday confirmed that two brothers Mohammad Ilyas and Tariq, who were brought to the hospital from Mansehra on suspicion of carrying H5N1, died of bird flu Monday last.

How many times are these two Durrani brothers going to die?

The two deaths occurred in November, not last week.

This is a repeat of a story first posted by Dutchy on December 13th. http://www.flutrackers.com/forum/sho...97&postcount=4

The story is also incorrect because Tariq is not one of the brothers who died. He is shown alive and breathing on December 16th in a wire service photo with his surviving brother Ishtiaq, the verterinarian.

Pakistani brothers Mohammed Ishtiaq, right, and Mohammed Tariq, left, who were treated for suspected H5N1 bird flu, come out from their house in Sukur village near Peshawar, Pakistan on Saturday, Dec. 15, 2007. Six people caught H5N1 bird flu in northern Pakistan last month and at least one person with the disease has died, the government said Saturday. The U.N. World Health Organization confirmed the deadly H5N1 strain was found in the six cases, but said a second round of tests were being carried out to make sure. (AP Photo/Mohammad Zubair)

http://apnews.myway.com/image/20071215/Pakistan_Bird_Flu.sff_PES105_20071215110552.html?date=20071216&docid=D8TIGLV00

[Niko]

Re: Pakistan: December 18+, WHO Begins Investigations

How many times are these two Durrani brothers going to die?

The two deaths occurred in November, not last week.

This is a repeat of a story first posted by Dutchy on December 13th. http://www.flutrackers.com/forum/sho...97&postcount=4

The story is also incorrect because Tariq is not one of the brothers who died. He is shown alive and breathing on December 16th in a wire service photo with his surviving brother Ishtiaq, the verterinarian.


http://apnews.myway.com/image/200712...ocid=D8TIGLV00

Several sources reported one death on Nov 19th, which happened to fall on a Monday. I suspect these are recycled articles.

[Theresa42]

Re: Pakistan: December 18+, WHO Begins Investigations

How many times are these two Durrani brothers going to die?

The two deaths occurred in November, not last week.

This is a repeat of a story first posted by Dutchy on December 13th. http://www.flutrackers.com/forum/sho...97&postcount=4

The story is also incorrect because Tariq is not one of the brothers who died. He is shown alive and breathing on December 16th in a wire service photo with his surviving brother Ishtiaq, the verterinarian.


http://apnews.myway.com/image/200712...ocid=D8TIGLV00

It could be that these are not any of the Durrani brothers but are, in fact, two other brothers (i.e. another familial cluster). Perhaps.

[AlaskaDenise]

Re: Pakistan: December 18+, WHO Begins Investigations

WHO suspects limited human H5N1 spread in Pakistan

GENEVA (Reuters) - The World Health Organisation (WHO) suspects there has been only limited human-to-human transmission of the H5N1 virus in Pakistan, but international test results are still pending, a top official said on Friday.

David Heymann, WHO assistant director-general for health security and environment, also said that no new suspect human bird flu cases had emerged in Pakistan since December 6, signaling there had been no further spread.

Global health experts fear that bird flu could mutate into a form that spreads easily from one person to another, triggering a pandemic that could kill millions of people.

Pakistan announced last week that 8 people had been infected since late October, including a veterinarian involved in culling whose two brothers died. A WHO team has investigated the outbreak, and international laboratory results on samples taken are now expected at the weekend.

"The team feels that this could be an instance of close contact human-to-human transmission in a very circumscribed area and non-sustained, just like happened in Indonesia and Thailand," Heymann told a news briefing in Geneva.

In Thailand, a mother was killed by the virus in 2004 after cradling her dying infected daughter all night. The largest known cluster of human bird flu cases worldwide occurred in May 2006 in the Karo district of Indonesia's North Sumatra province, where as many as 7 people in an extended family died.

Keiji Fukuda, coordinator of WHO's global influenza program, told Reuters in an interview on Tuesday the cases in Pakistan are probably a combination of infections from poultry and limited person-to-person transmission due to close contact from caring for a sick loved one.

.

[HenryN]

Re: Pakistan: December 18+, WHO Begins Investigations

Pakistan urges safer culling after bird flu outbreak
ISLAMABAD: The government is urging provincial authorities to obey health guidelines to prevent any bird flu outbreaks after eight people were recently infected with the H5N1 virus. The Health Ministry is sending out messages via radio and pamphlets to NWFP, where South Asia?s first cases of human infections occurred. ?These winter months are critical,? Federal Health Secretary Khushnood Akhtar Lashari said on Thursday. He said provincial authorities were requested to adhere to safety guidelines but it was difficult because of the remote areas. A WHO report on the situation is due soon. reuters
Courtesy DailyTimes.com.pk

http://www.pakistanlink.com/Headlines/Dec07/21/08.htm

[HenryN]

Re: Pakistan: December 18+, WHO Begins Investigations

Commentary at

http://www.recombinomics.com/News/12210702/H5N1_Pakistan_Confirm_More.html

[HenryN]

Re: Pakistan: December 18+, WHO Begins Investigations

<TABLE class=ap-story-table style="veritcal-align: :top" border=0><TBODY><TR class=ap-story-tr><TD class=ap-story-td>Dec 21, 10:05 AM EST


WHO: limited human-to-human bird flu transmission possible in Pakistan, no current threat
By MARGIE MASON
AP Medical Writer

</TD></TR><TR><TD><!-- Story-MediaBoxPosition: 0 empty -->Limited human-to-human bird flu transmission may have occurred in Pakistan, but no new infections have been reported for two weeks and there appears to be no threat of further spread, a top World Health Organization official said Friday.
A WHO team has finished its initial investigation in Pakistan after up to nine patients, including several family members, were suspected of being infected with the H5N1 bird flu virus in areas north of Islamabad. They were the country's first reported human cases.
The experts were expected back in Geneva to begin piecing together how the virus may have spread, but they found no evidence of anyone currently sickened by the virus, Dr. David Heymann, the WHO's top flu official in Geneva, told The Associated Press by telephone.
"I think the team right now feels on initial analysis that this might be a small chain of human-to-human, non-sustained transmission," he said, stressing that there was no cause for alarm.
He said the last reported case was on Dec. 6. Pakistani health officials have conducted initial testing on the samples, and found them to be positive, but WHO has sent the specimens to one of its collaborating laboratories for confirmation.
At least 209 people have died worldwide from the virus, which began plaguing Asian poultry stocks in late 2003. It remains hard for people to catch, but scientists worry it could mutate into a form that spreads easily among people, potentially sparking a pandemic.
Most cases have been linked to contact with infected birds, but scientists believe limited human-to-human transmission has occurred a few times before among blood relatives who had close contact.
Five brothers were sickened last month in the small city of Abbotabad, about 50 kilometers (30 miles) north of Islamabad. One was a veterinarian who was involved in slaughtering sick poultry infected with bird flu. Two of his brothers fell ill and died, one of whom was buried before tests were conducted. The veterinarian and his other two brothers recovered.
Up to five other people in the same area also tested positive for the virus in preliminary tests.
Heymann said no one knows when a pandemic will occur or what virus will start it, but countries need to be prepared to take action.
"The more it reproduces, whether it's in humans or chickens, the more likely there is that there's an event that will occur that causes it," he said. "We just have to wait to see what's going to happen."
Meanwhile, Indonesia, which is the world's hardest-hit country with 93 human deaths, also reported Friday that five people from an extended family had been hospitalized with flu-like symptoms in an area where bird flu was earlier reported in poultry. Specimens have been taken to determine whether any of the relatives were infected with the H5N1 virus.
Myanmar reported its first human case last week and a number of other countries have recently reported poultry outbreaks during the winter months when the virus typically flares.
----

</TD></TR></TBODY></TABLE>
Margie Mason covers medical issues across the Asia-Pacific region.

http://hosted.ap.org/dynamic/stories/A/AS_GEN_PAKISTAN_BIRD_FLU_ASOL-?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT&CTIME=2007-12-21-10-05-09

[HenryN]

Re: Pakistan: December 18+, WHO Begins Investigations

<!-- noPrint end --><!-- AN5.0 article header end --><!-- index -->
<!-- AN5.0 article title -->WHO says only limited human H5N1 spread in Pakistan
21 Dec 2007 15:10:33 GMT
<!-- 21 Dec 2007 15:10:33 GMT ## for search indexer, do not remove -->Source: Reuters

<!-- AN5.0 article title end -->
<SCRIPT language=JavaScript src="/bin/js/article.js"></SCRIPT></SPAN><INPUT id=CurrentSize type=hidden value=13 name=CurrentSize> <!-- WHO says only limited human H5N1 spread in Pakistan --><!-- Reuters -->(Adds China, quotes, background)
By Stephanie Nebehay
GENEVA, Dec 21 (Reuters) - The World Health Organisation (WHO) suspects there has been only limited human-to-human transmission of the H5N1 virus in Pakistan, but international test results are pending, an official said on Friday.
David Heymann, WHO assistant director-general for health security and environment, said no new suspect human bird flu cases had emerged in Pakistan since Dec. 6, signalling there had been no further spread.
Global health experts fear the virus could mutate into a form that spreads easily from one person to another, triggering a pandemic that could kill millions of people.
Pakistan said last week 8 people had been infected since late October, including a veterinarian involved in culling whose two brothers died. A WHO team has investigated the outbreak and international laboratory results on samples taken are expected at the weekend.
"The team feels that this could be an instance of close contact human-to-human transmission in a very circumscribed area and non-sustained, just like happened in Indonesia and Thailand," Heymann told a news briefing in Geneva.
HUMAN INFECTIONS
In Thailand, a mother was killed by the virus in 2004 after cradling her dying infected daughter all night. The largest known cluster of human bird flu cases worldwide occurred in May 2006 in the Karo district of Indonesia's North Sumatra province, where as many as 7 people in an extended family died.
But in China, it would never be clear whether a father who developed the disease days after his son died from it this month was due to contamination or common exposure to infected poultry, he said. This was because both conditions had existed -- close contact between the pair as well as sick chickens in the eastern province of Jiangsu.
Even if the disease had spread from the son to the father, it had stopped there, according to Heymann. Blood samples taken from 600 of their contacts had not shown antibodies, a sign that would have indicated the virus was circulating widely.
"So this remains a zoonotic (animal) disease, which under very intimate contact of some type -- whether it is touching a person and getting the virus on your finger and then getting it into your eye or mouth, it's not clear -- on occasional instances can be transmitted," Heymann said.
In Pakistan, the investigation had shown there were "no active suspect cases at present", he added.
He said Indonesia, the nation worst hit by bird flu with 93 deaths, had not shared bird flu samples since those from two Indonesian women who died in the resort of Bali in August.
It was the only country not to share samples, which are vital for tracking the virus and developing diagnostic tests as well as vaccines against a pandemic, he added.
Indonesia is seeking a guarantee that developing nations will have control over the use of samples and access to affordable vaccines derived from them.
Negotiations among the WHO's 193 members will continue next year on a system for sharing samples which would offer equitable access to vaccines, according to Heymann. (Editing by Jonathan Lynn)

http://www.alertnet.org/thenews/newsdesk/L2190517.htm

[HenryN]

Re: Pakistan: December 18+, WHO Begins Investigations

Commentary at

http://www.recombinomics.com/News/12210704/H5N1_H2H_Media_Myth.html

[AlaskaDenise]

Re: Pakistan: December 18+, WHO Begins Investigations

Commentary at

http://www.recombinomics.com/News/12...firm_More.html

Commentary

Confirmation of New H5N1 Cases in Pakistan

Recombinomics Commentary
December 21, 2007

The World Health Organisation (WHO) suspects there has been only limited human-to-human transmission of the H5N1 virus in Pakistan, but international test results are still pending, a top official said on Friday.

David Heymann, WHO assistant director-general for health security and environment, also said that no new suspect human bird flu cases had emerged in Pakistan since December 6, signaling there had been no further spread.

The above comments from WHO raise additional concerns about the human to human (H2H) transmission in Pakistan. Although media reports have described two H5N1 fatalities in a large familial cluster, the number of additional reported cases continues to grow. The above statement indicates new cases have been confirmed this month by NAMRU-3, which contradicts statements made yesterday by the Pakistan Ministry of Health that the last case was November 23.

Many of the cases appear to be mild, which limits detection and contact tracing. Testing of patients after they have been given prophylactic oseltamivir (Tamiflu) also limits detection. However, even with these limitations, new cases are being identified. It remains unclear if these new cases extend the transmission change, which would appear to be the longest and most sustained reported to date for H5N1.

The index case for the longest chain developed symptoms October 25, and two brothers died November 19 and November 29. New cases this month may extend this chain further. Earlier reports described a female health care worker who had tested positive. A male doctor was also hospitalized with symptoms at the same hospital that treated the index case as well as the two fatal cases. It remains unclear if the positive patients this month included the two previously mentioned health care workers, but if they are confirmed, it seems likely that the transmission chain has been sustained for at least six weeks.

Media reports indicated the initial lab positives were confirmed last Saturday in Pakistan.

The absence of a WHO situation update, detailing age, gender, disease onset dates, hospital admission dates, dates of death, and the relationship between confirmed cases remains a cause for concern.


.

[AlaskaDenise]

Re: Pakistan: December 18+, WHO Begins Investigations

Commentary at

http://www.recombinomics.com/News/12...edia_Myth.html

Commentary

H5N1 Human to Human Transmission Media Myth

Recombinomics Commentary
December 21, 2007

Limited human-to-human bird flu transmission may have occurred in Pakistan, but no new infections have been reported for two weeks and there appears to be no threat of further spread, a top World Health Organization official said Friday.

A WHO team has finished its initial investigation in Pakistan after up to nine patients, including several family members, were suspected of being infected with the H5N1 bird flu virus in areas north of Islamabad. They were the country's first reported human cases.

The experts were expected back in Geneva to begin piecing together how the virus may have spread, but they found no evidence of anyone currently sickened by the virus, Dr. David Heymann, the WHO's top flu official in Geneva, told The Associated Press by telephone.

Most cases have been linked to contact with infected birds, but scientists believe limited human-to-human transmission has occurred a few times before among blood relatives who had close contact.

Five brothers were sickened last month in the small city of Abbotabad, about 50 kilometers (30 miles) north of Islamabad. One was a veterinarian who was involved in slaughtering sick poultry infected with bird flu. Two of his brothers fell ill and died, one of whom was buried before tests were conducted. The veterinarian and his other two brothers recovered.

Up to five other people in the same area also tested positive for the virus in preliminary tests.

The above comments perpetuate a number of media myths concerning human to human H5N1 transmission. The myths are clearly contradicted by WHO confirmed cases. These statements have no scientific basis, but the propagation by the popular press continues.

Although WHO has yet to put out a detailed situation update on the confirmed cases, a consensus from media reports strongly suggests that this is the longest and most sustained H5N1 infection reported to date. The longer chain appears to involve five brothers and a cousin, as well as one or two health care workers. Media reports indicate the index case developed symptoms on October 25. Two brothers were fatally infected after visiting their brother in the hospital. The two brothers died November 19 and 29. Media reports suggest two health care workers also tested positive or had bird flu symptoms and appear to be affiliated with the same Kyhber Teaching Hospital that treated several family members.

The health care workers, who are unlikely to be blood relatives, are not the first unrelated members of a cluster. A family of five in Haiphong, Vietnam was confirmed H5N1 positive. The husband and wife were both positive. Another cluster in Vietnam included a brother and sister, a confirmed health care worker, and an unconfirmed health care worker with symptoms. A cluster in Azerbaijan included a friend in addition to family members.

However, in addition to clusters involving contacts who were not blood relatives, there have been many clusters involving family members with disease onset dates with gaps of 5-10 days. Many of the earlier clusters in Vietnam and Thailand were documented in a peer reviewed publication authored by WHO consultants.

Similar peer reviewed publications by WHO consultants have describe three likely H2H clusters in Indonesia in 2005, as well as the Azerbaijan cluster in 2006. These clusters were in addition to the Karo cluster in Indonesia in 2006 and the cluster in Thailand in 2004.

Most clusters involve two family members, and in many instances samples are not collected from the index case prior to death. In other instances, such as the many clusters in Turkey, the samples that were H5N1 positive in local testing in Turkey, were not confirmed after shipment to a WHO reference center in Mill Hill, England. The pairing of the positives in Turkey strongly suggested the positives were true positives, and the reduction of 21 positives in Turkey to 12 positives in Mill Hill was due to sample degradation. Moreover, sequences from only four isolates from the 12 positives were released, providing additional evidence for sample degradation and false negatives.

The number of H5N1 human clusters has been large, and most clusters have gaps in disease onset dates.

These growing transmission chains provide additional evidence for a more efficiently transmitted H5N1 that is not linked to genetic factors.

The latest cluster is almost certainly linked to the Qinghai clade 2.2 sub-clade, which has PB2 E627K fixed, which allows the H5N1 to replicate more efficiently at lower temperatures. Human clusters in 2006 and 2007 have additional changes in the receptor binding domain (including S227N, N186K, N186S, Q196R, V223I, M230I) , which would also facilitate a more efficient transmission.

Changes in the receptor binding domain many play a role in the current extended cluster. Sequence data on the cases and clusters in Pakistan would be useful.


.

[HenryN]

Re: Pakistan: December 18+, WHO Begins Investigations

Pakistan H5N1 situation stable as Indonesia reports possible cluster

Robert Roos News Editor

Dec 21, 2007 (CIDRAP News) ? The World Health Organization (WHO) said today there has been no evidence of more cases of H5N1 avian influenza in the wake of a recent case cluster in Pakistan, as news services reported at least five suspected H5N1 cases in an Indonesian family.
WHO officials in Geneva said no more H5N1 cases have been identified in the area of Abbotabad in northern Pakistan, where the cluster was reported last weekend. Results of confirmatory tests in the eight cases are still awaited, they told CIDRAP News.
Keiji Fukuda, coordinator of the WHO's global influenza program, told Reuters this week that the Pakistan cases probably represent a mix of poultry-to-human infections and human-to-human transmission resulting from close contact when people cared for infected relatives.
"We don't have any indication of a broader health threat, other than poultry outbreaks" in the area, WHO spokesman John Rainford told CIDRAP news today. "Our risk assessment suggests no evidence of sustained transmission. All the close contacts and involved healthcare workers remain asymptomatic and have been released from close medical observation."
The WHO sent a team of experts to Pakistan to help investigate the situation, and US Navy Medical Research Unit 3 (NAMRU-3) in Cairo has sent a portable laboratory.
Rainford declined to predict today how soon confirmatory testing in the eight cases, which were identified in preliminary tests by Pakistan's national lab, will be completed. He said some samples from the patients would be sent to London for analysis.
"I hope we'll get some early results but question whether we'll have lab results that are what we need," he said. "We've got, hopefully, samples arriving in London sometime over the weekend that will provide a better environment to assess what we've got."
He said he expected both the NAMRU lab and the one in London will play a role in the testing: "NAMRU staff on site will be able to give us some information, but I guess there's a role for an additional lab to give us a full picture."
The patients who tested positive include four brothers in one family, one of their cousins, and two other people, according to news reports. The family group was originally described as four brothers and two cousins, but one patient initially identified as a cousin was actually a brother, the Associated Press reported on Dec 21. One of the four brothers died, and a fifth brother also was suspected of having the disease but died without being tested. The other three people were described as a man and his niece who were involved in culling poultry in connection with avian flu outbreaks, and a male farm worker from another town nearby.
WHO spokesman Gregory Hartl told CIDRAP News today that all of the surviving case-patients have recovered, adding, "I believe that all of them have also been released from hospital."
Meanwhile, five members of a family from Indonesia's West Java province have been hospitalized with suspected H5N1 cases, according to news reports citing Indonesia's state news agency, Antara, as their source.
A man named Fathurahman told Antara that his three children, aged 8, 10, and 16, suffered from high fevers, coughing, and breathing difficulty after an H5N1 outbreak among local poultry, according to a report by the Straits Times, a Singapore newspaper.
The three children and two other people in their extended family?siblings aged 17 and 30?were hospitalized in Serang, about 80 kilometers west of Jakarta, early this week, the story said. They were transferred today to Persahabatan Hospital in Jakarta, which is designated to treat avian flu patients, the report said.
A Xinhua report today said avain flu was suspected in the patients after health officials learned that 60 chickens and ducks in their village had died of H5N1 disease.
Two more members of the same family have also had symptoms suggesting avian flu but have not been hospitalized, the Straits Times reported.
In other developments, WHO officials said they will never know whether the recent H5N1 cases in a son and father in China involved person-to-person transmission. The patients were a 24-year-old man who died Nov 27 and his father, who was hospitalized with an H5N1 infection 6 days later.
David Heymann, the WHO's assistant director-general for communicable diseases, said today that the possibility of person-to-person transmission can never be confirmed or excluded, because the father and son had a common environmental exposure, Hartl told CIDRAP News.
Hong Kong newspapers reported earlier this month that before falling ill, the two men had both eaten undercooked chicken at a restaurant in Nanjing, capital of Jiangsu province.
See also:
Dec 17 CIDRAP News story "Possible H5N1 family cluster probed in Pakistan"
Dec 10 CIDRAP News story "Reports suggest common source in family H5N1 cases"

http://www.cidrap.umn.edu/cidrap/content/influenza/avianflu/news/dec2107avian.html

[Niko]

Re: Pakistan: December 18+, WHO Begins Investigations

<table id="table4" border="0" cellpadding="0" cellspacing="0"><tbody><tr><td class="Heading"> No new bird flu infections in humans reported

</td> </tr> <tr><td>

AP
Published: December 22, 2007, 00:23

</td> </tr> <tr> <td class="ArticleBody"> Geneva: Limited human-to-human bird flu transmission may have occurred in Pakistan, but no new infections have been reported for two weeks, a top World Health Organisation official said on Friday.
A WHO team has finished their initial investigation in Pakistan after up to nine patients, including several family members, were suspected of being infected with the H5N1 bird flu virus in areas north of Islamabad.
The experts were expected back in Geneva to begin piecing together how the virus may have spread, but they found no evidence of anyone currently sickened by the virus, said Dr David Heymann, WHO's top flu official in Geneva.
"I think the team right now feels on initial analysis that this might be a small chain of human-to-human, non-sustained transmission," he said, stressing that there was no cause for alarm.


http://www.gulfnews.com/world/Pakistan/10176556.html

</td></tr></tbody></table>

[HenryN]

Re: Pakistan: December 18+, WHO Begins Investigations

<table style="border-right: 2px solid; direction: ltr;" border="0" cellpadding="0" cellspacing="0" width="760"><tbody><tr><td style="border-right: 1px solid; border-bottom: 1px dashed;" valign="top" width="489"><table style="direction: ltr;" border="0" cellpadding="0" cellspacing="2" width="489"><tbody><tr><td valign="top"><table style="direction: ltr;" border="0" width="100%"><tbody><tr><td>WHO Says Spread of Bird Flu Among Humans Limited</td></tr><tr><td valign="top">By Lisa Schlein
Geneva
22 December 2007
</td><td align="left" valign="top"></td></tr></tbody></table>
The World Health Organization (WHO) says limited human-to-human transmission of the H5N1 avian influenza virus may have occurred in Pakistan. But it says the threat of further spread appears to have stopped as no new infections have been reported for two weeks. Lisa Schlein reports for VOA from WHO headquarters in Geneva.
<table class="APIMAGE" style="direction: ltr;" align="right" width="210"><tbody><tr><td></td></tr><tr><td class="imagecaption">Hospital staff clean and disinfect room in isolation ward where bird flu patient was treated in Abbotabad, Pakistan, 17 Dec 2007 </td></tr></tbody></table>Assistant Director-General of the World Health Organization and top bird flu expert, Doctor David Heymann, says a team of WHO experts has completed an investigation into an outbreak of bird flu in Pakistan. He says tests were carried out among a group of people who became infected with the deadly H5N1 strain of the virus in October.
Doctor Heymann says an analysis of the information is not yet complete. But preliminary results indicate there was human-to-human transmission of the virus. He says there could have been a common source of the infection.
"The team feels, we have not seen all their evidence yet, but they feel that this could be an instance of close contact of human-to-human transmission in a very circumscribed area and not sustained," he explained. "Just like happened in Indonesia and in Thailand."
Nine people, including five brothers, became infected with the H5N1 bird flu virus in a small town north of Islamabad. One was a veterinarian involved in culling sick poultry. Two of his brothers fell ill and died. The veterinarian and his other two brothers subsequently recovered.
Doctor Heymann says H5N1 remains an animal disease. He says there have been only occasional instances where human-to-human infections have occurred.
The World Health Organization reports at least 209 people have died worldwide from the virus, most in Indonesia. Scientists fear the H5N1 or another as yet unidentified virus could mutate into a form that could easily spread the disease among humans.
Doctor Heymann says there were three avian flu pandemics in the last century and other pandemics before then. He says there is a clear understanding in the scientific community that there will be another pandemic of influenza.
"We do not know what virus will cause that, but we know there are avian influenza viruses out there and those viruses could cause a pandemic eventually," he explained. "As long as H5N1 is circulating anywhere in the world, there is a chance that that virus can, either through an adaptive mutation or re-assortment, cause a pandemic. The problem is nobody can quantify that risk."
Doctor Heymann says countries have to be prepared to take action when a pandemic strikes. He says the World Health Organization is stockpiling H5N1 vaccines.
He says they would be used to vaccinate essential populations, such as health workers and security forces, in countries where the pandemic is starting. He says the vaccines also would be used to vaccinate people in areas surrounding a contaminated zone to try to contain the virus and stop it from spreading.

http://www.voanews.com/english/2007-12-22-voa9.cfm

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