May 24, 2006:   WHO: Indonesian cases of H5N1 avian influenza may have been transmitted from human to human

Evidence of Human to Human Transmission?

The World Health Organization (WHO) reported on May 24th that an H5N1 influenza outbreak in Indonesia earlier this month in north Sumatra, which was confirmed to have infected seven members of an extended family and resulted in seven deaths (a 100% fatality rate), may have been caused by human-to-human transmission of the H1N5 bird flu virus. Spokesman Peter Cordingley of the WHO stressed that there was no evidence that the influenza strain had mutated into a form that will facilitate transmission between people (which could be a harbinger for an upcoming pandemic), but that it could not be excluded.

"All confirmed cases in the cluster can be directly linked to close and prolonged exposure to a patient during a phase of severe illness. To date, the investigation has found no evidence...that efficient human-to-human transmission has occurred," the WHO said in a statement reported on CNN. At this time, the virus does not appear to have spread outside the affected family, but WHO virologists are closely monitoring this case.

The WHO could not find an animal vector (such as an infected bird) in this case. "We can still find no sign of any sick animals that might have infected these people so we've got a puzzle on our hands and it's a worrying one." Cordingley said.

The WHO is monitoring this case closely because "We have not had a cluster as large as this -- seven people in an extended family," Cordingley said.

The WHO tested two viruse samples taken from 2 of these 7 cases and found no evidence of "significant mutations" or resistance to neuraminidase inhibitors, including Roche's Tamiflu. The WHO indicated that it is continuing its investigation of this case.

The WHO has confirmed 218 human cases of bird flu worldwide; of those, 124 died. The world wide fatality rate to date: 57% Source: First Word

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