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. Officials are checking for signs of human-to-human transmission, Health Minister Siti Fadilah Supari said last week. “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. About three new human cases have been reported a week on average 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.
Since 2003, H5N1 is known to have infected 239 people in 10 countries, killing 140 of them, the WHO said on Aug. 17. The virus has killed 63 people this year, compared with 22 in the first eight months of 2005. 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. “Rumors” of additional deaths from respiratory disease in neighboring hamlets in late July and early August are also being investigated, the WHO said Aug. 17 on its Web site. At least 16 others are being tested 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. (Bloomberg)