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Scientists Believe Human to Human Transmission of Bird Flu Has Begun

The World Health Organization has concluded that human-to-human transmission likely occurred among seven relatives who developed bird flu in Indonesia.

In a report obtained Wednesday by The Associated Press, WHO experts said the cluster's index case was probably infected by sick birds and spread the disease to six family members. One of those cases, a boy, then likely infected his father, it said.

The U.N. agency stressed the virus has not mutated and that no cases were detected beyond the family.

Seven of the eight relatives died last month, but one was buried before samples could be taken to confirm bird flu infection.

"Six confirmed H5N1 cases likely acquired (the) H5N1 virus through human-to-human transmission from the index case ... during close prolonged contact with her during the late stages of her illness," the report said.

The report was distributed at a closed meeting in Jakarta attended by some of the world's top bird flu experts. The three-day session was convened after Indonesia asked for international help. The country has recorded the world's highest number of human bird flu cases this year, and 39 of those infected have died.

"What is happening in Indonesia? That is the No. 1 question," said Bayu Krishnamurthi, Indonesia's national bird flu coordinator. "With all of these limited resources - human, financial, institutional - what should we do?"

The experts were expected to discuss the large family cluster during the session. One of the remaining mysteries is why only blood relatives - not spouses - became infected.

The WHO report theorizes the family shared a "common genetic predisposition to infection with H5N1 virus with severe and fatal outcomes." However, there is no evidence to support that.

Keiji Fukuda, WHO's coordinator for the Global Influenza Program in Geneva, said the Indonesian case appears to resemble other family clusters where limited human-to-human transmission occurred following close contact. He said scientists must find out whether anything is different about the way the virus is behaving.

"The really critical factor is why did that cluster develop?" he said. "What's the reason why people in a cluster got infected?"

Fukuda said that although the cluster in the farming village on Sumatra island grabbed world attention, no country - including Vietnam and Thailand, which have largely controlled the virus - is safe from bird flu.

"This is a virus that you both have to respect a lot and (you) have to be concerned about the overall situation, even in areas in which it looks like control has been achieved," he said on the meeting's sidelines. "The real question is: Can you sustain that control for a virus which is really able to persist this way?"

Bird flu has killed at least 130 people worldwide since it began ravaging Asian poultry stocks in late 2003. Experts fear the virus will mutate into a form that spreads easily among people, potentially sparking a pandemic. So far, it remains hard for people to catch, and most human cases have been traced to contact with infected birds.

Indonesian officials said the country lacks manpower and money to battle the H5N1 virus alone. The government has been saddled with a series of natural disasters, including the 2004 tsunami and an earthquake last month on Java Island.

Indonesia needs $50 million from donors in the next three years to establish a system to help fight bird flu in poultry, according to Peter Roeder of the U.N. Food and Agriculture Organization.

Indonesia has said it needs $900 million over the next three years for its overall battle against the H5N1 virus but has only budgeted $59 million.



Associated Press reporter Zakki Hakim in Jakarta contributed to this report.

Copyright 2006 Associated Press.  All rights reserved.