U.N. Warns Deadly Bird Flu Strain Has More Chance To Mutate With Each New Case

By BENJAMIN HARVEY
Associated Press writer

DOGUBAYAZIT, Turkey (AP) -- Authorities urged Turks to keep children away from dead birds Monday as preliminary tests showed five more youths had been stricken with the deadly H5N1 strain of bird flu.

Indonesia and China also each reported a new case and the U.N. health agency warned every new human infection increases the virus' chances of mutating into a form easily transmitted between people.

Turkey has reported 15 suspected or confirmed cases, resulting in three deaths, and the new ones were in four separate provinces -- indicating the disease was spreading.

"It's clear that the virus is well-established in the region," said Guenael Rodier, a senior World Health Organization official for communicable diseases.

Rodier said the human infections appear to have resulted from contact with infected domestic birds, but warned the chances the virus might mutate into a dangerous form transmitted from person to person increases with every new case.

"The more humans infected with the avian virus, the more chance it has to adapt," Rodier said while visiting Dogubayazit, a largely Kurdish town bordering Iran. "We may be playing with fire."

Turkish officials said they had so far culled 106,000 fowl as the virus spread from the easternmost Iranian border to Istanbul, on the edge of Europe.

Two teenagers from the same family in Dogubayazit died of bird flu last week, the first fatalities from H5N1 outside East Asia, where 74 people have been killed by the virulent strain since 2003. A third sibling also died of bird flu, but a WHO lab has not yet confirmed H5N1 as the cause.

On Monday, a fourth sibling was released from the hospital in the nearby town of Van after tests indicated he did not have the disease. Six-year-old Ali Hasan Kocyigit, the family's only surviving child, left the hospital in his uncle's arms, shyly gazing at cameras and journalists waiting outside.

Suspected bird flu cases are turning up in Turkish villages hundreds of miles apart, in every section of the country except the west. Officials said they are near wetlands on the paths of migratory birds, which have been carrying the disease from country to country.

Indonesian authorities reported Monday that a 39-year-old man with a history of contact with poultry had died of bird flu, according to preliminary tests.

In China, authorities said local tests showed a 6-year-old boy at a central China hospital has tested positive for the H5N1 strain. Chickens at the boy's home died before he fell ill, the official Xinhua News Agency reported.

The outbreaks in Turkey are linked to the close interaction between humans and animals, which must be minimized, Rodier said. "The front line between children and animals, particularly backyard poultry, is too large," he said.

The problem was highlighted during efforts to destroy sick fowl, children would join in, chasing chickens, geese or ducks with their bare hands.

Turkish labs have detected H5N1 in five new cases discovered in four provinces in eastern and central Turkey, as well as the Black Sea coast, Turkish officials said Monday. All five were children ages 4 to 12, the Anatolia news agency reported.

Two preliminary H5N1 cases reported Sunday in Ankara, about 600 miles west of Van, involved boys ages 5 and 2 who apparently caught the virus while playing with gloves their father used to handle two dead wild ducks.

An 8-year-old girl hospitalized in Van apparently contracted the virus by hugging and kissing dead chickens.

Ten people earlier tested positive for H5N1 in tests in Turkish labs, four of which have been confirmed by WHO. The Geneva-based agency on Monday also classified 10 cases as "preliminary positive."

In addition, more than 60 people with flu-like symptoms who came in close contact with fowl had been hospitalized around the country by Monday and were being tested, officials said.

WHO spokeswoman Maria Cheng expressed concern about the rapid increase in cases but said a team of experts said "so far it looks very much like ... these cases were infected through contact with sick poultry."

On Monday, Health Minister Recep Akdag arrived with WHO officials in Dogubayazit, where many of the cases originated.

"If as a community, we take the necessary measures and educate (people) we can in a short period of time combat this," Akdag said. "We will manage to slow its progress."

He said, however, that because Turkey was on the path of migratory birds, the country would continue to be at risk in years to come, and urged people to abandon raising poultry in backyards.

Akdag climbed a snowy hill to visit Zeki Kocyigit, whose three children died of the disease. As he left, villagers shouted complaints about a lack of doctors.

Associated Press reporters Alexander G. Higgins in Geneva and Selcan Hacaoglu and Suzan Fraser in Ankara contributed to this report.