News - Avian flu 'may be spread by humans' Sick mother and child could be victims of first transmission

Health authorities are studying whether the latest fatal outbreak of bird flu in Turkey has been spread by human-tohuman contact for the first time.The World Health Organisation is examining a mother and her child who were infected with the virus to determine whether a mutation of the H5N1 strain has occurred which could trigger a global pandemic.The 78 people who have died from bird flu to date are thought to have caught the disease from direct contact with infected poultry. However, Guenael Rodier, the WHO's head of communicable diseases and response, said yesterday questions had been raised by the latest outbreak. He said: "When you have a mother and a child, and both get sick, you don't know if they both were exposed to the chickens, or if the mother got sick because she was caring for the child. It leaves room for some question marks. We have not documented every transmission story."Preliminary tests have confirmed H5N1 in 18 Turks, including three children who died last week.The Medical Research Council in Britain announced on Thursday that the H5N1 virus detected in Turkey had mutated into a form that could bind more easily to human cells than those of birds. A similar mutation occurred during the flu outbreaks in Hong Kong in 2003 and Vietnam in 2005.However, there is no evidence that the virus has undergone the further changes needed before it can be transmitted between humans. The WHO stressed that, even if this was the case, the outbreak could still be contained and would not necessarily start a pandemic which could kill millions of people. Mr Rodier added: "The virus could spread like Sars and still be contained."In Britain, health authorities have begun stockpiling Tamif lu, the antiviral drug which has proved effective against the symptoms of bird f lu, but there has been criticism from microbiologists that not enough is being done to develop an effective vaccine.Despite reassurances by the Scottish Executive that a robust pandemic contingency plan has been in place since 1997, GPs appear not to have been informed of what measures are in place.Mary Church, joint chair of the British Medical Association's Scottish GP committee, said emergency measures were being drawn up by the chief medical officer, but doctors had not yet been informed of them.She said: "At the moment, the number of beds we have may not be sufficient to cope with the number of very ill people who may have to be treated. People who would normally be treated in hospital may have to be treated in the community. That would involve training non-medical staff."As reports of more deaths emerged from Turkey this week, British vets warned that measures should be taken to keep domestic birds away from lakes and waterways where they could come into contact with wild carriers of avian f lu.Bob McCracken, a former president of the British Veterinary Association, said the bird flu danger would be greatest during the wild duck migratory season.The WHO has asked Turkey's health ministry for permission to conduct more intensive screening and tests in areas where outbreaks have occurred.Patients seemed to be responding well to Tamiflu, Mr Rodier said.Some experts have expressed concern that H5N1 could become entrenched in Turkey, and that a permanent presence of the strain on the rim of Europe would pose a serious threat to the rest of the continent, as well as to Africa, since the country lies on a major migratory route for wild birds.Mr Rodier said he could not say whether H5N1 would become endemic to Turkey, but conceded: "We are expecting this constant threat for months to come."

Avian flu 'may be spread by humans' Sick mother and child could be victims of first transmission