WHO Tracing Contacts
Of H5N1 Indonesia Death Family

By Diyan Jari

JAKARTA (Reuters) -- Members of an Indonesian family who died of bird flu may have infected each other and health experts are tracing anyone who had contact with them, the World Health Organisation (WHO) said.
Seven of the family have died this month but so far there is no evidence of anyone else being infected.
A senior WHO official said in Jakarta this was not the first time such a family cluster had been seen. The WHO has stressed that fresh scientific evidence had shown the virus in Indonesia has not mutated to one that can spread easily among people.
The WHO said it had no immediate plans to call a meeting of experts to discuss raising its global bird flu alert.
"Right now it does not look like the task force will need to meet immediately, but this is subject to change depending on what comes out of Indonesia," WHO spokeswoman Maria Cheng said, when asked to comment on press reports of an imminent meeting.
Financial markets, however, were spooked by fears the Indonesia cluster could be the start of a pandemic. Currencies in Asia, where most bird flu cases have occurred, fell. U.S. commodity prices came under pressure, while shares in poultry industry companies fell in New York.
Concern has been growing about the case in north Sumatra in which seven family members from Kubu Sembilang village died this month. The case is the largest family cluster known to date.
WHO and Indonesian health officials are baffled over the source of the infection but genetic sequencing has shown the H5N1 bird flu virus has not mutated, the U.N. agency said on its Web site (
Nor was there sign of the virus spread among villagers.
"To date, the investigation has found no evidence of spread within the general community and no evidence that efficient human-to-human transmission has occurred," the WHO said.
Sick poultry have been the source of bird flu infection for most human cases worldwide.
Clusters are looked on with far more suspicion than isolated infections because they raise the possibility the virus might have mutated to transmit efficiently among humans.
That could spark a pandemic, killing millions of people and devastating economies.
The WHO statement came after one of the family members, a 32-year-old father, died on Monday after caring for his ailing son, who had died earlier. The agency said such close contact was considered a possible source of infection.
Firdosi Mehta, acting representative of the WHO in Indonesia, urged against any over-reaction, saying this was not the first cluster that the world has known.
Limited transmissions between people are caused by close and prolonged contact when the sick person is coughing and probably infectious. Experts in Kubu Sembilang were acting to contain any further spread.
"We are going wide, contacting the various contacts, putting on (anti-viral) Tamiflu whoever has had close contact, basically putting family members who have not been affected on Tamiflu as a precaution," Mehta told Reuters in an interview in Jakarta.
"There is active surveillance in the village, fever surveillance to look for any more cases that are occurring outside this immediate family cluster," he said.
But another WHO spokesman said the agency was worried.
"This is the most significant development so far in terms of public health," Peter Cordingley, spokesman for the West Pacific region of the WHO, said in the Philippine capital on Wednesday.
"We have never had a cluster as large as this. We have not had in the past what we have here, which is no explanation as to how these people became infected."
"We can't find sick animals in this community and that worries us," he added.
Bird flu has killed 124 people in nine nations since it re-emerged in Asia in 2003. It is essentially a disease in birds and has spread to dozens of countries in wild birds and poultry.
Patricia A. Doyle DVM, PhD
Bus Admin, Tropical Agricultural Economics
Univ of West Indies
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