WHO Says Bird Flu
Virus Mutated

By Margie Mason
AP Medical Writer

JAKARTA, Indonesia - A World Health Organization investigation showed that the H5N1 virus mutated slightly in an Indonesian family cluster on Sumatra island, but bird flu experts insisted Friday it did not increase the possibility of a human pandemic.
The virus that infected eight members of a family last month - killing seven of them - appears to have slightly mutated in a 10-year-old boy, who is then suspected of passing the virus to his father, the WHO investigative report said.
It is the first evidence indicating that a person caught the virus from a human and then passed it on to another person, said Tim Uyeki, an epidemiologist from the U.S. Centers for Disease Control and Prevention. He said the H5N1 virus died with the father and did not pass outside the family.
"It stopped. It was dead end at that point," he said, stressing that viruses are always slightly changing and there was no reason to raise alarm.
Dr. William Schaffner, a bird flu expert at the Vanderbilt University, called the mutation "noteworthy but not worrisome." Generally it takes a series of mutations in a bird flu virus to raise the danger of a pandemic in humans, he said in a telephone interview.
Schaffner said it is remarkable that scientists were able to discover a mutation that occurred in a remote village in Indonesia. That's the result of intense surveillance linked with "21st-century laboratory virology," he said. "That's awesome."
The findings appeared in a report obtained by The Associated Press that was distributed at a closed meeting in Jakarta attended by some of the world's top bird flu experts.
The three-day session that wrapped up Friday was convened after Indonesia asked for international help. The country has experienced an explosion of human bird flu cases this year and is on pace to become the world's hardest-hit nation with 39 deaths.
The government said it needed $900 million over the next three years to fight the virus, which is ravaging poultry stocks across the archipelago. Health experts urged full implementation and funding of its national bird flu plan.
"Human cases and clusters are expected to continue to occur in Indonesia as long as avian influenza in poultry persists," said Bayu Krisnamurthi, Indonesia's national bird flu coordinator.
But Welfare Minister Aburizal Bakrie said the virus has shown no sign of changing in any way that would allow it to spread easily among people, potentially sparking a pandemic.
So far, the H5N1 virus remains hard for people to catch, and most human cases have been traced to contact with infected birds.
WHO concluded in its report that human-to-human transmission likely occurred among seven relatives infected with the H5N1 virus. An eighth family member who was buried before specimens could be taken is believed to have been infected by poultry, the report said.
Despite the virus' slight mutation, Uyeki insisted that an analysis suggested there was "nothing remarkable about these viruses."
Bird flu has killed at least 130 people worldwide since it began ravaging Asian poultry stocks in late 2003. Indonesia trails on Vietnam, where 42 people have died, in human bird flu deaths.
WHO and others continue to investigate a report that a Beijing man originally thought to have SARS actually died of bird flu in November 2003 - two years before the Chinese reported any human H5N1 flu infections from the mainland.
Eight Beijing scientists detailed the case in Thursday's New England Journal of Medicine. At the last minute, the lead author without explanation asked to have the report withdrawn, but that was not possible because it was already printed. The journal has been unable to reach the scientists to see whether they want to retract the report.
WHO had been unaware of the case.
"We have asked the Ministry of Health via a formal letter (our usual protocol) to clarify the report," said Roy Wadia, a spokesman in WHO's China office. "The ministry says they are investigating this report, and will get back to us soon."
Efforts to reach the scientists for comment have been unsuccessful.
Associated Press reporter Zakki Hakim in Jakarta, Medical Writer Marilynn Marchione in Milwaukee and Science Writer Malcolm Ritter in New York contributed to this report.



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