May 25, 2006
H5N1 Bird Flu Human To Human Transmission?

The World Health Organization is pondering whether to raise the level of alert on H5N1 avian influenza.

JAKARTA, Indonesia, May 24 -- The World Health Organization might soon convene an expert panel to decide whether an unprecedented human outbreak of bird flu in Indonesia should trigger a higher global alert for a possible pandemic, health officials said Wednesday.

Why this concern? Suspected Human-To-Human (H2H) transmission of bird flu in 8 members of an Indonesia family got bird flu. Only 1 survived! A strain this lethal would exact a terrible toll if it mutates into a pandemic strain.

Indonesian health authorities this week confirmed that the virus had killed at least six members from one extended family on Sumatra island, including a 32-year-old man Monday. A seventh family member also died from what investigators suspect was bird flu, but she was buried before samples could be taken. Another relative is hospitalized with a confirmed case and is recovering.

Experts fear the bird flu spread in this family from person to person person.

May 24, 2006 (CIDRAP News) For the first time, evidence suggests that the H5N1 avian influenza virus may have passed from one person to another and on to a third, according to a World Health Organization (WHO) official.

Referring to the extended-family case cluster in Indonesia, the WHO's Maria Cheng told the Canadian Press (CP) yesterday, "This is the first time we have seen cases that have gone beyond one generation of human-to-human spread."

The big fear about bird influenza is that it could mutate so that such human-to-human transmission becomes easy.

Even the first case in this cluster had no easily identifiable animal source of initial exposure.

One of the major puzzles about the cluster, in which human-to-human-to-human transmission is suspected, is the lack of an identifiable animal source of infection for the first case. Steven Bjorge, a WHO epidemiologist in Jakarta, told the AP that the 37-year-old deceased woman who is regarded as the first case-patient might have picked up the virus in her home or workplace. She died April 29 and was buried before samples could be collected for testing, but the WHO believes her illness was avian flu.

"We believe she may have had some contact either with dead or dying chickens in her household or through her activities as a vegetable grower and a seller in a market," Bjorge said of the woman.

The family were exposed to each other and members successively became sick.

On April 29, three people who later fell ill shared a small room with the mother of the family, who was gravely ill and coughing, and has since died. Others who have been stricken cared for family members who were dying. There are no cases reported in the village outside of the family.

The fact that other members of their village have not yet become ill is good news. Hopefully this cluster won't get any larger.

Recombinomics influenza commentator Henry Niman argues that the incubation time of H5N1 bird flu is overestimates by some public health officials and therefore they are underestimating the extent of human-to-human transmission.

WHO assumes that the incubation time for bird flu in humans is 7 to 10 days, longer than that of regular flu, she said.

Henry Niman, who runs, a Web site tracking the genetics of flu cases, argues that the incubation period is closer to the two to four days of regular flu, so the boy may have been infected by another family member, meaning that the virus may have made three consecutive human-to- human jumps.

But Cheng said the health agency's "working hypothesis" was still that it had jumped only twice.

Niman thinks the number of human-to-human (H2H) clusters has been underestimated due to the overestimate of the H5N1 incubation time. Niman therefore believes that we are already at phase 4 of the development of a pandemic virus strain. Phase 5 would include a much higher level of H2H transmission. Phase 6 would be "it is time to move to that cabin in the country with lots of survivalist supplies".

I do not know if or when H5N1 will mutate into a pandemic strain. I hope it does not. But if it does then you should prepare yourself to rapidly and radically restructure your life to decrease your odds of getting exposed to carriers.

Share |      Randall Parker, 2006 May 25 08:58 PM  Pandemic Signs

Paul Dietz said at May 26, 2006 4:40 AM:

The fact that it spread rapidly within the family, but not beyond the fanily, suggests a genetic susceptibility in that family was at work here. This should be mildly encouraging.

Al Tanner said at May 27, 2006 9:33 AM:

It is hard to separate genetic from social influences:

From the CDC: "Notable findings of epidemiologic investigations of human H5N1 cases in Vietnam during 2005 have suggested transmission of H5N1 viruses to at least two persons through consumption of uncooked duck blood."


Tess said at May 31, 2006 10:21 AM:

hej yall

I do actually believe it will not take to much time before bird flu will be able to transfer from human to human. It is a virus after all, and we all know that all viruses mutate.

Besides, there are way to many people in this world and nature is just finding a way to clean up the mess. maby it is whise not to ask if it will happen but when it will happen!!!
Even if bird flu will not be the disease that will desease a big part of the human population, some other virus will. Strains of the Ebola and Marburg virus still linger somewhere in the jungle, waitingt for an opertune moment to get out.

I am not trying to scare anyone,and i neither want to come across negative. It is just my opinion that I have formed after loads of research and thinking.

Greets, Tess, Holland

Kulothungan said at January 22, 2008 8:21 AM:

Great panic on people about bird flu ,administrators take adequate steps

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