Authorities in Pakistan have announced that country's first reported cases of H5N1 avian flu in a cluster of family members which may have involved human-to-human transmission.
Boys play outside an empty chicken farm closed last month after an outbreak of bird flu in in Abbotabad, Pakistan.
(Greg Baker/Associated Press)
There was some confusion Saturday about how many people had tested positive for the virus, with Pakistan announcing six cases but a World Health Organization official suggesting as many as nine people may have tested positive for the virus in that country.
The WHO spokesperson said investigations are still underway to try to determine how the various people became infected, but some human-to-human spread is possible. "We can't rule it out," WHO spokesperson Gregory Hartl said from Geneva.
"There are other plausible explanations.… We don't know enough at this point. And in some of these cases, one never will know enough."
The cluster of cases involved four brothers and two cousins living in the country's North West Frontier Province. Two of the brothers died, one without having been tested.
A doctor who treated members of the family also has tested positive for H5N1, Hartl said. But she was not tested with the standard diagnostic assay used to detect H5N1 infection and further testing is needed to determine if she is indeed a case.
Three people who are unrelated to the family but who were involved in culling H5N1-infected poultry in the same area have also tested positive, Hartl said.
Meanwhile, U.S. health officials have confirmed they conducted H5N1 testing on a man who had recently visited Pakistan and was complaining of mild respiratory symptoms. The man is believed to be another brother from the affected family.
A spokesperson for the U.S. Centers for Disease Control confirmed Saturday that the CDC sent its plane to Albany last Saturday to collect specimens taken from the man, who lives in Nassau County. Tests done in the state lab and confirmed at the CDC in Atlanta showed the man was not infected with the virus.
Pakistan slow to report cases
The initial infection dates back to Oct. 25, when a livestock official — a brother in the family — fell ill. It appears that it was only after two of the man's brothers fell ill and died that testing was done looking for H5N1 infection. It is believed the first positive test was received in late November.
The WHO was officially alerted on Dec. 12, Hartl said. "We feel that the Pakistanis have done everything right in terms of their response," he said, noting the country has done a "huge" amount of work to strengthen infection control and increase surveillance. "(But) yes, they could have alerted us earlier."
A lab team from the U.S. Naval Medical Research Unit in Cairo is travelling to Pakistan to conduct confirmatory testing. And WHO is sending a team of two doctors with experience treating H5N1 patients as well as an epidemiologist to help with the investigation of cases.
Pakistan is the 14th country to announce human infections with the H5N1 virus. If these cases are confirmed, they will bring the global case count since late 2003 to nearly 350 human cases and 209 deaths.
On Friday, the WHO announced that Myanmar had reported its first human case in a seven-year-old girl who fell ill in late November. She has since recovered.
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