2 bird-flu victims may have been infected by sibling

By Richard C. Paddock
Los Angeles Times

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JAKARTA, Indonesia — The World Health Organization (WHO) said yesterday that two sisters who died in Vietnam's Thai Binh province last week were victims of bird flu and might have contracted the disease from their brother.

If confirmed, the sisters' deaths would represent the first human-to-human transmission of the illness during this outbreak. Until now, health officials had concluded that human victims in Vietnam and Thailand were contracting the virus through direct contact with infected fowl.

The deaths of the two women, ages 23 and 30, bring to 11 the number of confirmed bird-flu deaths in Vietnam. There also have been three confirmed deaths in Thailand from the virus, which has hit 10 Asian nations and killed millions of chickens and ducks. Millions more fowl have been killed in attempts to control the epidemic.

"The investigation has not been able to conclusively identify the source of infection for the two sisters," the World Health Organization said in a statement issued by its Hanoi office. "However, WHO considers that limited human-to-human transmission, from the brother to his sisters, is one possible explanation."

Doctors suspect that the women's 31-year-old brother was the first to come down with the virus. He fell ill and died Jan. 12, WHO said. His body was cremated soon after, so doctors have been unable to determine the cause of death.

The day after he died, his sisters and his wife were admitted to a hospital suffering from respiratory infections. His wife recovered but the sisters died Jan. 23. All four had been together at the wedding of the brother and his wife five days before he fell ill.

Tests showed that all three women were suffering from the virulent form of bird flu — known as H5N1 — sweeping Asia.

On Wednesday, when Vietnamese officials announced the death of the two sisters, the director of Vietnam's Institute of Clinical Research in Tropical Medicine said the victims had helped their brother handle chickens during preparations for the wedding reception.

"The man helped to put the chickens into the cages while the sisters slaughtered the chickens. It's likely that they got the virus from the sick chickens," Le Dang Ha said at the time.

WHO said it found no such link "The investigation failed to reveal a specific event, such as contact with sick poultry, or an environmental source to explain these cases," the WHO statement said.

While the number of human victims of avian flu has been relatively small, health experts fear that if the virus gains a foothold in the human population it could develop the ability to spread easily among people, potentially killing millions worldwide.

During a 1997 bird-flu outbreak in Hong Kong that killed six, doctors found "similar instances of limited transmission" of the virus between humans but these cases never developed into a significant health threat, WHO said.

Material from The Associated Press is included in this report.

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