Children in Turkey die after contracting avian flu

BMJ 2006; 332 doi: (Published 12 January 2006) Cite this as: BMJ 2006;332:67
  1. Jane Parry
  1. Hong Kong

    The World Health Organization has sent a team of experts to eastern Turkey to investigate the outbreak of H5N1 avian flu there, after three children in the area died from the infection.

    The confirmed cases have been attributed to close contact with infected poultry, but much remains unknown about the situation in Turkey, said Maria Cheng, a WHO spokeswoman in Geneva. “We have too little information. We don't know if it's the same strain of the virus that is circulating in Asia,” she said.

    The Turkish authorities reported to WHO that approximately 38 people, mostly children from Dogubeyazit in Agri province, are being monitored and evaluated for possible H5N1 infection at a hospital in the city of Van. “We know that the authorities have a lot of people under surveillance, but we don't have a clear idea of how they are classifying the cases—for example, whether they are people who were admitted to hospital with fever and a cough, or whether they have been in contact with poultry. If so, we don't have enough epidemiological information to know how they were infected,” said Ms Cheng.

    As of Monday 9 January, the Turkish authorities had announced that there were 14 confirmed cases of human infection: six from Agri and one from Van in eastern Turkey, three in the capital Ankara, and four in other parts of the country.

    Turkey's first two confirmed fatal cases in humans were in a 14 year old boy, who died on 1 January, and his 15 year old sister, who died on 5 January, in a rural area near Dogubeyazit.

    Another sibling, a 12 year old girl, also died of similar symptoms on 6 January, but initial tests for H5N1 were negative and further tests are under way.

    Embedded Image

    An Imam prepares the body of a 12 year old girl for burial after she died from suspected avian flu


    In terms of animal husbandry practices, eastern Turkey has similarities with countries in other parts of Asia that have had outbreaks of avian flu, with people living close to their small backyard flocks.

    WHO has praised the Turkish Ministry of Health's response to the situation. Marc Danzon, WHO's regional director for Europe, said: “My contacts with the Turkish health authorities have convinced me that all necessary measures are being taken to bring the whole situation under control.”

    The deaths in Turkey have been the first to occur in humans outside eastern Asia, where the disease has killed 72 and infected 142 people since 2003. WHO, together with the Japanese government, is hosting a meeting in Tokyo on 12 and 13 January of 14 Asian countries at risk of further outbreaks of H5N1 avian flu.

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