Three people catch bird flu in Turkish capital

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Bird flu in humans appears to be spreading in Turkey, with preliminary tests for the deadly H5N1 strain of bird flu on Sunday returned positive in three people in Ankara, the first suspected cases outside the eastern city of Van, where at least two siblings have died in the past week.

Health officials caution that the virus has so far only been confirmed in humans who were in close and prolonged contact with fowl, but are monitoring the virus for fear it could mutate into a form easily transmissible among humans and spark a pandemic.

A third sibling also died of suspected bird flu in Van, but the cause of death has not yet been confirmed by a World Health Organization laboratory.

If confirmed, the third sibling and the three new cases in Ankara, about 1,000 kilometers (600 miles) west of Van, would bring to 10 the total number of bird flu cases in humans in Turkey. Seven are currently in hospital and three have died.

Maria Cheng, a WHO spokeswoman in Geneva, said the UN health agency had too little information to confirm the three cases in Ankara.

"We've been informed about it, but we're not confirming those today," she told the AP. "We don't have confirmation from the Ministry of Health about what exactly that means, if this is based on laboratory testing or whether that was done."

The fatalities here were the first caused by the virus outside of 74 deaths in east Asia, where the virus killed more than half of the people it infected.

A British laboratory confirmed the deadly H5N1 strain of the virus in a 5-year-old Turkish boy, and Cheng said WHO has accepted Turkish testing as confirming the infection in an 8-year-old girl as well. Both children are in intensive care in Van, about 60 miles from the Iranian border. Another brother and sister in Van also were found to be positive for H5N1 in the preliminary tests, Health Ministry official Turan Buzgan said.

The two children and an adult who were hospitalized in the Turkish capital, Ankara, would be the first cases of H5N1 found outside the vicinity of Van.

Health Minister Recep Akdag arrived in Van late Sunday with officials from WHO. They were to travel to Dogubayazit, a largely Kurdish town where most of the cases have originated, on Monday.

Guenael Rodier, a senior official for communicable diseases at WHO praised the Turkish government for its policy of "transparency" in the outbreak.

"It has allowed us to bring our experience in other countries," Rodier said. "The problem is local but it is also global."

Dozens of people who had recently been in close contact with fowl have been hospitalized and were being tested for bird flu across Turkey, as reports of outbreaks and a sense of worry spread across the country and into others.

Russia's chief epidemiologist, Gennady Onishchenko, urged Russians not to travel to eastern parts of Turkey because of the bird flu outbreak, according to a statement released Sunday, and Iran has closed down its border to Turkish citizens.

Birds in Turkey, Romania, Russia and Croatia have recently tested positive for H5N1.

The doctor who treated the thee children who died in Van said they probably contracted the illness by playing with dead chickens.

Health officials believe the best way to fight the spread of bird flu is the wholesale destruction of poultry in the affected area. But they often run into problems in rural areas like Dogubayazit, where villagers have resisted turning in their animals.

Authorities here have had difficulties explaining the danger of close contact with fowl to local residents and the need to deliver all birds for destruction, whether or not they appear sick.

"This virus spreads rapidly," workers shouted through loudspeakers in Dogubayazit on Sunday, demanding that villagers turn in their poultry. Akdag himself urged people during a televised news conference to abandon the practice of raising poultry in backyard coops.

On Sunday, a group of Turkish workers in Dogubayazit had to climb over a wall when a woman refused to open the door and hand over her several chickens, insisting they were not sick. The workers could not persuade her to part with the chickens and left, saying they would return with police.

It was a scene often repeated across the impoverished eastern parts of the country, where sometimes chickens, ducks or turkeys are a family's most valuable possession.

Others who realized the danger, however, were seen inviting workers to collect their poultry in Dogubayazit on Sunday. Tens of thousands of fowl have been culled in the latest outbreaks across Turkey so far.

WHO is investigating whether the disease had been transmitted from human to human, Cheng has said. But Akdag said there was no reason to suspect it had.

"This is a disease in fowl, the people who are in contact with them are at risk," he said. "This is the problem which must be addressed."

Akdag urged calm, but Dr. Gencay Gursoy, head of the Istanbul Physicians Association, said the situation was grave.

"Turkey and the world are facing the threat of a serious infection," he said.