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    Bird Flu Kills Indonesian Boy, Infects Man in China (Update1)

    By Jason Gale and Karima Anjani

    Jan. 10 (Bloomberg) -- Bird flu killed a 14-year-old boy in Indonesia, and China reported its first human case in five months as the World Bank warned countries to prepare for a potential deadly global outbreak.

    The teenage boy from West Jakarta died today, three days after testing positive for the H5N1 strain of avian influenza, a health ministry official said. The virus infected a 37-year-old farmer from Tunxi in the central Chinese province of Anhui, the country's Ministry of Health said today. In Azerbaijan, officials are investigating a possible outbreak in poultry.

    ``It's not a threat we should start to ignore,'' John Underwood, the World's Bank's avian-flu adviser, said in a statement yesterday. ``There will be another human pandemic at some point. They've occurred periodically throughout history and we need to be prepared for another one.''

    The H5N1 strain is known to have infected 263 people in 10 countries since 2003, killing three of every five of them, the World Health Organization said yesterday. Millions could die if H5N1 becomes easily transmissible between people, sparking a lethal pandemic.

    Fresh outbreaks were reported in Vietnam, South Korea, Egypt and Nigeria last month, leading to the deaths of thousands of fowl and adding to economic losses for the poultry industry, estimated at about $10 billion in Southeast Asia alone.

    New Outbreaks

    ``Even in countries where there have been huge efforts in control, there have been new outbreaks,'' Underwood said. ``One of the things we need to do is keep the attention on the fact that this is still a threat.''

    The latest fatality brings the death toll from H5N1 in Indonesia to 58, more than any other country.

    ``As long as we have the virus circulating almost freely in backyard poultry where there is a high density of population, we will continue to see infection in humans,'' Indonesia's Health Minister Siti Fadilah Supari told reporters in Jakarta today.

    Tests were negative on six other patients in Indonesia suspected of being infected, ``ruling out the possibility of a cluster'' of cases, I Nyoman Kandun, the health ministry's director general of disease control and environment, told reporters.

    Health officials monitor suspected clusters closely because they may signal the virus is becoming more adept at infecting humans, not just birds.

    `Timely Reporting'

    China's Centers for Disease Control and Prevention confirmed the country's 22nd case on Jan. 8. The man developed symptoms on Dec. 10 and was discharged from the hospital four days ago, said Joanna Brent, a WHO spokeswoman in Beijing.

    Tests for H5N1 were repeated this month after initial screening in December found no trace of the virus, Brent said. The United Nations health agency was informed of the positive test result yesterday, she said.

    ``This is in fact a case of very fast and timely reporting,'' Brent said over the telephone today. ``We are very encouraged by the health ministry's management of this case.''

    No additional human cases were reported, she said, adding that surveillance of both people and poultry needs to be improved to help disease trackers detect changes in the virus.

    In Azerbaijan, mass poultry deaths were discovered in the village of Boyuk Bahmanli in the Fuzuli region near the Iran border, the Azeri-Press Information Agency said on Jan. 8.

    Azerbaijan Investigation

    No evidence of avian flu was found during initial monitoring and the state veterinary service is investigating the bird deaths, Yolchu Khanveli, a spokesman for the service, told the agency. Eight human H5N1 cases, including five fatalities, were reported in the West Asian nation in March and April last year. Azerbaijan reported two outbreaks in poultry in 2006, including infections among fowl on a farm in Boyuk Bahmanli.

    Avian flu is slowly becoming endemic in Africa, increasing the risk of the virus mutating. A virus that spreads among people as easily as seasonal flu could spark a pandemic similar to one in 1918-1919 that killed about 50 million people.

    ``Once that happens, you have a completely different situation, and you cannot start preparing then, because that will be way too late,'' said Ok Pannenborg, a senior health adviser for the World Bank in Africa.

    Concern over a possible pandemic has prompted governments to stockpile flu treatments, including vaccines aimed at protecting people against a worldwide outbreak sparked by H5N1.

    Indonesia and Baxter International Inc., the world's biggest maker of blood-disease products, are developing a vaccine based on an H5N1 variant circulating in the Southeast Asian nation, Health Minister Supari said today.

    ``Clinical trials of the vaccine are under way and will take between three and six months,'' Supari told reporters. ``We will need around 2 million doses'' initially, she said.

    Indonesia also plans to increase its supply of the antiviral drug oseltamivir to 15 million doses this year from 12 million in 2006, Supari said. Oseltamivir is the active ingredient in Roche Holding AG's Tamiflu medicine.

    To contact the reporters on this story: Jason Gale in Singapore at j.gale@bloomberg.net ; Karima Anjani in Jakarta at kanjani@bloomberg.net

    Last Updated: January 10, 2007 05:15 EST

    ?Addressing chronic disease is an issue of human rights ? that must be our call to arms"
    Richard Horton, Editor-in-Chief The Lancet

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