SE TURKEY--3 children with diarrhea test negative for H5N1

[Sharpe]

Did we miss something? H5N1 causes diarrhea anyway. Why did they think these kids had bf? Did their poultry die? It's worth pointing out how close this is to the family cluster in Iran which tested positive locally for H5N1 but not officially, 3 out of the 5 of which died, and it may also be close to the unspecified area of northern Iran which the Iranian government has been denying rumors of bird flu roughly every five days for the last three weeks. Perhaps Theresa could try and see if she can translate some Turkish articles from the Van area? Map attached.

http://www.zaman.com/?bl=hotnews&alt=&trh=20060726&hn=35086
<table border="0" cellpadding="0" cellspacing="10" height="175" width="100%"> <tbody><tr><td>
</td> <td>07.26.2006 Wednesday - ISTANBUL 19:42</td> </tr> <tr> <td colspan="2" width="100%">
Three Children in Hakkari Test Negative for Bird Flu
By Cihan News Agency
Wednesday, July 26, 2006
zaman.com

Three children who were hospitalized on the suspicion of bird flu have tested negative, Van University Hospital announced on Wednesday.
Van hospital said in a statement that the children were suffering from diarrhea. "The children have been treated and discharged from hospital," the statement added.
Three children suffering from what doctors suspected was the bird flu were transferred to Van University Hospital from Hakkari Hospital, where their health condition had initially worsened.
When the parents of the children refused to transfer them to Van, police intervened and forcibly transferred them to Van University Hospital.
The deadly H5N1 strain of the bird flu virus has killed 133 people worldwide by July 25, 2006, according to a release by the World Health Organization (WHO). The first Turkish bird flu outbreak appeared in western Turkey in October 2005, but no deaths or infections of humans were reported. In a second outbreak in eastern Turkey in January, the H5N1 virus claimed the lives of four children, aged between 11 and 15, three of whom were siblings.
More than 1.7 million poultry were culled across the country in efforts to contain the second Turkish bird flu outbreak.
</td></tr></tbody> </table>

 

[Snowy Owl]

Re: SE TURKEY--3 children with diarrhea test negative for H5N1

As last year, the problem seems to concentrate on what would be 'Kurdistan' if it exist that is,

Anatolia Turquey, Northeast Irak and Northwest Iran.

 

[Sharpe]

Re: SE TURKEY--3 children with diarrhea test negative for H5N1

Breaking news headline from "Turkish Daily News":


http://www.turkishdailynews.com.tr/


Hospital tests shows that three children who were hospitalized with possible signs of bird flu only had an infectious intestine disease, a doctor says.

 

[Sharpe]

Re: SE TURKEY--3 children with diarrhea test negative for H5N1

The only English language news I can find coming out of Hakkari in the last few days is the below Promed report about almost 100 cows and sheep in 4 villages dying of suspected anthrax.

ANTHRAX, LIVESTOCK - TURKEY (HAKKARI)
*******************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: 14 Jul 2006.
From: Alfonso Rodriguez, M.D.<ajrm_msds@yahoo.es>
Source: Kurdishinfo.com, Turkey, 13 Jul 2006 [edited]
<http://www.kurdishinfo.com/modules.php?name=News&file=article&sid=8323>


Officials say 5 villages in Hakkari's Yuksekova district have been placed
under quarantine in fear of anthrax outbreak after loss of 80 livestock.
The District Agriculture Director is warning locals against contracting the
disease. The Agricultural Director of Yuksekova district in the Southeast
province of Hakkari has ordered a 15-day quarantine on 4 local villages and
a hamlet to contain a possible anthrax outbreak and asked villagers to take
measures against contracting the disease.

Director Mehmet Bilgin said the quarantine was imposed after reports of
loss of 30 small [sheep and goats] and 50 large livestock [cattle] and that
it would be in effect for 2 weeks until all of the animals have been
vaccinated. Bilgin said the required vaccine had arrived from capital
Ankara and that the vaccination had started. The municipality, he added, is
burying the dead animals.

The chieftain of the Gurdere villages where [the livestock were] lost,
Tahir Duzce, said they had been aware of the spread for 15 days but
measures had only been taken in the past week.

--
ProMED-mail
<promed@promedmail.org>

[This problem had certainly existed for more that 15 days, if 4 villages
and a hamlet were involved. To find this area, go to:
<http://www.fallingrain.com/world/TU/0/Yuksekova.html>http://www.fallingrain.com/world/TU/0/Yuksekova.html>

Turkey regularly reports outbreaks involving large and small ruminants. The
disease is very common in Turkey, especially in eastern Turkey. Human cases
have been reported for many years and latterly the not atypical numbers
are: 1999 (690), 2000 (396), 2001 (532), 2002 (368), 2003 (325). - Mod.MHJ]

[see also:
2005
----
Anthrax, human, ovine, caprine - Turkey (Bingol) 20050708.1935]
..........................................dk/mhj/pg/dk


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[Theresa42]

Hakkari'de kuş gribi ş?phesi

Hakkari'de kuş gribi ş?phesi

Sounds as thought there have been some chicken deaths in their village...

Machine-translated from Turkish:

Bird flu (kuş gribi) suspects Hakkari ?ukurca il?esinden Van sent to three children bird flu suggested(?)
July 26, 2006

?ukurca'nın ?z?ml? village chickens death that following Hakkari State Hospital sent edilen 1.5 year-old Adem Seven, 8 month old Ismail Kaya together with 3 month old Canan Seven, Hakkari State Hospital put under treatment following bird flu suspects Van g?nderildi.

Van Y?z?nc? Yıl ?niversitesi Araştırma Hospital yapılan first investigate children bird flu being/happen belirlendi. The three children under treatment following Hakkari sent off.


26 Temmuz 2006
Hakkari'de kuş gribi ş?phesi

A.A

Kuş gribi ş?phesiyle Hakkari'nin ?ukurca il?esinden Van'a g?nderilen ?? ?ocuğun kuş gribi olmadığı belirlendi.

?ukurca'nın ?z?ml? k?y?nde tavukların telef olmasının ardından Hakkari Devlet Hastanesine sevk edilen 1.5 yaşındaki Adem Seven, 8 aylık İsmail Kaya ile 3 aylık Canan Seven, Hakkari Devlet Hastanesindeki tedavinin ardından kuş gribi ş?phesiyle Van'a g?nderildi.

Van'da Y?z?nc? Yıl ?niversitesi Araştırma Hastanesinde yapılan ilk incelemede ?ocukların kuş gribi olmadığı belirlendi. ?? ?ocuk tedavilerinin ardından Hakkari'ye g?nderildi.

http://www.hurriyet.com.tr/gundem/4816790.asp?m=1&gid=69&srid=3049&oid=6

 

[Sharpe]

Re: SE TURKEY--3 children with diarrhea test negative for H5N1

Thank you my fellow researcher. As I suspected. Now I have one more favor to ask of you. Could you find an article in Turkish that talks about the villages experiencing anthrax and tell me if they're the same villages with poultry deaths? If you can't don't worry about it. Could you translate this article-it mentions veterinarian I think: http://www.hurriyet.com.tr/gundem/4820013.asp

 

[Theresa42]

Anthrax - Bitlis province

Anthrax - Bitlis province

Here's one article (which I don't have the time to translate just now -- my machine-translation process is a word-by-word ordeal!). It starts off, though, talking about Bitlis province (eastern Turkey - borders on Lake Van) ... Hizan district (I think) ... Akbiyik village. Glancing through it, I don't see any other placenames ... but, obviously, zkurmus or Oric would be able to translate properly!

Here's the Turkish-English dictionary I use:
http://www.turkishdictionary.net

The headline: Anthrax present quarantine not present [So, they've confirmed anthrax but not instituted a quarantine, I think. ??]

Şarbon var karantina yok
July 23, 2006

Bitlis'in Hizan İl?esi'ne bağlı Akbıyık K?y?'nde yaşayan insanlarda şarbon hastalığı tespit edildi. Şarbonlu hayvanları kesip yiyen aileler, tek tek hastalığın pen?esine d?ş?yor. S?zgelimi 9 kişilik bir ailenin en k???k ?yesinden en b?y?ğ?ne kadar herkes şarbon hastası. K?yde g?rev yapan doktor ve veteriner hekimler, hastalığı teşhis ettikten sonra k?y?n karantinaya alınması i?in kaymakamlıktan tarım il?e m?d?rl?ğ?ne kadar pek ?ok yetkili kuruma durumu bildirdi. Sağlık Bakanlığı tarafından ihbarı zorunlu hastalıklar kapsamında olan hastalık i?in k?yde hen?z bir ?nlem alınmış değil.

HAYVANLARDAN BULAŞTI

Akkbıyık K?y?'nde şarbon hastalığına neden olan antraks mikrobunun ne zaman ortaya ?ıktığı veya ka? kişinin hayatına mal olduğu bilinmiyor. Zira bug?ne kadar b?lgede g?rev yapan doktorlar kendilerine cildinde ?ıkan yaraların tedavisi i?in başvuran hastalara yumuşak doku enfeksiyonu teşhisi koydu. Ancak yaklaşık 25 g?n ?nce b?lgede bulunan doktor ve veteriner hekimler tarafından yapılan incelemeler ve tahlillerin ardından hastalığın şarbon olduğu ortaya ?ıktı.

Şarbonlu hayvanları kesip yiyen k?y halkının, hastalığın pen?esine d?şt?ğ? anlaşıldı. K?y halkının ifadesine g?re sadece temmuz ayı i?inde iki haftada 20 adet koyun ve ke?inin ?ld?ğ?, ?len hayvanların etlerinin hayvan sahipleri tarafından yenildiği belirlendi. Hastalıktan ?len hayvanların leşleri 'hastalıktan ?l?yorlar' d?ş?ncesiyle k?y?n ortasındaki dereye atıldığı i?in vir?s hızla yayılıyor. Derenin kenarında ?ocuklar oyun oynuyor, hayvanlar su i?iyor.

HEMEN ?NLEM ALINMALI

Şarbon vir?s?n?n ortaya ?ıkmasından sonra b?lgede g?rev yapan doktorlar ve veteriner hekimler, durumu tutunaklara ge?irdi. Tutanaklar; Hizan Kaymakamlığı, İl?e Tarım M?d?rl?ğ?, Hizan Devlet Hastanesi Başhekimliği, Bitlis İl Sağlık M?d?rl?ğ?'ne g?nderilerek, k?y?n karantina altına alınması istendi. Tutanaklarda ayrıca, b?lgede en kısa zamanda tam donanımlı bir inceleme yapılması gerektiği belirtildi. Ancak aradan haftalar ge?mesine karşın, hen?z bir ?nlem alınmadı.

9 KİŞİLİK AİLENİN HEPSİ HASTA

9 n?fuslu Korkmaz Ailesi en b?y?ğ?nden en k???ğ?ne kadar şarbon hastası. Baba Beh?et Korkmaz, hastalık taşıyan ke?iyi kesince hem kendisi hem de ke?iyle temas eden iki ?ocuğu antraks bakterisi kaptı. Aile ?yelerinin v?cudunun ?eşitli yerlerinde kapanmayan yaralar a?ıldı. Aile şarbonlu hayvanın artıklarını k?y?n deresine attı. 15 g?n ?nce aile i?inde yapılan taramada 8.5 aylık hamile Rahime Korkmaz'ın şarbon hastası olduğu ortaya ?ıktı. Aileye ve diğer k?y halkına hayvanların nasıl itlaf edilmesi gerektiği anlatıldı. Konuyla ilgili olarak tutulan tutanak ve veteriner hakim raporları ilgili kurumlara g?nderildi.

Hastalık ciltte kurşun yarası gibi ?ıkıyor

Antraks bakterisinin neden olduğu şarbon hastalığı, deri ve organ şarbonu olmak ?zere ikiye ayrılıyor. Deri şarbonu, kurşun yarası gibi bir bi?imde insan v?cudunun ?eşitli yerlerinde ?ıkıyor ve tedavisi m?mk?n. Ama mikrop solunum yoluyla bulaşıp i? organlara ulaşırsa, 24 ila 48 saat i?inde grip hastalığına benzer belirtilerle kendini g?steriyor. Zamanında m?dahale edilmez ve i? organlarda kanama başlarsa hastanın kurtulması ?ok zor. Antraks bakterisi biyolojik ter?r i?in de kullanılıyor. Yani yeme, i?menin yanı sıra hava teması ve tozla da insana bulaşabiliyor. Uzmanlar, hastalık taşıyan hayvanlarla temas edilmemesi y?n?nde uyarıyor, bu hayvanlar ?ld?ğ?nde 2 metrelik ?ukurlara g?m?l?p ?zerlerine s?nmemiş kire? atılması gerektiğini s?yl?yor.

http://www.aksam.com.tr/haber.asp?a=47389,3

 

[Sharpe]

Re: SE TURKEY--3 children with diarrhea test negative for H5N1

Thanks Theresa. It's a pretty bad automatic translator, but it may be helpful for you in the future:
http://www.translationbooth.com/tb/aojb/Tpl/freeTranslation/index.html

 

[Theresa42]

Re: SE TURKEY--3 children with diarrhea test negative for H5N1

Oh yeah -- they've got anthrax in Hakkari...

Hakkari anthrax panic experience(?)

Y?ksekova district ....

District Tarım M?d?rl?ğ? ... Kısıklı, Karlı, G?rdere, ?i?ek?z? and Yemişli villages ....

Hakkari'de şarbon paniği yaşanıyor
July 13, 2006

Y?ksekova İl?esi'nde ortaya ?ıkan şarbon hastalığı nedeniyle onlarca hayvan telef olurken, yetiştiricilerde panik yaşandığı bildirildi.

İl?e Tarım M?d?rl?ğ?, hastalığın tespit edildiği Kısıklı, Karlı, G?rdere, ?i?ek?z? ve Yemişli k?ylerinde 15 g?nl?k karantina uygulaması başlattı. Yetkililer, 30 b?y?kbaş ve 50 k???kbaş havyanın ?l?m?ne sebep olan şarbon hastalığına karşı kasapları uyararak belirlenen k?ylerden hayvan alınmaması i?in uyarıda bulunuldu. İl?e Tarım M?d?r? Mehmet Bilgin, il?ede şarbon hastalığı endişesiyle hayvanlardan alınan numunelerin tahlil i?in Elazığ'a g?nderildiğini ve sonucun pozitif ?ıktığını s?yledi. Y?ksekova'da ?ift?ilerin ihbarı ?zerine Kısıklı k?y? Yemişli mezrasına giden İl?e Tarım M?d?rl?ğ? elemanları aşılama ?alışmaları yaptı. ?len hayvanların Y?ksekova Belediye Başkanlığı'ndan sağlanan kep?elerle a?ılan 2 metre derinliğindeki ?ukurlara g?m?ld?ğ?n?, ?zerlerinin de kire?le kaplandığını aktaran İl?e Tarım M?d?r? Mehmet Bilgin, "Belirlenen k?ylere hayvan giriş ?ıkışıyla meraların kullanılması 15 g?n s?reyle yasaklandı. Şarbon, solunum yoluyla, hastalıklı hayvanların etlerinin yenmesi ve yaralara dokunulmasıyla insana ge?mektedir" dedi.

G?rdere k?y? muhtarı Tahir D?zce, 15 g?nden beri mevcut olan hastalığını kısa bir s?re ?nce tespit edildiğini s?yledi. Bir hafta ?nce 7 b?y?kbaş hayvanın telef olmasının ardından başlatılan inceleme sonrası şarbon hastalığının tespit edildiğini kaydeden D?zce, "K?yde şimdiye kadar 13 b?y?k baş hayvan telef oldu. Bazı ailelerin tek ge?im kaynakları olan hayvanları telef oldu. Diğer hayvanların durumuysa tehlikede" dedi. K?yl?lerden Meryem D?zce ise "B?t?n hayvanlarımız şarbon hastalığına yakalanmış. Bazı hayvanlarımız ?ld?. Onun i?in devletten yardım bekliyoruz. Bu hastalığın insanlara da bulaşmasından korkuyoruz" diye konuştu. Bu arada, aşılama ?alışmalarını g?r?nt?lemek isteyen basın mensuplarına koruyucu elbise giydirilirken, bazı k?yl?lerin aynı duyarlılığı g?stermemesi dikkat ?ekti. Ahırlarda aşı ?alışması devam ederken, dışarıda da Tarım M?d?r? Mehmet Bilgin ?ocuklara gofret dağıttı.

İHA
Yayın Tarihi : 13 Temmuz 2006 Perşembe
G?ncelleme :13 Temmuz 2006 Perşembe 11:40

http://www.kenthaber.com/Arsiv/Haberler/2006/Temmuz/13/Haber_151584.aspx

 

[Theresa42]

Re: SE TURKEY--3 children with diarrhea test negative for H5N1

Thanks Theresa. It's a pretty bad automatic translator, but it may be helpful for you in the future:
http://www.translationbooth.com/tb/aojb/Tpl/freeTranslation/index.html

Oh, hey -- thanks! Anything's better than nothing!

 

[Theresa42]

Re: SE TURKEY--3 children with diarrhea test negative for H5N1

More on the three kids suspected of having bf (photo of one of the babies if you follow the link below). There's mention of a hundred (or hundreds of?) poultry dying:

Hakkari'de kuş gribi ş?phesi
July 26, 2006

Hakkari'nin ?ukurca İl?esi ?z?ml? k?y?nde yaşayan ve kuş gribi hastalığına yakalandıklarından ş?phe edilen 3 ?ocuk, d?n gece Hakkari'den Van Y?z?nc? Yıl ?niversitesi Araştırma Hastanesi'ne sevk edildi.

Sevk kararına itiraz eden ve ?ocuklarını Van'a g?t?rmemekte direnen aile, 3 saat boyunca hastane kapısında ambulansta bekledikten sonra polis aileyi ikna etti.

Irak'ın sıfır noktasında bulunan 75 hanelik ?z?ml? k?y?nde 100'e yakın tavuğun ?lmesi ve 3 ?ocuğun hastalanması ?zerine ?ukurca İl?esi Sağlık Ocağı'nda g?revli Dr. Elif Kaya k?ye gitti. K?yde hastalanan ?ocukları muayene eden Dr. Kaya, kuş gribi ş?phesiyle ?ocukları ambulansla Hakkari'ye g?nderdi. Hakkari Devlet Hastanesi acil servis ?n?ne getirilen ?ocuklar, maske takmış g?revliler tarafından karşıladı. Kuş gribi ş?phesi bulunan 3 aylık Canan ve 1.5 yaşındaki Adem Seven isimli kardeşlerle annesinin kucağında olan 8 aylık İsmail Kaya bir s?re ambulansta bekletildi. Acil servis g?revlisi Dr. Eseng?l Kalkan ve ?ocuk Sağlığı Uzmanı Emine D?lger, ?ocukların muayenesini ambulansta yaparak, ?ocukları kuş gribi ş?phesiyle Van Araştırma Hastanesi'ne sevk etti. Ancak 2 anne de Van'a gitmek istemediklerini belirterek, ambulanstan inmek istedi.

G?revliler ?ocukların anneleriyle başa ?ıkamayınca hastane ?n?ne polis takviyesi istendi. Gelen polislerde ikna edemeyince devreye İl Emniyet M?d?rl?ğ? Atat?rk Polis Merkezi Amiri Aydın ?zt?rk girdi. Bir s?re aileyle g?r?şen ?zt?rk, "?ocuklarınızın tedavi olması gerekir. Devletin ambulansı 3 saattir sizi bekliyor. Sizden ?crette talep eden yok. Bu ?ocukları ?l?me terk etmeyin, inadınızdan vazge?in Van'a g?t?r?n" dedi. Aileler ise ısrarla Van'a gitmek istemediklerini bildirerek, zorluk ?ıkarttı. Bunun ?zerine polis ambulans s?r?c?s?ne kapıları kilitleyip, ambulansı hareket ettirme talimatı verdi ve ara? polis otomobili eşliğinde aileyi Van'a g?nderdi.

İHA muhabirinin telefonla g?r?şt?ğ? 75 hanelik ?z?ml? k?y? muhtarı Nevzat Duman ise k?ylerinde 100 yakın tavuğun hastalanarak ?ld?ğ?n? bildirerek, kuş gribi ş?phesini akılarından bile ge?irmediklerini s?yledi. Duman, "K?y?m?zdeki hasta 3 ?ocuk ambulansla Hakkari'ye g?nderildi. Herhangi bir hastalığa yakalandıklarını sanmıştık. K?yde bulunan 15'e yakın ?ocuk hastaneye g?t?r?len ?ocuklardan daha k?t? durumdadır. Bir s?re ?nce k?ye tesad?fen ?ukurca İl?esi'nden veteriner hekimler geldi. Kendilerine 'Tavuklar ?l?yor' dedim. Onlarda '?l?mleri normaldir' dedi. Kuş gribi hastalığından bahsetmediler. ?yle bir şey varsa k?y?m?z?n sağlık taramasından ge?irilmesi lazım" dedi.

(G?ncelleme):

Daha sonradan Van İl Sağlık M?d?rl?ğ?'nden edinilen bilgiye g?re, d?n gece ambulansla Van'a getirilen 3 aylık Canan ve 1.5 yaşındaki Adem Seven isimli kardeşler ile 8 aylık İsmail Kaya'nın yapılan tahlillerinde kuş gribi vir?s?ne rastlanmadı. Yetkililer, hastalığın normal ishal olduğunun belirlendiğini ve ?ocukların, tedavilerinin ardından taburcu edildiğini ifade etti.

İHA
Yayın Tarihi : 26 Temmuz 2006 ?arşamba
G?ncelleme :26 Temmuz 2006 ?arşamba 12:30

http://www.kenthaber.com/Arsiv/Haberler/2006/Temmuz/26/Haber_154491.aspx

 

[Sharpe]

Re: SE TURKEY--3 children with diarrhea test negative for H5N1

It appears that the dying poultry and sick kids are in Cukurka, which is in the southwestern corner of the province on the border with Iraq and on a tributary that runs into the Euphrates, while the putative anthrax outbreaks are occurring in the eastern part of the province in Y?ksekova. These areas are about 45 miles apart. I wonder what's happening in Iraqi Kurdistan.

 

[Sharpe]

Re: SE TURKEY--3 children with diarrhea test negative for H5N1

All 3 kids are from the same family. Is this deja vu or what? From Bloomberg.

http://www.bloomberg.com/apps/news?pid=20601082&sid=a6l5JNGPB.iM&refer=canada
CNN Turk television reported earlier today that three children from the same family in Hakkari, a province bordering Iraq and Iran, had been taken to Van hospital for treatment for suspected avian flu.

 

[Theresa42]

Re: SE TURKEY--3 children with diarrhea test negative for H5N1

All 3 kids are from the same family. Is this deja vu or what? From Bloomberg.

http://www.bloomberg.com/apps/news?pid=20601082&sid=a6l5JNGPB.iM&refer=canada
CNN Turk television reported earlier today that three children from the same family in Hakkari, a province bordering Iraq and Iran, had been taken to Van hospital for treatment for suspected avian flu.

Sounds like 2 siblings and, perhaps, a cousin (if they are indeed all members of the same family) given the surnames (if they are surnames) and their ages -- they're all awfully young:

1.5 year-old Adem Seven, 8 month old Ismail Kaya together with 3 month old Canan Seven....

 

[Sharpe]

Re: SE TURKEY--3 children with diarrhea test negative for H5N1

Agreed. Probably cousins.

 

[Sharpe]

Re: SE TURKEY--3 children with diarrhea test negative for H5N1

How the story ends...

http://www.turkishdailynews.com.tr/article.php?enewsid=49899
Three children hospitalized in Hakkari after showing signs of bird flu infection have been cleared by tests

ANKARA - Turkish Daily News

Turkish doctors admitted three children to hospital on Wednesday with sings of possible bird flu such as vomiting and high fever, following unexplained deaths of dozens of winged animals in their village on the Iraqi border but later tests showed the children had not contracted the deadly bird flu virus.

Hospital tests showed the children had only an infectious intestine disease, a doctor said. Turkish media reports said dozens of chickens were found dead in the children's village of ?z?ml?, on the Iraqi border, but Health Ministry officials and WHO said they were unaware of this. The doctor at a hospital in the eastern city of Van said the children were released from the hospital on Wednesday, a day after they were brought in with high fevers.

The children, all younger than one-and-a-half years old were from Hakkari province. An outbreak of the deadly H5N1 strain in eastern Turkey killed four children earlier this year.

The children were forcefully taken to Van because their families objected. Doctors tried to persuade the families to allow them to take the children to Van and when failed to do so, police were called in.

Bird flu is known to have killed at least 85 people and infected 160 since it re-emerged in late 2003. Local officials had confirmed 21 bird flu cases, which resulted in the death of four children, but later tests in Britain showed only 12 had the contracted H5N1. The WHO said it had found no clear evidence of human-to-human transmission of the virus and no sign it was now spreading more easily from birds to humans.

"The vast majority of cases have occurred in children aged 15 years or younger. This age pattern remains puzzling, as adult members in some families were engaged in such high-risk behaviors as the slaughtering of obviously ill birds, yet did not develop infection," the WHO said in a statement.

This raised the possibility of a yet unidentified genetic or immunological factor influencing the likelihood of human infection. It remains relatively hard for people to catch, but experts fear it may eventually change in such a way as to be easily transmitted from person to person. Because people lack any immunity to it, it could sweep the world in weeks or months, killing millions.

Turkey has culled 1.3 million birds in an effort to curb the spread of the virus. The WHO said some additional human cases may occur in Turkey, but the numbers are expected to be small. The information indicating a smaller case load in Turkey would also mean that the four bird flu deaths -- now confirmed by laboratories in both Ankara and London -- would translate into a 33 percent mortality rate. This would be closer to death rates from the disease seen in Asia. In all, the virus has killed at least 85 people among 160 known cases since late 2003, according to the WHO.Scientists fear the H5N1 virus may mutate into a form easily transmissible between humans and trigger a pandemic that, in a worst-case scenario, could kill millions around the world.