Fewer Human Deaths From Virus Even as It Spreads Among Poultry

By DONALD G. McNEIL Jr.

With the arrival of winter, H5N1 avian flu is on the rise again in Asia and Egypt.

The outbreaks are part of an annual trend: cases peak between December and March each year in birds as well as humans.

Children have died from it recently in Indonesia and Egypt, and a Cambodian teenager tested positive but survived.

Only 30 human deaths have been confirmed by the World Health Organization this year. That is well below the 59 recorded last year and the peak of 79 recorded in 2006. All 30 deaths this year occurred in only four countries: Vietnam, China, Indonesia and Egypt. No large family clusters, like those found from 2005 to 2007, have been confirmed.

Indonesia may have had more flu deaths than it has admitted. Its health minister said in June that she “wanted to focus on positive steps by the government” and would not announce all confirmed deaths. There were several family clusters of fatal respiratory diseases this year, according to news reports, but all were officially attributed to other causes.

New poultry outbreaks have been found recently in Kandal province in Cambodia, Jiangsu province in eastern China, rural parts of Hong Kong, Bangladesh and West Bengal and Assam provinces in India.

Although there have been no human deaths in India, poultry outbreaks appear to be increasing rapidly. In other countries in this situation, human cases have usually followed.

India does not vaccinate poultry. China does, and mismatched vaccines may be to blame for new outbreaks, experts said.

Some vaccines were made from H5N2 virus strains, and their ability to protect against H5N1 may have faded.