Bird flu in humans appears to be spreading in Turkey, with preliminary tests for the deadly H5N1 strain of bird flu on Sunday returning 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 (WHO) laboratory.
If confirmed, the third sibling and the three new cases in Ankara, about 1,000 km 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 said. "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 in Turkey 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 five-year-old Turkish boy, and Cheng said WHO has accepted Turkish testing as confirming the infection in an eight-year-old girl as well. Both children are in intensive care in Van. 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 on Sunday with officials from the WHO. They were due to travel to Dogubayazit, a largely Kurdish town where most of the cases have originated yesterday.
Guenael Rodier, a senior official for communicable diseases at the 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 on 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.