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Turkish official tosses a bag of poultry for burial, 7 January 2006 (AFP) Concern is rising about the deadly outbreak of bird flu in Turkey, following confirmation that three people in the capital -- far from the initial cases -- are suffering from the potentially fatal H5N1 strain of the flu.


PRAGUE, 9 January (RFE/RL) -- In all, five more people have tested positive for bird flu in the past two days, bringing the number of confirmed cases to 14.


The area worst affected remains eastern Turkey, where two siblings have already died. Bird flu has not yet been confirmed as the cause of the death of a third member of the same family, on 6 January.


Hospital officials in the city of Van announced on 8 January that two more patients had bird flu. At least 30 other patients have symptoms common to bird flu.


But it is the news that two young brothers and an elderly man in Ankara are suffering from the flu that is now raising particular concern. No bird -flu infections among humans have previously been identified in Ankara. Ankara is also far from Van -- roughly 800 kilometers -- and, by contrast, few of its inhabitants live in close proximity to poultry, suspected to be the main transmitters of the virus to humans.


It is not clear how the villages affected in eastern Turkey contracted the flu, but people in this remote and impoverished region live in close contact with their poultry.


Turkish Health Minister Recep Akdag said on 8 January that there is no evidence the virus is passing from person to person. "This type of bird flu virus is not transmittable from human to human," he declared. "It is only transmitted from animals to human. The transmission ratio is really low, thank God, but we need to be very careful."


The head of a mission dispatched to Van by the UN's World Health Organization (WHO), Gueneil Roder, confirmed that it is not spreading between humans. He said that a virus that spreads from animals to humans emerges "roughly every 30 years, 40 years" and that the current virus is "not adapting very well at the moment. But if the WHO is following the situation so closely, it is because we want to make sure it doesn't adapt. And, if it adapts, we are hopefully prepared because we have vaccines a bit more advanced."


The sudden emergence of bird flu in the Ankara region underlines the mystery of how the disease can spread across great distances and between areas with very different conditions.


Researchers who have studied the spread of bird flu in China and Southeast Asia say it is most often spread by wild birds to poultry. Chickens and other poultry forage for food in meadows visited by wild birds, and may pick up the virus from the wild birds' feces or saliva deposited on grass or seeds they eat.


"We don't know exactly how it is transmitted to humans," Maria Cheng, a spokesperson for WHO's communicable diseases division, told RFE/RL. However, "we believe that it's somehow airborne and that humans will get this disease if they come into very close contact with diseased birds. So if they are handling chickens who have died of H5N1, [if] they're preparing it for food maybe, if they inhale some of the dust in which these chickens have been, then it's possible that they could acquire this disease. But we don't know exactly how."


Researchers rule out the possibility that bird flu could be contracted from eating properly cooked chickens or eggs. "Well-cooked chicken and eggs are not a risk factor," Cheng said, noting that "we haven't had any cases that have been linked to consumption of food. But the reason that we talk about [poultry] is that in these parts of rural Asia, the people who are eating chicken are also involved in its preparation -- so they are de-feathering the chicken and slaughtering the chicken -- and that can be a risk factor for contracting H5N1."


Despite such assurances, the outbreak has created a panic in eastern Turkey among local inhabitants who believe they may have eaten diseased chickens. Many people crowded the hospital in Van on the weekend asking to be tested for the virus.


The outbreak in Turkey has also alarmed other states in the region.


Georgia and Azerbaijan have banned poultry meat imports from Turkey.


Russia's chief state epidemiologist, Gennadii Onishchenko, has advised Russians not to travel to Turkey, and Iran is reported to have closed at least one border crossing to Turkish citizens.

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