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Probable Case of Human-to-Human Bird Flu Transmission Reported
Date:4/7/2008

that the 24-year-old son, who died, was exposed to H5N1 when visiting a poultry market six days before he fell ill. The 52-year-old father, who survived, had had substantial contact with his son while caring for him in the hospital. The father had no known direct exposure to birds or other sick individuals.

The H5N1 viruses sampled from the father and the son were virtually genetically identical.

The father received antiviral treatment as well as plasma from an individual who had been vaccinated against the virus as part of a vaccine trial. The son was diagnosed too late to receive appropriate treatment.

All 91 exposed contacts, including the son's girlfriend and mother, tested negative for H5N1.

Transmission may have occurred if the father inhaled droplets coughed out by his son, or by contact with the son's clothing that was contaminated with fecal matter. The father wore a surgical mask during his last visit with his son but had not worn protective gear before that, the report stated.

Interestingly, no outbreaks of H5N1 in poultry were identified in Nanjing, a city in eastern China, before or after these two human cases. No sick or dead poultry were seen either, the report said, adding that it's also important to note that this case of son-to-father transmission has not been proven yet.

According to the study authors, more than 90 percent of H5N1 clusters in humans have occurred in blood-related family members.

And, experts said, this latest case is no reason for alarm.

Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, which funded the study, said, "This is not something new. Limited human-to-human transmission has been seen intermittently for years and years. This is just another example among a few. It's what we call a dead-end person-to-person transmission."

He added, "What we worry about is secondary and tertiary transmissi
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