Jan 3, 2006 (CIDRAP News) – Avian influenza has been ruled out in a 14-year-old Turkish boy who died over the weekend and in three siblings who were hospitalized with him, according to news services.

Tests on the four children were negative for avian flu, according to Turkish health officials quoted in an Agence France-Presse (AFP) report published yesterday.

The children were hospitalized in the eastern city of Van over the weekend after eating chicken that had shown signs of avian flu before slaughter, the report said. A BBC News story said the children live on a poultry farm.

Two other people, a 35-year-old woman and a 5-year-old boy, were hospitalized Jan 1 in Van with the same symptoms, including fever, coughing, and bleeding from the mouth, the AFP story said.

Huseyin Avni Sahin, chief physician at the hospital in Van, said the six patients had pneumonia, but he did not specify what type, according to the story.

His statement seemed to imply that avian flu had also been ruled out in the woman and the 5-year-old boy. But the BBC report said test results for those two patients were still awaited.

All six patients were from the town of Dogubeyazit in Agri province, less than 60 miles south of Aralik, where Turkey"e;s second poultry outbreak of avian flu was reported last week. Aralik is near the Armenian border.

Confirmed human cases of H5N1 avian flu in the past 2 years have been reported only in Vietnam, Thailand, Indonesia, China, and Cambodia.

In Indonesia, meanwhile, one suspected case of avian flu was ruled out as another one was reported, according to AFP. Hariyadi Wibisono of the Health Ministry said tests had ruled out avian flu in the 48-year-old man from central Java who died with suspicious symptoms last week, said a story published yesterday.

But avian flu is suspected in the case of a 39-year-old man who died after being treated for just 1 day at Jakarta"e;s Sulianti Saroo Hospital, AFP reported, quoting hospital spokesman Ilham Patu. He said the man was from Tangerang, a town near Jakarta where poultry outbreaks have occurred, and had a history of contact with live and dead chickens.

The World Health Organization (WHO) has confirmed China"e;s latest human case of avian flu, in a 41-year-old woman from the southeastern province of Fujian. She became ill Dec 6 and died Dec 21. Chinese officials announced the confirmation of her case Dec 29, and the WHO issued a notice about it Dec 30.

The case was China"e;s seventh human case of H5N1 avian flu since the current wave of poultry outbreaks began in late 2003. The woman was not known to have had any contact with poultry before her illness, the WHO said.

In other news, a leading flu expert said a lack of autopsies of avian flu victims is hampering efforts to understand and combat the disease, according to a report today in the British newspaper The Guardian.

Albert Osterhaus, head of the national influenza program at Erasmus University in Rotterdam, Netherlands, said that only four or five full autopsies have been conducted among the 74 people who have died of confirmed avian flu, according to the report. All the post-mortems were done in Thailand.

Osterhaus is concerned that the lack of autopsies will slow the search for a vaccine, because autopsy findings can help scientists choose the best animal species on which to test vaccines, the story said.

Cultural and religious barriers have limited post-mortem examinations in the countries that have had human cases, according to the report.

The World Organization for Animal Health (OIE) reports that a total of 3,786 poultry outbreaks of H5 avian flu had been reported as of Dec 30. Those occurred in 17 countries (with Hong Kong counted as a country).

Vietnam leads the list with 2,141 outbreaks, followed by Thailand with 1,164. The two countries together account for about 87% of the outbreaks.

Other countries in the top ten are Indonesia, 216; China, 78; Russia, 62; Romania, 36; Ukraine, 22; South Korea, 19; Cambodia, 15, and Japan, 11.