Dec 16, 2005 (CIDRAP News) – A sixth human case of H5N1 avian influenza has been confirmed in China, and two more cases are suspected in Indonesia, according to reports today.

The Chinese Ministry of Health has confirmed H5N1 infection in a 35-year-old man from the southeastern province of Jiangxi, the World Health Organization (WHO) reported. He became ill Dec 4 and is under intensive care in a hospital, the agency said.

An H5 virus has been found in ducks near the man"e;s home, the WHO said. His family members and close contacts are under observation.

The man"e;s illness brings the WHO"e;s count of confirmed H5N1 cases over the past 2 years to 139, including 71 deaths. Two of the six cases in China have been fatal.

In Indonesia, initial tests have pointed to avian flu in a 39-year-old man from South Jakarta who died Dec 13, according to Agence France-Presse (AFP) and other news services.

Local officials were running further tests, and samples from the man also were sent to the WHO reference laboratory in Hong Kong for testing, AFP reported.

The Indonesian health ministry is also testing samples from an 8-year-old boy who died yesterday in a Jakarta hospital, Bloomberg News reported today.

Ilham Patu, a physician at Jakarta"e;s Sulianti Saroso Hospital, said the boy suffered from a high fever, cough, and breathing problems and lived in a neighborhood with many pet birds and chickens, according to the story.

Indonesian officials reported the country"e;s 14th case of H5N1 infection earlier this week. The WHO confirmed the case, in a 35-year-old man from West Jakarta, on Dec 14. He died Nov 19 after a 2-week illness; his case was the ninth fatal one in Indonesia.

The man did not keep poultry, but samples from birds found in his neighborhood were being tested, the WHO said.

In other news, the United Nations"e; avian and pandemic flu coordinator said today that subtle mutations in the H5N1 virus may be increasing the threat of a pandemic, according to an AFP report.

"There are some subtle changes in the genetic makeup of H5N1 which suggest that it is making some of the mutations that would enable it to have a higher likelihood of being able to become a human-to-human transmitted virus," David Nabarro was quoted as saying.

Nabarro, speaking in Phnom Penh, Cambodia, said virologists who monitor the virus have warned against complacency. "It is quite feasible that H5N1 could mutate," he said. "The fact that it has taken some years should not lead you to believe that we are through the worst."

In Malawi, the unexplained deaths of thousands of migratory birds called drongos have sparked worries about avian flu, according to another AFP report published today.

The birds started dying early this week on a hill in the center of the southern African country, AFP reported. Scores of villagers were said to be eating the birds, Wilfred Lipita, Malawi"e;s livestock and animal director, told AFP.

Officials have sent blood and tissue samples to South Africa for testing. The birds were believed to have migrated from Israel, because one of them had a ring with the word "Israel" inscribed on it, the story said.