Oct 10, 2005 (CIDRAP News) – Avian flu extended its reach into new territory by spreading to Turkey and possibly Romania in the past week, while Indonesians face another suspected human case of H5N1 flu and allegations of vaccine-related fraud.

An outbreak in turkeys has resulted in 1,700 deaths from disease and 100 deaths from culling near Balikesir in northwestern Turkey, according to a report submitted yesterday by Dr. Nihat Pakil, with the Ministry of Agriculture and Rural Affairs in Ankara, to the World Organization for Animal Health (OIE). The virus has been typed as H5, but the neuraminidase subtype (N number) hasn"e;t yet been determined.

This is the first outbreak of highly pathogenic avian flu ever reported in Turkey, according to the OIE.

Military police set up roadblocks outside the village near Balikesir and were checking incoming and outbound vehicles, the Associated Press (AP) reported today. In addition, officials ordered all birds and "street dogs" in the affected village to be destroyed as a precaution, according to the story. Farmers are to be compensated for lost poultry.

Despite concerns and repeated testing more than a year ago in Thailand, there has been no evidence to date of dogs becoming infected with H5N1.

The farmer with the sick birds told the Anatolia news agency on Oct 8 that he hadn"e;t yet been checked for avian flu and was afraid to be near his family.

In the same region, Romania has notified OIE of its first possible avian flu outbreak since 1942, although the pathogen remains in doubt. An outbreak occurred on one farm in Ceamurlia-de-Jos in Tulcea County, in eastern Romania near the Black Sea. The report to OIE said 52 laying hens and 48 ducks were dead. Of those, 36 died of disease and 64 were destroyed. The Oct 7 report said Romania plans to control wildlife reservoirs but didn"e;t describe how.

Dead birds were first found in Ceamurlia-de-Jos late in September, Romanian officials told the AP, according to a Guardian newspaper story published online Oct 8.

However, British authorities announced today that preliminary tests in Romania were negative for any avian flu viruses, according to the online edition of the British newspaper The Mirror. A European Union team was en route to Romania to conduct more tests, the story added.

In Indonesia, a 4-year-old boy from Lampung, Sumatra, has tested positive for H5N1 infection in preliminary tests, according to a Reuters story yesterday. Samples from the boy—who remained in a hospital in Lampung but appeared to be suffering only a cough—were to be tested in a World Health Organization (WHO) reference laboratory in Hong Kong.

If the case is confirmed as H5N1, it would be Indonesia"e;s sixth WHO-recognized case. The WHO today announced it had confirmed Indonesia"e;s fifth case, that of a 21-year-old man, also from Lampung, who was hospitalized Sep 24. His case was reported by the media last week.

The man had been exposed to sick and dying chickens before falling ill on Sep 20, the WHO said. He remained in the hospital in stable condition. Three of Indonesia"e;s five WHO-confirmed H5N1 patients have died.

The Indonesian government said another six suspected avian flu patients were in a hospital in Jakarta, Reuters noted.

Signs of fraud in the production of Indonesia"e;s H5N1 poultry vaccine have forced officials to test doses to see if they were properly prepared, according to an Agence France-Presse (AFP) story picked up by The Jakarta Post today.

Government auditors have accused Indonesian vaccine makers of colluding with government officials to produce low-quality doses to boost profits, the AFP reported. The agriculture ministry is testing the vaccines still in stock to see if those doses meet minimum standards.

The agriculture minister, Anton Apriyantono, told AFP that tests last year in Java showed the vaccine"e;s protection level was from 11.8% to 28%.

A spokesman for the ministry said the testing would be a gradual process because laboratory capacity is limited.

"We will gradually test samples and decide which vaccine can continue to be used and which [will] have to be withdrawn from circulation," spokesman Syamsul Bahri told AFP.