The Public Health Ministry yesterday confirmed the second case of human bird flu in a new wave of the deadly disease and announced it was putting all parts of the country on high alert for the epidemic.

The ministry, however, insisted the feared humantohuman transmission of the H5N1 strain of avian flu had not been confirmed.

Public Health Minister Sudarat Keyuraphan said lab results confirmed that Pranom Thongchan, 36, of Kamphaeng Phet抯 Khanu Woralaksaburi district had been infected with the lethal virus.

Pranom is the aunt of 11yearold Sakuntala Premphasri, who died recently of birdflulike symptoms but went uncounted until Pranee Thongchan, the girl抯 mother, fell ill and died about a week after returning from her daughter抯 funeral.

Previously, the ministry insisted that neither Pranom or Pranee had been in contact with any established source of bird flu, such as infected fowl. However, Sudarat told reporters yesterday that Pranom, the aunt, had handled chicken carcasses at her house.

Previous information obtained by the ministry initial epidemiological investigation of how Pranom fell ill contained errors, according to Dr Charal Trinwuthipong, acting permanent secretary of the Public Health Ministry.

Over the past week, the relationship between the Kamphaeng Phet patients sparked fears of humantohuman transmission of the disease due to a possible mutation of the H5N1 virus capable of triggering a new global flu pandemic.

Lab results for Pranee are not yet available since testing is complicated by the fact that her body was injected with formalin prior to the autopsy, Charal said.

Whenever the lab results come out, and whether the virus has mutated or not, we promise not to cover it up,?he said.

The lab results are expected to be released this week, Sudarat said. She added the ministry was contacting specialists from both the World Health Organisation and the US Centres for Disease Control and Prevention to verify the results.

The case is very interesting because the patient had not come into contact with any possible source of bird flu except her sick daughter,Sudarat said, referring to the period when Pranee was taking care of her daughter in Kamphaeng Phet.

Pranom is still being treated in an isolation ward of Kamphaeng Phet Hospital even though her condition has improved greatly, according to Charal.

The first case of human bird flu since the disease resurfaced in July was confirmed on September 8. The victim was a young breeder of fighting cocks inPrachin Buri.

At a meeting of hospital directors and provincial chief health officers from across the country yesterday, Sudarat announced that all areas of the country were now on full alert for the birdflu epidemic.

Every province has been ordered to strictly follow safety measures in both watching for signs of the epidemic ?such as sick birds ?and screening and treating patients suspected to be infected with the lethal virus.

But Sudarat warned there needed to be faster reporting of infections to allow investigators to reach the scene in time. About 20,000 health volunteers across the country will help authorities educate people how to handle suspected cases, she added.

Meanwhile, the Ratchaburi chief health officer Dr Charuthas Narischat said one more patient on the watch list for human bird flu in the province died last night.

The patient was identified as Suthisa Petchpitak, 16, who died at Ban Pong Hospital where she was being treated following the death of another possible victim, identified as Sri Momtubkhang, 41, on Saturday.

Another suspected case, a child, is being treated at the hospital.

Duangkamon Sajirawattanakul,

Arthit Khwankhom

THE NATION

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Human birdflu cases Confirmed

Komsan Fakhorm, 18, Prachin Buri ?died Sept 7

Pranom Thongchan (Sakuntala Premphasri抯 aunt), 32, Kamphaeng Phet ?in hospital

Suspected

Sakuntala Premphasri, 16, Kamphaeng Phet ?died Sept 12

Santhana Karan, 13, Kamphaeng Phet ?died Sept 21

Pranee Thongchan (Sakuntala抯 mother), 26, Kamphaeng Phet ?died in Nonthaburi Sept 20

Kittiphong Premphasri (Pranom抯 son), 3, Kamphaeng Phet ?recovered

Awaiting lab tests

Lop Buri 3

Kamphaeng Phet 8

Bangkok 1

Chachoengsao 1

Prachin Buri 1

Saraburi 1

Nakhon Sawan 1

Ratchaburi 3 (including Sri Momtubkhang, 41, & Suthisa Petchpitak, 16)

Source: Public Health Ministry (Sept 27)

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Birdflu coordination lacking at local level?

The government birdflu committee has blamed lax coordination among working groups at the provincial level for hindering efforts to contain the second wave of the epidemic.

a lack of both coordination and workforce is to blame for the ineffective surveillance systems in some areas,Deputy Prime Minister Chaturon Chaisang, who chairs the committee, said.

Also needing a revision was the implementation of controls on livestock associated with the spread of the birdflu virus such as the movement and quarantining of suspect animals, he said.

Chaturon said not enough work had been done recently to raise awareness of the danger of the lethal virus among the grassroots nor to seek their help to act as watchdogs.

揑t抯 not a good idea to focus only on the areas where poultry are dying or to wait until a huge number of deaths are reported and then take action,?he said.

揥e need to step up the pace and make it more effective.?

Meanwhile, the UN Food and Agriculture Organisation and the World Organisation for Animal Health (OIE) yesterday issued a joint statement after a Thai woman was confirmed to have died of bird flu.

The agencies described the epidemic as a 揷risis of global importance?and said it demands the attention of the global community.

They said recent outbreaks in China and Southeast Asia show that the virus continues to circulate and will not probably be eradicated in the near future.The World Health Organisation (WHO), however, cautioned against jumping to conclusions.

揚eople have talked about humantohuman transmission. On the basis of what we抳e learned today, we can抰 make that kind of conclusion,?said Peter Cordingley, WHO抯 regional spokesman in Manila.