Turkey today confirmed two human cases of avian influenza, contradicting earlier statements and marking the disease´s first attack on people outside East Asia, according to news reports this afternoon.

A 14-year-old boy who died Jan 1 and a sister who is hospitalized in serious condition both tested positive for avian flu, according to news reports quoting Turkish Health Minister Recep Akdag. He said a third sibling also has a suspected case.

Two days ago Turkish officials said the two young people and two other siblings had tested negative for avian flu. The children had helped raise poultry on a farm in eastern Turkey and had been in contact with sick birds, the Associated Press reported.

Akdag did not say if the two patients tested positive for the H5N1 virus specifically. But Michael T. Osterholm, PhD, MPH, director of the University of Minnesota Center for Infectious Disease Research and Policy, publisher of this Web site, said he was told the virus was confirmed as H5N1.

"The lab in Turkey that ran the most recent tests is a very competent lab that´s been collaborating with WHO [the World Health Organization] in the past, and there´s no reason to doubt these results," Osterholm told CIDRAP News.

The WHO´s human avian flu case count, which at this writing did not show the Turkish cases, lists 142 cases with 74 deaths. They include cases in Vietnam, Thailand, China, Indonesia, and Cambodia.

An Agence France-Presse (AFP) report today said nine people have been hospitalized with a fever and cough in the city of Van, where the 14-year-old died.

The confirmed case-patients came from the town of Dobubeyazit, about 40 miles from Aralik, where Turkish authorities last week reported an H5 virus in chickens, the AP report said. Turkey´s first H5N1 outbreak in poultry was reported Oct 5 on a farm in Kiziksa, in the northeast, according to AFP.

Commenting on the cases, Osterholm said, "This should not be considered unexpected. There were sick birds, and the family had contact with them."

"This does not mean we´re closer to a pandemic; it means that the situation in Southeast Asia is moving," he said. Bird populations and the "density" of the H5N1 virus in birds remain much greater in East Asia than elsewhere, and the risk of an emerging pandemic strain is still greatest there, he added.

However, he said, "The fact that there´s more virus circulating in more birds around the world means there´s a greater likelihood of mutational change" that could lead to a pandemic strain.