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Officials report that Iraqi girl who died in Kurdistan had bird flu

SULAIMANIYAH, Iraq (CP-AP) _A 15-year-old Iraqi girl who died earlier this month is now believed to be that country's _ and the Middle East's _ first case of H5N1 avian flu, Iraqi and World Health Organization authorities confirmed Monday.

The girl's uncle, who tended her while she was sick and who died 10 days after she did, is also suspected of being a case. A WHO official said the agency needs to investigate the possibility that the man may have become infected by his niece.

``Obviously it looks a bit suspicious and it's something that we need to investigate,'' spokeswoman Maria Cheng told The Canadian Press from Geneva.

``We still don't have a lot of details about the context of these cases _ whether or not they both had contact with sick chickens or just how much contact they had. But given that he was said to have taken care of her when she was ill, that certainly does raise our level of concern.

``Based on the evidence we have right now, I don't think we can rule (human-to-human spread) out,'' Cheng said.

A team of four or five WHO experts _ epidemiologists, clinicians and a lab technician _ is being drawn up. It's hoped they can be on the ground in northern Iraq later this week, although the security situation in that country may make this response more challenging than most.

``There is a security situation which is going to make the team getting in and out a bit more difficult,'' Cheng acknowledged.

``I don't think we're ever excited to see H5N1 pop up in any country. But obviously seeing it in Iraq, there are some complications there that wouldn't exist for other countries.''

While suspicions of H5N1 were raised when the girl first died, testing at Iraq's national laboratory and at a WHO lab in Jordan turned up negative. But further test conducted at the U.S. Navy Medical Research Unit laboratory in Cairo produced a positive result, Cheng said.

Samples from the girl and her uncle, 50, are being flown to the WHO's collaborating laboratory in Britain for final testing.

``We're classifying this as a preliminary positive case, which is what we're using to describe the cases in Turkey, so that we can react as if it is a confirmed H5N1 case,'' Cheng said. ``But we'd still like the results to be confirmed by the WHO collaborating centre in the U.K.''

Iraqi health authorities began killing domestic birds in northern Iraq, which borders Turkey, where at least 21 cases of the deadly virus have been detected. Turkey and Iraq also lie on a migratory path for numerous species of birds.

``We regretfully announce that the first case of bird flu has appeared in Iraq,'' Iraqi Health Minister Abdel Mutalib Mohammed told reporters in the Kurdistan city of Sulaimaniyah, 260 kilometres northeast of Baghdad.

``The results show the inflection with the deadly H5N1,'' he said. ``We appeal to the World Health Organization to help us.''

The girl, Abdul Qader, died after contracting severe pneumonia in her village of Raniya, about 100 kilometres south of the Turkish border and just 24 km west of Iran. She had a history of heart problems.

The girl's mother rejected the bird flu results, but acknowledged that a number of her chickens had mysteriously died before her daughter's death.

``My daughter did not die from bird flu,'' Fatima Abdullah, 50, told The Associated Press. ``She did not like chickens nor had anything to do with them. She did not take care of these birds.''

The prospect of a bird flu outbreak in Iraq is especially alarming because the country is gripped by armed insurgency and lacks the resources of other governments in the region. Government institutions, however, are most effective in the Kurdish-run area of the north where the girl lived.

Kurdistan Health Ministry official Najimuldin Hassan said 14 people have recently been admitted to local hospitals exhibiting bird flu symptoms, but just two remain in Sulaimaniyah Teaching Hospital suspected of possibly having the disease.

It could take up to three weeks to find out how the virus entered Iraq and how it will be contained, WHO spokesman Dick Thompson said, adding that the security situation in Iraq would not prevent doctors from going to help.

``We need to identify what the source of this child's exposure was and to conduct epidemiological tests in the field,'' Thompson said. ``It has to be in the environment somewhere and we need to identify that before going ahead in assessing control or (bird) elimination efforts,'' the WHO official said.

Kurdistan's health minister said authorities started culling domestic birds in the village where the girl lived and nearby areas.
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