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In a report published in the New England Journal of Medicine, WHO researchers examined all 350 known cases of infection with the H5N1 strain of influenza, known popularly as "bird flu." Approximately three-quarters of these cases could be attributed to close contact with infected birds, often by poultry workers. A very few cases of human-to-human transmission are suspected, always between family members who came into close contact with each other. But the rest of the cases were more ambiguous. "In one quarter or more of patients with influenza A (H5N1) virus infection, the source of exposure is unclear, and environment-to-human transmission remains possible," the researchers wrote. Some of the unclear cases occurred in people whose only contact with birds was walking through live poultry markets. The authors speculated that the virus may remain active in fertilizer made from bird feces, or in certain fluids that stick to surfaces eventually touched by humans. The question has also been raised as to whether the virus needs to enter the nose or can infect humans by merely being eaten. "It is unknown whether influenza A (H5N1) virus infection can begin in the human gastrointestinal tract," the researchers wrote. "In several patients, diarrheal disease preceded respiratory symptoms, and virus has been detected in feces." The report confirmed government reassurances that well-cooked food is not a source of the disease, but cautioned that non-potable water might be: "Drinking potable water and eating properly cooked foods are not considered to be risk factors, but ingestion of virus-contaminated products or swimming or bathing in virus-contaminated water might pose a risk." Bird flu is a highly lethal strain of the influenza virus, killing 61 percent of the people that it has infected. Scientists fear that it might mutate into a variety that passes easily to and between humans, with catastrophic public health consequences. Related CounterThink Cartoons:
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