JONED GINTING watched his family die one by one. Now he lies desperately ill in hospital with bird flu.

Seven members of his family, including his ten-year-old son, have died within three weeks in what health experts fear is the first case of human-to-human transmission of the disease.

For Mr Ginting, it is a personal tragedy. For the world, it raises the alarming prospect that the H5N1 virus may be passed from one human being to another.

The World Health Organisation described the cluster yesterday as the most worrying outbreak since this strain of bird flu re-emerged three years ago.

Tests on Mr Ginting, who comes from the remote village of Kubu Sembelang in the North Sumatra region of Indonesia, and six of his family have shown that they contracted the H5N1 strain of the virus.

Mr Ginting’s sister was the first of the extended family to die. On April 29, as she coughed through the night, her two sons and her brother, 32, stayed with her in a small room. They are all now dead.

Four other members of the family lived next door and were also infected. Of them, only Mr Ginting is still alive.

The source of the H5N1 virus has “stumped” public health experts, leading to fears that the victims may have contracted it from one another and could mark the start of a pandemic.

If investigations prove that the cluster was formed by human transmission, it would be the first time that this has been confirmed for H5N1 flu.

Peter Cordingly, a WHO spokesman, said that genetic tests on the strain of H5N1 that infected the family showed no signs that it had mutated in a way that could ease its spread between people.

That prospect had alarmed scientists because the ability to move freely from person to person is one of the key evolutionary hurdles that the virus must overcome if it is to trigger a worldwide pandemic.

“We can find no sign of infected chickens, no sign of the virus in the environment around where they live. This is the first time that we’ve been completely stumped by a source for the infection.”

There is, however, no indication yet that the virus has spread beyond the family. “No matter what’s going on at this stage, it’s a limited transmission between members of the same family,” Mr Cordingly said. For an unmutated H5N1 virus to have spread from human to human as is suspected, very close contact would be needed.

The only suspected case of such transmission so far was recorded in a Thai mother who nursed her infected daughter.

“All confirmed cases in the cluster can be directly linked to close and prolonged exposure to a patient during a phase of severe illness,” the WHO said in a statement. “Although human-to-human transmission cannot be ruled out, the search for a possible alternative source of exposure is continuing.”

Reports and rumours of the outbreak caused chaos in financial markets and prompted a bout of panic-selling of currencies and stocks.

In a volatile day of trading on the Tokyo exchanges, the currencies of Indonesia, Thailand, the Philippines and Singapore all sustained big losses as traders fled towards the perceived “safe haven” status of the US dollar.

“There is no way to look at this WHO inquiry and not be worried,” one Tokyo-based currency trader said. “These are markets that have lived through Sars and know very well the economic impact of potential pandemics. Even if the disease itself is contained, you get people cancelling important business trips, and tourism drops off a cliff.”

The WHO said it had no plans to convene experts to discuss raising the global alert level over bird flu, though it will continue to monitor the situation in Indonesia.

SPREADING FEAR

1996 H5N1 virus is isolated from a farmed goose in Guangdong province, China

1997 Six deaths reported in Hong Kong linked to H5N1

December 2003 Two tigers and two leopards die after eating H5N1-infected chicken in Thai zoo

December 2003 South Korea confirmed H5N1 as a cause of poultry deaths at three farms

January and February 2004 Vietnam, Japan, Thailand, Cambodia, Laos, Indonesia, China and Malaysia report H5N1 in poultry

January to March 2004 Eight deaths reported in Thailand and 16 in Vietnam

July 2005 Russia reports bird flu in Western Siberia

January 2006 Three children from same family die in Turkish outbreak

February 2006 China reports eighth fatality and Indonesia its 18th

October 2005 H5N1 confirmed in poultry in Turkey and Romania and in wild birds in Croatia

January 2006 Iraq has its first human case

February 2006 Bulgaria, Greece, Italy, Slovenia, Austria and Germany find H5N1 in swans. Nigeria finds H5N1 in chickens and Iran finds it in wild birds

Click here for an interactive pandemic bird flu map

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