A Turkish teenager whose brother died of bird flu also succumbed to the disease today, a Turkish doctor said, as authorities tried to determine if the siblings had contracted the H5N1 strain of the virus.

If confirmed, the brother and sister would be the first people outside of Asia to die of the H5N1 strain in the latest outbreak. Preliminary tests have confirmed the teenagers had bird flu, and samples were being sent to a British lab to determine if it was the H5N1 strain.

Fatma Kocyigit, 15, died today in a hospital in the eastern city of Van, four days after the death of her 14-year-old brother, Mehmet Ali Kocyigit, the Anatolia new agency reported, citing Ahmet Faik Oner, the doctor who treated the siblings. Their 11-year-old sister, Hulya, is in hospital with suspected bird flu.

The siblings were admitted to the hospital last week after developing high fevers, coughing and bleeding in their throats. Eight other people with similar symptoms were being treated at the hospital, said Huseyin Avni Sahin, the head physician at the hospital. Mr Sahin told NTV
television that some other patients were hospitalised in the eastern city of Erzurum because his hospital was not capable of handling more cases.

More than 70 people — most of them farm workers in close contact with fowl — have died from the H5N1 strain of the virus in East Asia since 2003, where it has devastated flocks.

The H5N1 strain has been closely monitored amid fears that it could mutate into a form easily passed between people and consequently cause a pandemic. Samples from the Turkish victims are being sent to Britain for analysis.

Government officials in Britain were considering the implications of the Turkish fatality last night, although both the Department for Environment, Food and Rural Affairs, and the Department of Health said that their advice remained the same.

A spokesman for Defra said: “It is clear that if there are birds that are sick then people living cheek by jowl with them are at risk. The key is to keep birds and people separate.”

A spokeswoman for the Department of Health said: “At the moment we are trying to clarify exactly what has happened, but the level of risk has not changed. There is no human-to-human transmission. We have robust systems in place for monitoring this.”

Turkey, along with Romania, Croatia and Russia, has conducted a cull of birds to try to prevent the transmission to human beings. Turkey, which lies on the path of migratory birds that are thought to spread the virus, has suffered two outbreaks of the highly contagious disease among poultry in the past three months.

The Kocyigit children all helped to raise poultry on a small farm in the town of Dogubeyazit, near Mount Ararat and 40 miles from the town of Aralik, where Turkish authorities said last week that some chickens tested positive for an H5 variant of bird flu.

Experience in Asia has shown that if there is avian flu, there will be a few human cases. The virus does not transmit easily to human beings, but those who do catch it suffer badly. The death rate is running at between 40 and 50 per cent.

Public health specialists in Britain may be concerned at the implication that bird flu is more widely spread in Turkey than has been acknowledged, and at the apparent confusion over the diagnosis.

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