FEARS that avian flu has taken hold in Turkey are growing after the death of a second teenager and evidence that the disease is infecting birds in at least three areas of the country, hundreds of miles apart.

Samples of the virus from birds and from the first human victim, Mehmet Ali Kocyigit, aged 14, were flown to laboratories in Britain yesterday for confirmation that the flu is the same H5N1 strain that has caused more than 70 deaths in Asia. Eleven other people, including two members of the same family, are being treated in Van, eastern Turkey, where the boy’s sister, Fatma Kocyigit, 15, became the second victim yesterday.

She died despite treatment with Tamiflu, the antiviral drug that is the only known defence against the infection. Among others being treated are her 11-year-old sister, Hulya, who remains in a weak condition, and her brother, Ali Hasan, 6. The Kocyigit family are from the remote town of Dogubeyazit in the province of Agri, near the borders with Iran and Armenia and about 60 miles south of Aralik, where vets detected the second outbreak last week.

In Van, Huseyin Avni Sahin, the head physician of the Yuzuncu Yil University Hospital, said that he was expecting another five suspected cases. In Igdir province to the north, six more people were taken to hospital with suspected bird flu.

Mehdi Eker, the Turkish Agriculture Minister, who flew to the region yesterday, said that bird flu had now been identified in five separate places.

Mehmet Ali was buried yesterday by an imam wearing a mask, and lime was spread over his grave. Turkish officials are almost sure that the cause of his death was the H5N1 strain, but this will not be confirmed until tests have been completed at the World Health Organisation flu laboratory in Colindale, North London.

At the same time, tests on samples taken from the birds are being carried out at the Veterinary Laboratories Agency in Weybridge, Surrey. The extent of the outbreaks in Turkey has dismayed experts. Although the risks were clear, the Turkish authorities have not been able to prevent the spread to people.

This could mean that the extent of the outbreak in poultry in Turkey has been underestimated, or that the virus can jump more easily from birds to people, according to Professor John Oxford, of Queen Mary’s School of Medicine and Dentistry in London. “It is surprising that there are two deaths and a number of people have been infected in what we thought to be a rather small outbreak,” he said.

Worried local people went to hospitals in Dogubeyazit, forcing hospital staff to call the police. Doctors said that they were inundated with calls from people saying that they had slaughtered and eaten sick birds. Contrite villagers handed over chickens that they had kept from health officials. Newspaper reports said that the Kocyigit family had moved their chickens into the house for the winter. Doctors at the hospital said that the children had played with the infected chickens’ remains, including the head, after eating the birds.

Turkish officials imposed a ban on the sale and movement of animals in the region. Agriculture officials in Dogubayazit have culled 1,500 fowl and aimed to kill the remaining 2,000 yesterday before burying them outside the town.

Hugh Pennington, president of the Society of General Microbiology, said: “This shows we have to keep our vigilance up but the picture hasn’t changed. It’s still an avian virus and hasn’t mutated to enable human-to-human infection. So the message is, ‘Don’t panic!’” A spokeswoman for the Department of Health said: “The level of risk has not changed. There is no human-to-human transmission. We have robust systems in place for monitoring this.”

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