Yesterday a British laboratory confirmed that a Turkish brother and sister who died last week had the feared H5N1 strain of avian flu.

A third child from the same family in Dogubayazit, in eastern Turkey, has now died of avian flu and dozens more suspected cases have emerged.

“The laboratory in the UK said that they have detected H5N1 in samples of the two fatal cases,” said Maria Cheng, a spokeswoman for the World Health Organisation. They are the first fatalities outside East Asia.

The disease is most likely to have been carried to Turkey by migratory birds, which have already spread it across Asia and parts of Russia. Last year a number of birds with the illness were found in Europe. The fear is that these will cross-infect domestic poultry, which will pass the disease on to humans.

Yesterday six more children who have tested positive for avian flu remained in a critical condition in the Turkish city of Van, near Dogubayazit. Another 24 suspected cases are being treated in a special ward in the university hospital.

A further 18 patients with symptoms of the disease, most of them children, are being treated in hospitals in the eastern cities of Yozgat, Erzurum and Diyarbakir. Other cases are being investigated.

The more the virus comes into contact with humans, the more likely it is to mutate into a form that can be transmitted between people. This has not yet happened; if it does it could start a global pandemic.

The H5N1 strain has killed half of all the people who have contracted it. The Spanish flu of 1918, which killed 40m people, was fatal in fewer than one in 10 cases.

Professor John Oxford, an expert on flu at Queen Mary’s medical school, London, said the most worrying aspect of the deaths in Turkey was the large number of human cases resulting from exposure to a small number of birds. He urged British authorities to follow the Dutch in ordering farmers to separate poultry from wild birds by keeping them indoors.

Yesterday Mehdi Eker, the Turkish agriculture minister, confirmed that bird flu had also been identified in two dead ducks found by a reservoir near Ankara, the capital, about 750 miles west of Dogubayazit. And Necdet Unuvar, of the Turkish health ministry, said: “There has also been a large number of suspicious deaths amongst birds in three other counties in Ankara.”

The finds suggest that the disease is moving rapidly westwards and that its arrival in western Europe is only a matter of time.

Officials around Dogubayazit warned the government on December 16 of a surge in bird deaths but it took another 12 days for an investigation to begin. When Muhammet Ali Kocyigit, 14, became Turkey’s first avian flu victim last week, a government spokesman criticised doctors for mentioning the disease because they were “damaging Turkey’s reputation”.

In southeast Asia, more than 70 people have died from H5N1 since 2003 but none has involved human-to-human transmission.

A European commission spokesman said last night: “The latest deaths are a tragedy but, for the moment, we believe we are doing all we can and that we have in place the measures we need to guard against the spread of bird flu.”

This weekend Zeki Kocyigit, the father of the three dead children, said they contracted the disease after the family slaughtered and ate a sickly chicken.

At his two-room house in the poor Kockiran neighbourhood of Dogubayazit, he said: “When Muhammet Ali was getting worse, everybody in the hospital was too busy celebrating the new year to pay any attention. On the evening of January 1, when he began to deteriorate, I was alone by his bedside. His last words were, ‘Cuddle me, Daddy.’ I did and I felt him kiss me on my cheek. Then he died.”

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