JAKARTA, 23 June 2006 - Bird flu was spread directly between members of an Indonesian family in the first laboratory- confirmed case of human-to-human transmission of the lethal virus, a World Health Organization official said.

Genetic sequencing of a virus sample taken from a 10-year- old boy who died from the H5N1 avian influenza strain showed a minute change that was also found in a virus sample taken from his father, who later died from the virus, said Dick Thompson, a spokesman for the United Nations health agency in Geneva.

"We have seen a genetic change that confirms in a laboratory that the virus has moved from one human to another,'' Thompson said in an interview. The change in the virus "doesn't seem to have any significance in terms of the pathology of the disease or how easily it's transmitted,'' he said.

Human-to-human transmission had previously been suspected as the cause of infection in seven members of the Indonesian family from the island of Sumatra. The cases attracted international attention because they represent the largest reported instance in which avian flu is likely to have spread among people. They also provide the first evidence of a three- person chain of infection.

At least 130 of the 228 people known to be infected with bird flu since 2003 have died, according to the WHO. World health officials are tracking the spread of the virus in the event it becomes more adept at infecting people.

Clusters

Clusters of human cases in which the virus was transmitted from person to person, including to health workers treating infected patients, may signal the emergence of a pandemic strain capable of killing millions of people. "This was a more visible and a bigger cluster, but the concept and the mechanism behind it was what we've seen before'' in other cases of limited human-to-human transmission, Tom Grein, a senior WHO epidemiologist involved in the investigation, said in an interview yesterday.

"All H5N1 viruses were anti-genetically and genetically very closely related and similar to H5N1 viruses isolated from poultry and humans in Indonesia,'' Indonesia's Ministry of Health said in a summary of the investigation of the Sumatra patients. The document, produced in conjunction with the WHO, was obtained by Bloomberg News today. A 37-year-old Sumatran woman suspected of being the first family member to die was buried before samples were taken, so her cause of death can't be determined.

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