Confirms Fourth Human Bird Flu Death
Egypt According to Egypt's news agency Mena, an 18-year-old woman has died of H5N1 Bird Flu infection - the fourth such death in the country so far out of a total of 12 human infections - five of those twelve have made a full recovery.

Iman Abdel Gawad was from the Menufiya governorate, she was hospitalized on April 10. According to authorities she was already quite ill when the hospital received her. She died on Friday.

Egypt was bird flu free until February, 2006, when an outbreak was confirmed among birds. The first human infection appeared in March.

Iman Abdel Gawad, say authorities in Egypt, had been in close physical contact with sick birds.

Egypt has destroyed more than ten million birds and has banned domestic poultry farms.

Health experts are concerned about the spread of H5N1 among birds and humans in Egypt. The capital's zoo has been closed since February when birds were found to be infected with H5N1.

Egypt is in the path of many migratory birds - a stopover point. It is common for people to have poultry in their backyards.

It is evident that the risk of human infection is only present if there is a great deal of continuous physical contact with sick birds. H5N1 has hit many western European countries. However, there has not been one case of human infection in the European Union (as at 14 April 2006). Backyard poultry is much less common in the EU than in Egypt or some south east Asian countries where most of the human cases of infection have appeared.

It is still extremely rare for a human to become infected with the virulent H5N1 strain of bird (avian) flu. Hundreds of millions of birds have been infected and died. Just one hundred or so humans (globally) have died.

If the virus mutates, it may become more transmissible among humans. However, for the virus to do this it will have to infect the upper-respiratory tract. At the moment it can only make a human sick by infecting the lower respiratory tract (deep down in the lung, a hard place for the virus to get to). An infected human today cannot easily infect other humans because when he/she sneezes and coughs hardly any bird flu viruses are expelled (because they are so deep down). This behaviour of H5N1 explains two things:

1.When a human is sick with bird flu, the risk of death is high. This is because an infection deep down in the lung(s) is harder to treat.

2. Because the infecting virus is so deep down, passing it on to others is extremely rare.

For the virus to become human transmissible (pass from human-to-human) it will need to infect the upper-respiratory tract in order to make the person ill. However, it is much easier to treat if it is higher up in the lung. So, even if the virus mutates, it is unlikely to be as deadly for humans as the present one.