London, April 05: A report by BBC News has confirmed the first case of human-to-human transmission of bird flu in Pakistan.

Pakistan's north-west and southern regions were hit by bird flu last year.

Thousands of birds were culled to control the spread of the disease.

Tests carried out by the World Health Organisation (WHO) have now shown that bird flu killed some members of a family in northwest Pakistan late last year.

This is the first confirmation of people dying from bird flu in the country, with the samples collected from the family in Peshawar testing positive.

According to Dr Mukhtiar Zaman Afridi, head of the isolation ward for avian flu patients at Khyber Teaching Hospital in Peshawar, a poultry worker in Peshawar apparently passed the disease on to members of his family.

"The worker, whose name is being withheld on the request of the WHO, was brought to the hospital with avian flu symptoms on 29 October 2007," he said.

Though this worker has fully recovered since then, on 12 November, his elder brother was brought in with similar symptoms.

He died a week later.

On 21 November, two more brothers of the same worker came down with bird flu.

"One of them died on 28 November, while the other has recovered," said Dr Afridi.

Apart from the poultry worker, none of the others was found to have had any direct contact with sick or dead poultry.

Genetic sequencing tests performed by WHO laboratories in Egypt and the US on samples collected from three of the four brothers established human-to-human transmission.

Serum taken from all three was found to have been infected by the H5N1 avian influenza virus.

Though a WHO report said that the tests suggest "limited human-to-human transmission," it adds, however, that this "outbreak did not extend into the community, and appropriate steps were taken to reduce future risks of human infections".

IN Islamabad, Pakistan's health ministry said it was still investigating whether there was human transmission in the country's first death from bird flu.

It said initials tests by the World Health Organisation (WHO), which sent a team here last week, had ruled it out but that Pakistan had sent samples to Geneva � the WHO's headquarters � for further confirmation.

Scientists fear that if the virus were passed from one person to another, rather than from infected birds, it might indicate a mutation that could lead to a global pandemic with the potential to kill millions.

"In their preliminary tests the WHO team excluded suspected human-to-human transmission, but we have sent the samples to Geneva for further confirmation," health ministry spokesman Oriya Maqbool Jan told AFP.

The WHO team was sent after the ministry announced the death of a man who was one of six people infected with the deadly H5N1 strain of the avian influenza virus in North West Frontier Province along the Afghanistan border.

A brother of the victim also died before being tested for the virus.

Both had worked on a cull of infected poultry.

"We have been very closely monitoring the situation," said Rafiqal Hasan Usmani, the animal husbandry commissioner.

"There has been no new outbreak".

The H5N1 strain of bird flu has killed more than 200 people worldwide, mostly in Southeast Asia, since late 2003 .

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