The suspected cases of human-to-human transmission are currently being examined by international health authorities, and there has not yet been any confirmation that the disease can be contracted from anything other than infected birds and their mucus and feces.

It is possible that the cases currently under review, that of two young men in Thailand, and three members of the same family and a nurse in Vietnam, do not represent the human transmissible pandemic much forecast in the media, but instead are an interim step in the infectious process.

Scientists and health experts have long discussed the possibility that H5N1 may trade some of its virulence for increased transmission, leading to a dramatic increase in the number of cases reported, but an equal decline in the disease's mortality rates, currently in the vicinity of 50 percent.

Dr. Charoen Chuchottaworn, the Thai avian-flu expert whose fears of human-to-human transmission were reported by United Press International Dec. 2, believed that the cases he observed where the infected reported only mild influenza symptoms yet tested positive for H5N1 were a likely example of the virus exchanging pathogenicity for ease of infection and theorized that the cases he had seen may represent only "the tip of an iceberg."

A report originally published by the Cox News Service said, "Planners believe that some person-to-person transmission has occurred but say limited health care resources in Asia make it difficult to detect clustered cases."

However, Dr. Scott Dowell of the Centers for Disease Control and Prevention, said, "It is always difficult to be sure if you have a couple of cases in a family, because generally speaking, members of a family have been exposed to the family's chickens as well as to each other."

Although it is presently impossible to ascertain whether any form of human-to-human transmission has ever occurred, either of the high- or low-pathogenic variety, it is human-to-human transmission that health experts most fear, and the results of the investigations currently under way by international health authorities are eagerly awaited.

Meanwhile:

-- China confirmed its fourth human case of avian-influenza infection Tuesday.

A 10-year-old girl from Guangxi, in the south of the country, has been suffering from fever and flu-like symptoms since Nov. 23, although tests only confirmed the presence of H5N1 this week.

The girl, who is in critical condition, was exposed to infected birds before contracting the infection and is not thought to be an example of the possible human-to-human transmission suspected by some scientists in Southeast Asia.

None of her friends or family members has exhibited signs of infection, giving further credence to the belief that she was contaminated by sick poultry.

The Chinese government responded to the confirmation of infection by sending specialized infection-control teams to Ziyuan county, where the girl lives.

-- In response to the outbreaks confirmed over the weekend, and which locals claim have been reported without action since September, the Ukrainian government Tuesday declared a state of emergency in the autonomous region of Crimea.

Mass poultry vaccinations are currently in progress, and Ukraine has banned imports of poultry from the area covered by the state of emergency.

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