(Agencies)
Updated: 2004-02-03 16:00

Asia's bird flu crisis topped the agenda for a three-day emergency meeting opening in Rome on Tuesday, after the human death toll in the outbreak rose to 12 and fears of the disease reached Europe with a tourist tested for the virus after a trip to Thailand.

The UN Food and Agriculture Organization, which is hosting the Rome meeting, warned that the bird flu outbreak is far from over.

``Bird flu remains a serious public and animal health threat and continues to spread,'' said the FAO's He Changchui. ``The eruption of new infection cases in Thailand, China and Vietnam shows that the disease is far from being under control.''

FAO officials said they believe the disease is spreading within Thailand and Vietnam, but that the situation is less clear for China, where investigators may just now be picking up previously undetected cases.

A tourist in Germany was rushed by ambulance Monday to a Hamburg medical center where she was tested for bird flu after complaining of nausea, dizziness and fever following her return from Thailand.

But virus expert Herbert Schmitz of the Bernhard Nocht Institute for Tropical Health said she probably did not have the disease.

``The patient -- probably like hundreds of other tourists returning from Asia -- suddenly didn't feel well and immediately thought it was bird flu,'' he said.

The death toll stood Tuesday at 12, after Vietnam announced that an 18-year-old boy died early Monday and Thailand said a 58-year-old woman who died earlier was confirmed to have had the disease via an autopsy.

Thailand has an additional confirmed case of the disease who remains hospitalized, and is testing an additional 18 suspected cases, 11 of whom have died, officials said Tuesday.

The disease also has hit poultry farms in Cambodia, Indonesia, Japan, Laos, Pakistan, South Korea and China's Taiwan. However, health officials say the strain of bird flu striking Taiwan and Pakistan is milder and is not considered a serious threat to humans.

Indonesia on Tuesday confirmed its outbreak is of the more dangerous H5N1 strain -- which health officials say can jump to humans. Jakarta previously had confirmed only a milder strain.

At least 45 million chickens have been slaughtered across the region, devastating the poultry industry. Health officials say that culls, if safely carried out, are the best way to contain the disease.

Although 10 regions and countries are battling bird flu, cases in humans have been reported only in Vietnam and Thailand, and those cases have been attributed to the H5N1 strain.

Most of the infections have been traced to direct contact with sick birds. However, the World Health Organization says its investigation has been inconclusive in the case of a Vietnamese family, and that human-to-human transmission could not be ruled out.

Still, WHO said there is no evidence of a new strain that can easily be passed among people, and that the case does not raise the level of concern about the disease.

``The thing is still in the box. If we sit on the lid it will stay there,'' said Klaus Stohr, chief flu expert at the World Health Organization.

Witness accounts in the Vietnamese case were not consistent, but WHO investigators say the most likely story centers on a Jan. 3 family wedding. The groom and one of his sisters prepared a duck. The groom fell ill Jan. 6 and was admitted to hospital Jan. 7. On Jan 10th, the sister who had helped prepare the duck and the bride -- who had not -- fell ill. The next day, a second sister also got sick.

On Jan. 12, the groom died and the bride and two sisters were admitted to hospital a day later. The groom and his two sisters died, but the bride survived the flu.

Investigators could not trace the infections of the second sister or the bride to exposure to birds, although this could not be ruled out.

Health officials may never be able to confirm what happened, in part because the brother's remains already have been cremated and because family accounts were conflicting.

No other cases of people catching the virus from other people have been suspected anywhere else.

Limited human-to-human transmission of the virus is not the real danger. What experts fear is the virus mutating into a form that passes easily between people -- a pandemic strain that is a hybrid of the bird virus and a normal human influenza variety.