Oct 28, 2005 (CIDRAP News) – The World Health Organization (WHO) warned today that if H5N1 avian influenza spread to Africa and caused human cases, it “could push fragile health systems to the brink of collapse.”Also, China today ruled out H5N1 avian flu in the death of a girl who lived in a village recently hit by a poultry outbreak, while Romania reported finding the virus for the first time in an area other than the Danube delta.The virus has spread to Turkey, Romania, Croatia, and European Russia in recent weeks, and concern is rising that birds flying south from Siberia will bring the virus to Africa.The WHO said the arrival of the virus in Africa “would be of great concern for human as well as animal health.” Human and poultry populations are less dense in Africa than in Asia, but many African households have backyard flocks, which often mingle with wild birds.The agency said the risk of human cases in Africa would be similar to the risk in Asia. With weak disease-surveillance systems, cases and case clusters probably would not be detected quickly, especially when the symptoms resemble those of many other common diseases. Other diseases, including AIDS, malaria, and tuberculosis, already have overwhelmed healthcare and financial resources.”Sporadic cases of H5N1 infection and the frequent reluctance of residents to comply with recommended reporting and isolation measures during outbreaks of severe disease could push fragile health systems close to the brink of collapse,” the WHO said.In China, officials said a 12-year-old girl from Hunan province who died Oct 17 of suspected avian flu actually had pneumonia. The girl lived in Wantang, a village where 545 chickens and ducks died last week, the Associated Press (AP) reported.The girl’s 9-year-old brother is hospitalized in stable condition with pneumonia, according to a Reuters report today. China has had no confirmed human cases of H5N1 avian flu to date.Reuters reported that WHO officials in Geneva were calling for more information from China on the cases. WHO spokeswoman Maria Cheng said China had not provided any information. “We need more clarification because both [children] apparently had been exposed to sick chickens,” she was quoted as saying.Another WHO official said the agency wanted to know what tests were used to rule out avian flu, according to the AP.In Romania, officials said a dead heron found in the northeast, near the Moldovan border, tested positive for H5N1, according to an Agence France-Presse report today. The agriculture minister, Gheorghe Flutur, said tests conduced in Weybridge, England, confirmed the virus.Last week Flutur announced the virus had been found in two locations in the Danube River delta in southeastern Romania. Flutur said that more than 400 other tests on birds from eastern Romania had turned out negative, AFP reported.In other news, three tourists from Reunion Island who were suspected of catching avian flu while traveling in Thailand have tested negative for the virus, according to a Reuters report today.The story said a Thai health official, quoting unnamed French officials, said “final lab results” had excluded avian flu in the three French tourists. Reunion Island is a French possession off the east coast of Africa.The French health ministry had said yesterday that one of the three tourists, a 43-year-old man, had tested negative. The three had visited a bird park in Thailand.