The sound of shit hitting the fan?

Xinhua news is reporting that the doctor suspected of having contracted bird flu from handling specimens has been confirmed to have been infected with H5N1. He is reported to be in normal health, although earlier he was said to have had a fever.

The Xinhuanet report goes on to say that the Institute of Tropical Diseases in Hanoi currently has in its care 23 local people with bird flu symptoms "of whom 11 have been confirmed to have contracted bird flu virus strain H5N1 by the hospital's official." It adds that since last week "six more have been found to have contracted the disease."

This is the first we have heard of the 23 symptomatic cases or the confirmation of the recent six cases. If these figures are accurate--and they do not count previously reported cases, which is not at all clear-- this is an unprecedented outbreak, and taken together with the doctor's case, signals human to human transmission is likely underway in eaernest.