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a deadly outbreak of avian flu in turkey is spreading westward, with health officials confirming that a further three human cases have been found in the capital ankara on sunday, along with infected domestic fowl. with a total of 21 people from the istanbul and ankara area currently in hospital and three dead in a village to the east consumer fears over bird flu virus and the safety of europe's poultry flock has intensified. the first ever confirmed deaths of humans due to bird flu outside of asia makes for a dismal prognosis for european poultry processors. poultry consumption in europe was just rebounding after plummeting briefly when avian flu influenza was discovered in flocks in russia, ukraine, romania, turkey and greece. for example by poultry consumption fell by between 30 per cent to 40 per cent in italy, with lesser falls occurring in other countries the eu's poultry association reported in october and november. bans on imports of birds from affected countries also cut down the sources of supplies for food manufacturers. in spain, the bird flu scare resulted in a short-lived reduction in poultry meat consumption during late october and early november. by the third week of november poultry consumption had rebounded to top that of the previous year by 13 per cent, the spanish government said. cees vermeeren, the brussels representative of the eu's association of poultry processors and poultry trade (avec) said the outbreak in deaths in turkey in the eu countries was "worrying" for the industry. avec, other industry organisations and european commission food safety officials are due to meet tomorrow to discuss the response to the outbreaks. "it's too early to gauge the reaction in the market," vermeeren told foodproductiondaily.com. "everybody regrets what is happening in turkey. it worries us. we need a firm response." he called on the commission to ensure that any new measures put in place ensure that the poultry industry survives adverse consumer reaction. "perhaps we can look at measures that will have less impact on the sector," he said. consumer fears around europe resurfaced last week after turkey reported the death of two children in a remote village from bird flu. on saturday the government confirmed that a third child had died. the cases are the first time the virus has jumped from birds to humans outside of china and southeast asia. today local newspapers are reporting that the health ministry has reported twenty-one people from the istanbul area are in hospital, suspected of carrying he deadly strain of the disease. dead chickens suspected of carrying the disease have also been found in an istanbul district. tests are being done to determine whether the h5n1 strain was the cause of the sicknesses. ankara is about 1,000 kilometers from the region where the three deaths ocurred. a team from the world health organisation (who) is in turkey to assess the government's response and look for any signs of any mutation of the virus. turkey has been conducting emergency culls of poultry and issued bans n the sale and movement of fowl. so far only recorded cases of bird-to-human transmission of the virus has occurred and only when there has been close contact. scientists fear the virus could mutate so it becomes transmissible between humans. on turkey's ministry of health confirmed an additional two cases of human infection with the h5n1 avian influenza virus. both cases are children, aged five and eight years, and both are in hospital. in early october 2005 the european commission imposed a ban on imports from turkey of live birds and poultry products after the country detected the disease in flocks in the northwest of the country. the ban along with others remains in place. since january 2004, a total of 142 human cases of h5n1 infection have been reported in vietnam, thailand, cambodia, indonesia, and china, according to eurosurveillance. the cases in turkey bring the number of affected countries to six, from which 144 cases have now been reported. the eu produces about 11m tonnes of poultry meat annually, of which chicken accounts for 70 per cent of the total, turkey 20 per cent and ducks four per cent. the eu exports about 1.1m tonnes a year. in the eu poultry consumption overtook beef and veal in 1996, when bse hit the headlines. pork holds the number one position in the eu and could gain from the current crisis hitting the poultry industry. poultry production has gradually recovered since a 2004 outbreak of avian flu in the netherlands during spring 2003. the outbreak reduced eu production by about two per cent. production in 2004 was slightly less than in 2003. the outbreak of the milder h5n7 form of the virus in the netherlands in 2003 gives some idea of potential losses. the country was europe's biggest poultry producer at the time with more than 100 million chickens. about 30 million had to be destroyed at a direct cost of €150 million. the dutch agricultural research institute estimates that total costs for the dutch farm sector, including related industries, at €500 million. asian flu first appeared in wild birds and poultry in asia. the ongoing outbreak in asia has so far led to the destruction of more than 125 million birds, the death of around 60 people and economic losses estimated at €8 to €12 billion, according to avec, the eu's association for poultry processors. in europe the reduced import supply pressures from asian markets led to european poultry prices rising, which was also boosted by high feed grain costs last year. a who online survey of health issues found that people ranked avian flu as the number one health issue in 2005, ahead of hiv/aids, tobacco and chronic diseases, including cancer, diabetes and heart disease. after confirmation of the h5n1 virus in turkey, romania and croatia since october 2005, the eu has stepped up measures against the disease. the h5n1 virus was found in an imported parrot in quarantine in the uk, prompting the eu to ban imports of certain live birds from third countries. on 29 november 2005, the commission adopted a communication calling for the strengthening of eu-wide coordination in tracking and responding to avian flu.