Table 1 Timeline of the avian influenza outbreak in Turkey 2006

8–26 October 2005

• Turkish Ministiry of Agriculture (MoA) announced the presence of H5N1 influenza in poultry in the north-western part of the country on 8 October ^{a, b}.

• On 13 October, World Organization for Animal Health (OIE) confirmed the presence of H5N1 in samples taken from patient poultry in Turkey^a.

• Deaths of chickens occurred in Dogubeyazit near the end of 2005, and a confirmed outbreak of H5N1 avian influenza in chickens and ducks was reported on 26 December^b.

• The Turkish Ministiry of Health (MoH) published the country's first national pandemic influenza action plan, developed on the basis of the WHO checklist for influenza pandemic preparedness planning^a.

24–25 December 2005

• Three children in one family in Dogubeyazit, in Agri province, applied to the local outpatient clinic and treated for fever, sore throat, arthralgia and myalgia^a.

30–31 December 2005

• The children's condition had worsened and was brought to Dogubeyazit State Hospital's by their father^a.

• The doctor of emergency room and consultant pediatrician in DSH accepted them as suspected avian influenza cases and transferred to the Van Yuzuncu Yil Univesity (YYU) Hospital^{a, b}.

1–5 January 2006

• Samples taken from cases included in the ongoing influenza surveillance in the region were sent to the Turkish MoH, Ankara Hifzisihha Laboratories^a. On 4 January the MoH received confirmation of H5N1 from National Influenza Centre at the Refik Saydam Hygiene Centre in Ankara and Capa Hospital in Istanbul^a.

• Turkish MoH notified the WHO Regional Office for Europe of the outbreak through the WHO Country Office^a.

• The Turkish MoH put its avian influenza preparedness plan in action^{a, b}.

• A regional meeting was held at the Van PHD to which the Governors of eight cities, the responsible Deputy Director of the PHD, communicable disease unit directors, provincial agriculture and rural affairs directors and animal health unit directors were invited.

• Turkish and WHO experts assembled to review the epidemiological situation and provide further laboratory and clinical expertise^a.

6–7 January 2006

• The National Institute for Medical Research which is the influenza reference laboratory and WHO collaborating center confirmed the presence of H5N1 in samples from the patients at YYU Hospital^a.

• The surveillance started in the region and the health team was assigned with the avian influenza surveillance from Ankara to Van and Dogubeyazit^b.

• The members of Turkish MoH Avian Influenza Scientific Committee interviewed with the experts of WHO, CDC and European Union^b.

8–12 January 2006

• Turkish MoH and MoA teams moved to Van and organized the meeting with the authorities from nine provinces^b.

• Total 12 cases from Dogubeyazit (8), Van (1), Sanliurfa (1), Kastamonu (1) and Eskisehir (1) were confirmed by National Institute for Medical Research^b.

• Eight of confirmed cases were treated at Van YYU Hospital and the others treated at Diyarbakir Dicle University Hospital, Sanliurfa Children Hospital, and Agri State Hospital.