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Taiwan confirmed an H7N9 bird flu infection in a traveler who came back to the island from China, the first case of the killer virus outside the mainland.

A 53-year-old Taiwanese man tested positive for the strain of avian flu after a business trip to the eastern city of Suzhou and returning to Taiwan via Shanghai, Minister of Health Chiu Wen-ta said at a briefing in Taipei yesterday. The patient, who is in critical condition in an isolation room, didnt come into contact with birds, Chiu said.

The first discovery of the virus outside China, 10 years after an outbreak of severe acute respiratory syndrome, or SARS, may lead to increased scrutiny of travelers into and out of the country. Taiwans largest trade partner is battling to control spreading of the virus, which so far has killed 23, according to data compiled by Bloomberg from reports released by the government and World Health Organization.

With any new influenza virus that emerges, the concern is that it could genetically mutate to become easily transmissible between human beings, Raina MacIntyre, a professor of infectious diseases at the University of New South Wales, said in an interview before the announcement of Taiwans confirmed case. With all past pandemics, and even with SARS, they were spread around the world by travel.

Suzhou is in Jiangsu province, where more than 20 cases of the new bird flu strain have been reported. China has tallied 109 infections since the virus was discovered in March.

Taiwans Centers for Disease Control said in a statement that the infected male had not been exposed to birds and poultry during his stay in Suzhou and had not consumed undercooked poultry or eggs. He developed his illness three days after returning to Taiwan and came in contact with at least 139 people including 110 hospital workers, according to the CDC.

Scientists in China confirmed for the first time that people are contracting the virus from birds at a wet poultry market, according to research published in The Lancet medical journal today.

The scientists analyzed swabs from 20 chickens, four quails, five pigeons and 57 ducks from six markets likely to have been visited by four people who got sick. Forty percent of the pigeons and 20 percent of the chickens tested positive for H7N9, though the virus wasnt found in the quails or ducks, the researchers found. After studying virus samples taken from one of the patients, the scientists determined the source of the infection was exposure to birds.

Aggressive intervention to block further animal-to-person transmission in live poultry markets, as has previously been done in Hong Kong, should be considered, the researchers said. Temporarily closing live bird markets, surveillance, culling, separating bird species and possibly vaccinating poultry seem necessary to halt evolution of the virus into a pandemic agent, they said.

Taiwanese authorities are monitoring three medical staff who have exhibited symptoms of upper respiratory infection after coming in contact with the patient while wearing protective gear, the Centers for Disease Control said. Three others who came in contact without wearing protective gear have shown no symptoms, and are also being monitored.

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Bird Flu Strain Spreads as Taiwan Reports First H7N9 Case