BEIJING - CHINA'S Health Ministry said on Wednesday there was no evidence of a large-scale outbreak of bird flu even though the country has reported four cases this month, three of which were fatal.

The ministry said the illnesses, which have been scattered across different provinces, were isolated, unrelated and did not show significant mutations of the H5N1 virus.

They also occurred during the cold months, which experts have determined are high season for infections, it said.

'There's no evidence of a possibility of a large-scale outbreak,' the ministry said in a faxed statement.

The dead include a 16-year-old boy from Guizhou province in the southwest, a 27-year-old woman from Shandong province in the east and a 19-year-old woman who died in Beijing.

The fourth person, a 2-year-old girl, was hospitalised in her hometown in Shanxi province in the north.

The ministry said the toddler and her mother both had a history of being exposed to live poultry at a market in late December. The mother was diagnosed with pneumonia and died in January, but the cause of death could not be determined because no samples had been taken from the woman, the ministry said.

There is a possibility the 2-year-old contracted bird flu from her mother, it said, but it is more likely she was infected in the market.

Many bird flu cases stem from exposure to sick birds, but human-to-human transmission of the disease has happened about a dozen times, in countries including China, Cambodia, Thailand, Vietnam, and Turkey.

In nearly every case, transmission has occurred among relatives who have been in close contact, and the virus has not spread into the wider community.

While the disease remains hard for humans to catch, scientists have warned if outbreaks among poultry are not controlled, the virus may mutate into a form more easily passed between people.

The World Health Organisation says that bird flu has killed 249 people worldwide since 2003. The tally does not include the death of the 16-year-old boy announced on Tuesday in China, where a total of 34 infections have been reported.

The latest Chinese cases come at a worrisome time for the government as an estimated 188 million people travel between cities and rural hometowns for Lunar New Year, the country's biggest holiday, which begins next week.

Celebratory family meals often include dishes made from freshly slaughtered poultry, potentially increasing the risk of exposure to sick birds as people shop in markets or when chickens and ducks are transported to be sold.

The Health Ministry said the public should decrease contact with poultry, not touch or eat poultry that died from disease, properly cook their meat and eggs, observe good personal hygiene and go to the doctor for early detection and treatment if they have flu-like symptoms after being in contact with poultry. -- AP