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When Somsak Laemphakwan's chickens started dying in early August, he buried the corpses deep in the ground, hoping to halt the bird flu ravaging his village in northwest Thailand. It didn't work. Later that month, his 11-year-old niece Sakuntala Premphasri developed a stomachache and a high fever. When Somsak took her to a nearby clinic on Sept. 2, nurses dismissed her illness as a common cold. Five days later Sakuntala was back in the clinic, unable to walk and vomiting blood. She was sent to the district hospital, and her mother, Pranee Thongchan, was summoned from Bangkok to comfort her. Pranee kissed and held her through the last night of her life, and Sakuntala was cremated two days later. Doctors there never diagnosed the child with bird flu.

At her daughter's funeral, according to several witnesses, Pranee looked ill and complained of tiredness. "We thought it was because of the stress of losing her daughter," says a villager. Pranee visited a clinic, but like her child, was sent home, and then returned to Bangkok. Less than two weeks later, Pranee died of bird flu, the country's 10th confirmed victim of the disease—but one with a major distinction. On Sept. 28, a joint World Health Organization (WHO) and Thai investigation announced what scientists studying the H5N1 bird-flu virus had long feared: Pranee hadn't contracted the disease from chickens. She had almost certainly caught it in the hospital while nursing her dying daughter. Human-to-human transmission of the virus was possible.

If the bird-flu virus manages to become easily transmittable between humans, the world could be in for a health catastrophe approaching the "Spanish flu" pandemic of 1918, which killed an estimated 40 million people. But by week's end, health officials were relieved to discover that the disease had apparently failed to spread beyond the small family cluster. (Somsak's wife and six-year-old son were both quarantined in a provincial hospital with bird-flu symptoms, and his son has recovered.) The human-to-human transmission "is a nonsustained, inefficient, dead-end street," says Dr. Klaus Stohr, head of the WHO's influenza team. By the weekend, scientists at the U.S. Centers for Disease Control and Prevention were still studying the viral samples, trying to determine whether the virus had mutated significantly—or worse, reassorted with a human flu. The latter would be alarming, notes WHO avian-flu expert Dr. Hiroshi Oshitani, but it wouldn't automatically mean the virus had hit upon the right combination to start a pandemic.

But such a mutation could happen in the future—and the deaths in northwest Thailand demonstrate how unprepared Asia is for an unchecked outbreak. Most nations in the region have minimal stocks of antiviral drugs and no pandemic action plan. H5N1 vaccine, still in development, would not arrive in time to make a difference. If a pandemic occurred tomorrow, says Stohr, Asia would be "playing it by ear," politically improvising even as the death toll rose. "One of the most difficult things to explain to the public after a pandemic would be why we weren't prepared, because there have been enough warnings," he adds.

Thai officials, especially at the highest levels, are now taking the threat seriously. Prime Minister Thaksin Shinawatra has pledged to wipe out bird flu in the country by the end of October, and last week enlisted more than 900,000 volunteers to cull sick chickens and do spot checks on potential new outbreaks. His biggest challenge is to get poultry-dependent villages like Srisomboon, where Sakuntala Premphasri lived, onto the program. Villagers told a TIME reporter that even though they knew their chickens were likely dying of bird flu in August, they did not alert livestock officials because they believed the government would cull their poultry—including fighting cocks worth as much as $480 each. "We hoped it would just disappear," says villager Chanpen Rachsawang.

Alhough Pranee is apparently the first documented case of human-to-human bird-flu transmission, researchers suspect that such dead-end transmissions have occurred in previous outbreaks and simply escaped notice. "It's worrisome on one hand, but on the other hand it's nothing new," says Stohr. "Occasionally it can infect the next person, but then the infection chain stops."

But the chain can start again, as the residents of Srisomboon are now aware. They've turned to local monks to rid the village of malevolent spirits. "The evil that happened here in the last month was a sign," says village chief Hao Juikratoke. "We have done something wrong and we need to put things right again." Their diagnosis of the problem might not go over at the WHO—but the attitude is right.

• Bryan Walsh
• A tragic case in Thailand indicates that bird flu can be transmitted from one human to another