Germany reported an outbreak of highly pathogenic H5N1 bird flu on a farm in the eastern region of Saxony near the border with the Czech Republic, the World Organisation for Animal Health (WOAH) said on Monday.

After a patient with bird flu was hospitalized last month, state and federal health officials first determined the patient may have infected one household member and two hospital workers. However, "Missouri has since identified four additional health care workers who later developed mild respiratory symptoms,

At least eight people may be infected with H5N1 bird flu in Missouri, marking the first cluster of the disease spreading between humans in the United States. The first case of a human contracting bird flu with no known animal contact happened in Missouri in August,

Health authorities in the US are studying seven people who developed influenza symptoms after being exposed to a Missouri bird flu patient, raising the possibility of the first human-to-human transmission of the infection.