"She is the first suspected bird-flu patient in our province," Lop Buri public health chief Dr Pranom Kamtiang said yesterday. She said blood samples had already been sent for tests in Bangkok and the results should be available within 24 hours.

According to Pranom, public health officials have already inspected the girl's hometown in Khok Charoen district to find out if anyone else was similarly affected. She told journalists that bird-flu surveillance had been stepped up in other parts of the province.

"We have put 19 patients on the watch list," she said.

She let it be known that her department was working in tandem with livestock officials to find out if the disease was spreading in the province. Unlike its neighbouring province of Phetchabun, Lop Buri was not previously on the bird-flu watch list.

Lop Buri livestock chief Jintana Danwiwatporn yesterday insisted there had been no mass deaths of fowl in Khok Charoen district.

"Recently, some fowl died in Sa Bot district but lab tests ruled out bird flu," she said.

Jintana said she still could not understand why the girl had had the symptoms of bird flu. The girl's mother said there were dozens of home-raised fowl in her neighbourhoods but none of them had died.

"I saw my daughter playing with the birds but I never thought that would kill her," the grieving mother said.

According to her, her daughter had had a sore throat and been running a temperature since Monday. She gave her an antipyretic medicine but her condition did not improve.

On Tuesday, she sent her daughter to Khok Charoen Hospital, which referred her to Lop Buri Hospital on the same day because of the seriousness of her condition. Lop Buri Hospital kept the girl in a special zone for patients with severe viral or bacterial infections.

Despite the best efforts of the medical staff, the child died about 6.45am yesterday. Last month, a 17-year-old boy died of bird flu in Phichit.

In a related development, the Public Health Ministry's deputy permanent secretary Narongsak Angkhasuwaphala said all hospitals should strictly check patients with a high fever to prevent deaths and the spread of bird flu.

"If there are patients with bird-flu symptoms, relevant officials should be informed so that the necessary action is taken immediately," he said. According to him, 21 provinces in the country are associated with bird-flu risks.

According to official figures released on Tuesday, 164 patients were on the suspected bird-flu list. Of them, 107 were in Phichit.

Other provinces with reported suspected bird-flu cases include Sukhothai, Nan, Phitsanulok, Phetchabun, Kamphaeng Phet, Kanchanaburi, Chiang Mai, Uttaradit, Nakhon Phanom, Nakhon Pathom, Prachin Buri, Lampang, Nakhon Sawan and Nonthaburi.

In Sukhothai, more than 12,000 chicken in Sri Samrong were culled after some local fowl died en masse. Culling took place simultaneously in various areas in response to Sukhothai Governor Sukij Charoenrattanakul's instruction.

In Surat Thani, 35 checkpoints were erected to prevent illegal transportation of fowl. Offenders, if convicted, will be fined up to Bt10,000 and jailed for a year.