Hospital workers reported respiratory symptoms after encountering a Missouri patient with H5N1 who had not been exposed to farm animals. Officials say bird flu transmission is unlikely.

Missouri officials are under growing pressure from national public health experts to pinpoint the source of the state’s first human bird flu infection.

A routine flu screening in late summer found the H5N1 virus in a Missouri patient. Unlike the other reported cases of avian flu, this person did not report being in recent contact with animals.

U.S. health officials have run into obstacles in their efforts to determine whether a Missouri person infected with H5N1 bird flu passed the virus on to others.

Chances are low that human-to-human spread of bird flu occurred in a group of people who were exposed to a patient infected with the virus in Missouri, US health authorities said.

None of the health care workers or other contact have tested positive for avian flu antibodies so far — but could their illness signal human-to-human transmission?

Seven people in contact with a patient hospitalized with bird flu also developed symptoms, the C.D.C. reported. Some are undergoing further tests.