A woman in southwestern China died of bird flu on Wednesday, state media said, a rare case in the country of a fatality from the H5N1 virus since a major outbreak a decade ago. The 21-year-old patient from Guiyang passed away 13 days after showing symptoms, Xinhua news agency said, citing the health ministry. Another city resident, a 31-year-old man who developed signs of the virus around the same time, was reported over the weekend to be in critical condition. More than 365 people have died of bird flu globally since a 2003 outbreak, the World Health Organisation said in its latest report. It noted that China has seen one fatal case per year since 2010, down from a total of 25 from 2003 to 2009. The H5N1 virus typically spreads from birds to humans through direct contact, but experts fear it could mutate into a form transmissible between humans. Xinhua said neither of the Guiyang residents had come into close contact with birds and their cases appeared to be unrelated. China is considered one of the nations most at risk from bird flu epidemics because it has the world’s biggest poultry population and many chickens in rural areas are kept close to humans. Separate outbreaks among birds were reported last year in the northern region of Ningxia and the remote northwestern region of Xinjiang, prompting massive culls of chickens.