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Published Date: 2007-01-14 00:00:00
Subject: PRO/AH/EDR> Avian influenza, human (12): Indonesia
Archive Number: 20070114.0187

AVIAN INFLUENZA, HUMAN (12): INDONESIA
*****************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>
In this update:
[1] & [2] Indonesia: 61st death confirmed
[3] Indonesia: 2nd suspected cluster
[4] Indonesia: no increased transmissibility
******
[1] Indonesia: 61st death confirmed
Date: Sat 13 Jan 2007
From: Mike Buman <ayrman@frontiernet.net>
Source: Telugu Portal, DPA [edited]
<http://www.teluguportal.net/modules/news/article.php?storyid=28227>

Indonesia: 61st death reported
---------------------------------
Two Indonesian women have died from avian flu, bringing the total
number of deaths from the disease to 61, officials said Saturday [13 Jan 2007].
One female Tangerang resident died late Friday [12 Jan 2007], and one
female Jakarta resident, 22, died early Saturday [13 Jan 2007], after
they had undergone 2 and 3 days of treatment in a hospital
respectively. "Their deaths have been confirmed from bird flu," said
an official at the Indonesian health ministry.
The deaths followed that of a 37-year-old Indonesian woman who died
from bird flu earlier Friday [12 Jan 2007]. On Wednesday [10 Jan
2007], a 14-year-old boy from a West Java village died at the same
hospital from the virus.
The latest death was Indonesia's 61st in a total of 79 bird flu
cases, the world's highest fatality tally from the disease.
--
Mike Buman
<ayrman@frontiernet.net>
[The 14-year-old boy from West Java who died on 10 Jan 2007 was the
58th fatality (see Avian influenza, human (10) - Indonesia, WHO); the
37-year-old woman from Banten province who died on Fri 12 Jan 2007
was the 59th fatality (see Avian influenza, human (11) - Indonesia,
WHO 20070113.0173); the 27-year-old female Tangerang resident
described above who also died on Fri 12 Jan 2007 was the 60th
fatality, and the 22-year-old Jakarta resident who died on Sat 13 Jan
2007 was the 61st fatality. - Mod.CP]
******
[2] Indonesia: 61st death confirmed
Date: Sat 13 Jan 2007
From: Mike Buman <ayrman@frontiernet.net>
Source: SABC News, Reuters report [edited]
<http://www.sabcnews.com/world/asia1pacific/0,2172,141762,00.html>

Indonesia: 2 women die, cluster feared
---------------------------------------------
Two Indonesian women have died of bird flu, a health ministry
official said, taking the overall human death toll from the disease
in the country to 61, amid a spike of new cases.
A 27-year-old woman from south Jakarta died after entering
Persahabatan Hospital in the capital on Thursday [11 Jan 2007] for
treatment, Muhammad Nadirin, of the health ministry's bird flu
information center, said. She died last night [12 Jan 2007]. Asked
whether the woman had been in contact with sick fowl, he said: "A
week before she got sick, there had been dead chickens near her home."
The 2nd death was of a 22-year-old woman from Tangerang, west of
Jakarta, who died in the early hours of today [13 Jan 2007], the official said.
Separately, an 18-year-old man being treated in hospital was
confirmed to have bird flu after his mother died of the disease on
Thursday [11 Jan 2007], marking a cluster case, another official said.
The husband and son of the 37-year-old woman, from Serpong in west
Java, were being treated for symptoms of bird flu at Persahabatan
Hospital. Joko Suyono, another official at the bird flu information
center, said that the son had tested positive for bird flu. It was
not clear whether he had been in contact with sick birds, the official said.
There were no immediate test results on whether the father also had
the virus, but Nyoman Kandun, the director-general of communicable
disease control at the health ministry, said the positive test of the
son signaled a cluster case. Kandun said, however, there was no
evidence of human-to-human transmission of the virus so far in this case.
The largest known cluster of human bird flu cases worldwide occurred
in May 2006 in the Karo district of North Sumatra province, where as
many as 7 people in an extended family died. The cluster triggered
fears the virus had mutated into a form that could spread easily
between people.
Bird flu is endemic in around half of Indonesia's 33 provinces, and
the vast, developing country has struggled to contain the disease.
Millions of backyard chickens live in close proximity to humans, and
health education campaigns have often been patchy and rules difficult
to enforce, with the country's power structure increasingly devolved
to the provinces.
Indonesian officials have, however, defended their efforts to tackle
the disease. "Aside from the latest cases, we have had some major
improvement in fighting the disease, but the danger is still there,
and the nature of this virus is random," Bayu Krisnamurthi, the head
of the national commission on avian influenza, said. He said people
were more vulnerable to the virus during the rainy season but hoped
the latest cases did not indicate a trend.
--
Mike Buman, EMTPS/RN
Western Arizona Regional Medical Center
<ayrman@frontiernet.net>
******
[3] Indonesia: 2nd suspected cluster
Date: Sun 14 Jan 2007
From: Th. Schmidt <mediscon@web.de>
Source: Bloomberg News Agency [edited]
<http://www.bloomberg.com/apps/news?pid=20601202&sid=aypDR4isWC24&refer=healthcare>

Indonesia: Bird Flu Infects Indonesian Teenager Creating New H5N1 Cluster
-----------------------------------------------
Bird flu infected an 18-year-old man in Indonesia, whose mother died
of the disease 3 days ago, creating a new cluster of infections that
doctors are monitoring for signs the virus is becoming more adept at
infecting humans. The teenager from Tangerang, in Banten province,
tested positive for the H5N1 strain of avian influenza, said Mukhtar
Ikhsan, a doctor at Jakarta's Persahabatan hospital, which is
treating the man and 7 other suspected cases, including the man's
42-year-old father.
"Results may be announced within a few days by the Health Ministry,"
Ikhsan said over the telephone today [14 Jan 2007]. Tests are pending
on 6 others being treated in the hospital for suspected avian flu.
Another 4 suspected cases are being treated in a hospital in Bandung
city in West Java province.
Avian flu has killed 4 people in Indonesia since 10 Jan 2007, after a
hiatus of almost 2 months (see part [1] & [2] above). World health
officials say H5N1 may touch off a lethal pandemic capable of killing
millions if it mutates to become as infectious to humans as seasonal
flu. The H5N1 strain is known to have infected 265 people in 10
countries since 2003, killing 159 of them, the World Health
Organization said on 12 Jan 2007. Indonesia has recorded at least 59
[61 as of 14 Jan 2007] fatalities, it said.
The Southeast Asian nation attracted international attention in May
2006 when 7 members of a family from the island of Sumatra contracted
the H5N1 virus, 6 of them fatally. The cases represented the largest
reported cluster of infections and the 1st laboratory-proven instance
of human-to-human transmission.
Infections in birds and people are increasing, particularly in Asia,
where the virus was 1st identified a decade ago. Hong Kong, Japan,
Viet Nam, South Korea and Nigeria have reported diseased birds in the
past month, while China and Egypt also found new human cases. Almost
all human H5N1 cases have been linked to close contact with sick or
dead birds, such as children playing with them or adults butchering
them or plucking feathers.
A dead bird in Hong Kong's Shek Kip Mei area was found to have an H5
subtype of the avian flu virus, the city's 2nd reported infection in
2 weeks, a spokesman for Hong Kong's Agriculture, Fisheries and
Conservation Department said in a statement yesterday [13 Jan 2007].
More tests are being conducted on the bird, a crested goshawk found
on 9 Jan 2007 on a hill behind a health center, the statement said.
Shek Kip Mei is about 3 miles north of the Tsim Sha Tsui tourist
district in the city's Kowloon peninsula. A dead wild bird, a scaly
breasted munia, had been found previously in the shopping district of
Causeway Bay on 31 Dec 2006 and tested positive for the H5N1 strain
last week. "While we don't have a lot of information on this, I think
it would be logical to suggest that it was infected in southern
China," Peter Cordingley, a Manila-based spokesman for WHO, said in
an 11 Jan 2007 interview. "We have to ask ourselves whether the virus
is circulating unnoticed there."
[Byline: Aloysius Unditu]
--
Th. Schmidt
MediScon Worldwide
International Institute for Travel and Health
Kaulbachstr. 25
30625 Hannover - Germany
<mediscon@web.de>
******
[4] Indonesia: no increased transmissibility
Date: Sun 14 Jan 2007
From: Mary Marshall <tropical.forestry@btinternet.com>
Source: The Jakarta Post online, headline news [edited]
<tropical.forestry@btinternet.com>
Source: The Jakarta Post online, headline news [edited]
<http://www.thejakartapost.com/detailweekly.asp?fileid=20070113.@03">tropical.forestry@btinternet.com>
Source: The Jakarta Post online, headline news [edited]
<tropical.forestry@btinternet.com>
Source: The Jakarta Post online, headline news [edited]
<http://www.thejakartapost.com/detailweekly.asp?fileid=20070113.@03>

Indonesia: Officials say no mutation in latest avian influenza outbreak
-----------------------------------------------
Authorities are dismissing speculation that the bird flu [virus] has
mutated in its latest outbreak, which killed a 14-year-old boy
Wednesday [10 Jan 2007] and a 37-year-old woman the next day.
Accompanied by a panel of experts, the head of the National
Commission for Avian Influenza and Pandemic Preparedness, Bayu
Krisnamurthi, also denied a more virulent virus caused the outbreak.
He said the pattern of transmission remained the same, from chicken to human.
He added that further study must to be done to discover whether ducks
could also pass the virus to humans. "There is a variety of hosts,
but so far, there is no scientific evidence that other animals can
spread the virus to human beings besides chickens. The virus found in
other animals is still the avian virus and has not yet transformed
into a new variant," he said before the panel of experts in Jakarta.
In Bandung, West Java, 4 suspected bird flu patients -- a 33-year-old
woman and her 2 children from Cicalengka in Bandung regency, and a
poultry farm owner from Purwakarta -- remained in Hasan Sadikin
hospital Friday [12 Jan 2007]. The woman's husband said his wife and
2 children, a 14-year-old boy and an 8-month-old baby girl, started
suffering from high fever and coughing over the past 10 days. "Around
Idul Adha (31 Dec 2006), some 30 chickens around our house suddenly
died. One of them even died in our front yard," he said in the
hospital's Flamboyan room. The 3 were referred to the Bandung
hospital Thursday [11 Jan 2007] by a local community health center,
since they had a history of contact with dead chickens. Rapid test
results from the dead chickens around their house showed 2 were H5N1 positive.
Another suspected bird flu victim, a 55-year-old poultry farm owner,
had shown symptoms for 3 days before being taken to the hospital
Thursday [11 Jan 2007].
The West Java animal husbandry office head of the poultry health
subdivision warned on Friday [12 Jan 2007] that the H5N1 virus had
continued to spread and told people to maintain cleanliness,
especially during the monsoon season. The head of Hasan Sadikin
hospital's bird flu prevention team, Hadi Jusuf, has also told people
to be more aggressive in identifying bird flu symptoms, including
high fever, coughing, and breathing problems after having direct
contact with dead chickens.
Despite the return of the virus, the panel believed Indonesia was on
the right track toward eradicating the H5N1 virus. "By saying that
there is an improvement in our efforts, we don't mean the virus is
not around anymore. We have to remain alert to the danger, because
the nature of the virus is random. The war is far from over," said Bayu.
Bayu said bird flu control efforts in 2007 will focus on an expanded
public awareness and social mobilization program, strengthened animal
and human disease surveillance and control programs, and a
restructuring of the poultry industry. "Restructuring the poultry
industry is not an easy choice; we need a comprehensive policy in
order to reduce the cost. We need to be more careful because it will
reduce jobs and disrupt the protein supply from chickens," said Krisnamurthi.
[Byline: Yuli Tri Suwarni]
--
ProMED-mail
<promed@promedmail.org>
[The situation at present is that human cases of avian H5N1 influenza
are being reported from different regions of Indonesia; a 61st death
has been confirmed; at least 10 suspected cases are under
surveillance; a suspected new cluster of cases is being investigated;
and, so far, no evidence of alteration in transmissibility of the
outbreak virus has been observed. - Mod.CP]

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