Published Date: 2008-04-04 03:00:19
Subject: PRO/AH/EDR> Avian influenza, human (41): Indonesia, Pakistan, WHO
Archive Number: 20080404.1235
AVIAN INFLUENZA, HUMAN (41): INDONESIA, PAKISTAN, WHO
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In this update:
[1] Situation in Indonesia - update 41
[2] Situation in Pakistan - update 2
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[1] Situation in Indonesia - update 41
Date: Wed 2 Apr 2008
Source: World Health Organization (WHO), EPR, Outbreak News [edited]
<http://www.who.int/csr/don/2008_04_02/en/index.html>
Indonesia: avian influenza situation - WHO update 41
----------------------------------------------------
The Ministry of Health of Indonesia has announced 3 new cases of human H5N1
avian influenza infection. The cases are not linked epidemiologically. The
1st is a 15 year old male student from Subang District, West Java Province
who developed symptoms on 19 Mar 2008, was hospitalized on 22 Mar 2008, and
died on 26 Mar 2008.
The 2nd case is an 11 year old female student from Bekasi City, West Java
Province who developed symptoms on 19 Mar 2008, was hospitalized on 23 Mar
2008, and died on 28 Mar 2008.
The 3rd case is a 21 month old female from Bukit Tinggi, West Sumatra
Province who developed symptoms on 17 Mar 2008 and was hospitalized on 22
Mar 2008. She is presently recovering in hospital.
The source of infection for all 3 cases is still under investigation.
Of the 132 cases confirmed to date in Indonesia, 107 have been fatal.
--
communicated by:
ProMED-mail rapporteur Marianne Hopp
[This is the official WHO confirmation of the 3 most recent cases and the
107th death in Indonesia as reported previously in ProMED-mail post: Avian
influenza, human (40): Indonesia 20080331.1193.
The interactive HealthMap of Indonesia can be accessed at
<http://healthmap.org/promed?v=-2.6,120.9,5>. - Mod.CP]
******
[2] Situation in Pakistan - update 2
Date: Thu 3 Apr 2008
Source: World Health Organization (WHO), EPR, Outbreak News [edited]
<http://www.who.int/csr/don/2008_04_03/en/index.html>
Pakistan: avian influenza situation - WHO update 2
--------------------------------------------------
Two additional H5N1 cases were confirmed by serological testing, thus
providing final H5N1 infection test results on a previously reported family
cluster in Peshawar.
These tests were conducted by the WHO H5 Reference Laboratory in Cairo,
Egypt and the WHO Collaborating Centre for Reference and Research on
Influenza in Atlanta, USA. The table below summarises the testing results
of the confirmed/probable cases in the family cluster.
The preliminary risk assessment found no evidence of sustained or community
human to human transmission. All identified close contacts including the
other members of the affected family and involved health care workers
remain asymptomatic and have been removed from close medical observation.
These laboratory test results support the epidemiological findings from the
outbreak investigation in December 2007 and the final risk assessment that
suggested limited human to human transmission likely occurred among some of
the family members, which is consistent with some human-to-human
transmission events reported previously. This outbreak did not extend into
the community, and appropriate steps were taken to reduce future risks of
human infections.
Table
Case 1 (index):
---------------
Onset date 29 Oct 2007 / full recovery / direct contact with sick or dead
poultry / confirmed by serology
Case 2:
-------
Onset 12 Nov 2007 / died (19 Nov 2007) / close contact with case 1, no
known contact with sick or dead poultry / status unknown (no sample available)
Case 3:
-------
Onset 21 Nov 2007 / died (28 Nov 2007) / close contact with case 1 and 2,
no known direct contact with sick or dead poultry / confirmed by PCR
Case 4:
-------
Onset 21 Nov 2007 / full recovery / close contact with case 1 and 2, no
known direct contact with sick or dead poultry / confirmed by serology
--
communicated by:
ProMED-mail rapporteur Marianne Hopp
[This is the final instalment of the rather tortuous and conflicting story
laid out in the ProMED-mail posts listed below, which is best forgotten.
The final analysis summarized in the table above now indicates clearly that
person-to-person transmission of avian influenza virus infection occurred
within a family of brothers in Peshawar, Pakistan. There were, however, no
further human-to-human transmission events and no spread of infection into
the general community.
The interactive HealthMap at <http://healthmap.org/promed?v=30,69.4,5> can
be used to locate Peshawar, the capital of the North West Frontier province
of Pakistan. - Mod.CP]
See Also
Avian influenza, human (05): China, Pakistan 20080110.0134Avian influenza, human (03): Egypt, Pakistan, WHO 20080104.0038
2007
---
Avian influenza, human (177): Pakistan, Viet Nam, Egypt 20071227.4152
Avian influenza, human (172): China, Pakistan 20071222.4110
Avian influenza, human (171): Pakistan 20071220.4089
Avian influenza, human (169): Pakistan 20071218.4072
Avian influenza, human (168): Pakistan 20071217.4059
Avian influenza, human (167): Pakistan 20071216.4049
Avian influenza, human (166): Pakistan, WHO 20071215.4038
Avian influenza, human (165): Pakistan 20071214.4023
Avian influenza, human (163): Pakistan 1st report 20071213.4008
...............cp/msp/sh
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