Suspected Bird Flu Outbreak in North Sumatra (Air Batu, & Environs) Indonesia - Aug. 8 - Aug. 12, 2008

[Treyfish]

Re: Bird flu outbreak in Indonesia kills 3 : Officials

Belasan the Resident of shavings was expected Suspect Bird Flu of two was reconciled to RSU Medan human rights on Thursday, 07-08-2008 *indra sikoembang/cw 15 of MedanBisnis ? shavings of twelve residents of the IV Village, the Air Batu Village 39, the Air Batu Subdistrict, the shavings Regency, terindikasi suspect bird flu. Ten among them currently was treated in RSU H Abdul Manan Simatupang (HAMS) the Range and two are still reconciled to RSU H Adam Malik (human rights) Medan. ?Kami was forced to reconcile both of them, namely FH (7) and MSM (8 months) because of being expected strong affected suspect flu burung,? said Director RSU HAMS KISARAN, Dr Bambang Wahyudi, to MedanBisnis in his office, on Wednesday (6/8). FH and MSM, explained Bambang, was reconciled to RSU HAM Medan on Tuesday struck 20,00 WIB was accompanied by the medical RSU HAMS Kisaran team. His intention so that they get the maintenance of the continuation and are handled more intensive by the team of the doctor was based on results of recording the medic. ?Sebelum was reconciled to Medan, the temperature of the FH body achieved 41 Celsius levels and MSM 39.5 Celsius levels were accompanied breathless, so as to be based on results of the analysis of the medical team of the two patients it was concluded terindikasi suspect flu burung,? he said. The patients who were treated in RSU HAMS Kisaran were isolated in the room of the floor VIP of two hospitals. They were given tami flu (anti the virus H5N1), as well as was checked by the temperature of the body and his breathing by the medical team every time four hours. According to Bambang, the last condition showed nine temperature patients of his body came back was normal and was not gotten by the sign again breathless. ?Namun the development of their condition continued to be monitored, the possible tomorrow (the day this-red) already might pulang,? he said. Bambang also explained, at this time the patients were handled by the Kesehatan Service (Dinkes) Pempropsu and the sample of their blood were taken to be checked further in the Department of Health laboratory in Jakarta. Met was separated, Kasubdis Pencegahan and the Eradication of the Illness (P2P) Dinkes Asahan, Yunan Pane, claimed to be his side did not know definitely since when the 12 residents were affected suspect bird flu because just accepted information from the resident Monday (4/8). Yunan said that to anticipate expanded him suspect bird flu, his side took steps in the handling coordinated with the related agency. At this time, he revealed, Dinkes Asahan built the control command post, at the same time dropping the medical team off was led by Dr Citra Dewi Kusuma from Dinkes Asahan and Muhammad Hafiz from PTPN4 Kebun Air Batu, Kecamatan Air Batu, Asahan. http://www.medanbisnisonline.com/rub...&more=1#122585

[Oracle]

Re: Bird flu outbreak in Indonesia kills 3 : Officials

Chickens and pigeons dying before human cases were reported. Doesn't that sound familiar (despite the fervent squawks of the 'experts' that pigeons don't die of H5N1 infections).

Hmmm. Just after the Karo cluster, in early June 2006, a young man died in Jakarta after alleged exposure to pigeon droppings, while cleaning out his roof gutters.

The other REALLY bothersome item in these Indonesian H5N1 cases:

Henry pointed this out long ago:

"The latest case added retrospectively to H5n1 confirmed cases is from West Sumatra. The patient had mild symptoms that did not included a fever, yet he has tested positive for a four fold or greater increase in neutralizing antibody levels after caring for his H5N1 positive sister. Similarly, the third confirmed case in Indonesia was the nephew of the second confirmed case in Indonesia. He also had a mild case of H5N1 and had influenza symptoms for a few days, although his aunt died."

Well lookey here. We had similar reports of mild illness in a nurse who took care of the June 2006 Jakarta case and the two nurses in North Sumatra who cared for the Karo cluster cases. And, we had at least suggested mild illness in the extended family rounded up for treatment in the Karo case.

See, we got this pattern pretty firmly established after several years of examining caseload. Family members and kin, caregivers, and medical staff, all reporting mild flu symptoms after exposure to patients died of H5N1 infection. It's a very, very common theme. Not just in Indonesia either (remember the squawking over the so-called Chinese cluster? Yeah, the girlfriend of the 'index case' and nurses had mild flu symptoms, too - and tested negative).

Most test negative - after a bout of tamiflu treatment. So easy to sweep it under the rug, especially if you can call it 'seasonal flu', which of course, it ain't, although coinfection is always possible.

We got this nexus of villagers (who may or may not be kin/extended family, as is often the case in rural Indonesia), reported started to have fever (but not severe respiratory symptoms/complications), and were treated successfully. They will probably be released from hospital quarantine tomorrow.

In a sense, this is reassuring, because it does appear that a tiny minority of those who are exposed to, and contract infection, develop severe, life-threatening illness.

You know, just like 1918. Maybe as many as two-thirds of the populace was exposed and developed mild-to-moderate symptoms. Most cases got relatively little attention, because they were nothing more than a bit worse-than-normal seasonal flu.

A small subset, however, developed severe symptoms of two distinct presentations. The first were pneumonia-type infections (caused by a few pathogens that we all carry around in our upper respiratory microflora). The second, maybe 10% or less of the total cases in many locales, had severe and rapid onset of fever, followed by hemorrhagic symptoms that developed within a scant 24-48 hours of reported symptom onset. These cases got a lot of attention, and constitute the majority of mention in historical documentation of the Spanish Influenza Pandemic of 1918-1920.

They were the ones sampled for virus identity, eh?

[Laidback Al]

Re: Bird flu outbreak in Indonesia kills 3 : Officials

A map showing the location of the Karo Regency former outbreak with respect to this suspected outbreak in Kisan, would be useful.

The map below shows the general location of the Karo Cluster in relation to the recent suspected cases in Air Batu. The locations are about 80+ miles apart.

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[Sally Furniss]

Re: Bird flu outbreak in Indonesia kills 3 : Officials

Indonesia has rushed a team of specialists to a village in Sumatra to confirm a suspected outbreak of bird flu which has affected at least 13 people, a health official said.

"We suspect an outbreak of bird flu judging by the number of people who have fallen ill with bird flu symptoms,'' said North Sumatra provincial health office chief Chandra Syafei.

"We are now waiting for the results of blood samples we sent to Jakarta.''
The official could not confirm that three people had died from bird flu-like symptoms after the suspected outbreak hit Air Batu village last week.

http://www.thestandard.com.hk/breaking_news_detail.asp?id=2088&icid=4&d_str=20080807

[AlaskaDenise]

Re: Bird flu outbreak in Indonesia kills 3 : Officials

..........
Most test negative - after a bout of tamiflu treatment. So easy to sweep it under the rug, especially if you can call it 'seasonal flu', which of course, it ain't, although coinfection is always possible.
.............
You know, just like 1918. Maybe as many as two-thirds of the populace was exposed and developed mild-to-moderate symptoms. Most cases got relatively little attention, because they were nothing more than a bit worse-than-normal seasonal flu.

A small subset, however, developed severe symptoms of two distinct presentations. ..........

Are you saying here that mild H5N1 cases are kept mild primarily by tamiflu? - but mild cases in 1918 got a mild version of H1N1?

.

[sharon sanders]

Re: Bird flu outbreak in Indonesia kills 3 : Officials

Indonesia has rushed a team of specialists to a village in Sumatra to confirm a suspected outbreak of bird flu which has affected at least 13 people, a health official said.

"We suspect an outbreak of bird flu judging by the number of people who have fallen ill with bird flu symptoms,'' said North Sumatra provincial health office chief Chandra Syafei.

"We are now waiting for the results of blood samples we sent to Jakarta.''
The official could not confirm that three people had died from bird flu-like symptoms after the suspected outbreak hit Air Batu village last week.

http://www.thestandard.com.hk/breaki...d_str=20080807

Our source says that the 3 dead may have died of something other than bird flu since the chickens got sick and started dying after the victims were admitted to the hospital.

Seems the news reports have dropped the mention of the 3 deaths.

Still trying to get more info......

[Giuseppe]

Re: Bird flu outbreak in Indonesia kills 3 : Officials

(1c) [AVIAN INFLUENZA, CLUSTERED CASES, HUMAN, INDONESIA] Indonesia testing 13 for bird flu in Sumatra village

07 Aug 2008 07:19:40 GMT - Source: Reuters

JAKARTA, Aug 7 (Reuters) -

Thirteen people from a village in North Sumatra are due to be tested for bird flu after falling sick, Indonesian health officials said on Thursday.

The 13, from Air Batu village, were hospitalised this week after suffering fever, but their conditions had improved on Thursday and they might not be suffering from the disease, a health official said.

A bird flu surveillance team from Indonesia's health ministry has been sent to the area.

"Although they found dead chickens in the area, the symptoms are not like bird flu," said Erna Tresnaningsih, the health ministry's director of animal-borne disease control.

A seven-year-old girl and an eight-month-old child were being treated in Adam Malik hospital in North Sumatra's capital Medan with Tamiflu, the medication most often used to treat bird flu, said hospital spokesman Sinar Ginting.

A spokeswoman for the World Health Organisation said she was not authorised to comment on the case.

The country's largest known cluster of bird flu cases in humans occurred in May 2006 in the Karo district of North Sumatra province, where as many as 7 people in an extended family died.

The World Health Organisation said at the time that limited human-to-human transmission could not be ruled out but that the virus samples from the scene did not show any significant genetic mutations.

Ginting was quoted by media as saying on Wednesday that not all the patients were believed to have had contact with fowl, which is the most common way of contracting the H5N1 bird flu virus, after some chickens in the area had died suddenly and were found to have been infected.

Suspected cluster cases can raise concerns about rare human-to-human transmission or that the virus might have mutated into a form that can pass easily among people, triggering a pandemic.

Bird flu remains mainly an animal disease but experts fear the H5N1 virus might mutate into a pandemic strain that would sweep the globe, possibly killing millions and hobbling economies.

Health experts say monitoring of the virus across Indonesia's thousands of islands to detect any genetic changes is vital, but there has been some confusion over the government's stance on reporting cases.

Indonesian Health Minister Siti Fadillah Supari, who has clashed with the international community over virus sharing, said in early June her ministry would only report cases every six months, although the ministry has reported three deaths since.

The virus is known to have infected 385 people in 15 countries, killing 243 of them since late 2003, according to the WHO's June 19 tally.
Indonesia reported on Sunday that a 19-year-old man died from bird flu last week, bringing the total death toll in the Southeast Asian country to 111, the highest of any nation.

(Reporting by Telly Nathalia; Writing by Olivia Rondonuwu; Editing by Ed Davies and David Fogarty)
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[Giuseppe]

Re: Bird flu outbreak in Indonesia kills 3 : Officials

13 Indonesians hospitalized with bird flu symptoms

The Associated PressPublished: August 7, 2008

JAKARTA, Indonesia: Thirteen people hospitalized with high fevers and respiratory problems are being treated as suspected bird flu patients after dozens of chickens died of the disease in their tiny Indonesian village, a health official said Thursday.

Swab and blood samples have been taken, but it could be days before results come back, said Memed Zulkarnaen, spokesman for the National Bird Flu Commission, adding, however, that "their condition appears to be improving."

The 13 were admitted to two hospitals in the past week after chickens started dropping dead in Air Batu, their village on Sumatra island, 680 miles (1,000 kilometers) northwest of the capital, Jakarta.

Tests for the H5N1 virus on the poultry came back positive.

Indonesia has regularly recorded human deaths from bird flu since the virus began ravaging poultry stocks across Asia in 2003.

Its death toll of 112 accounts for nearly half the 240 recorded fatalities worldwide.

Bird flu remains hard for people to catch, but health experts worry the virus could mutate into a form that passes easily between humans, possibly triggering a pandemic that could kill millions. So far most human cases have been linked to contact with infected birds.
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http://www.iht.com/articles/ap/2008/08/07/asia/AS-Indonesia-Bird-Flu.php

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[Giuseppe]

Re: Bird flu outbreak in Indonesia kills 3 : Officials

[UPDATED with S. Setiogi comments]

Indonesia testing 13 for bird flu in Sumatra village
07 Aug 2008 08:55:29 GMT
Source: Reuters

(Adds comments on tests from WHO and head of lab)

JAKARTA, Aug 7 (Reuters) -

Thirteen people from a village in North Sumatra are due to be tested for bird flu after falling sick, Indonesian health officials said on Thursday.

The 13, from Air Batu village, were hospitalised this week after suffering fever, but their conditions had improved on Thursday and they might not be suffering from the disease, a health official said.

A bird flu surveillance team from Indonesia's health ministry has been sent to the area.

"Although they found dead chickens in the area, the symptoms are not like bird flu," said Erna Tresnaningsih, the health ministry's director of animal-borne disease control.

Sari Setiogi, a spokeswoman for the World Health Organisation in Geneva, and the head of a laboratory in Jakarta conducting the tests said the findings were expected later on Thursday.

A seven-year-old girl and an eight-month-old child were being treated in Adam Malik hospital in North Sumatra's capital Medan with Tamiflu, the medication most often used to treat bird flu, said hospital spokesman Sinar Ginting.

(...)

(Additional reporting by Geneva bureau)
(Reporting by Olivia Rondonuwu; Editing by Ed Davies and David Fogarty)
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http://www.alertnet.org/thenews/newsdesk/JAK41114.htm

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[Commonground]

Re: Bird flu outbreak in Indonesia kills 3 : Officials

This post is a composite of what I believe are important quotes and excerpts from this thread.

Two patients who were meant to have the initials F (7) a woman and the male baby was 8 months old had the initials Ms. "Kedua this child remained neighbouring," said the rays.

The "Dinas official" of the "local Health tested the poultry and evidently positive was attacked by the virus H5N1," he said.

http://www.flutrackers.com/forum/showpost.php?p=172390&postcount=3

Selamet Riadi said, his two children experienced the high fever since a last week.

according to Selamet, his two children could in treated two days in RS Sakit Abdul Manan. However the hospital side afterwards suggested his two children were reconciled to RSUP Adam Malik Medan in order to receive the maximal handling.

"Heard by me, there were my two villagers who died because of the high fever a last week." The possibility was affected by bird flu, said Selamet

http://www.flutrackers.com/forum/showpost.php?p=172522&postcount=39

"According to residents there, a number of chickens died suddenly last week followed by several pigeons. Days later, three people died with the same ailments,'' the nurse, Mariana, said.

The father of the baby boy, Slamet Riadi, said a lot of poultry had died in the village a week ago. His baby developed a high fever and respiratory problems shortly afterward.

A spokeswoman for the health ministry could not be reached for comment.

http://www.flutrackers.com/forum/showpost.php?p=172396&postcount=4

Pig livestock breeding disturbed the Resident Monday
August 04 2008
Talang Dapok Kelurahan Air Batu Kecamatan Talang Kelapa restless.
Not only pollution of air that was caused resulting from this pig livestock breeding, resulting from the waste of this livestock also to result in the emergence being varied the illness, like asthma and bird flu.

http://www.flutrackers.com/forum/showpost.php?p=172400&postcount=7

When being met in parents of the patient Ms, Slamet Riyadi (31) said the resident in his village in the condition for the fear. Two weeks beforehand, three residents in his village died the too serious fever. Not old at intervals of, dozens of poultries were killed.

The reason the resident decided to evacuate their relative, tertuama children to the other village. In spite of that Slamet that wanted to place his one child to your house him. "We had not known what happened." Moreover the matter of bird flu. All of us worried had anything, said Slamet. Gradually even more of his villagers who were sick. Whereas the extermination of the poultry in his village was not yet equitable to all the owners of the poultry. To the end his child took part in being sick.

http://www.flutrackers.com/forum/showpost.php?p=172426&postcount=13

?First him my child was feverish one on Sunday. I thought that the common fever, but how come did not recover-recovered. Then, was brought by me took medicine to RS, did not know him bird flu. I was not maintained the poultry, my child then did not have contact with the poultry, the age he then just 8 months. The distance from my house to the neighbouring house that his chicken died that around 150 meter,? Slamet's words that was met in space of the isolation of the bird flu patient of RSUP H Adam Malik Medan yesterday.

The last condition showed, nine people of the temperature of his body came back was normal after receiving the intensive maintenance and being not gotten by the sign again breathless.

They just accepted information on Monday (4/8) on the report on the resident. However, his side suspected strong the area contaminated with the bird flu virus.

http://www.flutrackers.com/forum/showpost.php?p=172477&postcount=25

[Giuseppe]

Re: Bird flu outbreak in Indonesia kills 3 : Officials

Indonesia Testing 13 Ill People in North Sumatra for Bird Flu

By Arijit Ghosh

Aug. 7 (Bloomberg) --

Indonesia is conducting tests on 13 people in North Sumatra who fell ill with fever following chicken deaths in the area, to determine whether they are suffering from avian influenza, a Health Ministry official said.

The people under surveillance live in the Asahan region about 1,400 kilometers (871 miles) northeast of Jakarta, said I Nyoman Kandun, the Health Ministry's director-general for illness control and environmental health.

Those who develop influenza-like symptoms will be isolated and given the anti- viral drug oseltamivir, he said.

About 81 percent of the people who contracted the disease in Indonesia have died, according to World Health Organization data.

Health officials worldwide are concerned the virus may mutate into a form easily passed between humans and set off a lethal pandemic.

``So far we have been able to prevent human-to-human transmission because of quick response, better public awareness and better health teams at grass roots level,'' Kandun said in a mobile-phone text message.

``Humans are still at risk because the H5N1 virus is circulating in the poultry population.''

At least 110 of the 135 people who contracted bird flu in Indonesia have died, according to the WHO.

Indonesia's Health Minister Siti Fadilah Supari on June 6 said the government will delay reporting new deaths by six months. She didn't give a reason for the move.

Three people have died in Asahan after suffering from bird flu-like symptoms, Agence France-Presse reported yesterday citing Mariana, a nurse in Kisaran hospital, where the 13 people are being treated. Kandun said he couldn't confirm the report.

Indonesia in April released a national plan for coping with an influenza pandemic.

The plan assumes a pandemic flu virus will strike 30 percent of the world's fourth-most populous nation, or 66 million people, and kill more than 153,000.

To contact the reporter on this story: Arijit Ghosh in Jakarta at aghosh@bloomberg.net
Last Updated: August 6, 2008 23:36 EDT
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http://www.bloomberg.com/apps/news?pid=newsarchive&sid=aN6uLDJJFWk8

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[Commonground]

Re: Bird flu outbreak in Indonesia kills 3 : Officials

Now, here are some important quotes, since the health authorities are on the site:

"Although they found dead chickens in the area, the symptoms are not like bird flu," said Erna Tresnaningsih, the health ministry's director of animal-borne disease control.

http://www.flutrackers.com/forum/sho...8&postcount=52

Swab and blood samples have been taken, but it could be days before results come back, said Memed Zulkarnaen, spokesman for the National Bird Flu Commission, adding, however, that "their condition appears to be improving."

http://www.flutrackers.com/forum/sho...0&postcount=53

"Although they found dead chickens in the area, the symptoms are not like bird flu," said Erna Tresnaningsih, the health ministry's director of animal-borne disease control.

http://www.flutrackers.com/forum/showpost.php?p=172598&postcount=54

[Giuseppe]

Re: Bird flu outbreak in Indonesia kills 3 : Officials

Now, here are some important quotes, since the health authorities are on the site:

http://www.flutrackers.com/forum/showpost.php?p=172588&postcount=52

http://www.flutrackers.com/forum/showpost.php?p=172590&postcount=53

http://www.flutrackers.com/forum/sho...8&postcount=54

And perhaps WHO finally awakes:

Sari Setiogi, a spokeswoman for the World Health Organisation in Geneva, and the head of a laboratory in Jakarta conducting the tests said the findings were expected later on Thursday.

[Commonground]

Re: Bird flu outbreak in Indonesia kills 3 : Officials

``So far we have been able to prevent human-to-human transmission because of quick response, better public awareness and better health teams at grass roots level,'' Kandun said in a mobile-phone text message.

So this says the virus has mutated to be easily transmitted. Right?? If you are saying you have been able to prevent h2h, then you are saying h2h is occurring.

[Anne]

Re: Bird flu outbreak in Indonesia kills 3 : Officials

so far... and now ?

it s the context which is boring.
they do not communicate at all for few months,( a great saga with M Supari , they made black out ) and suddenly, there are plenty of very well documented and very long news , and they send medical teams on site.

Suddenly they communicate to much.
a lot of effervescence.

what does it mean ?

"We are able to fight bird flu very effectively?"
is it because it is near the karo cluster ?
is it because they have some informations about the virus among chickens this year (I checked on genbank: there is no recent chicken virus , but D Henry Niman could say it better than me )

a little bit strange, even if it is seasonal flu. ( I hope so )