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

[Giuseppe]

Re: Suspected Bird Flu Outbreak in Indonesia Hospitalizes 13, 3 Suspected Deaths

If they are not willing to release the samples, they must correctly inform the WHO about the nature of the agents and its isolation on the field.

If even that can't be achieved, we couldnt even have the famous 2-3 weeks of prealarm in the case of something big.

A moment please: self-limiting pneumonia is caused sometimes by agents that cannot be isolated even in well equipped laboratory (richest nations-like). It is difficult to grow some pathogens.

It should be considered that in some cases there isn't samples to share with other, because no pathogens survived after patient's recovery.

One may search for antibodies... but there are hundreds of possible causative agents...

[tropical]

Re: Suspected Bird Flu Outbreak in Indonesia Hospitalizes 13, 3 Suspected Deaths

A moment please: self-limiting pneumonia is caused sometimes by agents that cannot be isolated even in well equipped laboratory (richest nations-like). It is difficult to grow some pathogens.

It should be considered that in some cases there isn't samples to share with other, because no pathogens survived after patient's recovery.

One may search for antibodies... but there are hundreds of possible causative agents...

OK, but in that case it are self-limiting, thus no pandemic possibilities.
And that means that new virus laced samples are non-existed to be shared with.

The problem is an flu virus (or other high infective virulent deadly microbe) capable of going pandemic, without regional containment - and in that case it must be enaugh detectable (now it can be compared by a genetic fingerprint tecnic).

[Anne]

Re: Suspected Bird Flu Outbreak in Indonesia Hospitalizes 13, 3 Suspected Deaths

old article : 2007 : http://www.journals.uchicago.edu/doi...10.1086/519692
indonesia
Epidemiological investigations. We investigated 1127 contacts associated with 54 confirmed cases of H5N1 virus infection for illness. Paired serum samples were available for 130 contacts. During these investigations, we identified 4 ill persons who tested positive for H5N1, 3 by RT-PCR and 1 by a 4-fold increase in H5N1 antibody titer between paired acute and convalescent serum samples.

[Sally Furniss]

Re: Suspected Bird Flu Outbreak in Indonesia Hospitalizes 13, 3 Suspected Deaths

Thank you Anne

[Gert van der Hoek]

Re: Suspected Bird Flu Outbreak in Indonesia Hospitalizes 13, 3 Suspected Deaths

Can?t do more than this snip at this moment, fee free to translate.

Ten patients suspect bird flu resident's of Pondok Damuli, the Village of IV,Desa Air Batu 39, the Plantation PTPN4 the Water Garden of Batu,Kecamatan Air Batu, Asahan, stated to be recovered.

http://www.seputar-indonesia.com/edisicetak/sumatera-utara/10-pasien-suspect-ai-sembuh-3.html

[Giuseppe]

Re: Suspected Bird Flu Outbreak in Indonesia Hospitalizes 13, 3 Suspected Deaths

[Toggletext translation of the above news]

The RANGE (SINDO) –

ten patients suspect the resident's bird flu of the Damuli Hut, the Village of IV,Desa Air Batu 39,Perkebunan PTPN4 the Water Garden Batu,Kecamatan Water Batu,Asahan,dinyatakan has recovered.

“Semua the infusion hose of the patient suspect bird flu (Aviant Influenza-AI) has was released. All of them have recovered like ready kala,” said Director RSU HAMS Kisaran Bambang Wahyudi yesterday.

The patient suspect bird flu was not yet allowed to come home him was their respective although they were stated recovered.

After results of the research test from the sample of blood of the Centre of Kesehatan Research And Development (Puslitbangkes) the Department of the Health in Jakarta went out and was known by their results might come home.

“Ini to more convincing apakahmerekapositifterkena suspectatau tidak,”ujar him. Bambang explained, the sign suspect bird flu that is the high fever through to reached 39–41 the Celsius level that was accompanied breathless was not met again to these patients. Currently they only lie down was accompanied by their respective family in space the isolation of space of the floor VIP 2 of RSU HAMS Kisaran.

Mereka were also seen patient in being waiting for results of the laboratory inspection.

“Selama they were treated in sini,bahkan until entering his recuperation stage, they continued to receive the maintenance that was intensive from the team of medis,”ujar Bambang.

The patients got treated that khusus,berbeda from the patient lainnya.Hal that was carried out because suspect bird flu needed the serious handling. This Penaganan in line with Section Head's appeal the Regional Government Health (the Regional Government) shavings of Armansyah Siregar.

Pejabat this beforehand asked for the side of RSU HAMS the Range treated the sufferer suspect this bird flu before results of the research of Puslitbangkes Department of Health were known.

Separately, the Division Head Regional Government public relations of Asahan Rahmat Hidayat Siregar said, Regent Risuddin visited the patients suspect bird flu in RSU HAMS Kisaran after the Friday prayer (8/8) yesterday.

The official of the number of one among them this Asahan Regional Government also visited to the location of the occurrence of the plague.

According to him, this visit was the form and attention of Regent Asahan Risuddin to the residents.

Was based on results of the visit, the situation and the condition in the village that terindikasi the plague suspectflu birds have come back was calm.

Till yesterday did not have again casualties who improved. The guidance added, although 12 residents of the IV Village, the Air Batu Village 39,Kecamatan Water Batu,Kabupaten shavings were still being treated in the hospital, two among them still received the intensive maintenance in isolation space of RSUP Adam Malik,Medan.Kini the resident's concern began to subside.

“Warga has come back carried out the activity like biasanya,”ucap him. (edy useful hasby)
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[Treyfish]

Re: Suspected Bird Flu Outbreak in Indonesia Hospitalizes 13, 3 Suspected Deaths

On Sunday, on August 10 2008 01:10 WIB Unggas died suddenly in Air Batu 39, positive bird flu was on the alert ONLINE The RANGE - results of the inspection with rapid test against a poultry that died suddenly the IV Afdeling V Village, Desa Air Batu 39, Kec. The ice, Kab. Shavings were stated positive was attacked by the bird flu virus or Avian Influenza (AI). Peternakan Kabupaten Asahan Octoni Heryanto Section Head went through Kasi P4H Yusnani explained, on Thursday (7/8). "Rapid Test showed the poultry that died suddenly in the Air Batu Village 39, positive was attacked by the virus of Avian Influenza or Bird Flu," he explained. Officially Kab Livestock Breeding. Shavings got information about the virus on Monday (4/8), at once dropped the team to the location off identified at the same time sprayed disinfectant and in the afternoon him the team that was dropped off found a poultry (the chicken) died suddenly belonging to one of the residents. According to Yusnani, was based on the clinical sign, if being found the poultry died suddenly good that was followed by the clinical sign other or not as the head increased, the cock's comb turned blue, foot and the palm foot became red like dikerok ought to be suspected the poultry was attacked by the virus H5N1 (AI) or Newcastle Deases (ND). Anticipated the spreading, the resident agreed to carry out depopulation of the limited poultry by means of being cut off and burnt in one hole without hoping for the compensation fund. "286 depopulation poultries", he revealed. Now, suspect Air Batu bird flu 39, that is the Bang, 32, Mis, 35, Uj, 38, Su, 39, IPS, 6, Rin, 8, DY, 5, the RACE, 2. Two were treated in the Public Hospital of Pusat H. Adam Malik Medan that is and Ms, 8 months and FH, 7. Whereas the condition for the two children suspect has improved in RS Adam Malik Medan, stated Bambang. Now the Kesehatan Service (Dinkes) North Sumatra dropped the joint team off to carry out observation in Kec. The ice, Kab. Shavings, followed dozens of local residents experienced suspect bird flu. The "team" with the personnel from various discipline" of "knowledge has been dropped off monitored for the prevention" of the "spreading" of "the virus," said Kadis Kesehatan North Sumatra Dr Chandra Syafei, SpOG ended visited the patient suspect bird flu from shavings in RSUP H Adam Malik Medan, on Thursday. According to Chandra, the team carried out observation in the area until the area until the area was again restored. His side also established the observer's command posts. Also distributed protective clothes to the resident. The "sample has produced by the inspection and the team's research of casualties been sent to the Department" of the "Health." Two days more results were known by us, he said. Chandra said, with the existence suspect this bird flu, then the status of the area of the Air Batu Village 39, the Damuli Afdeling Hut 5, Kec. The ice, Kab. Shavings in the Luar Biasa Condition (KLB). Said he, the main task of the team was to carry out observation already how far the endemic spreading of the virus. When results of the positive research the bird flu virus, then did not have the choice of all the poultry that was worried terjangkit the possibility was destroyed. The "mass extermination against the poultry belonging to the resident" must be carried out by coordinating with the local Regional Government," he said. http://www.waspada.co.id/Berita/Sumu...lu-burung.html

[Treyfish]

Re: Suspected Bird Flu Outbreak in Indonesia Hospitalizes 13, 3 Suspected Deaths

The patient Diduga Terserang DBD Bird Flu
On Sunday, August 10 2008 | 20:35 WIB Medan, on Sunday - the Team of the doctor suspected the patient of being suspected of by bird flu having the initials F (7) was attacked by dengue fever dengue fever or DBD. the Content trombosit in the F body was below normal. The team of the doctor was merunut the DBD attack origin. F was one of the patients who underwent the maintenance in Isolasi Rumah Sakit U Space mum the Centre of Adam Malik Medan. His condition that's right. We were contacting the Hospital of Abdul Manan, Kisaran to ask for story information of his health. We were not sure the dengue fever attack happened from here (Medan), said public relations of RSUP Adam Malik Medan Sinar Ginting, on Sunday (10/8). According to the temporary condition rays for the F patient like the patient who was attacked by dengue fever. Despite this, the team of the doctor RSUP Adam Malik continued to be waiting for results of the testing of the example of blood and the liquid tenggoran from the Centre of Research And Development of Kesehatan RI. Although suffering the sign of dengue fever, the temperature of the F body gradually has gotten normal. Last days while undergoing the maintenance in RSUD Abdul Manan Asahan. The Volunteer's recruit Officially Kedehatan North Sumatra recruited the volunteer to monitor the development of bird flu especially in the Air Batu village, the Air Batu Subdistrict, shavings. The volunteer furthermore was assigned to monitor 5 to 10 families that suffered the sign of bird flu. This was done by the government to reduce the spreading of the virus (that has been positive in poultry-Red). The head sub the Service P2P (penyecegahan the illness and sanitation) the Health Service North Sumatran Surya the Service said the volunteer's recruitment as one of the consequences of the determination of the Air Batu Village in the status of the extraordinary condition (KLB) bird flu. The observer's volunteer of bird flu also was in the area that beforehand had the story of the development of bird flu. One of them was in the Karo Regency. "We did not promise them the pay, but this empowered them who were aware of the prevention" of "this virus." If having the fund from the government of the centre, certainly they who were bundled into the volunteer will receive the part, he said. http://www.kompas.com/read/xml/2008/....terserang.dbd

[Giuseppe]

Re: Suspected Bird Flu Outbreak in Indonesia Hospitalizes 13, 3 Suspected Deaths

I cannot understand: if the child was affected by dengue fever (not dengue hemorrhagic fever), why does the hospital put it on tamiflu? and why do the x-ray images portrait a fast pneumonia remission? Does the hospital require to external lab to test children for dengue virus?

[Treyfish]

Re: Suspected Bird Flu Outbreak in Indonesia Hospitalizes 13, 3 Suspected Deaths

12 residents of the Stone of shavings of the Bird Flu Negative of 09/08/2008 | 18:00:00 Evy Rachmawati | Jakarta - results of the reaction inspection of the chain polimerasi real time (RT-PCR) the Body of the Department of the Health of Health Research And Development showed, 12 residents in Afdeling 5 Damuli the Village of IV Air Batu, the shavings Regency, the North Sumatran Province, was not infected by bird flu. The twelve residents at this time still were treated in the Daerah Public Hospital (RSUD) the Range and the Public Hospital of H Adam Malik Medan. The condition for the patient who was treated in RS Adam Malik, Medan, that was the hospital of bird flu reconciliation, that is FH (7) and MSM (8) has been stable and improved. Whereas the other patient was treated in RSUD Kisaran. Results of the laboratory inspection showed, 12 residents of bird flu of the negative. "So, they evidently suffered the other illness kind that his sign resembled bird flu," said Director General Pengendalian of the Illness and Lingkungan Departemen Sanitation of the Nyoman Kandun Health, when being contacted, on Saturday (9/8), in Jakarta. The case was expected by the bird flu being found was based on the activity surveilans active since 57 in August 2008 by the Kesehatan Service of the North Sumatran Province and D inkes the Asahan Regency. Followed up results of the findings, was carried out by maintenance efforts free in RS, medical treatment with oseltamivir, the taking and the sending specimen to the Body of Litbangkes Department of Health, observation of the case suspek, surveilans contact as well as health counselling. Till at this time, the team from the Department of Health still did surveilans was active in the community to look for the new case. Moreover also was carried out by Communication, Informasi and the Edication (KIE) the problem of Bird Flu. Had a basis would the Rapid Test inspection by the Peternakan Kab Service. Shavings and the Laboratory inspection of Veterinar Dinas Peternakan Provinsi North Sumatra, against 15 poultries (the chicken and the duck) that died suddenly last July 28 in Afdeling 5 of Damuli Dusun IV Air Batu, Kabupaten Asahan, this was positive Bird Flu. According to information that was accepted by the Centre of Communication of Publik Department of Health, the resident's majority Afdeling 5 of Damuli Dusun IV Air Batu raised chickens, ducks, and ducks to be consumed and sold. Generally their livestock pen adhered with the house, in fact had also the livestock that was not penned. Children the Village of IV Air Batu generally do not wear the footwear when playing in fact many wandering poultries around their residence. While environmental sanitation in the Air Batu Village generally not all that filled the condition for the health. The situation like this definitely became the risk factor especially in the area that has been infected by bird flu to the poultry, the headword of Puskom Publik Department of Health Lily S Sulistyowati, in the press release. To avoid bird flu, the community was asked to continue to be on the alert and preceptive against the poultry that was sick and died suddenly, as well as must make the clean and healthy life accustomed so that was avoided from the Bird Flu virus with steps as not touching the chicken, the duck, and the other poultry, everything that was sick or died, washed the hands and the cooking utensils with soap, separated the poultry from humankind. The step in the other prevention was, memeriksakan to the community health centre if having the resident who experienced the sign of flu and the fever after being adjacent with the poultry, used gloves, the cover of the mouth and the nose when holding the poultry, did not eat the poultry that was sick or died, sembelih, burnt and the poultry grave that was sick or died, as well as did not leave children playing with the poultry. "This case showed, the community's vigilance has towards the bird flu threat been good enough," said Nyoman Kandun added. http://suryalive.com//index.php?opti...370&Itemid=170

[Diane Morin]

Re: Suspected Bird Flu Outbreak in Indonesia Hospitalizes 13, 3 Suspected Deaths

<TABLE class=contentpaneopen><TBODY><TR><TD class=createdate vAlign=top colSpan=2>In connection with dengue:

18 patients in Tanjung Balai to approximately 80 kilometer in the south of Air Batu (the article speaks about 15 of Tanjung Balai + 2 of Asahan Regency)

1) Siti Aisyah, 15,
2) Indra, 8 mois,
3) M. Arifin, 13,
4) Natalia, 13,
5) Agnes, 8,
6) Indra Gunawan, 4,
7) Ina, 10,
8) Neiza Amanda, 3,
9) Ziha Nabila, 7,
10) Al Fasya, 2,
11) Muhammad Ridho, 6,
12) Indra Syahputra, 8,
13) Sukma Damayanti, 9,
14) Arianti, 12,
15) Anggreini, 5,
16) Julianti, 16,
17) Maulina, 16
18) et Faisal 15.

More on this outbreak to see the following thread which contains the English versions

http://www.flutrackers.com/forum/showthread.php?t=76421

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Saturday, 09 August 2008 11:11 WIB


</TD></TR><TR><TD class=contentheading width="100&#37;">17 pasien DBD dirawat di rumah sakit </TD><TD class=buttonheading align=right width="100%"> </TD><TD class=buttonheading align=right width="100%"> </TD><TD class=buttonheading align=right width="100%"> </TD></TR></TBODY></TABLE><TABLE class=contentpaneopen><TBODY><TR><TD vAlign=top colSpan=2>WASPADA ONLINE</TD></TR></TBODY></TABLE>

TANJUNGBALAI - 15 inhabitants of the Balai Cape and two from Kab. Asahan underwent the intensive maintenance in the room of the child RSU Dr. T. Mansyur resulting from terjangkit Dengue Dengue Fever, on Friday (8/8). Resulting from the number of patients who exploded that, the hospital side was forced to provide the room treated inap in addition.

As for the patient who was treated that, namely Siti Aisyah, 15, Indra, 8 months, M. Arifin, 13, Natalia, 13, Agnes, 8, Indra Gunawan, 4, Ina, 10, Neiza Amanda, 3, Ziha Nabila, 7, Al Fasya, 2, Muhammad Ridho, 6, Indra Syahputra, 8, Sukma Damayanti, 9, Arianti, 12, Anggreini, 5, Julianti, 16, Maulina, 16 and Faisal 15. "17 patients DBD that still was treated by us, and from him from the different place," said Mayor Tanjung Balai, Dr H Sutrisno Hadi,SpOG during considered the DBD patient in RSU Dr. T. Mansyur the City of the Hall Cape, on Friday afternoon.

Take part in accompanying Mayor, Asisten Ekbangsos Dr. H. Husinuddin, Kepala BPRSU Dr. T. Mansyur, Dr. Hj Diah Retno, Kadis Kesehatan Dr. H Azwar Mahmud Lubis, Kakan Infokom Dra. Darul Yana Siregar and public relations RSU Dr. T Mansyur Cosmas Siagian as well as the Head of Sector P2PL the Health Service of the City of the Hall Cape Dr. H. Surya the NS Service, BA. According to the Mayor, with the number of patients who exploded that, the DBD case in the Tanjung Balai City his source could have been categorised in the sporadic stage. "Casualties DBD this year was the increase and has been very startling we," said the mayor.

Touched on by the problem of the handling of the patient DBD, the Mayor said, his side carried out the maintenance conventionally with the medicine that was determined as well as the inspection through the laboratory. Besides this, all the patient DBD that underwent the maintenance inap in the hospital, was given the special mosquito net help from the Kesehatan Service of the Tanjung Balai City. The "patient DBD was treated by us while being controlled, trambosit him travel by or descended." If trombosit him improved, meant his condition improved. And especially to the patient that really could not, the cost perobatan him was helped fully by Pemko, explained the Mayor.

To deal with DBD in the Tanjung Balai City, Pemko carried out various efforts to take the form of the tightening surveillan epidemiology, penapisan the fever sufferer, the inspection pinched around the house, abatesisasi, and fogging. Afterwards, carried out direct counselling to the resident around the place of the discovery of the DBD case related the problem of the importance of the movement 3 M. (a37)

http://www.waspada.co.id/Berita/Sumut/17-pasien-DBD-dirawat-di-rumah-sakit.html

[Anne]

Re: Suspected Bird Flu Outbreak in Indonesia Hospitalizes 13, 3 Suspected Deaths

Dengue: clinical differential diagnosis of flu at the onset of illness( even in 1918.. some doctors tought about dengue ) .
I don't know if indonesian hospital make systematically serology for dengue ( I will search ), because it 's a common disease.
when there is no available laboratory, "therapeutic test" is made ( don't know if it's the same world in english ) .

We had one documented case with Dengue and bird FLU ( a young man )

[Giuseppe]

Re: Suspected Bird Flu Outbreak in Indonesia Hospitalizes 13, 3 Suspected Deaths

In Thailand there was a patient with dengue fever symptoms but later he was stated bird flu positive after specific test was done. Dengue was discounted.

I think that rather a specific test for dengue fever, one may also try to look at routine blood screening panel (ie. blood cells count, platelets count, Proteic C, complements, serum proteins (albumin - globulin: low protein level in sera may indicate a intravascular coagulation due to blood vessels increased porosity), uric acid level; increased hematocrite...)...

[Treyfish]

Re: Suspected Bird Flu Outbreak in Indonesia Hospitalizes 13, 3 Suspected Deaths

Not changing this to a dengue thread but the outbreak is near the recent bf outbreak and now the authorities are saying the baby had dengue and all is well..so ...
The SUFFERER DBD IN TANJUNGBALAI rose DRASTIC The sufferers DBD middle dirawat On Sunday, August 10 2008 23:44 WIB Metrotvnews.com, Tanjungbalai: the Illness of dengue fever dengue fever (DBD) increasingly became an epidemic in the Tanjungbalai City, North Sumatra. In time three days, the DBD sufferer in this city increased drastic. Originally DBD plague casualties numbering seven people, but currently has reached 19 sufferers. Currently, from 19 sufferers, as many as 17 people were undergoing the intensive maintenance in the Tanjungbalai Public Hospital. Sedangka two other people were in the critical condition reconciled to the Provinsi Hospital in Medan. The patient's families complain about slow him the Kesehatan Service of the Government of the Tanjungbalai City handled this DBD plague http://www.metrotvnews.com/new/berita.asp?id=64305

[Farmer]

Re: Suspected Bird Flu Outbreak in Indonesia Hospitalizes 13, 3 Suspected Deaths

<TABLE class=contentpaneopen><TBODY><TR><TD class=createdate vAlign=top colSpan=2>In connection with dengue:

18 patients in Tanjung Balai to approximately 80 kilometer in the south of Air Batu (the article speaks about 15 of Tanjung Balai + 2 of Asahan Regency)

1) Siti Aisyah, 15,
2) Indra, 8 mois,
3) M. Arifin, 13,
4) Natalia, 13,
5) Agnes, 8,
6) Indra Gunawan, 4,
7) Ina, 10,
8) Neiza Amanda, 3,
9) Ziha Nabila, 7,
10) Al Fasya, 2,
11) Muhammad Ridho, 6,
12) Indra Syahputra, 8,
13) Sukma Damayanti, 9,
14) Arianti, 12,
15) Anggreini, 5,
16) Julianti, 16,
17) Maulina, 16
18) et Faisal 15.

More on this outbreak to see the following thread which contains the English versions

http://www.flutrackers.com/forum/showthread.php?t=76421

********************************************

While the age distribution of the patients listed above are certainly consistent with dengue, there are other inconsistencies in this thread that do not add up to a compelling picture that the "Air Batu 13" were dengue patients.

1) Why is dengue exploding now? The typical rainy season starts in fall (October through December - varies by report) and continues though spring (March - April). Has there been recent heavy rainfall that would support local amplification of the mosquito vector? I could not find any reports of recent heavy rains or flooding in N Sumatra.

2) While dengue commonly presents with high fever and severe muscle aches, lower respiratory symptoms are not typically associated with this illness. The 13 patients are described as having respiratory symptoms:"Another 13 people had been admitted to the hospital with "high temperatures and respiratory problems,'' she said." (From post #4 in this thread).

The exception is late stage dengue hemorrhagic fever/dengue shock syndrome where patients may have severe pleural effusion combined with adult respiratory distress syndrome.

There are few reports of this and patients do not have brief hospitalizations, most die :

See:
Ann Trop Paediatr. 1995 Dec;15(4):335-9.
Dengue-associated adult respiratory distress syndrome.

Lum LC, Thong MK, Cheah YK, Lam SK.
Department of Paediatrics, University of Malaya, Kuala Lumpur, Malaysia.

In dengue shock syndrome, an acute increase in capillary permeability results in leakage of plasma into the interstitial space. Pleural effusion is commonly seen in dengue shock syndrome. We report three cases of dengue-associated adult respiratory distress syndrome (ARDS) in children, in all of whom dengue haemorrhagic fever, presenting with grade 3 or grade 4 dengue shock syndrome with disseminated intravascular coagulopathy, was confirmed. The criteria for the diagnosis of ARDS were based on the expanded definition of ARDS by Murray et al. Treatment consisted of fluid resuscitation, correction of coagulopathy and mechanical ventilation. All three children had multi-organ impairment, but it was more severe in the two who died. The one survivor was well at discharge.