Suspect H2H in Bali Indonesia Aug 13 to Aug 15, 2007

[HenryN]

Re: Suspect H2H in Bali Indonesia

the 'Case' of 'Bird Flu in Balinese Dipastikan Cluster'
Jakarta -- MIOL: Health Minister Siti Fadilah Soepari said, the case of bird flu in Bali that claimed the life of two people, it was confirmed the case cluster (the case of gathering bird flu).
"If according to me that cluster, first his child who was named the Lamp died on August 5."
Afterwards entered his mother, Ni Luh Putu Sri Widiani to the hospital with the same sign, namely difficult pneumonia, he said to the press, in Jakarta, on Tuesday (14/8).
Fadilah said, although the Lamp, could not be taken by the example spesiemen him because keburu died, but with the same sign and the story of the incident, was believed in the positive also Lamp was attacked by bird flu.
That struck Ni Luh Putu Sri Widiani, 29, really were similar to the case of bird flu to humankind that was first in Indonesia.
That is to the deceased's family Iwan Sunarya, in Tangerang, in June 2005.
Concerning the status of the Luar Biasa Incident (KLB), Fadilah said, since 2005 the KLB status bird flu has been put into effect and up to now is never pulled out.
"So KLB bird flu has been put into effect from long before."
If KLB local, could, because of the bird flu incident there just the first time.
According to Fadilah, Pemda local carried out prevention efforts well.
The proof is, since being known had hundreds of chickens died suddenly on July 17 2007, the Regional Government carried out the extermination (culling) the poultry.
"Possibly culling was carried out not wider, so as to there are those that slipped away."
The member the Command Post of Flu Burung Muhammad Nadhirin added, when followed mazhab the health agency of the world, WHO, cluster could be stated from a minimal case consisted of one positive person of bird flu, and one person more (could relatives or the neighbour).
Although being not yet proven to be positive in a manner the laboratory but was proven menunjukan the same sign and mutually related, this case daapt was said cluster.
If in Indonesia, the procedure of a case was said cluster, if, minimal was gotten by two people that remained in one community, and both of them were stated positive by two quality laboratories of WHO. Yakni, Laboratorium

http://www.media-indonesia.com/berita.asp?id=140411

[Laidback Al]

Re: Suspect H2H in Bali Indonesia

Approximate location of Dangin Tukadaya, the village where the mother and child were from.

[Treyfish]

Re: Suspect H2H in Bali Indonesia

Visitors to Bali see terror as big threat

5:00AM Wednesday August 15, 2007
By Angela Gregory

People are more worried about acts of terrorism in Bali than the risk of a bird flu outbreak, say travel agents.
Concerns about Bali as a holiday destination were heightened this week after tests confirmed a 29-year-old village woman from the western area of the island died from bird flu, which seems likely to have also been the cause of death of her 5-year-old daughter a few days earlier.
They lived in the relatively isolated town of Negara, in the Jembrana district, where a 2-year-old neighbour with similar symptoms has now returned positive tests for the H5N1 strain of the disease after displaying bird flu symptoms.
After 82 deaths from bird flu in Indonesia, the country accounts for about half of all cases worldwide, but this was the first in the tourist destination of Bali.
Travel agents yesterday reported little concern from their clients about the risks.
None of those contacted by the Herald had had customers query or cancel their travel to Bali.
Steve Kirwan, manager of the Holiday Shoppe in Mt Eden, said Bali was not a popular destination anyway because of the fatal bombings in 2002 and 2005 which had targeted tourists.
"It's nowhere like it used to be."
According to Statistics New Zealand there were 10,843 short-term visitors to Indonesia in the year to December 2006 compared with 15,193 in the year to December 2002.
Mr Kirwan said the threat of terrorism remained a concern especially for less experienced travellers.
Meadowbank travel agent Stephanie Daji said only a few clients came in wanting to travel to Bali, which was not a very popular destination.
"It's not just the bombing, some question Indonesia's political system."
Ms Daji said travellers were more put off by what they could relate to, such as tourists being attacked by terrorists, than what happened to villagers in remote areas of the island.

While she could understand people's anxiety, Ms Daji said she had just returned from a holiday in Bali where she felt safe because of the security in place.
The health risk of the flu deaths has been fuelled by reports that villagers fed dead and dying chickens to pigs which could provide a vector for the disease to jump from birds to humans.
Health Minister Pete Hodgson said yesterday that the Indonesian authorities should be given time to find out whether pigs were involved before anyone started panicking.
"If it did involve pigs that could be potentially serious. http://www.nzherald.co.nz/category/s...ectid=10457786

[HenryN]

Re: Suspect H2H in Bali Indonesia

AM - Tuesday, 14 August , 2007 08:16:00

Reporter: Peter Cave

TONY EASTLEY: A remote west coast village in Bali has become the focus of a big operation by Indonesian authorities to stop the spread of the deadly H5N1 strain of bird flu.

Already a mother and her five-year-old daughter have died, and a two-year-old neighbour is recovering in hospital.

It's thought they caught the virus from direct contact with infected birds and not from each other.

Foreign Affairs Editor Peter Cave reports from Jakarta.

PETER CAVE: The village of Tukadaya in the west of the tourist island is not a place normally visited by tourists. Like most of the rest of this vast archipelago, bird flu is endemic in poultry and wild birds in the area, and it was known that birds were dying in great numbers around the village.

There should've been a mass cull, and the bodies of the infected birds should've been burnt. But that didn't happen. Some of the sick birds were consumed by local people, others were even fed to pigs.

Twenty-nine-year-old mother Ni Luh Putu Windiani and her five-year-old daughter Dian daughter feeling ill about two weeks ago. The child died quite quickly from breathing difficulties and a high temperature and her body was cremated without samples being taken for analysis. Her mother soldiered on for almost a week before she became dangerously ill, and she was transferred to Bali's Sanglah hospital in the capital Denpasar at the weekend.

Dr Made Bagiaga treated her.

"When she got here," he says, "we carried out tests and when we found out her child had died too after less than a day in the local Negarra hospital, we also discovered that chickens had been dying around her house. That's when we decided it was probably avian influenza."

Samples were immediately dispatched to the central testing laboratory in Jakarta, to confirm the diagnosis, but by this time a two-year-old girl from the same village had been sent to Sanglah with the ominous signs of bird flu.

The baby, Putu Narayani, was treated by paediatrician Dr Siadi Purniti. She was luckier than her neighbours.

"What's important here is that the patient is now getting better," she says, "not worse. She's under intensive care, but she's getting better."

Late yesterday the worst fears of bird flu were confirmed.

Bayu Krishnamurti is the Chairman of the National Bird Flu Centre. He was asked at a news conference about reports from his own colleagues that local people had been feeding dead and dying chickens to their pigs, opening the frightening possibility that a third species was acting as a conduit in the disease transmission to humans.

"Pigs can get infected from humans," he says, "but there's no proven case of infection from pigs to humans. It's the same for cats and dogs, but no case of infection from dogs, cats or pigs to humans has been found. That sort of conclusion is not yet confirmed."

Over the past six months Bali has seen tourism increase by more than a third on the cripplingly low levels which followed the two Bali bombings of recent years, and now there are very real fears that this first human outbreak of H5N1 could turn around those gains.

This is Peter Cave reporting from Jakarta for AM.

http://www.abc.net.au/am/content/2007/s2004314.htm

[Treyfish]

Re: Suspect H2H in Bali Indonesia

Bali in fear after first human bird flu death

By Cindy Wockner in Jakarta
August 14, 2007 04:00am
Article from: </IMG>
<!-- END Story Header Block -->
<!-- END Story Toolbar --><!-- Lead Content Panel -->BALI has recorded its first human death from bird flu, with hundreds of birds being culled yesterday in a bid to contain a possible outbreak.

It is also suspected that the dead woman's daughter died from the H5N1 virus earlier this month.
However, the child was buried before it was realised she could have fallen victim to the deadly virus.
Agriculture authorities yesterday destroyed 400 birds in a 1km radius of the village of Tukadaya in Jembrana regency, in northwestern Bali, where the victims lived, and will continue the operation today.
Indonesia's National Bird Flu Control Committee confirmed that 29-year-old Ni Luh Putu Sri Windani, who died in Bali's Sanglah hospital in Denpasar late on Sunday, was positive to bird flu.
She was brought to the hospital three days earlier suffering pneumonia-like symptoms.
Her five-year-old daughter Dian died on August 3 at a local hospital with similar symptoms.
However, her death was not linked to to bird flu and no tests were done.
Chickens owned by a neighbour of the dead woman had previously died and have tested positive to the virus.
A two-year-old child from the same village is under observation in Sanglah Hospital with similar symptoms.
Doctors there say she has not tested positive to avian flu and that her condition is now improving.
Her grandmother Wayan Norni said chickens belonging to her family had previously died and that the dead woman lived about 200m away in the same village.
Authorities are very keen to ensure that Bali does not fall victim to bird flu which would be another blow to the island's tourist industry, hit by a series of terrorist bombings from which it has just lately begun to recover.
Tens of thousands of Australians visit the island every year.
Officials said the affected village, about three hours drive from the main tourist area of Kuta, is not in a tourist area,
In Jakarta yesterday, bird flu committee head Bayu Krisnamurti said the effect on the tourism industry was still unknown.
"We need to give the correct and proper information about bird flu to the tourist sector," he said.
He said the main thing now was to localise the outbreak and ensure it did not spread to other villages, urging people to be vigilant.
Indonesia has now confirmed 82 bird flu deaths from 103 cases since July 2005. Mr Krisnamurti said the reported cases had decreased to about one per month.
Bali Health Department head Dewi Made Oka said a team had gone to the village to cull birds, spray disinfectant and ensure no more birds are brought to the area.
He said there were so far no more reports of villagers with symptoms. http://www.news.com.au/story/0,23599...95-401,00.html

[HenryN]

Re: Suspect H2H in Bali Indonesia

AM - Tuesday, 14 August , 2007 08:16:00


Bayu Krishnamurti is the Chairman of the National Bird Flu Centre. He was asked at a news conference about reports from his own colleagues that local people had been feeding dead and dying chickens to their pigs, opening the frightening possibility that a third species was acting as a conduit in the disease transmission to humans.

"Pigs can get infected from humans," he says, "but there's no proven case of infection from pigs to humans. It's the same for cats and dogs, but no case of infection from dogs, cats or pigs to humans has been found. That sort of conclusion is not yet confirmed."

http://www.abc.net.au/am/content/2007/s2004314.htm

TITLE Infection of a Wisconsin Man by a Swine-like Influenza Virus
Containing Avian and Human Polymerase Genes

Source Link



LOCUS AF342821 1064 bp
RNA linear VRL 04-APR-2003
DEFINITION Influenza A virus (A/Wisconsin/10/98 (H1N1))
heamagglutinin precursor, gene, partial cds.
ACCESSION AF342821VERSION AF342821.1 GI:29539579
KEYWORDS .SOURCE Influenza A virus (A/Wisconsin/10/98 (H1N1))
ORGANISM Influenza A virus (A/Wisconsin/10/98 (H1N1))
Viruses; ssRNA negative-strand viruses; Orthomyxoviridae; Influenzavirus A.
REFERENCE 1 (bases 1 to 1064)
AUTHORS Cooper,L., Xu,X., Olsen,C., Klimov,A. and Cox,N.
TITLE Infection of a Wisconsin Man by a Swine-like Influenza Virus Containing Avian and Human Polymerase Genes JOURNAL Unpublished
REFERENCE 2 (bases 1 to 1064)
AUTHORS Cooper,L., Xu,X., Olsen,C., Klimov,A. and Cox,N.
TITLE Direct Submission
JOURNAL Submitted (26-JAN-2001)
School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA 70803, USA
FEATURES Location/Qualifiers source 1..1064 /organism="Influenza A virus (A/Wisconsin/10/98 (H1N1))"
/mol_type="genomic RNA"
/db_xref="taxon:157642"
/note="subtype: H1N1" CDS 33..>1064
/note="contain HA1 region"
/codon_start=1
/product="heamagglutinin precursor"
/protein_id="AAO88265.1"
/db_xref="GI:29539580"
/translation="MKAILVVLLYTFTTANADTLCIGYHANNSTDTVYTVL KKNVTVT HSVNLLEDRHNGKLCKLRGVAPLHLGKCNIAGWLLGNPECESLFTASSWS YIVETSNS DNGTCYPGDFINYEELREQLSSVSSFERFEIFPKTSSWPNHDTNRGVTAA CPHAGANS FYRNLIWLVKKGNSYPKLSKSYINNKEKEVLVLWGIHHPSTSADQQSLYQ NADAYVFV GSSRYSKKFKPEITTRPKVRDQAGRMNYYWTLVEPGDKITFEATGNLVVP RYAFAMKR NSGSGIIISDTSVHDCNTTCQTPKGAINTSLPFQNIHPVTIGECPKYVKS TKLRMATG LRNIPSIQSR"
sig_peptide 33..83
mat_peptide 84..1064
/product="heamagglutinin"
ORIGIN 1 agcaaaagca ggggaaaata aaagcaacca aaatgaaggc gatactagta gtcctgctat
61 atacatttac aaccgcaaat gcagacacat tatgtatagg ttatcatgcg aacaattcaa
121 ctgacactgt atacacagta ctaaaaaaga atgtaacagt aacacactct gttaaccttc
181 tagaagacag gcataacggg aaactatgta aactaagagg ggtagcccca ttgcatttgg
241 gtaaatgtaa cattgctggc tggctcctgg ggaatccaga gtgtgaatca ctcttcacag
301 caagctcatg gtcctacatt gtggaaacat ctaattcaga caatgggacg tgttacccag
361 gagatttcat caattatgaa gagctaagag agcagttgag ctcagtgtca tcatttgaaa
421 gatttgagat attccccaag acaagttcat ggcccaatca tgacacgaac agaggtgtga
481 cggcagcatg tcctcatgct ggagcaaata gcttctacag aaatttaata tggctggtca
541 aaaaaggaaa ttcataccca aagctcagca aatcctatat taacaataag gaaaaggaag
601 tcctcgtgct atggggcatt caccatccat ctaccagtgc cgaccaacaa agtctctacc
661 agaatgcaga tgcctatgtt tttgtggggt catcaagata cagcaagaag ttcaagccag
721 aaataacaac aagacccaag gtgagggacc aagcagggag aatgaactat tactggacac
781 tagtagagcc tggagacaaa ataacattcg aagcaactgg aaatctagtg gtaccgagat
841 atgccttcgc aatgaaaaga aattctggat ctggtattat catttcagat acatcagtcc
901 acgattgtaa tacgacttgt cagacaccca agggtgctat aaacaccagc ctcccatttc
961 agaatataca tccagtcaca attggagaat gtccaaaata tgtaaaaagc acaaaattga
1021 gaatggccac aggattaagg aatatcccgt ctattcaatc taga//
</PRE>

[Treyfish]

Re: Suspect H2H in Bali Indonesia

Avian influenza ? situation in Indonesia ? update 13

14 August 2007
The Ministry of Health of Indonesia has announced a new case of human infection of H5N1 avian influenza. A 29-year-old female from Bali Province developed symptoms on 3 August and was hospitalized on 7 August. She died on 12 August. Investigations into the source of her infection indicate exposure to sick and dead poultry.
The case's five-year-old daughter was sick with a respiratory illness in the days preceding the onset of illness in the confirmed case. The daughter's onset of symptoms was 26 July, she was hospitalized on 30 July but died without suspicion of avian influenza infection on 3 August in the district hospital. The child had contact with sick and dead poultry before becoming ill.
All of the household and healthcare worker contacts of the confirmed case have been traced. All remain healthy and will continue to be monitored for ten days after their last contact with the case.
Of the 103 cases confirmed to date in Indonesia, 82 have been fatal. http://www.who.int/csr/don/2007_08_14a/en/index.html

[HenryN]

Re: Suspect H2H in Bali Indonesia

Daughter's disease onset was July 26
Mother's disease onset was August 3

8 day differential in disease onset dates = H2H

[Treyfish]

Re: Suspect H2H in Bali Indonesia

Thanks dr Niman.So,what you think of the father with typhus?Is there a date of his illness?

[HenryN]

Re: Suspect H2H in Bali Indonesia

Thanks dr Niman.So,what you think of the father with typhus?Is there a date of his illness?

The father with typhus is the father of the neighbor.

[Treyfish]

Re: Suspect H2H in Bali Indonesia

Yes, what i meant to ask, is do you think he really has typhus and has there been a mention of the onset of his disease. Off the record

[HenryN]

Re: Suspect H2H in Bali Indonesia

Yes, what i meant to ask, is do you think he really has typhus and has there been a mention of the onset of his disease. Off the record

It's not clear what his daughter has.

[Treyfish]

Re: Suspect H2H in Bali Indonesia

Thanks again!We will have to wait a bit for more definitive info on them...and the pigs

[Theresa42]

Re: Suspect H2H in Bali Indonesia

Daughter's disease onset was July 26
Mother's disease onset was August 3

8 day differential in disease onset dates = H2H

I think the daughter's onset date might go back farther than July 26. Commonground can prolly verify as she will have a better handle on all the dates than I have at the moment!

Here's an excerpt from this article...

http://www.balipost.com/balipostcetak/2007/8/14/b29.htm

...regarding how long D [the daughter] was sick -- 2 weeks apparently. She died on Aug 3 -- so that would put her symptom onset date back to around July 20.

Hat-tips to commonground & SouthernBlueNeck!

toggletext-ed from Indonesian:

Flu Burung di Jembrana Mewabah

Negara (Bali Post) -

(...)

In the meantime, the husband of casualties right Putu Sri Widiatari, Ngurah Putu BS, when being met in his house on last Monday expected the Kesehatan Service to carry out the blood test to confirm keadaaan himself.

He said his child died after receiving the maintenance in RSU Negara. My child could be treated two weeks through to finally died.

Afterwards was followed by my wife, after receiving the maintenance for two days and finally was reconciled to RS Sanglah, he said sad. For the death ceremony of his wife still was waiting for the decision of the local tradition.

(....)

[Theresa42]

Re: Suspect H2H in Bali Indonesia

Test results on Dina positive?

Republika is reporting that tests on samples from 5 yr old Dina were positive. Toggletext is still down, but here are two 'manual' machine-translations (one by bgw in MT and another by me) of two sentences in this article (4th paragraph) that seem to indicate that the lab in Jakarta got positive results on samples from Dina.

Hat-tip to bgw in MT for finding and hand-translating this article!

Nlpsw child, that has died on last 3 agustus also stated positive get flu bird. Certitude obtained fbpi parties predicated laboratorium examination product that done by departemen kesehatan and laboratorium eyckman in jakarta.

Child NLPSW [Bali?], that has died on last Aug 3 afterwards also declared positive stricken bird flu. Certainty obtained part/portion FBPI based on result of investigation laboratory that perform for this reason the Department of Health and Eyckman Laboratory in Jakarta.