Indonesia H5N1 Ginting family cluster in Bandung - 05/24 - 05/27, 2006

[HenryN]

Re: Indonesia 5/24

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Liputan6.com, Bandung: the Body Ade Firman Cahyana, 18 years, and Ai Eti, 10 years, the older brother was siblings that was expected terjangkit the bird flu virus was buried in the Cisitu Village, the Cimekar Village, the Cileunyi Subdistrict, the Bandung Regency, West Java, on Wednesday morning (24/5).
This case increased long the list of casualties who died had the family's relations or cluster in West Java after beforehand two families from Sumedang and Indramayu [read: the Older Brother was siblings the Assumption of Bird Flu died].
Officially West Javanese Livestock Breeding as far as this is concerned has taken the sample of poultry blood as well as destroyed dozens of poultries in casualties's residence.
This was carried out after the death of two older brothers was siblings this made some citizens of the Sukahayu Village, Cileunyi, the residence of the family of frightened casualties.
From results of the sample test of poultry blood, three chickens were stated positive terjangkit the bird flu virus.

http://www.liputan6.com/view/7,123389,1,0,1148475454.html

(ORS/Patria and Guidance Divine Guidance)
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[Mellie]

Second Suspect H5N1 Bird Flu Cluster Member Dies in Bandung

http://www.recombinomics.com/News/05240601/H5N1_Bandung_Fatalities_2.html

Second Suspect H5N1 Bird Flu Cluster Member Dies in Bandung

Recombinomics Commentary
May 24, 2006

Teti died after being treated 19 hours in Space of the Poinciana Tree Isolation RSHS. The Hose five hours after the Teti death, Ade that also was treated in same space appeared the Power.

The above translation indicates the second sibling in Bandung in West Java has died. Death was 5 hours after index case, indicating both died on the day that they arrived. Other media reports indicate a third sibling is being treated at home.

Indonesia has a high case fatality rate, due in part to late admission of patients. Usually patients are kept at home or treated in primary facilities and only those admitted to infectious disease hospitals are tested. Thus, surveillance remains poor and clusters remain high. Family members are not trained in universal precautions and frequently become infected by the index case or additional family members.

The clusters of cases in north Sumatra, Bandung, Jakarta, and Surabuya are cause for concern. The case fatality rate is high and the cluster in Sumatra has been transmitted through several generations of human-to-human transmission (H2H2H2H2).

[HenryN]

Re: Indonesia 5/24

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<!--BEGIN DATE STAMP-->Wednesday, May. 24, 2006
<!--END DATE STAMP-->A New Bird Flu Cluster
Seven family members in rural Indonesia fall ill, and medical investigators are racing to figure out why
By BRYAN WALSH/HONG KONG
Public fears of bird flue seem to have abated in recent weeks, but scientists know the world is always one viral mutation away from a deadly pandemic. That fact has been driven home again by a worrying cluster of human bird flu cases in rural Indonesia that could represent the first time the H5N1 virus has managed to pass from human to human to human. The cluster likely began with a 37-year-old woman who hosted a family pork roast on April 29 in the Indonesian village of Kubu Sembilang in north Sumatra. The woman had become sick on April 27, and as she worsened, several family members slept in the same small room as she did. By the first week of May six more members of the family had fallen ill with avian flu. The first woman died on May 4 and was buried before any tissue samples could be taken, but doctors were able to confirm H5N1 in the remaining family members, all but one of whom have died. An eighth family member, a 32-year- old man, became sick on May 15 and died May 22; he may have caught the virus while caring for his infected 10-year-old son, who died of the disease on May 13.
The WHO has dispatched a team of investigators to the area, including experts from the organization's headquarters in Geneva, but they have been unable to find any evidence of contaminated poultry in the village that may have triggered the human infections. "If we can't find an external source that explains all seven confirmed cases, then we have to go with the theory that this is human to human," says Peter Cordingley, the spokesperson for the WHO's Western Pacific regional headquarters. Human to human transmission within a family is believed to have occurred at least twice before, in Thailand and Vietnam, although never involving this many people. But if the 10-year-old boy was infected by a family member, and then went on to infect his father, it would represent the first known time the virus had passed from human to human to human. "It's certainly possible," says Gregory Hartl, a WHO spokesperson in Geneva.
That's a worrying threshold to cross, but the good news is that the virus doesn't seem to have spread outside the family. The 32-year- old man ran away from doctors after falling ill, and passed though four neighboring villages before he was apprehended, coming into contact with 33 people. All of them are currently under observation and being given the antiviral drug Tamiflu as a prophylactic, but none have shown signs of infection. Scientists have genetically sequenced two viruses isolated from the cluster and found no evidence of the kinds of significant mutations that would likely be necessary before the virus could pass easily from person to person. "The virus looks pretty much the same as other cases," says Dr. Guan Yi, an avian-flu expert at the University of Hong Kong who has seen the genetic sequences. If those contacts remain healthy for the next week and a half, then the outbreak at Kubu Sembilang will likely be judged contained. But the cluster itself could remain a mystery. Villagers have been extremely uncooperative with investigators, complicating efforts to get samples from animals and forcing the WHO to set up its command hub 5 miles from the village. "We don't have a lot of access to the village right now," says Hartl. "But they've lost seven people. There's a lot of shock and grief they have to work through first." It's a reminder of the power bird flu still has to surprise?and to kill.
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http://www.time.com/time/health/prin...197527,00.html

[DB]

Re: Indonesia 5/24

http://www.medicalnewstoday.com/heal...p?newsid=43974
Is H5N1 Evolving In Indonesia Or Not?

We hear that seven members of the same family in Kubu Sembelang, Indonesia, became infected with the H5N1 bird flu virus strain, all within a few days of each other. The World Health Organization (WHO) says it is possible that people infected people. However, the level of alert remains unchanged. Nobody can find an animal source for these human infections.

These seemingly ambiguous reports do nothing to alleviate anxiety levels for millions of readers around the world. Readers are immediately gripped with the thoughts: ?What is really going on? Has the virus mutated? What do we do? Why don't they tell us more? Are we being told everything?' Conspiracy theories abound. However, looking closely, the reports are not ambiguous or contradictory.

Let's recap on exactly what has happened in Indonesia so far:

It all started when a woman infected with H5N1 shared a very small room with family members. The woman was very sick, coughing and sneezing a lot. Her nephew, 10, who was also in this small room, got infected. Then the nephew's father got ill after spending a couple of days caring for his very sick son. Eventually seven family members got ill.

There have been cases of humans infecting other humans before. The WHO said, many months ago, that a human can catch bird flu from another human if there is prolonged and close physical contact - as would be the case when someone is caring for an infected person.

If all the seven members of this family were in close contact with each other, and subsequently infected each other - this is nothing new.

The H5N1 virus, in its current form, can only make a human sick if it manages to reach deep down in the lungs. It does not infect the upper-respiratory tract of a human, it infects the lower-respiratory tract. For a human to become infected and ill he/she must be exposed to a large, continuous cluster of H5N1. When an infected person coughs, tiny quantities of H5N1 are expelled, because it is so deep down in the lung. This makes it even more difficult for one human to infect another. The only way one human can infect another is by constantly coughing, really close to that other human, in close quarters, for a long time.

With family members all sharing a small room, it is easily possible that a sizeable cluster built up - enough to start infecting other family members. H5N1 already does that without having to mutate - transmit from human-to-human if conditions are right. What it cannot do is transmit from one human who sneezes in the supermarket to another who is walking by.

So, the infection of these family members is easily possible without H5N1 needing to mutate. In fact, if it had mutated we would have expected to see more infected people, perhaps neighbours and other people down the road - this has not happened. The only ones to become infected were the ones who shared this tiny room with an infected person who was coughing a lot.

What may raise some eyebrows is that even so, for all seven to become infected is surprising. Experts have said, even if a human is caring for another H5N1 infected person, and has close, prolonged physical contact, transmission is possible, but difficult.

What conclusions can we draw from the information so far?

-- We know all the family members, if they did infect each other, did so in a small room - a situation which could lead to human-to-human infection without the virus having to mutate.

-- Perhaps there is an animal source for all the seven. That source has not been found yet.

-- It would be premature to say H5N1 has mutated - more people would have become infected in that area.

-- It is possible H5N1 has mutated ever so slightly and that is why seven people were infected. But this is only speculation.

According to WHO, there is no evidence of ?efficient' human-to-human transmission. Authorities in the area have to be thorough - turn every stone to find a possible animal source, keep checking all humans for further infection.

Written by: Christian Nordqvist
Editor: Medical News Today

[DB]

Re: Indonesia 5/24

The H5N1 virus, in its current form, can only make a human sick if it manages to reach deep down in the lungs. It does not infect the upper-respiratory tract of a human, it infects the lower-respiratory tract. For a human to become infected and ill he/she must be exposed to a large, continuous cluster of H5N1. When an infected person coughs, tiny quantities of H5N1 are expelled, because it is so deep down in the lung. This makes it even more difficult for one human to infect another. The only way one human can infect another is by constantly coughing, really close to that other human, in close quarters, for a long time.

With family members all sharing a small room, it is easily possible that a sizeable cluster built up - enough to start infecting other family members. H5N1 already does that without having to mutate - transmit from human-to-human if conditions are right. What it cannot do is transmit from one human who sneezes in the supermarket to another who is walking by.

So, the infection of these family members is easily possible without H5N1 needing to mutate. In fact, if it had mutated we would have expected to see more infected people, perhaps neighbours and other people down the road - this has not happened. The only ones to become infected were the ones who shared this tiny room with an infected person who was coughing a lot.

I find it interesting how they are acting like this is old news. They make it sound as if we should all know this, like this shouldn't be alarming to us.

I am sorry but statements like these really anger me because they convey a false sense of reality. They do not emphasize the fact that this is a MAJOR change, if not in the virus, then in what we are being told about the virus.

How many articles mention that the virus is a 'disease of the birds'?

Thousands.

How many articles mention that you can only catch the virus if you are handling infected poultry?

Thousands.

How many articles mention that you can only catch the virus if you have close contact with infected poultry?

Thousands.

How many articles mention that you can catch the virus if you have close contact with an infected human being?

Zero. Until yesterday.

[HenryN]

Re: Indonesia 5/24

Commentary at

http://www.recombinomics.com/News/05...2H_Review.html

[DB]

Re: Indonesia 5/24

Commentary

Extended Human to Human H5N1 Transmission Review

Recombinomics Commentary
May 24, 2006

"If we can't find an external source that explains all seven confirmed cases, then we have to go with the theory that this is human to human," says Peter Cordingley, the spokesperson for the WHO's Western Pacific regional headquarters. Human to human transmission within a family is believed to have occurred at least twice before, in Thailand and Vietnam, although never involving this many people. But if the 10-year-old boy was infected by a family member, and then went on to infect his father, it would represent the first known time the virus had passed from human to human to human. "It's certainly possible," says Gregory Hartl, a WHO spokesperson in Geneva.

The above comments contain qualifiers that keep the statements true, but misleading. The qualifiers are "at least" for the number of cases of human-to-human (H2H) transmission, and "known" for the number of times longer chains (H2H2H) been reported.

There has been a long list of H2H clusters. The vast majority of familial clusters have a 5-10 day gap between the disease onset date of the index case and other family members. In many instances, the index case has contact with poultry, and this link is used to discount the H5N1 in the family members. The current cluster has been acknowledged to be H2H because the poultry source has not been identified and the length of time between the disease onset date of the index case (April 27) and the most recent fatality (May 15) is long and the number of fatal cases in between is large (five plus one H5N1 confirmed survivor).

However, the number of transmission is still cloudy because WHO has failed to release the disease onset dates for the six family members between the first and last case. The incubation time for H5N1 is 2-4 days, which suggests the chain was H2H2H2H or H2H2H2H2H, which is also supported by contact hisptory in the WHO update. Both of these chains are long, but may not be the longest.

Earlier this year there were two large clusters involving several families. The first began at the end of 2005 and extended well into January. This cluster was in Turkey and confirmed cases were identified in three families of cousins. However, the WHO updates failed to indicate that the three family members were related and failed to mention the hospitalizations of family members when other family members were confirmed. Media reports suggest the index case infected his three siblings. The index case and two siblings died and were H5N1 confirmed. Cousins were at a family gathering, and they also developed symptoms and 10 family members were hospitalized. Two were placed in intensive care and tested positive for H5N1. The timing of the cases suggested that these two families represented H2H2H2H. However, these cases were followed by the hospitalization of two more cousins who also tested positive and one died. Thus the chain would then be extended to H2H2H2H2H. However, there hospitalization was followed by the hospitalization of yet another set (five) of cousins who were said to have tested negative.

The reports from Turkey stopped suddenly when the members of the fourth family were hospitalized and the number of negative cases, including the fourth sibling of the index case, raised credibility issues. However, WHO announced in January that they were planning on collecting 10,000 serum samples from contacts of the cases to determine the level of H5N1 transmission. Most patients infected with H5N1 will develop peak serum antibodies about 3 weeks after infections. Thus, samples should have been collected in late January and February. The results from that testing has not been disclosed.

Since the cases had connections with poultry. These cases were not considered as H2H (or H2H2H2H2H), but there is little reason for the cases to be focus in these three related families. In Azerbaijan, cases extended over a month, and although wild bird feathers may have led to infection of the index case, it is likely than transmission to family members over such an extended time period was a long H2H chain.

Thus, the current cluster in Indonesia may not be the longest chain, but it is the deadliest, with seven fatal cases in the eight member cluster. This may be due to a combination of a cleavage site common in Asian H5n1 isolates, coupled with a PB2 E627K polymorphism that is usually not found in birds and is almost always fatal when coupled with the H5N1 cleavage site.

Media Link

Map

[DB]

Re: Indonesia 5/24

http://www.bangkokpost.com/News/25May2006_news19.php

Thai team to join WHO probe
A Thai team of epidemiologists will work with the World Health Organisation (WHO) to look into a case of possible human-to-human transmission of the H5N1 strain of bird flu virus reported in Indonesia. Kamnuan Ungchusak, head of the Epidemiology Bureau, said the team will leave for Sumatra island on Sunday to work with WHO officials on the case in which seven people from the same family died of avian influenza. ''We have to closely monitor the situation in Indonesia for at least 10 days. If it gets worse, we are ready to implement preventive measures under WHO's recommendations,'' he said.


The WHO said close contacts were considered a possible source of infection among the seven victims. However, genetic sequencing of the virus showed no signs of mutation, it said.

[HenryN]

Re: Indonesia 5/24

<TABLE cellSpacing=0 cellPadding=0 width=770 border=0><TBODY><TR vAlign=top><TD class=BGTengah vAlign=top width=* colSpan=3><TABLE cellSpacing=0 cellPadding=3 width="100%" border=0><TBODY><TR><TD><TABLE cellSpacing=0 cellPadding=0 width="100%" border=0><TBODY><TR><TD colSpan=2>Tak Ada Bukti Virus H5N1 di Indonesia Bermutasi</TD></TR><TR><TD colSpan=2></TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE></TD></TR><TR vAlign=top height=300><TD width=5></TD><TD class=BGTengah vAlign=top width=485><!--tengah --><TABLE cellSpacing=0 cellPadding=3 width="100%" border=0><TBODY><TR><TD>Penulis: Teguh Rachmanto
PARIS--MIOL: Sejauh ini belum ada bukti virus flu burung jenis H5N1 yang menyebar di Indonesia telah mengalami mutasi, menyusul meninggalnya tujuh orang dalam sebuah keluarga di Sumatera Utara akibat virus itu.
Hal itu diungkapkan Direktur Jenderal Organisasi Dunia untuk Kesehatan Hewan (World Organisation for Animal Health-OIE), Rabu (25/5).
"Berdasarkan informasi yang ada, belum ada tanda-tanda virus H5N1 telah bermutasi," kata Dirjen OIE Bernard Vallat kepada wartawan.
Organisasi Kesehatan Dunia (WHO) mengatakan Rabu bahwa perpindahan virus dari manusia ke manusia mungkin terjadi di sebuah keluarga di Karo, Sumatera Utara, tapi belum ada bukti virus mematikan itu telah bermutasi dalam bentuk yang mudah berpindah.
Vallat mengatakan bahwa belum ada kekhawatiran bahwa virus itu telah berpndah antarmanusia. Tapi yang jelas, katanya, jika sejumlah tes yang dilakukan menunjukkan bahwa terjadi perubahan rangkaian genetik pada virus H5N1, maka itu akan menimbulkan pandemik baru di dunia.
Ia juga mengaku sedikit pesimistis terhadap upaya pemerintah Indonesia dalam mengatasi penyebaran virus flu burung, beda dengan upaya keras yang dilakukan Vietnam dan Thailand untuk membasmi penyebaran virus itu pada hewan dan manusia.
Di Indonesia, katanya, upaya mengatasi penyebaran virus flu burung itu hampir tak ada peningkatan, dan justru semakin parah. menurut dia, kesulitan yang dihadapi pemerintah adalah sulitnya mewajibkan pengendalian veteriner di seluruh wilayah yang tersebar di lebih dari 600 pulau.
Tahun ini tercatat 32 orang meninggal akibat virus H5N1 di Indonesia, sementara di seluruh dunia lebih dari 120 orang yang dijemput maut akibat terinfeksi virus tersebut sejak 2003. (Tr/AFP/OL-03)
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http://www.mediaindo.co.id
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[HenryN]

Re: Indonesia 5/24

<TABLE cellSpacing=0 cellPadding=0 width=770 border=0><TBODY><TR vAlign=top><TD class=BGTengah vAlign=top width=* colSpan=3><TABLE cellSpacing=0 cellPadding=3 width="100%" border=0><TBODY><TR><TD><TABLE cellSpacing=0 cellPadding=0 width="100%" border=0><TBODY><TR><TD colSpan=2>Tak Ada Bukti Virus H5N1 di Indonesia Bermutasi</TD></TR><TR><TD colSpan=2></TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE></TD></TR><TR vAlign=top height=300><TD width=5></TD><TD class=BGTengah vAlign=top width=485><!--tengah --><TABLE cellSpacing=0 cellPadding=3 width="100%" border=0><TBODY><TR><TD>Penulis: Teguh Rachmanto
PARIS--MIOL: Sejauh ini belum ada bukti virus flu burung jenis H5N1 yang menyebar di Indonesia telah mengalami mutasi, menyusul meninggalnya tujuh orang dalam sebuah keluarga di Sumatera Utara akibat virus itu.
Hal itu diungkapkan Direktur Jenderal Organisasi Dunia untuk Kesehatan Hewan (World Organisation for Animal Health-OIE), Rabu (25/5).
"Berdasarkan informasi yang ada, belum ada tanda-tanda virus H5N1 telah bermutasi," kata Dirjen OIE Bernard Vallat kepada wartawan.
Organisasi Kesehatan Dunia (WHO) mengatakan Rabu bahwa perpindahan virus dari manusia ke manusia mungkin terjadi di sebuah keluarga di Karo, Sumatera Utara, tapi belum ada bukti virus mematikan itu telah bermutasi dalam bentuk yang mudah berpindah.
Vallat mengatakan bahwa belum ada kekhawatiran bahwa virus itu telah berpndah antarmanusia. Tapi yang jelas, katanya, jika sejumlah tes yang dilakukan menunjukkan bahwa terjadi perubahan rangkaian genetik pada virus H5N1, maka itu akan menimbulkan pandemik baru di dunia.
Ia juga mengaku sedikit pesimistis terhadap upaya pemerintah Indonesia dalam mengatasi penyebaran virus flu burung, beda dengan upaya keras yang dilakukan Vietnam dan Thailand untuk membasmi penyebaran virus itu pada hewan dan manusia.
Di Indonesia, katanya, upaya mengatasi penyebaran virus flu burung itu hampir tak ada peningkatan, dan justru semakin parah. menurut dia, kesulitan yang dihadapi pemerintah adalah sulitnya mewajibkan pengendalian veteriner di seluruh wilayah yang tersebar di lebih dari 600 pulau.
Tahun ini tercatat 32 orang meninggal akibat virus H5N1 di Indonesia, sementara di seluruh dunia lebih dari 120 orang yang dijemput maut akibat terinfeksi virus tersebut sejak 2003. (Tr/AFP/OL-03)

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There was No Virus Proof H5N1 in Indonesian Bermutasi the writer: Firm RachmantoParis -- MIOL: As Far As This Is Concerned did not yet have proof of the virus of kind bird flu H5N1 that spread in Indonesia experienced the mutation, following the death of seven insiders of a family in North Sumatra resulting from the virus.That was revealed by Organisasi Breakingprep Dunia Director General for the Health of the Animal (World Organisation for Animal Health-OIE), on Wednesday (25/5)."Was based on available information, did not yet have signs of the virus H5N1 has bermutasi," said the Director General OIE Bernard Vallat to the reporter.The organisation of the Health of the World (WHO) said on Wednesday that the move of the virus from humankind to humankind possibly happened in a family in Karo, North Sumatra, but did not yet have the deadly virus proof has bermutasi in the form of that found it easy to move.Vallat said that not yet having the concern that the virus has berpndah antarmanusia.But that clear, he said, if several tests that was carried out showed that the change in the genetic series in the virus happening H5N1, then will cause pandemik just in the world.He also claimed somewhat pessimistic towards Indonesian government efforts in overcoming the spreading of the bird flu virus, unlike hard efforts that were carried out by Vietnam and Thailand to eradicate the spreading of the virus to the animal and humankind.In Indonesia, he said, efforts to overcome the spreading of the bird flu virus did not almost have the increase, and precisely increasingly serious.According to him, the difficulty that was dealt with by the government was the difficulty obliged the control veteriner all over the spread territory in more than 600 islands.This year was recorded by 32 people died resulting from the virus H5N1 in Indonesia, now all over the world more than 120 people that was picked up by the death as a result of being infected by this virus since 2003.(Tr/AFP/OL-03)</PRE>

[DB]

Re: Indonesia 5/24

http://english.people.com.cn/200605/...25_268504.html
No evidence H5N1 virus mutates in Indonesia, OIE says

The World Organisation for Animal Health (OIE) said Wednesday that there is no evidence the H5N1 bird flu virus has mutated in Indonesia.

"Nothing demonstrates that the virus has mutated or recombined, " Bernard Vallat, director general of the global watchdog for veterinary standards in farm trade, told reporters.

The World Health Organisation (WHO) said earlier in the day that limited human-to-human transmission of bird flu may have occurred in the Indonesian family -- but that there was no evidence it had mutated into an easily transmissible form.

The OIE chief confirmed there was currently "no cause for concern", but didn't exclude a new epidemic event if further tests reveal significant changes to the genetic sequences of the virus.

More than 120 people have died from bird flu since it re- emerged as a threat in 2003, mostly in Asia.
Source: Xinhua

[DB]

Re: Indonesia 5/24

"Nothing demonstrates that the virus has mutated or recombined, "

It seems that the OIE Cheif Bernard Vallat has been reading Dr. Niman's work.

The OIE chief confirmed there was currently "no cause for concern",

Dr Niman, did he ask your permission to hijack your tagline?

[Theresa42]

Ginting family leave home / staying with other relatives

Sure as h*ll hope they don't spread it on...

toggletext-ed from Indonesian:

Casualties's FAMILY LAND BIRD FLU KARO the TRAUMA
May 25, 2006

Metrotvnews.com, Tanah Karo: All of the family's member from seven citizens who were killed resulting from bird flu in the Simbelang Fortification Village, the Karo Land, North Sumatra, up to now still is fleeing to relatives's closest house. Beforehand several citizens that live in around the house of these bird flu casualties also could flee to the family's closest house. The worried generally citizen will join in tertular the bird flu virus.

When visiting the house the family of casualties of the bird flu virus, on Wednesday (24/5), the reporter Metro the TV found this house in the empty situation. According to the neighbour, casualties's family Praise Boru Ginting, Anta Boru Ginting and Dowes Ginting have for a long time been empty. They fled to several of his relatives. They the trauma with the death of his family's member. The husband from Anta Boru Ginting, Hendra Tarigan said, his house deliberate was remained because he still could not forget the wife and his child who died.

http://www.metrotvnews.com/berita.asp?id=17313

[Shannon Bennett]

Re: Indonesia 5/24

They have all scattered? And all of them could be infected. I think I need a tall scotch............make it two.

[Theresa42]

More about the brother &amp; sister who died in Bandung

Having trouble with toggletext -- couldn't manage to translate the whole article for some reason....

toggletext-ed from Indonesian:

2 ?Suspect? Bird Flu died
After could 18 hours were treated in RSHS Bandung
Bandung, (HOMEWORK).

Photo caption: Two nurses issued the bed to bring the patient's body "suspect" bird flu, AT (10), from Poinciana Tree Space to the Morgue Installation of RSHS Bandung, on Tuesday (23/5). The patient was named AT with his older brother, A (18), was the patient who was reconciled from the Ujungberung Hospital because breathless and feverish high. They entered RSHS, on Monday night (22/5).


Two older brothers were siblings, AT (10) and AC (18), the patient suspect the citizen's bird flu Kec. Cileunyi Kab. Bandung, died in RS Handsome Sadikin (RSHS), on Tuesday (23/5). AT died struck 14.50 WIB in Handsome Sadikin Space of the Isolation of the Hospital Poinciana Tree (RSHS) Bandung. Whereas AC died four hours at intervals of.

The managing director (the Managing Director) RSHS Dr. Cissy B. Kartasasmita, overnight said, AC died approximately struck 19.00 WIB. ?Itu temporary information that was received by me from Poinciana Tree Space, the place of the patient dirawat,? he said.

Beforehand, on Tuesday late afternoon (23/5), Cissy, announced the death of AT. ?Dengan heavy-hearted, we must announce the obituary. The patient AT died, whereas his older brother still in the condition really gawat,? said Cissy B. Kartasasmita.

The patient AT and AC began to be treated in Poinciana Tree Space on Monday (22/5) struck 21.00 WIB with the hot and breathless sign. Both of them were the reconciliation patient from RSUD Ujungberung, the Bandung City.

According to the Chairman Tim the Control of Bird Flu of RSHS Bandung, Dr. Hadi Jusuf, results of the laboratory inspection showed the level of Leucocytes the two low patients and trombosit him was rather low.

Now results of the photograph thorax showed pneumonia has crept as far as two rods of his lungs.

?Sejak on Monday night, the patient was at once given the tablet oseltamivir (Tamiflu) 150 mg. Also was given kartikosteroid to inflamasi that great and help of oxygen tinggi,? he said.

Mechanics breathing

Three hours before died to his lap, the AT breath out of breath. The attraction of the girl's small breath, that just sat in the class bench 3 primary schools, canned be heard like someone who cried. Only at intervals of some time after mechanics breathing (the ventilator) was installed, he died.


?Kita sudah memasang ventilator, tapi dia tetap tidak tertolong. Paru-parunya sudah mengalami pembengkakan,? ujar dr. Djatnika Setiabudi, Wakil Ketua Tim Penanggulangan Flu Burung RSHS Bandung.

Kondisi sang kakak, AC (18), meski telah dipasangi ventilator juga kian kritis. Sang ibu, Ny. C (47), hanya bisa menangisi kematian putri bungsunya. Namun, sebagai orang tua tunggal dengan tiga anak, ia terlihat berupaya tegar demi putra keduanya yang terbaring lemas di ruang probable .

Sembilan ayam mati

Ny. C mengakui sembilan ayam miliknya mati secara beruntun pada pekan lalu. Tiga hari setelah itu, AC yang berprofesi sebagai tukang ojek, mengalami demam dan batuk. Sang adik, AT, kemudian juga memunculkan gejala serupa.

Hanya 18 jam mendapatkan perawatan di RSHS Bandung, AT pulang dalam peti jenazah yang diantarkan ambulans. Sang paman, Adang (35), tak dapat memastikan kapan keponakan kesayangannya itu akan dimakamkan.

?Saya ke sini (RSHS) untuk menemani ibunya. Tapi sampai di sini, keponakan saya sudah meninggal. Untuk pemakaman, harus rembukan keluarga dulu,? ujarnya.

http://www.pikiran-rakyat.com/cetak/2006/052006/24/0206.htm