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**HenryN** · May 14, 2006, 08:12 AM

Re: Indonesian Health Care Worker With Symptoms

Commentary at

H5N1 Symptoms in North Sumatra Health Care Worker

http://www.recombinomics.com/News/05140603/H5N1_Sumatra_HCW.html

Recombinomics Commentary

**Theresa42** · May 14, 2006, 09:50 AM

Re: Indonesian Health Care Worker With Symptoms

No wonder they're saying they can't rule out H2H.

**MHSC** · May 14, 2006, 06:28 PM

Re: Indonesian Health Care Worker With Symptoms

Originally posted by niman

<REPRINTSDISCLAIMER>A nurse who attended to some of the patients also came down with an influenza-like illness, although she seems to have shown symptoms prior to treating the patients, according to Dr. Kandun. She and others in the family's village are currently being tested for the virus.
<CENTER>
</CENTER>

If this nurse turns out to have H5N1, than this is major, it is one of the signs we have been looking for.

**LMonty** · May 14, 2006, 06:38 PM

Re: Indonesian Health Care Worker With Symptoms

yes, HCW infection is one of the pandemic "canaries", isnt it?

But, I'll be honest- just one infected worker doesnt scare me. I believe limited H2H is already happening in the community, but not going past the second generation. One HCW would be a limited second generation type infection. If more HCW get infected (like 3 or 4), or that HCW's contacts (family, friends, etc) get infected- then I'll get worried. Thats the time, for me, that the alarm bells go off.

It seems like the virus is sloooooowly moving along, learning new tricks. Bigger clusters is definitely a concern. Though this may be just an outlier, a fluke caused by some particularly efficient B2H spread (as AD pointed out somewhere, aerosolizing the virus and spraying it, might really have given the virus a helping hand to get into deep lung tissue).

We really need more detail- dates of symptom break for each victim, and SEQUENCES so people like Henry can figure out if the virus has changed, and epidemiological surverys of that village....WHY cant we get stuff like that done more quickly? We have the technology. We have the people who know how to use it ready to go. But somehow, that doesnt seem to come together...

**GaudiaRay** · May 14, 2006, 09:32 PM

Re: Indonesian Health Care Worker With Symptoms

WHO can test its mettle.
Who here believes that WHO will be honest or prompt?
The joke here is that they think they can call in the "troops" to start a tamiflu blanket when at this time, weeks after the incident, they're reporting nothing that to them is strartling. Everyone here is aware this is a "different" strain. It infected quickly, and broadly, a wide age range, and it killed with time lapses, especially mother and then the cluster of kids and relatives, and even now, with all medical efforts there, life yet continues in 1 or 2.
Again, who here thinks that WHO will tell the truth?
Anyone think the Indonesians are even capable of analyzing what happened here?
And silence on the HCW is another proven trait of the Indonesian health authorities. Clear facts will be so much more helpful.

**Mellie** · May 14, 2006, 10:08 PM

Re: Indonesian Health Care Worker With Symptoms

I'd like to know what flu symptoms exactly the health care worker has.

It also seems like the test for H5 can be done fairly quickly. Does the fact that they haven't said it's not H5 mean it's likely to be H5?

Politics and economics should not be the driving force on providing information. If they don't know, they should say so. If they do know which Hemaglutanin subtype it is (or is ruled out), that information should be made public.

**Laidback Al** · May 14, 2006, 10:15 PM

Re: Indonesian Health Care Worker With Symptoms

GR, from my perspective it is pointless to argue and speculate about WHO. Whether it is an incompetent bureaucracy mired in ineptitude or a agency with a self-perceived role as the international broker of bird flu information is irrelevant.

WHO will not act quickly and they will not provide the data in a timely manner. I think we owe a debt of gratitude to all of the forum members combing the internet for foreign language news, cruising foreign forums, and tapping foreign friends and relatives for tidbits of information.

Without doubt we will be the first to known when when H5N1 goes pandemic. WHO representatives will read about it here first, even before it shows up in their morning in-box.

**sharon sanders** · May 14, 2006, 10:38 PM

Re: Indonesian Health Care Worker With Symptoms

Actually, WHO does access this site for information.

**GaudiaRay** · May 15, 2006, 12:04 AM

Re: Indonesian Health Care Worker With Symptoms

Originally posted by Florida1

Actually, WHO does access this site for information.

Would it not be better if they called their local representative who would call the Government and instruct them to call the hospital and send over a simple questionnaire?

The questionnaire would always be the same, correct?

This is not rocket science for them to use the National Government to fill in the Health Form, and the Police Form, and the Military Form.

In Indonesia, in some areas, there is a soldier on every few blocks. There are many, many, many people who are in the army and police. They should be taxed with the job...not HCW's who never, and I mean never, go into the communities. The HCW sits at the clinic or works at the hospital. That's how it operates over there. It's the same thing in Egypt. I was just there. (In fact, when I walked into 5 separate pharmacies and asked what they knew about bird flu, one person "knew" that amantadine was ineffective, that it would not be of value for bird flu. In Egypt, the people are not ready. They, the doctors at the pharmacies, as of 4 weeks ago, did not know what to do! Every pharmacy has an internet connection, or at least nearly every pharmacy has that connection. Every one of them needs an instruction sheet on what to do when someone presents themselves with the symptoms of flu. That doctor who I saw sitting on one side of the counter and the sick patient on the other, with her arm draped across the glass topped counter, will be the basis of the rapid transmission of bird flu in Egypt. Any human who looked would know. Certainly WHO knows this. But not a single doctor or assistant at any of the pharmacies I entered in Cairo, Luxor and Aswan had even the slightest knowledge first about bird flu and if they did, they knew inaccuracies and held them out as truths.

If WHO wants to help, I encourage them to act as I've described above. The cost would be nearly zero as HQ can prepare the questionnaire at HQ and the procedure sheet...step 1 2 3...at the HQ.

If we are acting as their eyes and ears, then this is my suggestion to them.
Be proactive. If on the internet or in a fax, with instructions on how to complete the form, they can do a simple tracking and tracing. This will take them at most 2 days or 3 days from the time they learn of a new outbreak.

What is WHO's strategy? Even I saw the tamiflu blanket scheme to be a Public Relations gimmick to get the world notified that the pandemic has started. But we want to know "before" that time.

**Laidback Al** · May 15, 2006, 09:29 AM

Re: Indonesian Health Care Worker With Symptoms

GR, thanks for the positive suggestions to WHO. I hope they read them, implement them, and then I hope they will make the data available in a timely fashion.