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  • Indonesian Woman Dies of Bird Flu, Cluster Feared

    Contributed by Tom Harrison| 20 August, 2006 19:06 GMT

    Confirmation that a 35-year-old Indonesia woman who died last week was infected with the H5N1 virus has stoked concern that a new bird flu cluster case may have emerged in the country. Tests have confirmed that an a 35-year-old Indonesian woman, Euis Lina, died last week of bird flu, health officials have announced. H5N1 infections in twelve other residents of the Cikelet subdistrict of West Java are confirmed or suspected, according to numerous press reports.Two weeks ago, Lina's nine-year-old daughter died after becoming ill with similar symptoms, but authorities have not confirmed bird flu in her case.

    Health officials are monitoring Cikelet for any signs that the disease might be spreading from person to person, a situation that could spark a pandemic. Clusters of cases heighten that possibility.

    The situation is especially worrisome because of Cikelet's location about 90 miles from Jakarta -- the largest city in Indonesia, with a population close to 9 million.

    Seven members of a Sumatra Island family died of the H5N1 virus in May. That was the largest known cluster case to date. Although limited human-to-human transmission probably took place in that case, the World Health Organization concluded that the disease did not spread beyond that family group.

    At this point, officials believe that the infected individuals in Cikelet contracted the virus from sick birds -- H5N1 is known to be endemic among poultry in the region.

    Lina's death brings the total number of bird flu fatalities in Indonesia to 46 -- 34 of them having occurred this year. The country has been hit harder by the disease than any other in the world, with millions of birds -- mostly chickens and ducks -- known to be infected with the virus.

    Bird flu has killed at least 141 people worldwide since late 2003. After Indonesia, Vietnam has been worst-affected, with 42 deaths. However, no case has emerged in Vietnam this year, according to the WHO.

    The Indonesian government claims it is doing everything possible to combat bird flu in Cikelet by slaughtering poultry there and distributing antiviral drugs to villagers for free. However, it says it cannot afford to mount a campaign of widespread slaughter of poultry in the country.

    While criticism mounts that Indonesia is not doing enough to prevent a pandemic from starting there, government officials have complained that the international community has not contributed to the effort.

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    • Re: INDONESIA - Garut Cluster Part II

      Niko, if it helps, I have a notation that it's spelled Jojok/Jojoh

      Comment


      • Re: Indonesian Woman Dies of Bird Flu, Cluster Feared

        Comment


        • Re: INDONESIA - Garut Cluster Part II

          Commentary at

          Comment


          • Re: INDONESIA - Garut Cluster Part II

            From your commentary:

            "The patients have been confirmed to be H5N1 positive, but they are linked to family members who died as early as July 31."

            Dr. Niman, I think you need to have "not" inserted in this sentence? [patients have not been confirmed....]. Unless I missed the confirmations?





            laidback Al at 12:15"

            With the admission of the young boy to the hospital, the official number of people suspected of having contracted bird flu released by the health office stood at 10

            Comment


            • Re: INDONESIA - Garut Cluster Part II

              Originally posted by Commonground
              From your commentary:

              "The patients have been confirmed to be H5N1 positive, but they are linked to family members who died as early as July 31."

              Dr. Niman, I think you need to have "not" inserted in this sentence? [patients have not been confirmed....]. Unless I missed the confirmations?





              laidback Al at 12:15"

              With the admission of the young boy to the hospital, the official number of people suspected of having contracted bird flu released by the health office stood at 10
              Thanks for the ehads up. It should read THREE patients were confirmed.....

              Comment


              • Re: INDONESIA - Garut Cluster Part II

                Originally posted by Commonground
                Here is a map from Theresa42 at CurEvents. It shows the villages in Garut. And Pameungpeuk is one of them.

                http://www.bplhdjabar.go.id/soe/garut/index.cfm
                The map is also here in this thread:

                ...when you have eliminated the impossible, whatever remains, however improbable, must be the truth. - Sherlock Holmes

                Comment


                • Gilang from Pameungpeuk sub-district (i.e. not Cikelet)?

                  Originally posted by Laidback Al
                  Geographic locations of several places in Garut

                  original name: Cikelet
                  geographical location: Garut, Jawa Barat, Indonesia, Asia
                  geographical coordinates: 7? 36' 0" South, 107? 40' 0" East

                  original name: Cigadog
                  geographical location: Garut, Jawa Barat, Indonesia, Asia
                  geographical coordinates: 7? 13' 0" South, 107? 59' 0" East

                  original name: Pameungpeuk
                  geographical location: Garut, Jawa Barat, Indonesia, Asia
                  geographical coordinates: 7? 38' 0" South, 107? 43' 0" East
                  From:
                  http://www.maplandia.com/indonesia/jawa-barat/garut/
                  Awesome, LaidbackAl! Thanks.

                  The latest patient, Gilang, is reportedly being treated at Pameungpeuk Community Health Centre. Pameungpeuk is another sub-district in the Garut Regency -- just as Cikelet is a sub-district (there's also Cikelet village, which is what makes understanding the placenames so confusing! And, yes, it looks like there's a Pameungpeuk village, too.).

                  Pameungpeuk sub-district is to the east of Cikelet. I think part of Pameungpeuk sub-district borders on Cikelet sub-district -- it looks to me as though Pameungpeuk sub-district is bi-sected by another narrow sub-district called Cibalong, so that there's a "west Pameungpeuk" and an "east Pameungpeuk" [my naming]. I've outlined "west Pameungpeuk" with a red dotted line and "east Pameungpeuk" with a red solid line.

                  I wonder where this latest patient, Gilang, is from? From somewhere bordering Cikelet sub-district? Or from farther afield?

                  Click image for larger version

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                  ...when you have eliminated the impossible, whatever remains, however improbable, must be the truth. - Sherlock Holmes

                  Comment


                  • Re: INDONESIA - Garut Cluster Part II

                    Originally posted by Laidback Al
                    Geographic locations of several places in Garut

                    original name: Cikelet
                    geographical location: Garut, Jawa Barat, Indonesia, Asia
                    geographical coordinates: 7? 36' 0" South, 107? 40' 0" East

                    original name: Cigadog
                    geographical location: Garut, Jawa Barat, Indonesia, Asia
                    geographical coordinates: 7? 13' 0" South, 107? 59' 0" East


                    original name: Pameungpeuk
                    geographical location: Garut, Jawa Barat, Indonesia, Asia
                    geographical coordinates: 7? 38' 0" South, 107? 43' 0" East
                    From:
                    http://www.maplandia.com/indonesia/jawa-barat/garut/
                    This looks to be another Cigadog -- not Cigadog village in Cikelet sub-district. It's just too far away from the Cikelet area.

                    Here's a map of where the 7 Cikelet sub-district villages are (unfortunately not named):


                    Here's a list of the 7 villages in Cikelet sub-district -- one is Cigadog:


                    Here's the map of the Cigadog according to the co-ordinates from Google Earth -- it's just too far away. Must be another Cigadog:
                    Cigadog google map. Satellite image of Cigadog, Indonesia and near destinations. Travel deals.
                    ...when you have eliminated the impossible, whatever remains, however improbable, must be the truth. - Sherlock Holmes

                    Comment


                    • Re: Gilang from Pameungpeuk sub-district (i.e. not Cikelet)?

                      Originally posted by Theresa42
                      Awesome, LaidbackAl! Thanks.

                      The latest patient, Gilang, is reportedly being treated at Pameungpeuk Community Health Centre. Pameungpeuk is another sub-district in the Garut Regency -- just as Cikelet is a sub-district (there's also Cikelet village, which is what makes understanding the placenames so confusing! And, yes, it looks like there's a Pameungpeuk village, too.).

                      Pameungpeuk sub-district is to the east of Cikelet. I think part of Pameungpeuk sub-district borders on Cikelet sub-district -- it looks to me as though Pameungpeuk sub-district is bi-sected by another narrow sub-district called Cibalong, so that there's a "west Pameungpeuk" and an "east Pameungpeuk" [my naming]. I've outlined "west Pameungpeuk" with a red dotted line and "east Pameungpeuk" with a red solid line.

                      I wonder where this latest patient, Gilang, is from? From somewhere bordering Cikelet sub-district? Or from farther afield?
                      Scratch that.

                      Pameungpeuk sub-district has 7 villages (desa) - easily seen on the map above: Pameungpeuk, Mancagahar, P A A S, Mandalakasih, Jatimulya, Bojong and Sirnabakti


                      And, according to this, Cibalong has 9 (although I can't make 9 out on the map): Karyasari, Maroko, Sancang, Karyamukti, Sagara, Mekarsari, Simpang, Mekarmukti and Cigaronggong


                      So, there's Cikelet sub-district with Cibalong sub-district to the east of it -- and Pameungpeuk to the east of that. Cikelet and Pameungpeuk do not appear to border each other.
                      Last edited by Theresa42; August 20, 2006, 11:08 PM.
                      ...when you have eliminated the impossible, whatever remains, however improbable, must be the truth. - Sherlock Holmes

                      Comment


                      • Re: INDONESIA - Garut Cluster Part II

                        Someone on another board mentioned that Umar was also being treated (part of his follow up) at Pameungpeuk Community Health Centre, so maybe that's the nearest "hospital" to Cikelet. In which case, that leaves room for Gilang to be from Cikelet as well.

                        Hat-tip, MomCares!
                        ...when you have eliminated the impossible, whatever remains, however improbable, must be the truth. - Sherlock Holmes

                        Comment


                        • Re: INDONESIA - Garut Cluster Part II

                          Approximate location of Cikelet subdistrict on southwest coast of Java plotted on United Nation population map from July 2006. Local names do not match any listed for the subdistrict.

                          7 Desa / villages: Cikelet, Linggamanik, Kertamukti, Cigadog, Pamalayan, Karangsari and Cijambe
                          source for map: http://unosat.web.cern.ch/unosat/

                          Click image for larger version

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                          http://novel-infectious-diseases.blogspot.com/

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                          • Re: INDONESIA - Garut Cluster Part II

                            Originally posted by Theresa42
                            Someone on another board mentioned that Umar was also being treated (part of his follow up) at Pameungpeuk Community Health Centre, so maybe that's the nearest "hospital" to Cikelet. In which case, that leaves room for Gilang to be from Cikelet as well.

                            Hat-tip, MomCares!

                            According to a tourist pamphlet for Garut, Pameungpeuk is 86 km, a 3.5 hour ride, from Garut. A nearby resort is at the very bottom of page 10.

                            http://www.garut.go.id/static/engli...tourism%20%2 2

                            I wonder if Gilang was exposed to Umar or someone else with bird flu in that facility.
                            Absence of evidence is not evidence of absence

                            Comment


                            • Re: INDONESIA - Garut Cluster Part II

                              Another map of area around Pameungpeuk from 1954. No villages names here either.

                              From a 1:250,000 topographic map "Garut, Indonesia"


                              source map: http://www.lib.utexas.edu/maps/ams/i...61-sb49-13.jpg

                              Click image for larger version

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                              http://novel-infectious-diseases.blogspot.com/

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                              • Re: INDONESIA - Garut Cluster Part II

                                Has Indonesia's Monday news come out yet on what's going on with this cluster? It sounds pretty serious to me.

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