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Re: Indonesia 5/24
Bird flu team 'too late'
From: The Australian
By Clara Pirani
May 26, 2006
DELAYS in the investigation of the world's largest outbreak of bird flu may prevent health officials from ever knowing if human-to-human transmission of the disease killed six members of the same family in Indonesia.
A team of the world's leading avian flu experts has arrived in the remote village of Kubu Sembelang in North Sumatra to investigate the deaths, which occurred during the past three weeks.
However, the director of the World Health Organisation's Collaborating Centre for Reference and Research on Influenza in Melbourne, Ian Gust, said most of the evidence would already have been destroyed.
"We've found with the investigation of clusters in the past that by the time the investigators get there, it's too late," he said yesterday. "Any infected birds that might have been around have gone or been killed.
"You can't take the adequate samples and you'll never know the cause, and that's a problem."
Indonesian health officials were not responding quickly enough to potential cases of the disease, Dr Gust told The Australian.
"Indonesia is still struggling with it. Vietnam, which had a very serious problem with bird flu, has essentially brought it under control by very vigorous health measures, whereas Indonesia is still getting lots of outbreaks in birds and lots of cases in humans," Dr Gust said.
Vietnam reported 61 cases of bird flu last year, including 19 deaths - significantly more than any other country.
Twenty-two people have died of bird flu in Indonesia this year while Vietnam has experienced no new cases.
Peter Cordingley, spokesman for the WHO's West Pacific region, said investigators were concerned about the cluster of deaths in North Sumatra - the largest to date - and the source of the outbreak.
He said they had not found any infected poultry in the village.
"When we can't find a common outside source, we have to look at the potential for human-to-human transmission," he said.
Infected poultry has been the source of the majority of human infections worldwide. However, the WHO suspects human-to-human transmission may have caused up to half a dozen previous clusters in recent years.
Mr Cordingley said there was no effective test to confirm human-to-human transmission.
"We've had very strong evidence of human-to-human transmission before, but in the end we haven't been able to draw any further conclusions, so we just don't know," he said.
Seven members of the same family in North Sumatra contracted the disease and six have died in the past three weeks.
An eighth family member, the first to become ill, died on May 4, but no samples were taken to confirm the cause of death.
Two of the men who died spent the night of April 29 in a small room with their mother - the first family member to fall ill - who was reportedly coughing frequently. A third son has the disease and is the sole surviving family member.
Another family member, a 32-year-old father, died on Monday after caring for his sick son.
Other infected family members lived in adjacent homes.
The H5N1 virus has killed 124 people since 2003 and more than 30 countries have reported outbreaks in poultry or wild birds.
The WHO has previously warned that clusters of the disease are considerably more dangerous than isolated infections because they raise the possibility that the virus might have mutated, allowing it to spread rapidly among humans, and sparking a pandemic that could kill millions of people.
However, Mr Cordingley said there was no evidence of spread within the general community with the latest cluster.
"Nobody outside the family shows any sign of infection, so we don't have a virus on the run," he said. "The virus samples from those who died shows the virus is not mutating and it shows no new ability to mutate from chickens to humans."
Bird flu team 'too late'
From: The Australian
By Clara Pirani
May 26, 2006
DELAYS in the investigation of the world's largest outbreak of bird flu may prevent health officials from ever knowing if human-to-human transmission of the disease killed six members of the same family in Indonesia.
A team of the world's leading avian flu experts has arrived in the remote village of Kubu Sembelang in North Sumatra to investigate the deaths, which occurred during the past three weeks.
However, the director of the World Health Organisation's Collaborating Centre for Reference and Research on Influenza in Melbourne, Ian Gust, said most of the evidence would already have been destroyed.
"We've found with the investigation of clusters in the past that by the time the investigators get there, it's too late," he said yesterday. "Any infected birds that might have been around have gone or been killed.
"You can't take the adequate samples and you'll never know the cause, and that's a problem."
Indonesian health officials were not responding quickly enough to potential cases of the disease, Dr Gust told The Australian.
"Indonesia is still struggling with it. Vietnam, which had a very serious problem with bird flu, has essentially brought it under control by very vigorous health measures, whereas Indonesia is still getting lots of outbreaks in birds and lots of cases in humans," Dr Gust said.
Vietnam reported 61 cases of bird flu last year, including 19 deaths - significantly more than any other country.
Twenty-two people have died of bird flu in Indonesia this year while Vietnam has experienced no new cases.
Peter Cordingley, spokesman for the WHO's West Pacific region, said investigators were concerned about the cluster of deaths in North Sumatra - the largest to date - and the source of the outbreak.
He said they had not found any infected poultry in the village.
"When we can't find a common outside source, we have to look at the potential for human-to-human transmission," he said.
Infected poultry has been the source of the majority of human infections worldwide. However, the WHO suspects human-to-human transmission may have caused up to half a dozen previous clusters in recent years.
Mr Cordingley said there was no effective test to confirm human-to-human transmission.
"We've had very strong evidence of human-to-human transmission before, but in the end we haven't been able to draw any further conclusions, so we just don't know," he said.
Seven members of the same family in North Sumatra contracted the disease and six have died in the past three weeks.
An eighth family member, the first to become ill, died on May 4, but no samples were taken to confirm the cause of death.
Two of the men who died spent the night of April 29 in a small room with their mother - the first family member to fall ill - who was reportedly coughing frequently. A third son has the disease and is the sole surviving family member.
Another family member, a 32-year-old father, died on Monday after caring for his sick son.
Other infected family members lived in adjacent homes.
The H5N1 virus has killed 124 people since 2003 and more than 30 countries have reported outbreaks in poultry or wild birds.
The WHO has previously warned that clusters of the disease are considerably more dangerous than isolated infections because they raise the possibility that the virus might have mutated, allowing it to spread rapidly among humans, and sparking a pandemic that could kill millions of people.
However, Mr Cordingley said there was no evidence of spread within the general community with the latest cluster.
"Nobody outside the family shows any sign of infection, so we don't have a virus on the run," he said. "The virus samples from those who died shows the virus is not mutating and it shows no new ability to mutate from chickens to humans."
], Kandun said the teenager exhibited the same clinical symptoms as his sister.
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