No announcement yet.

AFD - Indonesian Outbreaks August 2008

  • Filter
  • Time
  • Show
Clear All
new posts

  • AFD - Indonesian Outbreaks August 2008

    No News Is Bad News

    # 2197

    It has been over six weeks since the last `monthly' update on bird flu cases was released from Indonesia's government. The last official statement came from the WHO on June 19th.

    19 June 2008 -- The Ministry of Health of Indonesia has announced two new cases of human H5N1 avian influenza infection. The cases are not linked epidemiologically. The first is a 16-year-old female from South Jakarta, DKI Jakarta Province developed symptoms on 7 May, was hospitalized on 12 May and died on 14 May. Investigations into the source of her infection indicate exposure to sick and dead poultry.

    The second case is a 34-year-old female from Tangerang District, Banten Province who developed symptoms on 26 May, and was hospitalized on 2 June and died on 3 June. Investigations into the source of her infection are ongoing.
    Of the 135 cases confirmed to date in Indonesia, 110 have been fatal.

    We continue to get sporadic newspaper reports from the local media indicating suspected cases, but thus far, no official confirmation.

    Right now, we are watching the case of a 19-year-old who died in Tangerang, suspected of having the H5N1 virus.

    No test results have been released, however - so this remains just a suspect case.

    A hat tip to Commonground on Flutrackers for this translation.

    Helped buried the chicken died.

    Tangerang - After could be treated two days in Tangerang space of the isolation of Public Hospital bird flu, the Bachelor (Joko), 19 years, the resident of the Village of Jambu Tegal, RT 06/02, the Village JambuGreat, the Rejeg Subdistrict, the Tangerang Regency, died.

    The employee of the factory in the region of Cikupa Tangerang experienced breathless great and died last Thursday in struck 22,00 WIB.

    Section Head Kesehatan of the Regency Tangerang Hani Heryanto says up to now was not yet known whether the Bachelor was infected by the virus H5N1 or not. Was researched, said he yesterday.

    According to Hani, if being seen from the biography of casualties, he once contact with the poultry of two last week. "In his residence had the poultry died," said he. However, he still will investigate further to confirm whether the Bachelor contracted bird flu or because of the other illness.

    Moreover, Hani added, the Service sent the sample of blood, the saliva, and the waste of casualties to the Penelitian Departemen Hall of the Health. The blood inspection to closest people of casualties also was carried out. Officially Peternakan, said he, has checked the poultry in the environment of the Bachelor's residence.

    According to Anang, casualties's father, the indication of the bird flu illness that was suffered by Joko it was said the team of the doctor. However, the assurance was still being waiting for the example inspection of the Bachelor's blood.

    July and August are traditionally slow months for bird flu news. But not usually this slow.

    With the recent lockdown of news out of Indonesia, government sensitivity over any bad press during the Olympics in China, and growing restrictions of freedom of the press in Egypt, getting reports from hot-zone countries is getting harder.

    Obviously, if there is a major outbreak, these countries won't be able to hide it for long. That's a small comfort, anyway.

    For now, though, we are in danger of being lulled into believing that the bird flu threat disappeared. That no news is good news. That a lack of reporting meant that the virus has gone away.

    It hasn't, of course.

    But without cases being reported in real time - and full transparency by hot-zone countries - we lose an important advantage. Early warning that things may be heating up, and of course, scientific evidence of changes to the virus.

    Hopefully international pressure will be brought to bear on nations that hide, obfuscate, or bury news of bird flu outbreaks, and in particular, human cases.

    But for now, their policy of controlling the news seems to be working.

    posted by FLA_MEDIC @ 11:24 AM

  • #2
    Re: AFD - Indonesian Outbreaks August 2008

    Indonesian Official Confirms Latest Bird Flu Fatality

    # 2199

    The reports of a 19-year-old's death from the bird flu virus in Tangerang, Indonesia have now been confirmed by a top health official in that country.

    No other details have been officially released.

    Flu forum newshounds first picked up on this case a couple of days ago, and I reported on it yesterday morning. Local media reported that the man, named Joko, died last Thursday.

    Indonesian man dies of bird flu, official says

    JAKARTA, Indonesia - An Indonesian factory worker died of bird flu, bringing the death toll in the country worst hit by the virus to 112, a top health official said Sunday.

    The 19-year-old died last week in a hospital just west of the capital, Jakarta, Nyoman Kandun, the director general of communicable disease control at the Health Ministry, said by text message. He gave no additional information.

    Indonesia has regularly recorded human deaths from bird flu since the virus began ravaging poultry stocks across Asia in 2003. Its toll of 112 accounts for nearly half the 240 recorded fatalities worldwide.

    Bird flu remains hard for people to catch, but health experts worry that the virus could mutate into a form that passes easily between humans, possibly triggering a pandemic that could kill millions. So far most human cases have been linked to contact with infected birds.
    Scientists have warned that Indonesia, which has millions of backyard chickens and poor medical facilities, is a potential hot spot for the start of a global pandemic.

    posted by FLA_MEDIC @ 12:15 AM


    • #3
      Re: AFD - Indonesian Outbreaks August 2008

      Indonesia: Suspected Bird Flu Outbreak

      # 2209

      I say `suspected' because right now, we don't have any test results to confirm the cause of this illness which has struck a village in North Sumatra.

      The symptoms are described as `bird-flu like', prompting the headlines. Early reports put the number of deaths at 3, with 13 others hospitalized.

      If this should prove to be avian flu - and all of these cases are related - this would be the largest known cluster in Indonesia and would rival the size of the Turkish cluster in 2006.

      Obviously this is a situation we need to watch closely, although we should keep in mind that early reporting can often be misleading.

      This report from the Straits Times.

      Aug 6, 2008

      3 dead in feared bird flu outbreak in Indonesia: officials

      MEDAN (Indonesia) - THREE people have died and 13 have been admitted to hospital with symptoms of bird flu in Indonesia, a nurse treating the patients said on Wednesday.

      Officials and residents in Asahan district of North Sumatra province said villagers began showing symptoms of avian flu after a large number of chickens died suddenly last week.

      The nurse at Asahan district's Kisaran hospital said three people had died after suffering bird flu-like symptoms in Air Batu village.

      'According to residents there, a number of chickens died suddenly last week followed by several pigeons. Days later, three people died with the same ailments,' the nurse, Mariana, said.

      Another 13 people had been admitted to the hospital with 'high temperatures and respiratory problems,' she said.

      Two of these - a baby boy and a seven-year-old girl - were transferred early Wednesday to a bird flu isolation unit at Adam Malik hospital in the provincial capital of Medan, officials said.

      Adam Malik hospital spokesman Sinar Ginting confirmed that blood samples from the two children were sent Wednesday to a health ministry laboratory in Jakarta for analysis.

      'We are now waiting for the result,' he said.

      The father of the baby boy, Slamet Riadi, said a lot of poultry had died in the village a week ago. His baby developed a high fever and respiratory problems shortly afterward.

      A spokesman for the health ministry could not be reached for comment. (Continue)

      posted by FLA_MEDIC @ 8:29 AM 1 comments


      • #4
        Re: AFD - Indonesian Outbreaks August 2008

        FluTrackers thread on this subject here


        • #5
          Re: AFD - Indonesian Outbreaks August 2008

          Premature Headlines

          # 2210

          The story out of Indonesia, currently finding its way into many newspapers around the world, is for now just a suspect outbreak.

          Until tests are conducted, we can't know if this is avian flu.

          A few newspapers, regrettably, are leaving the word `suspected' out of their headlines.

          Bird flu outbreak in Indonesia kills 3 : Officials


          Published: Wednesday, August 06, 2008

          MEDAN, Indonesia - Three people have died and 13 have been admitted to hospital with symptoms of bird flu in Indonesia, a nurse treating the patients said Wednesday.

          Officials and residents in Asahan district of North Sumatra province said villagers began showing symptoms of avian flu after a large number of chickens died suddenly last week.

          The nurse at Asahan district's Kisaran hospital said three people had died after suffering bird flu-like symptoms in Air Batu village.

          I'm sure that this sort of headline draws more attention to the article, but it is a bit premature. We don't know if this is a bird flu outbreak at this point.

          When the reader follows the headline and reads the story, the article does make the important distinction that confirmatory tests are still awaited, but not everyone will read the entire article.

          An outbreak of this size, if it is indeed caused by the H5N1 virus, is a big story. And we may find that this is, indeed, the case.

          But for now, we need to view these reports with a bit of skepticism. The numbers of those affected appear to be fluid, and the only quoted source has been a nurse from a local hospital.

          If this turns out to be avian flu, we'll know soon enough.

          posted by FLA_MEDIC @ 10:52 AM


          • #6
            Re: AFD - Indonesian Outbreaks August 2008

            TV News Coverage Of Indonesian Story

            # 2211

            We now are getting video, carried by MetroTV news in Indonesia, on the suspected outbreak in North Sumatra.

            From the video it is obvious that a good many reporters are on the ground and covering this story.

            I've machine translated the story on the website, and you can view the video by following the link. The language spoken is Indonesian in this video report.

            Two children shavings were expected by BIRD FLU

            On Wednesday, August 06 2008 17:10 WIB
  , Medan: the Case of the assumption of bird flu was again found in Medan, North Sumatra. Today, two people who were expected flattest bird flu entered the Public Hospital of Pusat Adam Malik Medan.

            The two patients came from Air Batu, Kabupaten Asahan, North Sumatra. Both of them currently improve after by the medical team continued to be given tamiflu.

            The reporter Metro TV Andrea Sentanti reported, the two patients were Muhammad Sani Muflih, pre-schoolers were eight months old and Fadillah Hanum was seven years old. They arrived in RSUP Adam Malik struck 02,00 at dawn earlier.

            Currently, both of them were isolated in handling space suspect bird flu of RSUP Adam Malik. This in accordance with the reconciliation letter from the origin hospital of the two patients was treated, namely the Public Hospital of Daerah Abdul Manan, Kisaran.

            The assumption both of them flattest bird flu strengthened because according to one of the parents of the patient, in their territory remained at many chicken livestock that died suddenly.

            Moreover, in a last week, three local residents died. Originally they experienced breathless and hot high. According to Sublime parents, in their village was gotten by 10 people who experienced the same matter. And they are currently treated in RSUD Abdul Manan.

            Some video captures from the news report showing two patients in isolation, neither of whom appear to be in distress.

            posted by FLA_MEDIC @ 11:20 AM


            • #7
              Re: AFD - Indonesian Outbreaks August 2008

              The Sound Bite And The Fury

              # 2213

              Yesterday the summer doldrums were abruptly broken by news out of Indonesia that 3 people had died, and 13 more were hospitalized in a tiny village in North Sumatra, and that bird flu was suspected.

              This suspected diagnosis, tentative and unconfirmed, was credited in most early news reports to comments made by an unnamed nurse at the hospital where a number of the patients were being treated.

              Since that time, practically every major news organization around the world has picked up, and run with this story. Here are a few examples of headlines overnight:

              Thirteen more bird flu suspects detected in North Sumatra Jakarta Post - National News 07:37
              Three Dead In Bird Flu Outbreak In Sumatra Nasdaq - Global Markets 06:47
              Three die in bird flu outbreak in Sumatra Gulf Times - Philippines/East Asia 06:35
              Three dead in bird flu outbreak in Indonesia The Peninsula - World News 01:33
              Suspected bird flu strikes Sumatra TV3 - Latest News 00:56
              Notice how some newspaper headlines have screamed `Bird flu Outbreak', while other's have more judiciously inserted the word `Suspected' into their titles.

              In any event, nearly 24 hours after those first reports surfaced, we don't know much more than we did when all of this started. Each news wire story seems to be a rehash of earlier reports, adding very little of note.

              From the symptoms described in the early news accounts, these suspected cases could be suffering from a great many diseases, of which the H5N1 bird flu virus is only one. Malaria, Dengue, Chikungunya, and even seasonal flu are all possibilities, along with more exotic diseases as well.

              The recent poultry deaths in the village, which some reports have claimed tested positive for the H5N1 virus (other accounts dispute that), are circumstantial evidence at best.

              Maybe this is a bird flu outbreak, and maybe it isn't.
              For now, I have no feeling either way as to what is really going on in North Sumatra. We simply don't have enough evidence to judge.

              Today, in fact, some news accounts appear to be backing off on the presumptive `bird flu' angle just a bit.

              This from Reuters.

              Indonesia testing 13 for bird flu in Sumatra village

              JAKARTA (Reuters) - Thirteen people from a village in North Sumatra are due to be tested for bird flu after falling sick, Indonesian health officials said on Thursday.

              The 13, from Air Batu village, were hospitalised this week after suffering fever, but their conditions had improved on Thursday and they might not be suffering from the disease, a health official said.

              A bird flu surveillance team from Indonesia's health ministry has been sent to the area.
              (Continue. . . )

              This, of course, may be nothing more than Indonesian damage control at work. Testing is underway, and we should know in the next few days.

              If this is the real deal, we'll know soon enough.

              In the meantime, I, along with the rest of the flu bloggers (see the sidebar links) will continue to cover this story as events unfold.

              Stay tuned.

              posted by FLA_MEDIC @ 6:05 AM


              • #8
                Re: AFD - Indonesian Outbreaks August 2008

                Indonesia: Culling In Village With Suspected Bird Flu Cases

                # 2218

                Nearly 48 hours since the first stories broke from North Sumatra and we still don't know if any of the 13 hospitalized patients from the Air Batu village are suffering from the H5N1 `bird flu'.

                Tests are pending, and we are reliant on an increasingly recalcitrant Indonesian government to relay the results to the press. One can only hope that the vigorous attention being paid by the local and international media will help convince authorities to release this data quickly.

                As far as the three fatalities in the Air Batu village, their bodies were quickly buried and no samples were taken for testing. We will probably never know what they died of.

                While test results for the remaining patients are awaited, culling of birds and disinfecting of backyard coops is underway in the affected village.

                For now, while bird flu is suspected, we don't know the cause of this outbreak.

                This from The Australian.

                Birds slaughtered as flu breaks out

                From correspondents in Jakarta | August 08, 2008
                HUNDREDS of chickens and ducks have been slaughtered to contain a suspected bird flu outbreak in Indonesia as 13 people with flu-like symptoms await laboratory results.

                Thirteen people were hospitalised earlier this week with fevers and respiratory problems after a large number of chickens died suddenly in their village in North Sumatra province.

                Two of them, a baby boy and a seven-year-old girl, have been put in a bird flu isolation unit at a hospital in the provincial capital Medan.

                "We have taken measures since Tuesday when we found strong indications of bird flu virus in some 100 chickens and ducks in several places in Air Batu village," said local husbandary office chief Oktoni Eryanto.

                At least 400 birds have been slaughtered and burned, and officials were continuing to spray backyard coops with disinfectant, he said.

                "We don't need to send samples from the poultry to a laboratory because it's pretty clear that the cause is the bird flu virus," he said.

                "Preventive action is more important to control it.

                (Continue . . .)
                posted by FLA_MEDIC @ 6:38 AM


                • #9
                  Re: AFD - Indonesian Outbreaks August 2008

                  Media Report: WHO Monitoring Air Batu Village

                  # 2221

                  While we are still unsure as to exactly what has caused the disease outbreak in the North Sumatra Village of Air Batu, according to local media sources the WHO (World Health Organization) now has a team on the ground in the area.

                  Earlier this week we learned of 13 villagers hospitalized with `bird flu-like symptoms', and of the deaths of 3 others in the village last week. We are awaiting test results before we can know the cause of their illness.

                  This report from Kompas indicates that some WHO team members are in the village, while others are visiting the patients in the hospital.

                  Additionally, culling of birds has been completed within 1 kilometer of the birds that tested positive for the H5N1 virus.

                  In the article below, `socialisation ' refers to public education.

                  A Hat tip to Dutchy on Flutrackers for posting this translation from

                  WHO is Monitoring Bird Flu in Air Batu

                  Sabtu, 9 Agustus 2008 | 00:59 WIB

                  The Head of the Health Section of the Province North Sumatran Candra Syafii in Medan, on Friday (8/8), said a team from the Organisation of the Health of the World (WHO) descended to monitor the development of the case of bird flu in Air Batu.

                  Some of the team's members saw directly the patient in RSUP Adam Malik, Medan, another part was in the Air Batu Village, Kecamatan Air Batu, Asahan.

                  They, said Candra, held investigation and the monitoring of the development of the illness (surveilans epidemiology). The team will be in North Sumatra until this case could be handled.

                  In the meantime, the Section Head Veteriner Dinas Peternakan North Sumatra Nurdin Lubis said, the extermination of the poultry has in the location been finished.

                  The team destroyed the poultry, especially in the radius one kilometre from the discovery of the positive case of the virus attack H5N1 in the village. ? We also has sprayed disinfectant in the pen and the settlement of the resident that we thought as the place of the development of the virus ,? he said.

                  The official of the combination, said Nurdin, continued to give the socialisation to the resident concerning bird flu. This socialisation was important to stifle the panic.
                  posted by FLA_MEDIC @ 4:30 PM


                  • #10
                    Re: AFD - Indonesian Outbreaks August 2008

                    Indonesia: Villagers Test Negative For Bird Flu

                    # 2222

                    Seventy-two hours after the story first broke, we are now getting word from Indonesia's Health Ministry that the thirteen villagers in Northern Sumatra have tested negative for the H5N1 virus.

                    Obviously good news. Not only for those who fell ill, but for the world.

                    The cause of their illness was not identified, nor do we know what took the lives of 3 villagers who first fell ill more than a week ago. Indonesia is rife with a variety of tropical diseases, however, and H5N1 isn't the only one capable of taking lives.

                    The other `good news', beyond the fact that this didn't turn out to be a bird flu outbreak, is that our hard working Internet newshounds picked up on this story early, and kept us informed every step of the way.

                    This bodes well for our ability to pick up on any future outbreaks. My thanks go to everyone who worked on finding these news items, translating or analyzing them.

                    This report from Reuters.

                    Indonesian villagers cleared of bird flu
                    August 9, 2008 Saturday

                    JAKARTA - THIRTEEN people from a village in Indonesia's Sumatra island who were hospitalised this week after showing symptoms of bird flu have tested negative for the H5N1 virus, a health ministry official said on Saturday.

                    The 13, including a seven-year-old girl and an eight-month-old child, had developed fever after a large number of chickens died in Air Batu village in North Sumatra province.

                    'Test results were negative for all suspected cases,' said Mr Nyoman Kandun, the health ministry's director-general of communicable disease control.

                    Suspected cluster cases can raise concerns about rare human-to-human transmission or that the virus might have mutated into a form that can pass easily among people, triggering a pandemic.


                    posted by FLA_MEDIC @ 7:22 AM


                    • #11
                      Re: AFD - Indonesian Outbreaks August 2008

                      Saturday, August 09, 2008

                      <!-- Begin .post --> The Veracity Drag

                      # 2223

                      With the announcement this morning that the 13 suspect Bird flu cases in North Sumatra tested negative for the H5N1 virus, many veteran observers are left with a bit of a dilemma.

                      Whether or not to believe the `official story'.

                      I'd like to, of course.

                      I'd much prefer to believe that the past few days has been a false alarm. And admittedly, right now, I see no solid evidence to counter the Indonesian government's claim.

                      Unfortunately, Indonesia has squandered much of their credibility on the bird flu issue over the past year or so by refusing to share virus samples with the rest of the world, despite the fact that numerous strains of the H5N1 virus now appear to be circulating in that nation.

                      In recent months, they've even delayed (for weeks) notifying the WHO (World Health Organization) and the press when human cases have been detected.

                      Simply put, Indonesia is systematically - and without visible shame -suppressing bird flu news in their country.

                      The Health Minister, Supari, has publicly stated that it harms their nation to talk about cases.

                      And in fact, it probably does.

                      Indonesia is a poor nation, struggling with economic woes, chronic infrastructure problems, an inefficient central government, and all-to-frequent natural disasters. They desperately need to attract foreign investments, and tourist dollars.

                      Constant talk of bird flu outbreaks, whether it be in poultry, or in people, is like an economic death of a thousand cuts for Indonesia. It isn't hard to understand why they are trying to quash bird flu stories.

                      Of course understanding their reasons falls far short of approving of their methods. Indonesia is playing a very dangerous game, both for them and the rest of the world, for a potential short-term gain.

                      Of all of the nations in the world, Indonesia is probably the mostly likely to birth an H5N1 pandemic strain. And if that happens, it will have global ramifications.

                      For now we are left with a great many questions regarding the events in North Sumatra, and only one cryptic, and vaguely unsatisfying text message from a government not known for their veracity in these matters.

                      That these villagers didn't have the H5N1 virus.

                      Obviously, I have no way of knowing if it they did or they didn't.

                      For now, I am tentatively accepting the Indonesian government's announcement simply because I have no information with which to dispute it.

                      That doesn't mean that I am completely comfortable with it.

                      It would have been nice to get some kind of diagnosis, some indication as to what claimed 3 lives and hospitalized 13 others.

                      Simply saying it wasn't bird flu doesn't inspire much confidence.

                      And third-party laboratory confirmation of these negatives would have been nice (but unlikely, given Indonesia's insistence on protecting their `intellectual property').

                      Perhaps we will get more clarification on these issues over the next few days.

                      That there were only 3 fatalities out of 16 suspected cases, in a nation where the CFR (case fatality ratio) has been greater than 80%, tends to argue against this being H5N1.

                      Of course, we desperately hope that if the virus does learn to transmit from person-to-person, that it loses some of its pathogenicity. So a lesser fatality rate doesn't completely rule out bird flu.

                      Inaccurate test results are not uncommon, and it generally requires multiple positive tests before Indonesia will accept that a patient is, in fact, infected. The testing sensitivity is poor, and is thought to degrade further once a patient is placed on Tamiflu.

                      And reports of other villagers with `flu-like symptoms' aside, we've heard of no new serious cases warranting hospitalization over the past 4 days. That would seem to be a good sign.

                      We could, of course, simply be seeing an effective use of a Tamiflu blanket.

                      Point. Counter-point.

                      And without better `facts', we could go back and forth like this all night, to little avail.

                      If Indonesia were perceived as being open and transparent about their bird flu problem, and interested in protecting the world against the ravages of a pandemic, it would be far easier to accept their pronouncements.

                      But credibility, once lost, is most difficult to rebuild. And without credibility, even the truth becomes suspect.

                      If there is more to this story, it will probably become apparent over the next few weeks. It would be difficult to conceal an extended outbreak for long.

                      But it is a pity that we can't just automatically assume that Indonesia is telling the truth when they declare than an outbreak is something other than bird flu.

                      By their actions, they have earned our wariness and mistrust. And so we are left with but one option.

                      To wait and watch to see what happens next.

                      posted by FLA_MEDIC @ 7:21 PM


                      • #12
                        Re: AFD - Indonesian Outbreaks August 2008

                        Tuesday, August 12, 2008

                        <!-- Begin .post --> North Sumatra Remains Under Alert

                        # 2228

                        Over the weekend Indonesia's Health Ministry announced that test results on 13 villagers from North Sumatra were negative, and that they were cleared of having the H5N1 bird flu virus.

                        Today we learn from the Jakarta Post that local Health Department officials aren't completely ready to accept those results, and that a KLB ("extraordinary occurrence") alert status remains in place.

                        The WHO (World Health Organization) investigation team reportedly remains in the village, and local officials continue to talk about this incident as if it were still a possible bird flu outbreak.

                        What to make of all of this?

                        Obviously, something is going on in North Sumatra, and local officials are clearly worried. After all, three people did die after the recent sudden deaths of poultry in the village of Air Batu, and 13 others were sickened enough to require hospitalization.

                        There have been reports of other villagers, as well, complaining of `flu-like' symptoms, and the area reportedly has been flooded with Tamiflu.

                        Whether it is bird flu or not remains to be seen, but health officials on the ground apparently are not willing to take chances.

                        At least not until more test results are returned.

                        This report from the Jakarta Post.

                        Tuesday, August 12, 2008 5:24 PM

                        N. Sumatra remains alert against bird flu outbreak

                        Apriadi Gunawan , The Jakarta Post , Medan | Tue, 08/12/2008 10:17 AM | Headlines

                        The North Sumatra Health Office remains on "extraordinary occurrence" (KLB) alert status following the deaths of three people and the hospitalization of 13 others believed to have contracted bird flu.

                        Office head Chandra Syafei Monday said his office had imposed KLB status because it had so far not received autopsy reports to determine the causes of deaths from the Health Ministry, including results on blood samples and bodily fluid from the patients from Air Batu district in Asahan regency.

                        Chandra said he personally learned that the patients' blood tests were negative for bird flu from the ministry's website, but remained wary due to the lack of an official report from the ministry.

                        "So far there has yet to be any report specifying whether the three victims in Asahan were positively or negatively infected with the bird flu virus. If the results are positive, we will have to monitor the area longer," Syafei told The Jakarta Post in Medan on Monday.

                        Chandra said a number of health workers were still in Asahan to monitor the situation.

                        "We are on full alert to monitor developments of a bird flu outbreak in Asahan. A team from the World Health Organization is still there to investigate the case," said Chandra.

                        He added that health officials were focusing on the three fatalities and the 13 current patients showing symptoms consistent with bird flu.

                        Chandra said so far those involved in the investigation could not determine the causes of death of the three victims and the 13 currently hospitalized.

                        "The three people died following the discovery of dead poultry, but we don't know whether or not it was the cause," Chandra added.

                        Chandra said authorities had disposed of 276 infected birds in Asahan and would continue to slay birds believed to be infected with virus.

                        Nearby Labuhan Ratu regency has killed 1,126 birds after seeing hundreds suddenly die in the past week.

                        Labuhan Batu Vice Regent Sudarwanto said the virus had affected the poultry population in six subdistricts of North Rantau: Padang Bulan, Cendana, Lobusona, Sirandorung, Ujung Bandar and Padang Matinggi.

                        Sudarwanto said his office had taken several measures to prevent the spread of the disease, such as disposing of birds, conducting public awareness campaigns and using rapid testing. It has also set up posts in bird flu-prone areas.

                        "We have so far carried out various anticipatory measures to curb the virus spread, and we urge people to remain alert," Sudarwanto said.

                        Interestingly, this newspaper story states that officials are awaiting `autopsy reports' and a determination of the `cause of death' of the three early victims of this outbreak.

                        We've been told, repeatedly, that the first three victims were buried more than two weeks ago without testing. Autopsies are rarely done in Indonesia due to religious and social objections, and exhumations are even less likely.

                        If exhumations and autopsies have actually been performed, then officials have been taking extraordinary steps (for Indonesia) to determine the cause of this outbreak.

                        News reporting being what it is in Indonesia, I'll need to see the autopsy results before I believe they've been performed.

                        Until we know more about what killed these 3 villagers, and sickened more than a dozen others, I'm taking some heart in the fact that local officials are willing to continue to investigate this matter, despite the bland assurances of Indonesia's Health Ministry.

                        posted by FLA_MEDIC @ 7:43 AM


                        • #13
                          Re: AFD - Indonesian Outbreaks August 2008

                          Thursday, August 14, 2008

                          <!-- Begin .post --> CIDRAP News On North Sumatra

                          # 2233

                          CIDRAP (Center for Infectious Disease Research & Policy) News, out of the University of Minnesota, has an excellent overview about what we know (and don't know) about the events in North Sumatra over the past couple of weeks.

                          I've just posted the opening paragraphs to Lisa Schnirring's story. Please follow the link to read the entire article.

                          Indonesia rules out H5N1 case cluster in Sumatra

                          Lisa Schnirring Staff Writer

                          Aug 13, 2008 (CIDRAP News) ? In an online statement posted yesterday, the Indonesian government said 12 villagers from North Sumatra who were hospitalized for suspected avian influenza symptoms had tested negative for the disease, dampening speculation about a possible case cluster.

                          The statement from the health ministry's avian flu committee, known as KOMNAS FBPI, was dated Aug 9, but appeared on the group's Web site yesterday. It said 12 villagers from Air Batu village tested negative for the H5N1 virus. All were being treated at Kisaran Hospital, except for a 7-year-old girl and an 8-year-old boy who were at Adam Malik Hospital in Medan, the provincial capital, where they were reported to be in stable condition.

                          The ministry's statement did not mention three deaths from suspicious symptoms that have been mentioned along with accounts of up to 13 sick patients in recent media reports. Yesterday, however, Chandra Syafei, an official from North Sumatra's health office, acknowledged that three people had died and said his office was on "extraordinary occurrence" alert status, according to a Jakarta Post report.

                          "The three people died following the discovery of dead poultry, but we don't know whether or not it [avian influenza] was the cause," Chandra told the Post. He said his office had not received autopsy reports from the health ministry.

                          (Continue Reading . . . )
                          posted by FLA_MEDIC @ 7:19 AM


                          • #14
                            Re: AFD - Indonesian Outbreaks August 2008

                            the AFD-entries are so many and so long, I wished
                            there were shorter versions too, summaries or abstracts.

                            So you needn't read the whole article before you decide whether
                            you want to read it all all
                            I'm interested in expert panflu damage estimates
                            my current links: ILI-charts:


                            • #15
                              Re: AFD - Indonesian Outbreaks August 2008

                              May 14: 16 year old female died
                              June 3: 34 year old felale died
                              Aug. 8: hundreds of poultry culled
                              19 year old male died prior to August 22
                              Aug. 6: 3 deaths from bird-flu like symptoms, 13 others hospitalized
                              Aug. 9: WHO team arrives
                              Aug. 9: Test results are negative
                              Aug. 12: KLB (extraordinary occurrence) alert status remains in place
                              Health office remains wary of test results, due to lack of an official report
                              Officials are awaiting autopsy results
                              The salvage of human life ought to be placed above barter and exchange ~ Louis Harris, 1918