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INTERVIEW-Experts track contacts of Indonesian family cluster
http://www.alertnet.org/thenews/newsdesk/HKG166549.htm
<!-- 24 May 2006 10:31:56 GMT ## for search indexer, do not remove--> 24 May 2006 10:31:56 GMT Source: Reuters
By Tan Ee Lyn JAKARTA, May 24 (Reuters) - Health experts are tracing anyone who might have had contact with an Indonesian family struck down by bird flu and is putting them on anti-viral drugs as a precaution, a senior WHO official said. Seven of the family members died this month but so far there is no evidence of anyone else being infected, the World Health Organisation has said.
"We are going wide, contacting the various contacts, putting on (anti-viral) Tamiflu whoever has had close contact, basically putting family members who have not been affected on Tamiflu as a precaution," Firdosi Mehta, acting representative of the WHO in Indonesia told Reuters. "There is active surveillance in the village, fever surveillance to look for any more cases that are occurring outside this immediate family cluster," he said.
The H5N1 bird flu virus infected as many as eight members of the family in the remote village of Kubu Sembilang in north Sumatra. It is the largest bird flu family cluster known to date and has drawn an enormous amount of attention from medical experts. Clusters are looked on with far more suspicion than isolated infections because they raise the possibility that the virus might have mutated to transmit more efficiently among humans.
That could spark a pandemic that can kill millions.
But Mehta urged against any over-reaction, saying this was not the first cluster that the world has known. He added it was little different from other family clusters that have been documented in the past in Hong Kong, Thailand and Vietnam.
Such limited human-to-human transmissions of the virus are invariably, up till now, the result of very close and prolonged contact when a person takes care of a sick relative who is coughing and probably infectious. HUMAN TRANSMISSION VERY HARD TO PROVE "This is not the first time, and we cannot conclusively discard or prove this to be human-to-human transmission," Mehta said, echoing a statement made by the WHO.
On Tuesday, the WHO said limited human-to-human transmission of bird flu might have occurred in the family, but there was no scientific evidence that the virus had mutated to allow it to spread easily among people.
"What is reassuring is two of the human samples from Kubu Sembilang have shown no evidence of reassortment or significant mutations. The lineage of these viruses are very similar to H5N1 viruses from avian specimens from north Sumatra," Mehta said. Human-to-human transmission is very difficult to prove because epidemiologists will have to eliminate all other possible causes, such as the presence of a non-human source or any other infecting agent in the environment.
But in the case of this rural family, they had slaughtered and cooked a pig and chickens for a feast on April 29, animals which are known to be highly susceptible to the virus. Efforts to test chickens and pigs for the virus have failed because residents there have refused to cooperate.
Tensions are high as they blame the government for not helping enough.
This large cluster meanwhile has re-ignited interest in a theory expounded by a growing number of scientists that genetics might predispose certain people to being infected by H5N1, which remains essentially a disease of birds. Some people who survived H5N1 have been found to have more of a type of receptor cells along their respiratory tracts that avian flu viruses like to bind to -- which in theory would explain why some humans might be more susceptible to H5N1. Such a genetic trait would also explain why cluster cases have invariably involved blood relations, and never husbands and wives. "It appears that familial susceptibility amongst certain races, certain cultures and certain groups of people appear to be having a play in the pathogenesis and behaviour of this virus when it jumps from one species, like poultry, to humans," Mehta said, but added that evidence for this was still sketchy.
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http://www.alertnet.org/thenews/newsdesk/HKG166549.htm
<!-- 24 May 2006 10:31:56 GMT ## for search indexer, do not remove--> 24 May 2006 10:31:56 GMT Source: Reuters
By Tan Ee Lyn JAKARTA, May 24 (Reuters) - Health experts are tracing anyone who might have had contact with an Indonesian family struck down by bird flu and is putting them on anti-viral drugs as a precaution, a senior WHO official said. Seven of the family members died this month but so far there is no evidence of anyone else being infected, the World Health Organisation has said.
"We are going wide, contacting the various contacts, putting on (anti-viral) Tamiflu whoever has had close contact, basically putting family members who have not been affected on Tamiflu as a precaution," Firdosi Mehta, acting representative of the WHO in Indonesia told Reuters. "There is active surveillance in the village, fever surveillance to look for any more cases that are occurring outside this immediate family cluster," he said.
The H5N1 bird flu virus infected as many as eight members of the family in the remote village of Kubu Sembilang in north Sumatra. It is the largest bird flu family cluster known to date and has drawn an enormous amount of attention from medical experts. Clusters are looked on with far more suspicion than isolated infections because they raise the possibility that the virus might have mutated to transmit more efficiently among humans.
That could spark a pandemic that can kill millions.
But Mehta urged against any over-reaction, saying this was not the first cluster that the world has known. He added it was little different from other family clusters that have been documented in the past in Hong Kong, Thailand and Vietnam.
Such limited human-to-human transmissions of the virus are invariably, up till now, the result of very close and prolonged contact when a person takes care of a sick relative who is coughing and probably infectious. HUMAN TRANSMISSION VERY HARD TO PROVE "This is not the first time, and we cannot conclusively discard or prove this to be human-to-human transmission," Mehta said, echoing a statement made by the WHO.
On Tuesday, the WHO said limited human-to-human transmission of bird flu might have occurred in the family, but there was no scientific evidence that the virus had mutated to allow it to spread easily among people.
"What is reassuring is two of the human samples from Kubu Sembilang have shown no evidence of reassortment or significant mutations. The lineage of these viruses are very similar to H5N1 viruses from avian specimens from north Sumatra," Mehta said. Human-to-human transmission is very difficult to prove because epidemiologists will have to eliminate all other possible causes, such as the presence of a non-human source or any other infecting agent in the environment.
But in the case of this rural family, they had slaughtered and cooked a pig and chickens for a feast on April 29, animals which are known to be highly susceptible to the virus. Efforts to test chickens and pigs for the virus have failed because residents there have refused to cooperate.
Tensions are high as they blame the government for not helping enough.
This large cluster meanwhile has re-ignited interest in a theory expounded by a growing number of scientists that genetics might predispose certain people to being infected by H5N1, which remains essentially a disease of birds. Some people who survived H5N1 have been found to have more of a type of receptor cells along their respiratory tracts that avian flu viruses like to bind to -- which in theory would explain why some humans might be more susceptible to H5N1. Such a genetic trait would also explain why cluster cases have invariably involved blood relations, and never husbands and wives. "It appears that familial susceptibility amongst certain races, certain cultures and certain groups of people appear to be having a play in the pathogenesis and behaviour of this virus when it jumps from one species, like poultry, to humans," Mehta said, but added that evidence for this was still sketchy.
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