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Today the newshounds on the flu forums have been following what appears to be a strongly suspected human H5N1 case in Indonesia, that of a 37 year-old from Banten.
According to this news article, at least one positive H5N1 test result has been returned by a Department of Health testing laboratory. It generally requires two positive tests before a patient is declared positive.
Given Indonesia's recent policy change not to confirm human bird flu cases as they happen, we may have to wait a while for official confirmation.
A Hat tip to Ironorehopper on Flu Trackers for this article and Translation and to Dutchy and Niman for also contributing to the analysis.
A resident Belendung, Kecamatan Benda, of Kota Tangerang, Banten, the USA (37) that died last July 10 was stated positive terjangkit the virus of kind bird flu H5N1.
The executive the Task of the Sub Dinas Pemberantasan Head and the Prevention of the Illness and Lingkungan Sanitation (P2PL) the Kesehatan Service of the Tangerang City, Ati Pramudji Hastuti, on Sunday (13/7), said results of the blood inspection by the Departemen Laboratory of the Health showed that the USA died because positive was infected by the bird flu virus.
The USA that lived in Street Kyai the Pilgrim Kuding RT 04/07 the Blendung Village, the Object, Tangerang, that blew out the last breath in the Public Hospital (RSU) Tangerang (10/7).
Before dying, the USA experienced was sick with the condition for the high fever, the difficult cough, and breathless since Monday (5/7), but till three days afterwards, the condition for casualties will never improve, in fact the temperature of his body increasingly increased.
Because the condition for casualties continued to worsen, the US wife, Yuliana brought his husband to the Husada Insani Hospital, Cipondoh, Tangerang on Wednesday morning (9/7) and underwent the inspection of the interior body.
Results x-rayed in RS Husada Insani showed, the USA was it was suspected strong tertular the deadly virus that came from the poultry so as immediately underwent the maintenance in isolation space.
On that day also (9/7), the USA was carried to RSU Tangerang in order to undergoes the inspection of further blood, but results of the diagnosis changed, casualties were estimated suffered tuberkolosis (the TB) acute.
"As the step" in "anticipation, the status" of "casualties was stated by the sufferer suspect bird flu," said Ati Pramudji Hastuti.
However when undergoing the intensive maintenance in special isolation space the bird flu sufferer in RSU Tangerang, the USA died on Thursday early afternoon (10/7), afterwards the US body was buried the Umum Cemetery that was not far from his house.
Unofficial Confirmation Of Indonesian Bird Flu Fatality
# 2148
Last Sunday our intrepid Internet newshounds unearthed local Indonesian media reports of a bird flu fatality in Banten.
The reports, originally in the Bahasan language, were translated into English and posted on many of the flu forums. Here is a snippet of the translation I posted on Sunday.
(Hat Tips to Dutchy and Ironorehopper on Flutrackers)
The resident Banten Positive Terjangkit Burung Flu Tangerang, CyberNews. A resident Belendung, Kecamatan Benda, of Kota Tangerang, Banten, the USA (37) that died last July 10 was stated positive terjangkit the virus of kind bird flu H5N1.
The victim's intials listed are given as USA, but that is actually a machine translation error. The intials are really A.S., which just happens to be how the United States is abbreviated in Indonesia.
BELENDUNG, Indonesia - An Indonesian cargo worker died of bird flu, relatives confirmed Thursday, raising the unofficial toll in the world's hardest hit nation to 111 in three years.
The government recently started delaying announcements about bird flu fatalities, sometimes by several weeks. But health workers speaking on condition of anonymity confirmed the tests came back positive.
Asnawi Sandri, a 38-year-old father of two, died in the hospital on July 10, days after he came down with symptoms of the disease, including high fever, coughing and breathing difficulties, said Abdul Kadir, his brother-in-law.
"The doctor told us he died of bird flu," he said. "The tests came back positive from Jakarta."
<snip>
Asked whether she could confirm Sandri's cause of death, Health Ministry spokeswoman Lily Sulistyowati said: "I can't say now whether the tests were positive or negative ... but we'll let the public know when we release our report at the end of the month."
A member of the national bird flu commission, however, confirmed that the cargo worker died of bird flu, a local health worker said told The Associated Press. He asked not to be named because he did not have authorization to speak to the media.
Kudos to the AP reporter who obviously was not content to wait for the Indonesian government to dole out information on their arbitrary schedule.
Reasons Cited For High CFR In Indonesian H5N1 Cases
# 2152
CIDRAP (Center for Infectious Disease Research & Policy) News has an excellent overview of two of the recent journal articles that appeared in the June 2008 edition of Annals Academy of Medicine Singapore, which devoted the entire issue to Avian Flu.
A complete listing of the articles available can be found here.
The two journal articles referenced in today's CIDRAP report are:
Giriputro S, Agus R, Sulastri S, et al. Clinical and epidemiological features of patients with confirmed avian influenza presenting to Sulianti Saroso Infectious Diseases Hospital, Indonesia, 2005-2007. Ann Acad Med Singapore 2008 Jun;37(6):454-7 [Full text]
Sedyaningsih ER, Isfandari S, Soendoro T, et al. Towards mutual trust, transparency and equality in virus sharing mechanism: the avian influenza case of Indonesia. Ann Acad Med Singapore 2008 Jun;37(6):482-8 [Full text]
Follow the link to read the entire article by Robert Roos, News Editor for CIDRAP.
Jul 17, 2008 (CIDRAP News) ? Recent reports from Indonesian health officials tie the high fatality rate in human H5N1 influenza cases there to the difficulty of diagnosing the disease, late treatment with antiviral drugs, and a shortage of well-equipped hospitals.
The case-fatality rate (CFR) in Indonesia, which leads the world in H5N1 cases, climbed from 63% in 2005 to 80% in 2006 and 85.7% in 2007, according to a report in the journal Annals Academy of Medicine Singapore. The CFR remains high so far this year, with 15 of 18 cases fatal, or 83.3%, according to World Health Organization (WHO) figures.
By comparison, the CFR for the global total of 385 cases with 243 deaths is 63.1%. The fatality rate with Indonesian cases excluded is 53.2% (250 cases with 133 deaths, based on WHO figures).
Two reports in the Singapore journal discuss H5N1 cases in Indonesia. One, written by Indonesian Ministry of Health (MOH) officials, looks at the 116 cases, including 94 fatal ones, the country recorded from 2005 through 2007 (the article also defends Indonesia's refusal to share H5N1 virus isolates with the WHO). A second article, written by hospital physicians, profiles the 27 cases, including 21 fatal ones, treated at Sulianti Saroso Infectious Diseases Hospital in Jakarta during that period.
Amid increasingly inflammatory rhetoric emanating from Indonesia's Health Ministry, we get this quietly released statement on the Health Ministry's web site giving the details of two confirmed H5N1 deaths in July.
It has been nearly 90 days since the last `official' announcement.
The victims, a 20-year-old male who died on July 31st, and a 38-year-old male who died on July ninth, both hailed from Tangerang city, west of Jakarta.
The 20-year-old appears to be the same victim that an Indonesian official identified back in early August, as having died from the virus.
Sept. 9 (Bloomberg) -- Bird flu killed two men on Indonesia's Java island in July, the health ministry said, in its first reports of cases in almost three months.
Both fatalities occurred in Tangerang city in Banten province, according to the Ministry of Health. No cases of the H5N1 strain of avian influenza were reported in August, the ministry in Jakarta said in a statement on its Web site today.
Prior to these, Indonesia's most recent avian flu cases were reported by the World Health Organization on June 19, when the Geneva-based agency recorded 135 infections, including 110 fatalities. Indonesia accounts for more than a third of the global cases of H5N1, the strain world health officials say may mutate into a contagious form capable of touching off a pandemic.
Indonesia's Health Minister Siti Fadilah Supari said on June 6 that the government would delay reporting new avian flu- deaths by six months. She didn't give a reason for the decision.
Calls and a text message to a spokeswoman at the Indonesian health ministry seeking comment weren't immediately returned. (Continue . . . )
Meanwhile, Indonesia continues to withhold virus samples from the WHO (World Health Organization), insisting that they have intellectual property rights to the virus.
The WHO (World Health Organization) has posted their first avian flu update from Indonesia since the middle of June, with this recap of the information posted on the Indonesian Health Ministry's website yesterday.
As usual, the level of detail provided is discouragingly small.
10 September 2008 -- The Ministry of Health of Indonesia has retrospectively announced two confirmed cases of human infection with the H5N1 avian influenza virus. The first case, a 38 year old male from Tangerang Municipality, Banten Province developed symptoms on 4 July 2008, was hospitalized on 9 July and died on 10 July. There were free roaming poultry throughout his neighbourhood, including a commercial poultry pen owned by a neighbour.
The second case, a 20 year old male from Tangerang District, Banten Province developed symptoms on 20 July, was hospitalized on 29 July, and died on 31 July. Reports indicate that chickens from the case's household had died in the week preceding the onset of his symptoms and that he had slaughtered and consumed some of his stock during this period.
Of the 137 cases confirmed to date in Indonesia, 112 have been fatal.
