Discussion: INDONESIA - Java, 09/20+

[Sharpe]

Re: INDONESIA - Bandung Cluster, W. Java (2 bros. dead; cousin, 3 neighbors sick)

Re: INDONESIA - Bandung Cluster, W. Java (2 bros. dead; cousin, 3 neighbors sick)

Edit: Never mind. I'm clearly delirious. I thought this was the Bandung thread and you were talking about Taufik's sister. Just ignore me.

You're not delirious. I realized that you were right, so I moved the post into the Java thread. The Reuters article DOES say "east Java", so it most likely is that family, but the only problem is that it's saying a 21 year old, when E is 25. So there are 3 possibilities:
1) Reuters is confused--they're mixing up everything too. Not a good sign.
2) This is E, but they're getting the age wrong.
3) This is another sister. Maybe Winda?...

 

[Theresa42]

Re: INDONESIA - Bandung Cluster, W. Java (2 bros. dead; cousin, 3 neighbors sick)

Re: INDONESIA - Bandung Cluster, W. Java (2 bros. dead; cousin, 3 neighbors sick)

You're not delirious. I realized that you were right, so I moved the post into the Java thread. The Reuters article DOES say "east Java", so it most likely is that family, but the only problem is that it's saying a 21 year old, when E is 25. So there are 3 possibilities:
1) Reuters is confused--they're mixing up everything too. Not a good sign.
2) This is E, but they're getting the age wrong.
3) This is another sister.

At this stage, #3 wouldn't surprise me at all (unfortunately).

 

[Theresa42]

Re: INDONESIA - Java, 09/20+

Re: INDONESIA - Java, 09/20+

Here's some more...

Sister of Indonesia bird flu casualty also has H5N1
29 Sep 2006 03:23:36 GMT
Source: Reuters

JAKARTA, Sept 29 (Reuters) - A 21-year-old Indonesian woman, the sister of a boy who died of bird flu earlier this month, is suffering from the same disease, the health ministry said on Friday.

The patient, currently being treated at a hospital in East Java province, had contact with sick and dead fowl, as had her brother, said Runizar Ruesin, the head of the ministry's bird flu information centre. [Hmmmm....]

"She has been declared a bird flu positive case by the ministry lab and NAMRU," he told Reuters, referring to a U.S. Naval Medical Research Unit based in Jakarta.

The Soetomo hospital in East Java capital Surabaya said the woman was also suffering from pneumonia.

"Her condition is stable but her pneumonia has not improved yet. She is still being supported by a respirator," Urip Murtejo, the hospital's deputy director, told Reuters.

The H5N1 virus mainly affects birds but experts fear it could mutate into a strain capable of killing millions of people in a global pandemic.

Indonesia has become one of the frontlines in the battle against the disease. So far, 52 people have died of bird flu, the highest of any country, with the majority of deaths since the beginning of this year.

More deaths are feared because the virus is endemic in poultry across much of the complex archipelago of 17,000 islands, home to multitudes of different cultures and languages.

The government has also been reluctant to carry out mass culls of infected poultry, citing logistical problems, lack of donor cash and resistance by many farmers to accepting limited compensation for culled fowl.

More than 500 chickens have been culled by the government around the siblings' hometown of Tulungagung since the boy died to contain the virus.

http://www.alertnet.org/thenews/newsdesk/JAK21450.htm

 

[Sharpe]

Re: INDONESIA - Java, 09/20+

Re: INDONESIA - Java, 09/20+

Still being listed as 21 by Reuters, and not 23/25-year-old Eni. Most likely it is an additional sister, perhaps Winda, who was a family member tested earlier, but never mentioned further. It could also be Santi (if Santi was listed wrongly as a "brother" before). In that case:


Suspected/confirmed cases:
Abram (11) -- dead, index case, tested pos
Eni Wulandari (23) -- sister to index case, hospitalized, some initial tests neg
Tukinem -- grandmother to index case, presenting with some sort of symptoms, being tested
21-year-old sister (probably not Eni, but we're not sure, perhaps Winda/Santi)

Here's some more...

Sister of Indonesia bird flu casualty also has H5N1
29 Sep 2006 03:23:36 GMT
Source: Reuters

JAKARTA, Sept 29 (Reuters) - A 21-year-old Indonesian woman, the sister of a boy who died of bird flu earlier this month, is suffering from the same disease, the health ministry said on Friday.

The patient, currently being treated at a hospital in East Java province, had contact with sick and dead fowl, as had her brother, said Runizar Ruesin, the head of the ministry's bird flu information centre. [Hmmmm....]

"She has been declared a bird flu positive case by the ministry lab and NAMRU," he told Reuters, referring to a U.S. Naval Medical Research Unit based in Jakarta.

The Soetomo hospital in East Java capital Surabaya said the woman was also suffering from pneumonia.

"Her condition is stable but her pneumonia has not improved yet. She is still being supported by a respirator," Urip Murtejo, the hospital's deputy director, told Reuters.

The H5N1 virus mainly affects birds but experts fear it could mutate into a strain capable of killing millions of people in a global pandemic.

Indonesia has become one of the frontlines in the battle against the disease. So far, 52 people have died of bird flu, the highest of any country, with the majority of deaths since the beginning of this year.

More deaths are feared because the virus is endemic in poultry across much of the complex archipelago of 17,000 islands, home to multitudes of different cultures and languages.

The government has also been reluctant to carry out mass culls of infected poultry, citing logistical problems, lack of donor cash and resistance by many farmers to accepting limited compensation for culled fowl.

More than 500 chickens have been culled by the government around the siblings' hometown of Tulungagung since the boy died to contain the virus.

http://www.alertnet.org/thenews/newsdesk/JAK21450.htm

 

[HenryN]

Re: INDONESIA - Java, 09/20+

Re: INDONESIA - Java, 09/20+

Still being listed as 21 by Reuters, and not 23/25-year-old Eni. Most likely it is an additional sister, perhaps Winda, who was a family member tested earlier, but never mentioned further. It could also be Santi (if Santi was listed wrongly as a "brother" before). In that case:


Suspected/confirmed cases:
Abram (11) -- dead, index case, tested pos
Eni Wulandari (23) -- sister to index case, hospitalized, some initial tests neg
Tukinem -- grandmother to index case, presenting with some sort of symptoms, being tested
21-year-old sister (probably not Eni, but we're not sure, perhaps Winda/Santi)

Media is not very good with ages. I think there is only one sister that is being discussed in local media and wire services.

 

[HenryN]

Re: INDONESIA - Java, 09/20+

Re: INDONESIA - Java, 09/20+

Woman contracts bird flu in new family cluster: health official
[FONT=Arial, Helvetica]JAKARTA (AP): An Indonesian woman whose brother died of bird flu this month is also sick with the virus, a senior Health Ministry official said Friday, confirming the country's latest family cluster of infections.
The 21-year-old woman is being treated in a hospital in Surabaya city in east Java province, said Nyoman Kandun. Her 11-year-old brother died from bird flu on Sept. 18. He was suspected of contracting the virus from infected chickens close to his house.
"This is a family cluster," said Nyoman, adding that the source of the woman's infection was not yet known.
Most of Indonesia's 52 fatal cases have been linked to contact with infected chickens or their droppings. But the World Health Organization said the virus passed between humans in one large cluster of cases in a single family on Sumatra Island earlierthis year.
Cases of suspected human-to-human transmission are watched very closely because they increase the chances of the virus mutating into a form that is easily passed between humans, and that could possibly trigger a global pandemic.
The H5N1 strain of bird flu has killed at least 148 people worldwide since it started ravaging poultry stocks in Asia three years ago, according to WHO. Indonesia has been criticized for failing to aggressively attack the virus in poultry, either by mass slaughters or vaccination. It has said it lacks the resources to compensate farmers for slaughtered birds. (**)[/FONT]

http://www.thejakartapost.com/detaillgen.asp?fileid=20060929112837&irec=0<!--<hr noshade size="1" color="#333333">-->

 

[HenryN]

Re: INDONESIA - Java, 09/20+

Re: INDONESIA - Java, 09/20+

Age of the brother that died has been given as 7, 8, 11, so age discrepency in sister doesn't mean much. There may be more sick relatives / siblings, but most of the news has been on just two siblings, who have both now been confirmed.

 

[HenryN]

Re: INDONESIA - Java, 09/20+

Re: INDONESIA - Java, 09/20+

http://www.jatim.go.id/news.php?id=9342&t=103852
Results of the sample test of EW blood (23) from the Big Hall the Health Laboratory of the East Java province, through the Section Head the Health (Kadinkes) the East Java province, Dr Bambang Giatno Rahardjo MPH, has been stated the negative was infected by the bird flu virus.

Nevertheless, RSU Dr Soetomo continued to guard against the condition for the patient and to treat him in accordance with protap the handling of the bird flu patient to guard all the available possibilities.
--------------------------------------------------------------------------------
Deputy Director Pendidikan & the Research (Diklit) RSU Dr Soetomo, Dr Urip Murtedjo SpB-KL PGD Pall Med said, at this time the EW condition that currently is treated in space isolation-Anaesthesia long RSU Dr Soetomo Surabaya gradually improved.
The improvement of the EW condition was seen from his cough that has decreased.
Although being stated negative by Dinkes, but RSU Dr Soetomo was still being waiting for results of the test sample the patient's blood from WHO.

As Far As This Is Concerned we monitored and carried out appropriate therapy protap (the procedure continue to) the AI patient like the blood inspection and giving tamiflu.

See you later was gotten by results of the blood inspection from WHO,\he said.

Till at this time, meant to be recorded had three patients suspect AI and 1 positive AI patient that is Anang from Kediri that succeeded in being cured by the total.

The endemic area of Flu Burung casualties's Emergence suspect bird flu from Tulungagung that is EW and his brother, Abram, that were expected strong was infected by bird flu, did not surprise Dr drh CA Nidom Ms, the expert biomolekuler the Medical Faculty Animal-University Airlangga Surabaya.

Nidom said that the East Java status was the endemic area of bird flu, so as to be ascertained will continue to emerge human casualties that was infected by the bird flu virus, this if the handling of bird flu was still continuing to point the method that was the same as the superficial method.

\the Handling that only berkutat in the vaccination or disinfektan not a solution, because of could be considered to be the handling of bird flu in Indonesia could be said late.

Because already had human casualties just supported kabut,\stressed Nidom.
According to him, the handling of bird flu in Indonesia it was considered late.
Because related sides too much were sure that bird flu will not spread to humankind, so as the preventive action tended to be ignored.
According to Nidom at this time had two urgent matters to be done by the Government that is the arrangement.
The arrangement must be carried out by straightening out the domestic livestock breeding industry that was acknowledged as the source or the source of the problem of the proliferation of the bird flu virus by Nidom.
\Explain to any community that must be done to avoid the spreading of the bird flu virus, especially minimising contact too much close to the poultry especially ayam,\said Nidom.
The area in East Java that according to Nidom must be guarded against was Nganjuk, Kediri, Tulungagung, and surrounding area.
Apart from because most bird flu casualties came from this area, there also human contact really close to the poultry.
(eda)





</PRE>

 

[Sharpe]

Re: INDONESIA - Java, 09/20+

Re: INDONESIA - Java, 09/20+

Age of the brother that died has been given as 7, 8, 11, so age discrepency in sister doesn't mean much. There may be more sick relatives / siblings, but most of the news has been on just two siblings, who have both now been confirmed.

You may well be right. It is quite funny when you pay close attention to exactly what information the media gives out, in that if there were, say, five 10-year-old identical twin brothers infected, we might end up thinking that there were 8 and 10-year-old sisters, a 12-year-old brother, their 13-year-old cousin infected, and a 14-year-old aunt who wasn't confirmed yet.

 

[Niko]

Re: INDONESIA - Java, 09/20+

Re: INDONESIA - Java, 09/20+

You may well be right. It is quite funny when you pay close attention to exactly what information the media gives out, in that if there were, say, five 10-year-old identical twin brothers infected, we might end up thinking that there were 8 and 10-year-old sisters, a 12-year-old brother, their 13-year-old cousin infected, and a 14-year-old aunt who wasn't confirmed yet.

Too funny! (in a sick sort of way!)

I really don't know how some of you keep this straight. We need an "applause" smilie

 

[HenryN]

Re: Discussion: INDONESIA - Java, 09/20+

Commentary at

http://www.recombinomics.com/News/09290601/H5N1_Tulungagung_Sister.html

 

[Goju]

Re: Discussion: INDONESIA - Java, 09/20+

Dr. Niman... please comment...

from Pixie http://www.fluwikie2.com/pmwiki.php?n=Forum.AerosolTransmissionOfInfluenzaAVirus

Review of Aerosol Transmission of Influenza A Virus

In contrast, the situation with a pandemic strain of influenza A (H5) would become only too clear because no one would have any degree of immunity against such a virus, vaccines would not be available for months, and these viruses would likely be highly virulent. Even though efficient human-to-human transmission of the A (H5N1) virus has not yet been observed (by any mode), transmission of influenza A (H5N1) from geese to quails has been demonstrated in the laboratory (33). Thus, even in the current incarnation of A (H5N1), infection by the virus can generate aerosols that are infectious for highly susceptible hosts. As far as we know, 1 of the main blocks to efficient human-to-human transmission of influenza A (H5N1) is the virus?s current preference for specific sialic acid receptors. The current strains still prefer ??2,3?linked sialic acids, which is typical of avian influenza viruses, whereas human influenza viruses bind preferentially to ??2,6?linked sialic acids (34?36). In all likelihood, 1 of the mutations required for influenza A (H5N1) to give rise to a pandemic strain would be to change its receptor affinity to favor the ??2,6?linked sialic acids. For the influenza A (H1N1) pandemic strain of 1918, this change required only 1 or 2 amino acid substitutions (36). Once a highly transmissible strain of influenza A (H5) has arisen, it will likely spread in part by aerosols, like other human influenza viruses.

 

[HenryN]

Re: Discussion: INDONESIA - Java, 09/20+

Dr. Niman... please comment...

from Pixie http://www.fluwikie2.com/pmwiki.php?n=Forum.AerosolTransmissionOfInfluenzaAVirus

Review of Aerosol Transmission of Influenza A Virus

In contrast, the situation with a pandemic strain of influenza A (H5) would become only too clear because no one would have any degree of immunity against such a virus, vaccines would not be available for months, and these viruses would likely be highly virulent. Even though efficient human-to-human transmission of the A (H5N1) virus has not yet been observed (by any mode), transmission of influenza A (H5N1) from geese to quails has been demonstrated in the laboratory (33). Thus, even in the current incarnation of A (H5N1), infection by the virus can generate aerosols that are infectious for highly susceptible hosts. As far as we know, 1 of the main blocks to efficient human-to-human transmission of influenza A (H5N1) is the virus?s current preference for specific sialic acid receptors. The current strains still prefer ??2,3?linked sialic acids, which is typical of avian influenza viruses, whereas human influenza viruses bind preferentially to ??2,6?linked sialic acids (34?36). In all likelihood, 1 of the mutations required for influenza A (H5N1) to give rise to a pandemic strain would be to change its receptor affinity to favor the ??2,6?linked sialic acids. For the influenza A (H1N1) pandemic strain of 1918, this change required only 1 or 2 amino acid substitutions (36). Once a highly transmissible strain of influenza A (H5) has arisen, it will likely spread in part by aerosols, like other human influenza viruses.

These are comments on chnages in the receptor binding domain to change affinities. However, H5N1 in Vietnam and Indonesia have already been shown to be at high levels in the nose and throat.

 

[HenryN]

Re: Discussion: INDONESIA - Java, 09/20+

<TABLE class=lan18 cellSpacing=0 cellPadding=0 width="95%" align=center border=0><TBODY><TR><TD class=lan18 vAlign=bottom align=middle height=30>Indonesia confirms 69th bird flu case
</TD></TR><TR><TD bgColor=#006699 height=1></TD></TR></TBODY></TABLE><TABLE cellSpacing=0 cellPadding=0 width="50%" align=center border=0><TBODY><TR><TD height=5></TD></TR></TBODY></TABLE><TABLE class=hui12 cellSpacing=0 cellPadding=0 width="95%" align=center border=0><TBODY><TR><TD align=middle>www.chinaview.cn 2006-10-05 17:39:04 </TD></TR></TBODY></TABLE><TABLE cellSpacing=0 cellPadding=0 width="50%" align=center border=0><TBODY><TR><TD height=10></TD></TR></TBODY></TABLE><TABLE class=lt14 cellSpacing=0 cellPadding=0 width="93%" align=center border=0><TBODY><TR><TD class=lt14>



Special report: Global fight against bird flu
JAKARTA, Oct. 5 (Xinhua) -- Indonesia has recorded the 69th avian influenza infection in human being, Director of Animal Disease and Health Control under the Health Ministry Nyoman Kandunsaid here Thursday.
"A 21-year-old woman from Tulung Agung district of East Java Province is positively infected by the H5N1," Kandun told Xinhua.
The director said the woman who has developed symptoms since Sept. 19 and hospitalized since Sept. 25 had had contacts with fowls.
She is the sister of a confirmed H5N1 case, an 11-year-old boy who died on Sept. 18, Kandun said.
Indonesia has recorded 52 deaths out of the 69 cases, surpassing Vietnam, making Indonesia the world's most hard hit by the virus, according to the World Health Organization.
Millions of people can be killed should the highly pathogenic H5N1 mutates into a certain level, which can make it transmittable among humans.
The huge territory, back yard centered farming and relatively lack budget have hampered the authorities in the country to fighting avian influenza. Asia has been the hardest hit, with 130 out the 146 human deaths arising from bird flu since 2003 occurring in East Asian countries, according to the data from the World Bank

</TD></TR></TBODY></TABLE>
http://news.xinhuanet.com/english/2006-10/05/content_5170626.htm

 

[HenryN]

Re: Discussion: INDONESIA - Java, 09/20+

Avian influenza ? situation in Indonesia ? update 35
3 October 2006
The Ministry of Health in Indonesia has confirmed the country?s 69th case of human infection with the H5N1 avian influenza virus.
The case is a 21-year-old female from East Java Province. She developed symptoms on 19 September and was hospitalized on 25 September. She remains hospitalized.
She is the sister of a confirmed H5N1 case, an 11-year-old male who died on 18 September. Following that fatal case, health authorities initiated contact tracing, and on 24 September they received reports of symptoms in the sister. In line with the national protocol, she was immediately given the antiviral drug, oseltamivir, and isolated in hospital.
The source of her infection is presently under investigation. Poultry deaths in the family's household were noted both before and during the illness of the brother. The woman was likely exposed to these poultry as well as to her brother.
Of the 69 cases confirmed to date in Indonesia, 52 have been fatal.

http://www.who.int/csr/don/2006_10_03/en/index.html

 

[GaudiaRay]

Re: Discussion: INDONESIA - Java, 09/20+

Deaths of two children, 2 and 6, in Medan, Indonesia (I think Java), posted by Dutchy earlier today, 11-16.

We are now seeing local, geographically concentrated, clusters of UNRELATED individuals (emphasis added because WHO consultants recently publicly suspected genetic links because the clusters have been familial, and it's not appropriate that such a conjecture be left without response.)

 

[Theresa42]

Re: Discussion: INDONESIA - Java, 09/20+

Deaths of two children, 2 and 6, in Medan, Indonesia (I think Java), posted by Dutchy earlier today, 11-16.

Just a quick note that Medan is in northern Sumatra -- the hospital (RSU Adam Malik Medan) where the two children died is the same one where the Karo cluster folks were -- it's the major, bf hospital in the area -- Medan being the major city in the area.