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Discussion - Indonesia: Possible H5N1-H1N1 coinfection?

Greetings. I am a US expatriate living in Java island of Indonesia, just outside the capital Jakarta near ground zero of the bird flu outbreak. One of my wife's relatives died of bird flu a few years ago and the WHO was over here asking questions (she had been to a chicken farm).

Don't believe the "1000 officially recorded cases of H1N1" when you read news about Indonesia. H1N1 came here early.. approximately in May when the father of one of my sister-in-law's students flew back from Mexico sick with ILI (influenza-like illness).

Seeing 200 people lined up outside one of the public health clinics (called "Puskesmas") sick with obvious ILI and having more than half my friends come down with a "bad/heavy flu", with two of them being hospitalized (one was 17 and the other was the father of one of my friends).

Multiply that phony "protecting our tourism" number of 1000 to more like 20,000, but I would add more than that to it since it hasn't been updated in two months.

Also the Eid al-Fitr holiday here where everyone goes home to see their family and kiss their mother's hands and shake hands, etc... expect to see an explosion of cases.

Lots of people here have "flu", but they don't go to a doctor because they can't afford it. People are quite sick here.

I'm allergic to eggs (weakness within 10-20 minutes of eating them, with stabbing pains in the stomach, followed by fever for a few days and diarrhea, even though the eggs were cooked), so I am not sure if I can get the H1N1 vaccine or not. I also have asthma, but I don't need asthma medication. It is primarily reactive.

I'm not sure if I'll have my doctor order the Australian vaccine (Panvax) or try to get Tamiflu (I have a prescription on paper, but only the state hospitals dispense it and they are full of H1N1 patients).

:-(

Take care my friends. This flu, I fear, is worse than what the CDC and WHO are letting us believe. They keep saying "mild", but people take it out of context. I think "mild" means "mild relative to previous pandemics, namely the 1918 and 1957 pandemics", not mild in terms of symptomology.

I called the University of Iowa Hospitals and Clinics and asked the nurse there about H1N1 symptoms. She said in no uncertain terms, "Swine flu symptoms are SEVERE". I believe her.

Everyone I know that has had it said it was pretty bad. I'm sure some have mild cases, but I don't see that happening here.

I have to admit I am scared. Since May, I have not let my 2 1/2 year old son leave the house and I use alcohol-based sanitizers along with N95 masks if I go out. My wife uses a surgical mask and takes a shower before entering our side of the house if she's been teaching her students or after coming back from a crowded place. It sounds extreme, but we don't want to take chances with this virus.

She had a severe ILI in February this year and paracetamol was ineffective in relieving the fever. She had to take tramadol (Ultram) to reduce the fever. Everyone, except me (N95 mask on and compulsive hand washing hehheh) got that flu. Well, I got a mild version thanks to the low amount of viral particulates I probably inhaled. I wonder if H1N1 was around the world before the media discovered it in Mexico City when the military was handing out masks. Maybe my wife already had swine flu in February? She had never had a flu that bad in her life. I was worried about her.

Sorry for the rambling. I am panicking one moment and then take a few Xanax to calm down and put things into perspective. People that die around here are young and healthy.. scary!


Anyway, I don't have the dates on the news below but do recall reading it in either late August or September:


Bali ::: Avian flu outbreak. A pregnant woman dies of H1N1 infection

"After being away for 2 weeks, here are some articles from The Jakarta Post mentioning bird flu outbreak in Buleleng, Bali, and a fatal H1N1 suspect patient."

A 19-year-old woman died after being treated for the H1N1 flu virus for almost a week at Sanglah Hospital in Denpasar, Bali.

Ken Wirasandhi, a spokesman from the hospital, said Friday that Ni Wayan Siti of Tampaksiring, Gianyar, died on Thursday night. Ken said the patient, who had tested positive for the H1N1 infection, had also had pneumonia.

Siti was eight months pregnant when she was admitted to the hospital on Saturday last week. She had a miscarriage three days later.

The hospital also suspected that Siti was infected with bird flu, but had yet to receive test results to confirm it.

Source: http://bit.ly/9c9F #swineflu #flubabi #H5N1 #birdflu #fluburung



Buleleng, Bali ? Residents of Tejakula village culled 400 chickens infected with the avian flu, to prevent the disease spreading.

?Intensive culling must be carried out in two affected villages in the regency,? said Bali Husbandry Agency head I.B. Alit.

He added avian flu was still present on the island, mostly among domesticated fowl.

Meanwhile, a pregnant woman from Gianyar regency is being treated at Sanglah Hospital for avian flu. Her unborn baby was dead.



Source: Indonesia newspaper, The Jakarta Post. http://www.thejakartapost.com/news/2009/09/04/avian-flu-outbreak-recorded-buleleng.html



===AvianInfluenzaIndonesia===
 
Re: Indonesia: Possible H5N1-H1N1 coinfection?

Re: Indonesia: Possible H5N1-H1N1 coinfection?

Greetings. FT can always use "boots on the ground" sources in Indonesia. I'm sure Indonesia has far more H1N1 than officially confirmed, just like most other countries worldwide.

As far as that possible coinfection, we read that one through BFIC (Bird Flu Information Corner), and our take was that H1N1 was confirmed, but H5N1 was only suspect because the disease was so severe. I never heard a resolution on that one, but it seems that if H5N1 was present, we would have heard.
 
Re: Indonesia: Possible H5N1-H1N1 coinfection?

Re: Indonesia: Possible H5N1-H1N1 coinfection?

Do you speak indonesian at all?
 
Re: Indonesia: Possible H5N1-H1N1 coinfection?

Re: Indonesia: Possible H5N1-H1N1 coinfection?

Greetings. FT can always use "boots on the ground" sources in Indonesia. I'm sure Indonesia has far more H1N1 than officially confirmed, just like most other countries worldwide.

As far as that possible coinfection, we read that one through BFIC (Bird Flu Information Corner), and our take was that H1N1 was confirmed, but H5N1 was only suspect because the disease was so severe. I never heard a resolution on that one, but it seems that if H5N1 was present, we would have heard.

Is it possible that she had H5N1 previously, and the test was only looking for antibodies (I'm assuming it is a WIDAL test)? She could have been infected months or years ago with H5N1, recovered, and then got H1N1.
 
Re: Indonesia: Possible H5N1-H1N1 coinfection?

Re: Indonesia: Possible H5N1-H1N1 coinfection?

Do you speak indonesian at all?

Saya bicara Bahasa Indonesia sedikit-sedikit. hehheh. (I speak some Bahasa Indonesia.) I can definitely read it, but conversation-wise, I'm not so good.
 
Re: Indonesia: possible H5N1-H1N1 coinfection?

Re: Indonesia: possible H5N1-H1N1 coinfection?

Welcome knightrider2011, and thank you for all the information.
 
Re: Indonesia: Possible H5N1-H1N1 coinfection?

Re: Indonesia: Possible H5N1-H1N1 coinfection?

Saya bicara Bahasa Indonesia sedikit-sedikit. hehheh. (I speak some Bahasa Indonesia.) I can definitely read it, but conversation-wise, I'm not so good.

Great. How did you find this website?
 
Re: Indonesia: Possible H5N1-H1N1 coinfection?

Re: Indonesia: Possible H5N1-H1N1 coinfection?

This thread is better suited for the discusion forum though, because this is talking about a recent event.
 
Re: Indonesia: Possible H5N1-H1N1 coinfection?

Re: Indonesia: Possible H5N1-H1N1 coinfection?

This thread is better suited for the discusion forum though, because this is talking about a recent event.

I agree.

Welcome knightrider2011!
 
Re: Indonesia: Possible H5N1-H1N1 coinfection?

Re: Indonesia: Possible H5N1-H1N1 coinfection?

Great. How did you find this website?

I was googling for news about H1N1 vaccine and stumbled on some links to anti-vaccine scare-mongering websites, but flutrackers was not far below it.

This is a great website! Far more detailed than anything in the mainstream media or WHO's website. :-) Lots of topics here. Keep up the good work.
 
Re: Indonesia: Possible H5N1-H1N1 coinfection?

Re: Indonesia: Possible H5N1-H1N1 coinfection?

I was googling for news about H1N1 vaccine and stumbled on some links to anti-vaccine scare-mongering websites, but flutrackers was not far below it.

This is a great website! Far more detailed than anything in the mainstream media or WHO's website. :-) Lots of topics here. Keep up the good work.

You are very lucky to have found this website. It is one of the best on the internet, we not only track flu but we track a whole host of diseases. We have a mission to help all of hummanity regardless of gender, race or religion. We are also a charity. Welcome to Flutrackers and please enjoy your stay.

:)
 
Re: Indonesia: Possible H5N1-H1N1 coinfection?

Re: Indonesia: Possible H5N1-H1N1 coinfection?

I was googling for news about H1N1 vaccine and stumbled on some links to anti-vaccine scare-mongering websites, but flutrackers was not far below it.

This is a great website! Far more detailed than anything in the mainstream media or WHO's website. :-) Lots of topics here. Keep up the good work.


Thanks!

And thank you for the information.

As to the novel H1N1 information, would you say that compared to "seasonal" flu, it is a more severe illness and younger persons are disproportionally affected?

The numbers affected in the U.S. is in the millions, so I would expect many, many cases in Indonesia too.

As to H5N1 - what is your feeling about this situation in regard to infections in people?
 
Re: Discussion - Indonesia: Possible H5N1-H1N1 coinfection?

If I also may add. What is the situation regarding Health Minister Supari. Is President Yudhoyono going to keep her in the cabinet or get someone else?
 
Re: Discussion - Indonesia: Possible H5N1-H1N1 coinfection?

Sorry I am working in lobbying against adjuvant AS03 for H1N1 vaccine of Glaxo-Smith-Kline in Canada and the whole U.K.

did not read the afterwars, just reacting to the title of the thread.

Discussion - Indonesia: Possible H5N1-H1N1 coinfection?

I would add

Discussion - Egypt - Possible H5N1-H1N1 coinfection?

or..... and or.....


Are you specific on Indonesia or on dual infection ?

Snowy


He lives in Indonesia.
 
Re: Discussion - Indonesia: Possible H5N1-H1N1 coinfection?

If I also may add. What is the situation regarding Health Minister Supari. Is President Yudhoyono going to keep her in the cabinet or get someone else?

We do not discuss politics here.
 
Re: Indonesia: Possible H5N1-H1N1 coinfection?

Re: Indonesia: Possible H5N1-H1N1 coinfection?

Thanks!

And thank you for the information.

As to the novel H1N1 information, would you say that compared to "seasonal" flu, it is a more severe illness and younger persons are disproportionally affected?

The numbers affected in the U.S. is in the millions, so I would expect many, many cases in Indonesia too.

As to H5N1 - what is your feeling about this situation in regard to infections in people?

It seems that this flu is worse than the seasonal flu. People in Indonesia are usually:

1) too poor to be able to receive adequate treatment

2) don't know what swine flu is (my wife had to explain it to our neighbors.. they had no clue what it was or how it is spread. The government is hush hush on the matter)

3) having a lackadaisical attitude about influenza in general and very rarely seek out treatment. People here tend to "tough it out" and laugh off threats such as bird flu, typhoid, or other communicable diseases. They don't take dengue seriously, so with this flu, they just don't worry, even if they know what it is.

4) the victims of malpractice or nosocomial infections without legal recourse even if they can afford hospital treatment. You can be arrested for complaining about poor hospital services as occurred with the "Ibu Prita" case this year. Hospitals here are like the roach motel or Hotel California: you can enter any time you like, but you can never leave (leave in a body bag, no joke).

5) have poor nutritional status, work hard and get very little sleep

The biggest problem is the lack of education on this matter. Knowledge is power. People here strongly believe in fate/predestination, so it is hard to get the message across.

One private school that I know of forced all students and faculty to wear surgical masks.

My wife was laughed at for wearing a surgical mask to her university, but not long after that, about half her classmates began to follow her example, so I hope more will increase their hygiene.

As the population here is at least 220-240 million, I would expect there to be a million cases. I remember my friend in Palembang, Sumatera telling me her immediate family had this new flu and her father ended up in the hospital. She told me the city was full of people with the new flu. I could only assume that was H1N1 due to the confirmed outbreak of H1N1 in Medan, which is not very far away. This was in May or early June.

I am not sure if it is disproportionately affecting the young. There aren't many elderly in this part of the world. Retirement age is 55 and usually the elderly don't leave their house or drive, unlike in the developed world. Life expectancy is roughly 66 years of age. From the deaths so far, it seems that most of them were young people.

H5N1 has largely been forgotten. I'm sure there are still cases, but ever since the government forced people to stop raising chickens in their houses in Jakarta and elsewhere, and had the chickens vaccinated (supposedly), everything became rather quiet. Cases took a nose dive. This government is corrupt though, so I don't know what I can trust from their statistics.

A man tested positive for H5N1 a few years ago and he didn't remember being particularly ill and wasn't even sure when he had it. I wonder if H5N1 really is as deadly as it is said to be. There could be many who are exposed and develop antibodies but don't get the full-blown infection.

I thought I read an article where the CDC allegedly said that up to 40 percent of people do not get a fever with H1N1. I'm not sure about H5N1.

I still see chickens running around this neighborhood about 1 or 2km from my house in the village. I have serious doubts that they were vaccinated. If I try to raise any awareness of H5N1 or dengue, etc, people just laugh it off.

It's really too bad. If H5N1 mutated and the worst case scenario (i.e. the "real" pandemic) occurred, Indonesia would be totally unprepared. This is just my opinion though.

For starters, they need to sack Siti Fadila Supari. She is incompetent and should have never been made Health Minister. She made lots of outlandish statements and unsubstantiated claims about H1N1. (Don't eat pork! Indonesian's genetic makeup will protect them from H1N1. The weather in Indonesia is not conducive to H1N1, so we are safe..it won't come here. Etc. Etc.)

I think people here also have zero faith in their government. I fear a public health crisis after the Eid holiday is over as the hospitals might become overrun by people with H1N1. They are already strained to the limit in many places and are refusing new patients.
 
Re: Discussion - Indonesia: Possible H5N1-H1N1 coinfection?

Oops, sorry Florida1. I just saw your message after I posted (about the politics). I didn't mean to bring up politics. I hope we will have good information being spread to the people. Thus far, the people around this area don't know what H1N1 is (generally.. most of them don't).
 
Re: Discussion - Indonesia: Possible H5N1-H1N1 coinfection?

Hello, knightrider2011, thank you for sharing your perspective on the novel flu in Indonesia. I spent about a month in Bali and Jakarta almost twenty years ago; I remember all the pigs running around in Bali. Chickens too, but I guess that's changed. At the time I thought it was charming, but now I'm wondering if they're going to start culling swine like they did poultry.

I can see why Indonesians don't take flu seriously...Life is more dangerous there I can see that foiks get accustomed to it...I flew Garuda Airlines from Bali to Jakarta, on quite possibly the oldest plane in the world through a heavy storm, no diverting around it, that's for sissies, and no one else seemed to think anything of it. I'm a seasoned flyer, but nearly kissed the ground when the plane landed.

Breathtakingly beautiful country; I still remember it so vividly.
 
Re: Discussion - Indonesia: Possible H5N1-H1N1 coinfection?

We are unlucky: a lot of influenza viruses are circulating in the world population, seasonal and pandemic.

We are almost double unlucky because we have a lot of animal viruses circulating too.

In most cases, large industrial farms operate both in affluent countries and in developing nations with millions of ducks, chickens, cows, sheep, pigs, often crowded into huge facilities.

I can speak for my country, Italy: my region - Veneto - is in the north-east portion of paeninsula and hosts a large number of these facilities.

Influenza viruses are usually isolated in Italy: mostly, low path H5/H7 subtypes.

Now, we have pandemic influenza H1N1 2009.

Veneto has huge pigs population, especially in Rovigo and Verona provinces.

If a worker has H1N1 2009 and has contact with pigs, almost with certainty an animal outbreak will start, even unnoticed since morbidity in these animals is low.

Couple this with other influenza subtype in ducks and poultry flocks we will surely have the chance of a double infections in animals or humans or both, even without further spread of a novel ''reassorted'' variants.

Indonesia is a hot spot for H5N1.

Italy and other EU countries, and US as well, have a lot of influenza viruses in animals.

Our problem: to track novel strains before they start to circulate into human population.

[Novel H1N1 flu (changed from 'Mexican Flu' by Fla1)] Pandemic H1N1 2009 virus, early this year, is our best example of our detection capabilities: the virus circled the world in six weeks and no containment was possible, even a week after the virus was isolated.
 
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Re: Discussion - Indonesia: Possible H5N1-H1N1 coinfection?

Oops, sorry Florida1. I just saw your message after I posted (about the politics). I didn't mean to bring up politics. I hope we will have good information being spread to the people. Thus far, the people around this area don't know what H1N1 is (generally.. most of them don't).

Thanks for the information!

We do not engage in political discussion because 1) we are a 503 (c)(3) non-profit charity 2) these kinds of passionate discussions would eclipse the disease information we are trying to disseminate.


Thanks again!


:)
 
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