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Discussion on Indonesia Outbreaks

Re: Discussion on Indonesia Outbreaks

Here is a detailed map of Indonesia.
http://www.lib.utexas.edu/maps/ams/indonesia/index.html

I can?t paste maps in here. Here is a post my MomCares at CurEvents with the list of places this cluster is from:

I wish we could get a geography lesson from a local, or at least a REALLY detailed map of the area surrounding Garut. Theresa?s map is great (probably the best there is), but it still doesn?t clarify where all these little villages are.
Here are the relevant place names I found in the press releases I went through last night?
Ranlasalak Village,
Cikelet subdistrict, Garut district
Jojok village, Cikelet subdistrict,
Garut Pameungpeuk subdistrict
Jojoh Tipor village
Pasir Gambir village
Some of these may be translation issues, or they might all be discrete places. It sure would be great to understand it better!

[I was able to find Garut but I couldn?t find Cikelet. If you scroll down, there is a list of the districts and that?s where I found Garut.]
 
Re: Discussion on Indonesia Outbreaks

Garut is a lot larger area than I thought at first, Thank you for the information Commomground.
 
Re: Discussion on Indonesia Outbreaks

siam said:
Garut is a lot larger area than I thought at first, Thank you for the information Commomground.

All of the patients are in Cikelet Village, the Cikelet Subdistrict, Garut, West Java which is on the coast and only 20 km across.
 
Re: Discussion on Indonesia Outbreaks

Thanks Theresa42 for the map. If it's only about 4 miles to Dukuh, then these hamlets must be similar to our "housing developments" in our Country. They could be no more than a few dirt roads.
 
Re: Discussion on Indonesia Outbreaks

Yes thank you Theresa for the map, this one I can see a bit better.
 
Re: Discussion on Indonesia Outbreaks

Siam, I would have to try to get a total and a total number of deaths. You may be able to go to Dr. Nimans site to get clarification. I thought is was 10 suspected cases and I'm not sure out of that, how many deaths.
 
Re: Discussion on Indonesia Outbreaks

The newspaper Pikiran Rakyat is reporting one confirmed death -- Ai Siti Amanah -- and four suspected deaths -- Euis Lina, Rubiah, Misbah and Sardi. In other words, 5 altogether (out of ca. 11 suspected cases).
 
Re: Discussion on Indonesia Outbreaks

The Washington Post today ran a feature article revisting the Karo, North Sumatro family cluster. Dowes Ginting is the subject, the last to die in this unfortunate chain. What's not been made public is that Dowes had three viral samples taken, one when he became ill, and two others at death. The NA segment of these isolates is quite interesting.

When Dowes became ill he began popping Tamiflu, but then ran off into the hills not completing his 10 day regiment. His early genetic sequence shows Tamiflu sensitivity, but one of the later sequences shows the H274Y mutation indicating Tamiflu resistance.

So if Dowes had in fact infected others in his village, not only would they have been infected with highly pathogenic H5N1, but Tamiflu would have likely not given them much, if any, relief. Similar situation seen in Vietnam patients. This virus seems to adapt quickly to antivirals, at least Tamiflu.
 
Re: Discussion on Indonesia Outbreaks

Hi Mamabird,

Can you provide some links or virological references to corroborate your statement please.

Thank you
 
Re: Discussion on Indonesia Outbreaks

Am glad you posted this thread.The media headlines today stated we are safe and that the Alaska samples were all clear. Am not reading about the 9, h5 cases found. Isnt there one rogue reporter that will dig deeper below the surface? The media seems to always report on what you dont want to hear about.

Seems like there's an increase in the rate of infection in Indo. There are no current updates or scaled back reports from WHO and the only case reports are from translated Indonesian media.

Am also concerned by the means the disease is spreading. Neighbors and small clusters are cropping up. Is it possible the disease is being carried by air currents? Source of infection is still unidentified.

There has been a complete drop off in cases being reported worldwide.
 
Re: Discussion on Indonesia Outbreaks

Snowy Owl said:
Hi Mamabird,

Can you provide some links or virological references to corroborate your statement please.

Thank you

Mamabird is spot on. 560H has H274Y (Tamiflu resistant)

560H_06 IKMNPNQKIITIGSICMAIGTVSLMLQIGNMISIWVSHSIQTGNQHQAESISNTNPLTEK
CDC625 --MNPNQKIITIGSICMAIGTVSLMLQIGNMISIWVSHSIQTGNQHQAESISNTNPLTEK
**********************************************************

560H_06 AVASVTLAGNSSLCPIRGWAVHSKDNSIRIGSKGDVFVIREPFISCSHSECRTFFLTQGA
CDC625 AVASVTLAGNSSLCPIRGWAVHSKDNSIRIGSKGDVFVIREPFISCSHSECRTFFLTQGA
************************************************************

560H_06 LLNDKHSNETVKDRSPHRTLMSCPVGEAPSPYNSRFESVAWSASACHDGTSWLTIGISGP
CDC6256 LLNDKHSNETVKDRSPHRTLMSCPVGEAPSPYNSRFESVAWSASACHDGTSWLTIGISGP
************************************************************

560H_06 DNGAVAVLKYNGIITDTIKSWRNNILRTQESECACVNGSCFTVMTDGPSNGQASYKIFKM
CDC625 DNGAVAVLKYNGIITDTIKSWRNNILRTQESECACVNGSCFTVMTDGPSNGQASYKIFKM
************************************************************

560H_06 EKGKVVKSVELDAPNYYYEECSCYPDAGEITCVCRDNWHGSNRPWVSFNQNLEYQIGYIC
CDC625 EKGKVVKSVELDAPNYHYEECSCYPDAGEITCVCRDNWHGSNRPWVSFNQNLEYQIGYIC
***************:*******************************************

560H_06 SGVFGDNPRPNDGTGSCGPMSSNGAYGVKGFSFKYGNGVWIGRTKSTNSRSGFEMIWDPN
CDC625 SGVFGDNPRPNDGTGSCGPMSSNGAYGVKGFSFKYGNGVWIGRTKSTNSRSGFEMIWDPN
************************************************************

560H_06 GWTGTDSSFSVKQDIVAITDWSGYSGSFVQHPELTGLDCIRPCFWVELIRGRPKESTIWT
CDC625 GWTGTDSSFSVKQDIVAITDWSGYSGSFVQHPELTGLDCIRPCFWVELIRGRPKESTIWT
************************************************************

560H_06 SGSSISFCGVNSDTVSWSWPDGAELPFTID- 450
CDC625 SGSSISFCGVNSDTVSWSWPDGAELPFTIDK 449
******************************
 
Re: Discussion on Indonesia Outbreaks

Thank you Doctor Niman,

This raise some question for Indonesia. Does anybody know Relenza production capacity by GlaxoSmithKline??
 
Re: Discussion on Indonesia Outbreaks

PonyGirl said:
Seems like there's an increase in the rate of infection in Indo. There are no current updates or scaled back reports from WHO and the only case reports are from translated Indonesian media.

Am also concerned by the means the disease is spreading. Neighbors and small clusters are cropping up. Is it possible the disease is being carried by air currents? Source of infection is still unidentified.

There has been a complete drop off in cases being reported worldwide.

I have noticed the same issues Ponygirl. The overall confirmed numbers of infected and deaths don't seem to change in correlation to the cases reported outside of mainstream media.

I've been reading the translated articles for quite some time now and still keep seeing the same or slightly altered numbers reported as official.

Florida mentioned in another thread that more people are recovering, which may be true, but there also seems to be a growing number of people dropping into a black hole somewhere.

JMHO
 
Re: Discussion on Indonesia Outbreaks

My gut feeling on this is the situation is beginning to spiral out of control. I do not like putting on a foil hat. It clashes with my hair and I like to be known for level-headedness. But, I feel an ominous foreboding both with any resistance to Tamiflu and for patients who disappear off the radar into the hinterlands. We are faced with way too many unknowns. How many are sick? Who actually have H5N1? Where are they? Have any of these people been in contact with people who have subsequently become ill? Why do we keep seeing new people in the hospital? Where were they exposed? Are the doctors well-versed in how, and where, and when to take samples? Are the techies who do the samples experts? Considering how many times we have seen results go from uninfected to infected, all of us need to be skeptical of quick negative results. In short, I see way too many sick, no serious application of quarantine, and a mostly blase' press.

Last month I would have put my tin hat rating at a 4. This week I fear I must up it to at least a 5. Until we get some kind of reliable system for tracking the sick and who they came into contact with, the level will stay at a firm 5 for me.

I just got a PT from someone who did not understand what my system of moving from a 4 to a 5 means. It does not refer to the WHO system but rather to my own personal and internal radar. I am flummoxed that in this day and age given the catastrophic potential of the virus we are unable to track who, where, when, and how infected. Couple that with victims leaving the hospital at will and disappearing into oblivion and you have chaos. Without these simple yet profound answers we are all one step closer to pandemic.
 
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Re: Discussion on Indonesia Outbreaks

Giving people a false sense of security by saying there are no cases in Alaska is probably not a good idea. One plane ride from SE Asia to the US is more likely to get the ball rolling.
 
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