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Indonesia Bird Flu Issues

G

Goju

Registered User
Based on your numbers, Figure that by day 30 you'd better be "sheltering in place and all clear would be about day 140 it would be safe to re enter the world...

Thats about 3.6 months

if you shelter later and exit earlier you may get by with 2.5 - 3 months

that is once it hits YOUR community
 
Re: Indonesia BF - 5/16/06

Re: Indonesia BF - 5/16/06

Even if you take into account the highest of the possible infected numbers reported in Indonesia, the count is not high enough to indicate efficient and sustained H2H. The pandemic has not started.

Time will tell.
 
Re: Indonesia BF - 5/16/06

Re: Indonesia BF - 5/16/06

All I am saying is that it doesn't explode as fast as you are thinking.

It takes some time for these case numbers to start building up.

That is why I said you should be watching very carefully and not let your guard down if you don't hear something for a few days with the situation in Indonesia.

In essence you will know by the end of the month whether or not the switch has been flipped on this one.
 
Re: Indonesia BF - 5/16/06

Re: Indonesia BF - 5/16/06

I have been wondering about the apparent inability to find the source of the family's infection - whether environment, poultry, or another human. Recalling a post I read yesterday, I was curious about the sister of the first woman/man to die. This is a snippet of the post found here:
http://www.flutrackers.com/forum/showpost.php?p=12622&postcount=125

On Wednesday, May 10, a woman named Anta Beru Ginting, aged 29, died at the hospital at about 5 a.m. local time. Her relationship to the others has not been clearly stated, though there is some indication that she may have been a sister of Praise Ginting, and therefore aunt to Roy Karokaro. She was identified by some local sources as living in Kabanjahe, the capital of the Karo Regency (district), and not in the village where the others lived, but the accuracy of this last statement is not known.
Click to expand...

Did she travel from her home village to the family gathering or to care for her ill sister? Did she arrive prior to the onset of illness or afterwards? Chances are she didn't come to town to spread manure. These seem to be easy answers for the local investigators and would shed significant light on the situation, IMO. I wonder if we will ever know.

Just a comment on the "panic" (or protest?) in the village mentioned in previous posts... It seems to me that their chief complaint is they culled (or have been instructed to cull) their poultry in spite of the negative tests on local poultry. Compensation for culling, if based upon positive or negative tests is, and should, be an issue for these poor villagers.

Any clarification would be appreciated.
 
Re: Indonesia BF - 5/16/06

Re: Indonesia BF - 5/16/06

DB said:
All I am saying is that it doesn't explode as fast as you are thinking.

It takes some time for these case numbers to start building up.

That is why I said you should be watching very carefully and not let your guard down if you don't hear something for a few days with the situation in Indonesia.

In essence you will know by the end of the month whether or not the switch has been flipped on this one.
Click to expand...

In an article from last year, some researchers distinguish between transmissibility and basic reproductive number for airborne pathogens.

http://www.cdc.gov/ncidod/EID/vol11no08/04-0449.htm

Basic Reproductive Number (R0) refers to the the ratio of a single infected individuals infecting others in close contact situations. When this number is equal to one (1) each infected individual is only infecting one other person. When it is less than one, it means that over time fewer and fewer people are being infected. And when this number is greater than one (1) it means that each infected individual is infecting more and more people.

But according to the article, one also has to consider transmissibility

In any given network exists a critical transmissibility value, Tc, which indicates whether a large-scale epidemic is probable. Any disease with average transmissibility <Tc cannot cause sustained transmission within a population and will thus be limited to small outbreaks. Such diseases die out because of the probabilistic nature of transmission before the disease has a chance to spread to the population at large.
Click to expand...

We just don't know what the transmissibility value is for this group of infected people. Were they, as Niman asserts, all infected from an index case or were they infected due to some common source.

Given that it has been more than two weeks, I think we can assume that the transmissibility rate is not very high for this cluster. The R0 number will be dependent on how these people actually got infected and whether or not any more individuals have been infected, but we don't know about yet.
 
Re: Indonesia BF - 5/16/06

Re: Indonesia BF - 5/16/06

Laidback Al said:
Given that it has been more than two weeks, I think we can assume that the transmissibility rate is not very high for this cluster. The R0 number will be dependent on how these people actually got infected and whether or not any more individuals have been infected, but we don't know about yet.
Click to expand...

I still don't think that this can be assumed.

From the data we have been given on what type of infection rate to expect we have these two data points to work with at this time.

Day 1: 0
Day 28: 31

So if we are currently sitting at day 14 how many people should be infected?

5?
10?
15?

I think it would be most likely somewhere around 10.

So we are currently at day 14 and we have 8 people in one family cluster and 6 deaths from that family cluster.

We also have the potential for a nurse to be infected (I don't think the current negative on the nurse can be taken at face value).

If the nurse is included that would make it 9 cases, which brings us pretty close to something that one would expect at the halfway point between day 0 and day 28.

Once again, I think we should assume nothing and keep our eye on the numbers. You have been given a guide on what to expect. Now is the easy part, match the numbers to your guide.

If the case numbers reach into the 20's or higher within the next 2 weeks then you can be assured that we have a major problem.
 
Re: Indonesia BF - 5/16/06

Re: Indonesia BF - 5/16/06

To me, it is not the growth in "raw" numbers that is critical; it is the ease of transmission. If in fact this is H2H then I would have expected that there would be more non-family members infected by now. Assuming an index case was asymptomatic for several days I think others besides family members would be infected by now and spreading the virus even further.

I think the time to worry is when we have an H5N1 cluster of individuals who only had casual contact with each other.
 
Re: Indonesia BF - 5/16/06

Re: Indonesia BF - 5/16/06

What worries me even more is the fatality rate. It is not going down. 6 out of 8 and if you take the tamiflu and ventilators away from them... we are looking at a virus with a 100% kill rate.

This is as bad as it gets.
If this strain goes efficient H2H ... Heaven help us all.
 
Re: Indonesia BF - 5/16/06

Re: Indonesia BF - 5/16/06

"I think the time to worry is when we have an H5N1 cluster of individuals who only had casual contact with each other."

The major consideration.
 
Re: Indonesia BF - 5/16/06

Re: Indonesia BF - 5/16/06

Laidback Al said:
To me, it is not the growth in "raw" numbers that is critical; it is the ease of transmission. If in fact this is H2H then I would have expected that there would be more non-family members infected by now. Assuming an index case was asymptomatic for several days I think others besides family members would be infected by now and spreading the virus even further.

I think the time to worry is when we have an H5N1 cluster of individuals who only had casual contact with each other.
Click to expand...

The problem is you really don't know that this hasn't already happened.

There are 12 people who were mentioned as showing symptoms and another 57 samples that have been sent to Hong Kong for testing.

It some of those cases come back positive than they could very well have become infected by the casual contact you are looking for.

I have seen a lot of people sit back and say "It doesn't look like this is it" and I am unsure how you can reach this conclusion on the small amount of information we have been given from this remote location.

Once again, not enough is known and it will be known in the next 2 weeks.
 
Re: Indonesia Bird Flu Issues

Goju,

It's called reality.

I hope that this is just another false start but the scientist in me cannot ignore the data.
 
Re: Indonesia Bird Flu Issues

I have a question, is it possible that the 57 samples are numerous samples from just 12 people, such as throat swabs, blood work, etc? That is isn't 57 separate people?
 
Re: Indonesia Bird Flu Issues

DB, if you are right, we won't have to wait 2 more weeks. More cases should be starting to show up soon. The problem, of course, is getting accurate information. No country, even Indonesia, wants to be remembered as the country where the pandemic started.
 
Re: Indonesia Bird Flu Issues

Laidback Al,

I hope like hell the switch has not been flipped.

This story is really only 4 days old in terms of news reports and I believe we will get more clarity within the next week.

What has me mucho concerned right now is that WHO has been silent in terms of a press release about the largest cluster which means they either haven't got a handle as to what is going on or they have got a handle and they are notifying the top of the food chain first before they make any announcements.
 
Re: Indonesia Bird Flu Issues

siam said:
I have a question, is it possible that the 57 samples are numerous samples from just 12 people, such as throat swabs, blood work, etc? That is isn't 57 separate people?
Click to expand...

The 57 samples are from 5 nurses, certain members of the medical staff from the hospital that had worked with the family, and residents of their village. The story is here in the thread about the family or the thread about the nurse that details all of this out.
 
Re: Indonesia Bird Flu Issues

Two nurses ? :confused: I saw a post on another forum about two Indonesian nurses possibly contracting the virus. Is this confirmed ? If so, is there then the likelihood of efficient h2h ?
 
Re: Indonesia Bird Flu Issues

I have seen a lot of people sit back and say "It doesn't look like this is it" and I am unsure how you can reach this conclusion on the small amount of information we have been given from this remote location.
Click to expand...

I'm looking for the same thing I think Al is- not just one family cluster (those are concerning enough!) but tranmission outside that family in casual contacts.

Those second generation (if its true thats what it is) if they were the recipients of an easily transmitted virus, should have already spread it to their community. There should be many more cases noticable by now.

Do I absolutely know thats the way it will happen? Heck, no! Its an assumption on my part.

Is there the possibility that is why the WHO wasnt let into the village-that more are sick? I suppose it is- but I doubt it, because there ought to be more reports of it by now.

You could be right DB, this might be the start- but I think its more likely an incremental step in that direction. If that is the case, and the sequences allowing for easier transmission are conserved, than we should see signs of it soon.

Once I can suspend my emotional involvement and concern about apandemic and look at it from a purely science viewpoint- ya gotta admit, todays news and discussion are highlighting two very differenet but both equally possible ways a pandemic could begin.

First, you have this large Indonesian cluster, and it looks like another step in the direction of slow but sure adaptation to a new host.

Then theres the concerning story about the possible Ebola death on the Virgin airways flight from Africa to the UK.

An isolated case of illness, in a large international airliner. If this is a case of easily transmitted hemorrhagic flu, then we'll probalby know by the end of this week. People from that flight should start breaking with symptoms within that time. Theres no indication that passenger tracking has been done, but that might be in process.

Either way, both types of situtations are certainly worth watching. Either type of situation could easily herald the start. But unless we first become aware of the index case/cluster before that efficient transmission becomes apparent- IMHO it remains a waiting game, waiting to see if the ripples start to form.

If this case in Indonesia is it, I think we'd have seen ripples by now. The info that there might have been an earlier relative that spread this to the apparent index ccase of the cluster is concerning. If we can work out the time line on that, maybe we have a better idea of the incubation time. If its longer than the 2-4 day period for normal flu, than we do have a chance to catch it-and a longer period of time to see if it got loose...
 
Re: Indonesia Bird Flu Issues

LMonty,

I am unsure if this is the start. Let's just say I am reserving judgement till more facts come in.

There is way to much speculation going around from both WHO and Indonesia onto the source of these infections.

First it is fertalizer.
Then it was pigs.
Scratch that, it was the food they ate a barbecue.
Wait a sec it could be the cats and dogs.
Hold on, it might be faeces.

All of these explanations have been raised by WHO and Indonesia and non of them seem to be sticking.

They don't close the door on human-to-human transmission, they just don't put it on the 'most likely explanation' list.

Right now there are at least 4 more human cases of bird flu in Indonesia, that would make somewhere around 12-15 for the month.

Based on the numbers from King County, Seattle by day 28 we should see 31 cases. Now if we see 31 cases across Indonesia for the month of May I am going to be very concerned because there is very little knowledge about where all these cases are getting infected.

Could this just be some bubbling on the way to rapid boil, almost like April in Kansas in the year 1918, or could this be the start of the rapid boil?

I have no idea, but the numbers are still going up.

Oh and in regards to the Ebola on the airplane.:eek: :eek: :eek:
 
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