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Indonesia Discussion

Re: Indonesia Discussion

If you were an ignorant Sumatran villager who had animistic superstitions in your community and who was now saved by being Christian , and who knew that all but one of your friends died when they took Tamiflu, would you be eager to take that chance?

While we in the West think it smart, my ex gal pal wouldn't take that drug unless she was positive she would die without it. She'd wait until it was too late, and she's as Western as they get.

The Tamiflu distribution effort is culturally flawed. I've heard of no rational response which will be effective when facing irrational refusal to assume a perceived risk.

We may do better deciding how to bury so many so fast and not to pollute the watertable.
 
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Re: Indonesia Discussion

CreativeOne said:
Frm Post 23 ''We have to closely monitor the situation in Indonesia for at least 10 days. If it gets worse, we are ready to implement preventive measures under WHO's recommendations,'' he said.


Does anyone know what those preventive measures will be?
Click to expand...

That is what the Thai government said.

It could mean any number of things. Tamiflu is an option. So is closing their borders or shutting down their airports. It is whatever the Thai government deems necessary.
 
Re: Indonesia Discussion

We all now know that what we in the West thought was a wonderfully generous offer, the Tamiflu Blanket, will oft be met by superstition, derision and fear.

I have this image in my mind, the one after WWII when the Americans arrived in Paris and the Parisian girls ran up and placed flowers in the gunbarrels of the Yanks.

Geo Bush thought that would happen in Iraq.

WHO thinks it will happen in [insert name the 3rd world country, here]. Somehow they're ignoring the lesson of Karo, Sumatra. We're not.

It's tragic; darned tragic. That's what we have in store for ourselves.
 
Re: Indonesia Discussion

DB posted this in the Indo News thread, but it's so observant and interesting that I wanted to bring it into the Discussion thread.

This piece of journalism (and many others related to bf) really can appear like something issued from the Ministry of Truth (remember that George Orwell actually worked for the BBC and Britian's Ministry of Information during WWII, so presumably he understood how it all worked. Apparently he said of his time at the Ministry of Information that he felt like "an orange that's been trodden on by a very dirty boot")...
DB said:
The H5N1 virus, in its current form, can only make a human sick if it manages to reach deep down in the lungs. It does not infect the upper-respiratory tract of a human, it infects the lower-respiratory tract. For a human to become infected and ill he/she must be exposed to a large, continuous cluster of H5N1. When an infected person coughs, tiny quantities of H5N1 are expelled, because it is so deep down in the lung. This makes it even more difficult for one human to infect another. The only way one human can infect another is by constantly coughing, really close to that other human, in close quarters, for a long time.

With family members all sharing a small room, it is easily possible that a sizeable cluster built up - enough to start infecting other family members. H5N1 already does that without having to mutate - transmit from human-to-human if conditions are right. What it cannot do is transmit from one human who sneezes in the supermarket to another who is walking by.

So, the infection of these family members is easily possible without H5N1 needing to mutate. In fact, if it had mutated we would have expected to see more infected people, perhaps neighbours and other people down the road - this has not happened. The only ones to become infected were the ones who shared this tiny room with an infected person who was coughing a lot.​

I find it interesting how they are acting like this is old news. They make it sound as if we should all know this, like this shouldn't be alarming to us.

I am sorry but statements like these really anger me because they convey a false sense of reality. They do not emphasize the fact that this is a MAJOR change, if not in the virus, then in what we are being told about the virus.

How many articles mention that the virus is a 'disease of the birds'?

Thousands.

How many articles mention that you can only catch the virus if you are handling infected poultry?

Thousands.

How many articles mention that you can only catch the virus if you have close contact with infected poultry?

Thousands.

How many articles mention that you can catch the virus if you have close contact with an infected human being?

Zero. Until yesterday.
Click to expand...
 
Re: Indonesia Discussion

" How many articles mention that you can catch the virus if you have close contact with an infected human being?

Zero. Until yesterday."

Not strictly true, although the implication previously was that the carer came into contact with bodily fluids. What is different in this case is that airborne transmission is implicated. The point is well made all the same.

Questions:
Who (or what) gave the index case H5N1?

Has there been a change in the virus making it not only more likely to infect humans, but also to kill humans (7 out of 8 infected is not normal).

If so where does this leave proponents of the "virus is likely to trade mortality with the ability to infect humans" camp?

The implication of this cluster is that the virus has moved further up the respiratory tract, is this so?

When can we see the sequences and will anybody be spelling out the onset dates?

Given the revised criteria for a phase 4 alert level, if there are one or two more similar clusters in the near future will the WHO be raising the level or changing the criteria again?

If it's not about the size of the clusters, what is the WHO looking for before raising the level?

I dare say we can all add to the questions, but what are the odds of anybody being able to answer them?
 
Re: Indonesia Discussion

..When an infected person coughs, tiny quantities of H5N1 are expelled, because it is so deep down in the lung. This makes it even more difficult for one human to infect another. The only way one human can infect another is by constantly coughing, really close to that other human, in close quarters, for a long time.

With family members all sharing a small room, it is easily possible that a sizeable cluster built up - enough to start infecting other family members. H5N1 already does that without having to mutate - transmit from human-to-human if conditions are right. What it cannot do is transmit from one human who sneezes in the supermarket to another who is walking by.

So, the infection of these family members is easily possible without H5N1 needing to mutate. In fact, if it had mutated we would have expected to see more infected people, perhaps neighbours and other people down the road - this has not happened. The only ones to become infected were the ones who shared this tiny room with an infected person who was coughing a lot.<<

The above is just more nonsense. Those in the small room were the two sons and one brother of the index case. However, the cluster also included the other brother, his wfe, and son who were not in the room.

This is like the case in Thailand where the mother was infected by her dauighter becauise she held her close and the daughter vomited blood. However, the aunt of the index case was also infected and developed symptoms several days after her sister, so the explanations for one family member do not apply to the other(s).
 
Re: Indonesia Discussion

H5N1 Sequence Analysis of North Sumatra Cluster

Recombinomics Commentary
May 25, 2006

The CDC head said the genetic sequencing of viruses from the cluster so far has yielded four main findings:

The isolates are all "virtually identical," implying a single source.

They are susceptible to the antiviral drug Tamiflu (oseltamivir).

"There is no evidence of motif changes in the particular areas of the genes that are responsible for how the virus binds to the respiratory tract of people."

The isolates are very similar to viruses previously collected from poultry in the region.

The above comments from the CDC are similar to comments from Hong Kong. Both groups receive human samples from Indonesia as indicated in the WHO update. However, as with the earlier WHO updates, more information is available from what is not said in the reports. Since only part of human sequence has been made public (HA and NA from the first confirmed case in July of 2005), more sequence interpretations come from short and well parsed comments, such as those above.

The first two confirmed cases in Indonesia were associated with short descriptions which contained subtle differences. The released sequence from the first case in 2005 has a novel cleavage site (RESRRKKR), which is why it was not called ?virtually identical? but was said to have ?high homology? with poultry sequences, which have the more common cleavage site (RERRRKKR). The second sequence in 2005 was called ?essentially the same? as poultry (as opposed to essentially the same as the first human sequence), indicating it had the RERRRKKR cleavage site. Thus, there were two sequences in human cases in the Jakarta area.

A subsequent report indicated all human sequences from the area had RESRRKKR which did not match any known poultry source, which created a problem since all WHO updates indicated the human cases were linked to H5N1 in poultry. The only animal in the Jakarta area with a sequence with RESRRKKR was not a bird, but a cat, raising serious questions about origins and transmission, since many of the patients in the area were from familial clusters with 5-10 day gaps, indicating human-to-human transmission (H2H). These clusters included both of the above sequences, indicating both cleavage sites were linked to H2H, but only one was linked to poultry.

The comments above indicating that the sequences from the Sumatra cluster were ?virtually identical? to each other and ?very similar? to poultry isolated previously from the area indicates a poultry source infected the index case, but the subsequent infections were from the index case or other family members and the normal incubation time of 2-5 days suggests that there were multiple transmissions within the family that were not linked to the index case.

The cleavage site would be the common poultry sequence of RERRRKKR, but the failure to mention amantadine sensitivity suggests the cluster sequences were amantadine resistant, as has been seen previously in poultry isolates from Indonesia.

Thus, the only antiviral mentioned was Tamiflu susceptibility, and the United States is shipping Tamiflu to ?Asia?. However. local media reports indicate that the patients in the cluster were treated with 3 X 75 mg Tamiflu, and all but one died, even though the later cases seem to have been hospitalized shortly after developing symptoms. The exact times are not clear because the onset dates for all relatives other than the last fatality, who refused Tamiflu treatment, were not included in the WHO update.

The ?resistance? to the Tamiflu treatment may have been due to another change, which is not related to the receptor binding domain, which the above comments indicate the human isolates match an avian motif. That change, which has been seen in H5N1 human cases in Asia as well as dog and wild and domestic cat sequences in Thailand, is PB2 E627K, which may be why the cluster sequences are ?virtually identical? to each other, but ?very similar? to the poultry sequences, which have not been reported to have PB2 E627K. The only bird H5N1 sequences with E627K are the Qinghai strain, which is quite distinct from Indonesian bird or human HA and NA sequences (no other human genes have been released from Indonesia)..

The accuracy of the above analysis can be easily determined by simply releasing the full Indonesian sequences, which have been sequestered at the private WHO database at Los Alamos since August of 2005.
 
Re: Indonesia Discussion

Anyone who have followed the tracks of H5N1 and watched the ABC news last night should see the battle is lost in Indonesia. It is just a matter of time thousands if not millions will be infected in that environment where these exist:

1. Opened sewage
2. Kids play with pigs, poultry which are also their dinners
3. People eating with hands
4. People distrust westerner and their medicine


If WHO raises alert level to P4 for Indonesia, may be more resources can get in and save a few lives. The rest of the world can stay with P3. Why not?
 
Re: Indonesia Discussion

When it comes to Pandemic flu - indonesia is the world... the world is indonesia 4 is 4.
 
Re: Indonesia Discussion

Wall Street doesn't want to hear bad news. WHO doesn't want to be blamed for causing 100 million consumers to stay home. Congressmen and senators don't want cold water pouring on the party before the election. What gives?
 
Re: Indonesia Discussion

There will be no happy ending in Indonesia. Here is what WHO said:

Local authorities have resisted working with outside health experts and many villagers blame black magic, not bird flu, for the deaths of the family members.

On Monday, a half-dozen protesters beheaded a chicken and drank its blood to show local authorities that poultry was not the source of the problem.


Can one do in Indonesia what HK and Toronto did to deal with SARS?

No way.

Indonesia will be the next killing field.
 
Re: Indonesia Discussion

The Indonesian situation poses a series of four related important questions.

1.) Has there been a significiant change in the virus in this latest cluster?

If the answer is yes, on to the next question.

2.) Is it or it is not treatable with Tamiflu?

If the answer is no, on to the next question.

3.) Will "they" been able to contain it without a Tamiflu blanket?

If the answer is no, there is only one big question left

What the hell are we all going to do? :eek:
 
Re: Indonesia Discussion

Do you suppose they will make him or her drink uncooked chicken blood as a right of passage?

Quote:
<TABLE cellSpacing=0 cellPadding=6 width="100%" border=0><TBODY><TR><TD class=alt2 style="BORDER-RIGHT: 1px inset; BORDER-TOP: 1px inset; BORDER-LEFT: 1px inset; BORDER-BOTTOM: 1px inset">Originally Posted by DB
"There are 33 people identified as close contacts. We've asked them to observe home quarantine. That's something they are willing to do to protect themselves and their families," said Dick Thompson, spokesman for the WHO.
​
So Dick Thompson from WHO has said that 33 people that have had close contact with the infected family members have put themselves in quarantine.

Oh Really?
When visiting the house the family of casualties of the bird flu virus, on Wednesday (24/5), the reporter Metro the TV found this house in the empty situation. According to the neighbour, casualties's family Praise Boru Ginting, Anta Boru Ginting and Dowes Ginting have for a long time been empty. They fled to several of his relatives.

​
It must be one of those new 'mobile quarantines'.
</TD></TR></TBODY></TABLE>

I'm sure this will all be resolved when the WHO social mobization expert shows up next week.:D That is, assuming the villagers let him in.<!-- / message --><!-- sig -->
__________________
 
Re: Indonesia Discussion

OK, the spin is starting:
Bird Flu Clues In Indonesian Case
Woman May Have Had Contact With Sick Or Dead Chickens Before Passing Virus To Family
CBS News: http://www.cbsnews.com/stories/2006/05/25/health/main1655664.shtml

This is why:
Peter Cordingley, spokesman for the WHO's Western Pacific region, quoted in a Reuters report today, said, "This is the most significant development so far in terms of public health. We have never had a cluster as large as this. We have not had in the past what we have here, which is no explanation as to how these people became infected [in the first place]. We can't find sick animals in this community, and that worries us." (Source: CIDRAP)

"If we can't find an external source that explains all seven confirmed cases, then we have to go with the theory that this is human to human," says Peter Cordingley, the spokesperson for the WHO's Western Pacific regional headquarters. (Source: Time)

Could it be that a vaccinated bird passed it on?
Now there's a story you wouldn't want broadcast!
 
Re: Indonesia Discussion

Such a statement coming from Peter Cordingley, who is usually very discrete, some might say diplomatic, is very surprising.

Seems that this time via Indonesia, some pressure from South East Asia Regional WHO HQ is unfolding.

Wonder what Shigeru Omi will say now.
 
Re: Indonesia Discussion

Can members vote on this board?

How many members think Indonesia is at P4 now?

How many members think Indonesia will be at P5 by Christmas, 06?
 
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