Theresa42
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Bird flu, Puncak the Ice Mountain [Tip of the Ice Berg]
May 24, 2006
By: G Ngurah Mahardika the Expert Virology, the Co-ordinator the Researcher Avian influenza, the Medical Faculty the Udayana University Animal, Denpasar
Secretly bird flu was still haunting us. The local and national mass media, both printed and electronics, recently reported, a group of person that still was having the family's relations and was living in a village in North Sumatra it was suspected terjangkit the virus of sub-type influenza H5N1 that deadly.
At least two people were dying, while four or five other people were still being treated.
According to the Head of public relations of RSU Adam the Owner, Medan, the Ginting rays (Metro the Online TV, on Wednesday 10/5), all the patient had the same sign: hot high, the cough, and was gotten the liquid to his lungs. Before this touching incident, the mother from a sufferer also died suddenly after beforehand experienced the sign of the disturbance of the same health.
This case indeed still was acknowledged as the "assumption". His case still diinvestigasi. Several poultries were also checked to confirm the existence of bird flu, was like this news words.
Because of not yet having confirmation, this case did not yet enter official WHO information. Up until May 12 2006, the case of the virus infection that by National Geographic was mentioned "super flu has" to" the humankind been reported in 10 countries in the world. The number of sufferers was recorded already 208 people, 115 including dying.
Indonesia occupied the second place in the matter of the number of sufferers (33 people) and the death (25 people). The area of the spreading of the case of bird flu to humankind in Indonesia also, slow but certain, increasingly spread. At first in West Java and Jakarta, afterwards increasingly widened to Central Java, East Java, South Sulawesi, Lampung, and currently (if being proven) North Sumatra.
Tersembunyi
Although still the assumption, the pattern of the illness was typical the infection of the influenza virus H5N1. If the assumption was true, the number klaster (cluster) increased. Klaster, that is the case collection to humankind in the certain place, was signs of the pandemic of the beginning. If klaster even more, meant the virus increasingly was easy to spread antarmanusia. Beforehand, five phenomena klaster happened in Indonesia, whereas in Vietnam with 93 cases was gotten four klaster. In Thailand, the number klaster was recorded was two from 22 cases.
That not to mention the number of cases that through observation and the testing. From the official data, in Indonesia was gotten by 92 cases as the possibility (probable), was expected (suspect), or most exposed (exposed), 28 including dying.
That finally deserved to become attention. After mewancarai often was expert, mid last February, the BBC put on headline that the number of cases of bird flu possibly far more many of the official numbers. Many cases were passed by [missed] because of not pointing out the sign of the fever and breathless, the syndrome that was regarded as typical bird flu.
In Vietnam, the BBC covering, the virus H5N1 attacked all the body parts, not only breathing. Several patients that only showed the sign of enteritis and the brain evidently positive H5N1. One of the chairmen of the researcher, Dr Menno de Jong, the virology expert Oxford University Clinical Research the Unit that was assigned in the Hospital for Tropical Diseases Ho Chi Minh, Vietnam, said, "If having the patient who was sick heavy, we preferably considered the possibility of bird flu as his cause."
With the argumentation like that, the case of bird flu in Indonesia and the world could be compared as the peak of the ice mountain (ice berg). Under the surface, the number of cases could far more many. With the available health system now, the possibility was received by many cases that were not recorded, whether because of could not be checked, being not suspected completely, or being diagnosed by the other illness, dengue fever, for example. In villages, the bird flu illness with the fast development could was regarded as the illness of consignment mystique (black magic).
"3-E"
The key to the success of the handling of bird flu in being the early detection, pelaporan early, and the early action (3-E, early reporting, early detection, early action). The existence suspicion of the case must be it was reported early, furthermore it was confirmed as quickly as possible, and finally was done by the action the exact handling straightaway. One of the pillars 3E was the existence of the diagnostic laboratory with the high standard. The lab of that kind must be held in each province. Therefore, the speed could be guaranteed. The technique that was used also must be specific and sensitive. At this time the testing that best was the increase in the virus to the sprouting chicken egg or the cell culture, that afterwards was followeded by the detection of virus genes typical influenza with reverse-transcriptase/polymerase chain reaction (RT-PCR). RT-PCR was technical molecular to increase target genes in the tube of the reaction so as to be able to be known quickly.
Therefore, the bird flu virus could be detected from the suspect's specimen although in the number that very few. RT-PCR could be also used for the determination of the sub-type directly.
The development of the technique of RT-PCR to real time RT-PCR (RT-RT-PCR) increased the special characteristics of the diagnostic technique. Technically this, there was or not the influenza virus H5N1 could be known in time one or two hours. Besides this, this technique could in fact count the number of particles of the available virus in the specimen.
Center for Disease Prevention and Control (CDC) America developed and released the package reagensia for the detection of the virus H5N1 was based on RT-RT-PCR (Morbidity and Mortality Weekly Report, 10/2/2006 the number 55 (05); 127). Technically RT-RT-PCR for the virus avian influenza also had been tried in the Eijkman Agency, Jakarta.
Technically the increase in the virus indeed only could be carried out in the certain lab with facilities BSL-3 above. Meaning that, the increase in the virus must guarantee did not have pollution of the environment and the lab worker. Proposed by me the lab of this kind was built per regional. One national reference lab was enough as the place of the testing of the end.
The second technique, RT-PCR could be done safe and responsible in the lab that did not have facilities like that. The virus in the specimen at once could be put in the tube pelisis so as all the viruses (but also the bacteria, the fungus, the parasite) will fall without damaging the RNA gene the bird flu virus.
From the writer's experience, the technique of RT-PCR has been proven could detect the virus avian influenza H5N1 from the cloaca caress and the network of the poultry that was sick. Spesifisitas, meaning that the capacity detected only of the suspect's viruses, could approach perfect. Whereas his sensitivity, that is the capacity detected the virus in the network or the waste of the poultry that was sick, reached 90 percent. Meaning that, from 10 networks that contained the influenza virus, just one that was not detected.
With RT-PCR we could also detect the existence of the influenza virus H5N1 in a period less than 12 hours. The morning of the suspect's specimen arrived in the lab, in the afternoon we knew results. This happened if the specimen was at once done. Considering the bird flu threat, this achievement must be carried out all the diagnostic labs. The technique could be applied for the detection of the bird flu virus to humankind. His key also was easy. The execution of the influenza virus from the animal and humankind must be done in lab facilities that were separated.
The writer was sure the government could hold the lab was meant. By investment and the training of human resources, one of the pillars 3-E could be held in a short time.
http://www.kompas.com/kesehatan/news/0605/24/102532.htm
Bird flu, Puncak the Ice Mountain [Tip of the Ice Berg]
May 24, 2006
By: G Ngurah Mahardika the Expert Virology, the Co-ordinator the Researcher Avian influenza, the Medical Faculty the Udayana University Animal, Denpasar
Secretly bird flu was still haunting us. The local and national mass media, both printed and electronics, recently reported, a group of person that still was having the family's relations and was living in a village in North Sumatra it was suspected terjangkit the virus of sub-type influenza H5N1 that deadly.
At least two people were dying, while four or five other people were still being treated.
According to the Head of public relations of RSU Adam the Owner, Medan, the Ginting rays (Metro the Online TV, on Wednesday 10/5), all the patient had the same sign: hot high, the cough, and was gotten the liquid to his lungs. Before this touching incident, the mother from a sufferer also died suddenly after beforehand experienced the sign of the disturbance of the same health.
This case indeed still was acknowledged as the "assumption". His case still diinvestigasi. Several poultries were also checked to confirm the existence of bird flu, was like this news words.
Because of not yet having confirmation, this case did not yet enter official WHO information. Up until May 12 2006, the case of the virus infection that by National Geographic was mentioned "super flu has" to" the humankind been reported in 10 countries in the world. The number of sufferers was recorded already 208 people, 115 including dying.
Indonesia occupied the second place in the matter of the number of sufferers (33 people) and the death (25 people). The area of the spreading of the case of bird flu to humankind in Indonesia also, slow but certain, increasingly spread. At first in West Java and Jakarta, afterwards increasingly widened to Central Java, East Java, South Sulawesi, Lampung, and currently (if being proven) North Sumatra.
Tersembunyi
Although still the assumption, the pattern of the illness was typical the infection of the influenza virus H5N1. If the assumption was true, the number klaster (cluster) increased. Klaster, that is the case collection to humankind in the certain place, was signs of the pandemic of the beginning. If klaster even more, meant the virus increasingly was easy to spread antarmanusia. Beforehand, five phenomena klaster happened in Indonesia, whereas in Vietnam with 93 cases was gotten four klaster. In Thailand, the number klaster was recorded was two from 22 cases.
That not to mention the number of cases that through observation and the testing. From the official data, in Indonesia was gotten by 92 cases as the possibility (probable), was expected (suspect), or most exposed (exposed), 28 including dying.
That finally deserved to become attention. After mewancarai often was expert, mid last February, the BBC put on headline that the number of cases of bird flu possibly far more many of the official numbers. Many cases were passed by [missed] because of not pointing out the sign of the fever and breathless, the syndrome that was regarded as typical bird flu.
In Vietnam, the BBC covering, the virus H5N1 attacked all the body parts, not only breathing. Several patients that only showed the sign of enteritis and the brain evidently positive H5N1. One of the chairmen of the researcher, Dr Menno de Jong, the virology expert Oxford University Clinical Research the Unit that was assigned in the Hospital for Tropical Diseases Ho Chi Minh, Vietnam, said, "If having the patient who was sick heavy, we preferably considered the possibility of bird flu as his cause."
With the argumentation like that, the case of bird flu in Indonesia and the world could be compared as the peak of the ice mountain (ice berg). Under the surface, the number of cases could far more many. With the available health system now, the possibility was received by many cases that were not recorded, whether because of could not be checked, being not suspected completely, or being diagnosed by the other illness, dengue fever, for example. In villages, the bird flu illness with the fast development could was regarded as the illness of consignment mystique (black magic).
"3-E"
The key to the success of the handling of bird flu in being the early detection, pelaporan early, and the early action (3-E, early reporting, early detection, early action). The existence suspicion of the case must be it was reported early, furthermore it was confirmed as quickly as possible, and finally was done by the action the exact handling straightaway. One of the pillars 3E was the existence of the diagnostic laboratory with the high standard. The lab of that kind must be held in each province. Therefore, the speed could be guaranteed. The technique that was used also must be specific and sensitive. At this time the testing that best was the increase in the virus to the sprouting chicken egg or the cell culture, that afterwards was followeded by the detection of virus genes typical influenza with reverse-transcriptase/polymerase chain reaction (RT-PCR). RT-PCR was technical molecular to increase target genes in the tube of the reaction so as to be able to be known quickly.
Therefore, the bird flu virus could be detected from the suspect's specimen although in the number that very few. RT-PCR could be also used for the determination of the sub-type directly.
The development of the technique of RT-PCR to real time RT-PCR (RT-RT-PCR) increased the special characteristics of the diagnostic technique. Technically this, there was or not the influenza virus H5N1 could be known in time one or two hours. Besides this, this technique could in fact count the number of particles of the available virus in the specimen.
Center for Disease Prevention and Control (CDC) America developed and released the package reagensia for the detection of the virus H5N1 was based on RT-RT-PCR (Morbidity and Mortality Weekly Report, 10/2/2006 the number 55 (05); 127). Technically RT-RT-PCR for the virus avian influenza also had been tried in the Eijkman Agency, Jakarta.
Technically the increase in the virus indeed only could be carried out in the certain lab with facilities BSL-3 above. Meaning that, the increase in the virus must guarantee did not have pollution of the environment and the lab worker. Proposed by me the lab of this kind was built per regional. One national reference lab was enough as the place of the testing of the end.
The second technique, RT-PCR could be done safe and responsible in the lab that did not have facilities like that. The virus in the specimen at once could be put in the tube pelisis so as all the viruses (but also the bacteria, the fungus, the parasite) will fall without damaging the RNA gene the bird flu virus.
From the writer's experience, the technique of RT-PCR has been proven could detect the virus avian influenza H5N1 from the cloaca caress and the network of the poultry that was sick. Spesifisitas, meaning that the capacity detected only of the suspect's viruses, could approach perfect. Whereas his sensitivity, that is the capacity detected the virus in the network or the waste of the poultry that was sick, reached 90 percent. Meaning that, from 10 networks that contained the influenza virus, just one that was not detected.
With RT-PCR we could also detect the existence of the influenza virus H5N1 in a period less than 12 hours. The morning of the suspect's specimen arrived in the lab, in the afternoon we knew results. This happened if the specimen was at once done. Considering the bird flu threat, this achievement must be carried out all the diagnostic labs. The technique could be applied for the detection of the bird flu virus to humankind. His key also was easy. The execution of the influenza virus from the animal and humankind must be done in lab facilities that were separated.
The writer was sure the government could hold the lab was meant. By investment and the training of human resources, one of the pillars 3-E could be held in a short time.
http://www.kompas.com/kesehatan/news/0605/24/102532.htm