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INDONESIA - Garut Cluster PART I

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Re: INDONESIA - Garut Cluster

Re: INDONESIA - Garut Cluster

niman said:
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Siti personally beforehand suffered hot high and breathless since early August set.The first child could be from the couple Ade Supriadi and Solehah that were nine years old examined by the community health centre doctor and was stated only suffered the sign of typhus.​
Click to expand...


Sounds like Siti had symptoms since early August and was initially misdiagnosed. :(​
 
Re: INDONESIA - Garut Cluster

Re: INDONESIA - Garut Cluster

niman said:
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Suspect Bird Flu was from Garut reconciled to RSHSBandung -- MIOL: the Handsome Sadikin Hospital (RSHS) Bandung, on Wednesday (16/8) accepted the patient suspect bird flu, Is (5), the citizen of the Village Jojok the Village Cikelet the Village Tipar the Subdistrict Cikelet the Garut Regency.


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http://www.mediaindo.co.id/berita.asp?id=109035

http://www.mediaindo.co.id/cari.asp?E=A&query=flu+burung&Ctgl=
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Suspect Bird Flu was from Garut reconciled to RSHS Bandung -- MIOL: the Handsome Sadikin Hospital (RSHS) Bandung, on Wednesday (16/8) accepted the patient suspect bird flu, Is (5), the citizen of the Village Jojok the Village Cikelet the Village Tipar the Subdistrict Cikelet the Garut Regency.Is lived in the house that only be at a distance around 100 metre from the house of bird flu casualties that died on Tuesday (15/8), Ai Siti the message (9).Is came to RSHS Bandung around struck 14.30 WIB made use of the ambulance with his father, Pendi (32).The patient was reconciled from RSUD Dr Slamet Garut, and could be isolated for 30 minutes in the hospital.Because of being checked in RSUD Dr Slamet, the patient Is immediately was brought to Poinciana Tree space and immediately was handled by the team of the handling doctor of the RSHS bird flu illness.According to the nurse RSUD Dr Slamet that went along to RSHS, the Tedi smoke, Is before being brought to RSHS could be checked even isolated in RSUD drSlamet.However because the hospital did not have the ventilator implement, this patient was afterwards brought to RSHS Bandung.He suggested, Is had the sign of bird flu like coughs, breathless, and the temperature of the hot body through to 38 levels celcius.He said, till at this time in the Village Jojok the Cikelet Village has had three positive citizens was affected by bird flu, namely Umar (14), Ai Siti the message (9) that died last Tuesday, and Is.In the meantime Pendi said his child began to have a temperature on Tuesday night (15/8) around struck 00.00 WIB after taking part in paying together a condolence call for the death of his mother, Omay (27) to the house of Ai Siti the message that died because of bird flu."The next day I brought my child to the doctor and the doctor's direct words was brought to the hospital," he said.He added, the poultry not there are those that belonging to his parents died suddenly.Only in the house late Ai that his distance around 100 metre from the house Is was gotten by 20 chickens that died suddenly.(Ant/OL-06)</PRE>​
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Re: INDONESIA - Garut Cluster

Re: INDONESIA - Garut Cluster

Fourth H5N1 Suspect Case in Garut Indonesia
Recombinomics Commentary
August 15, 2006

Was based on information of several citizens, several last days, several poultries around the patient's house died suddenly. Moreover, the distance of the patient's house only one hundred metre from the Siti Aminah house that died on last Tuesday with the sign similar to the bird flu patient.

The above comments describe the fourth suspect H5N1 bird flu patient in Garut in West Java, Indonesia. The index case, from a nearby village died with bird flu symptoms. However, his cousin, who also developed symptoms tested positive for bird flu and is an official WHO case because the positive result was confirmed by two independent labs in Indonesia. The patient is recovering at home.

The third victim, a neighbor of the most recent case, also died with bird flu symptoms and at least one media report indicated she was positive. As noted above, the fourth case lives on 100 meters from the third case.

Thus, the first two patients were related and were neighbors. The third and forth patients were neighbors on a nearby village. The clustering in time and space of four suspect or confirmed cases is cause for concern. Although all had links to dying poultry, the genetic link between H5N1 in people and those in poultry has not been established. Although over 40 poultry H5N1 are public, none have the novel HA cleavage site detected in all but one of the reported sequences from Java.

The lack of a match was discussed at the recent H5N1 meeting in Jakarta. Phylogenetic trees of the sequenced isolates indicated the samples with the novel cleavage site formed a separate branch that did not contain any avian isolates. All eight gene sequences of H5N1 from these patients were recently released and they have a large number of additional polymorphisms on all eight gene segments that are not found in Indonesian poultry. Although these sequences are more closely related at the protein level, there are also antigenic determinants that are only in the human samples. Moreover, analysis of polymorphisms in common between bird and human isolates identifies clustering that signal recombination. Thus, although there may be a relationship between H5N1 outbreaks in people and poultry, the direct linkage may be through another animal reservoir.

More details and test results on the suspect cases as well as animals and people in these villages in Garut would be useful.
 
Re: INDONESIA - Garut Cluster

Re: INDONESIA - Garut Cluster

Indonesia: Bird flu claims girl, 9

JAKARTA, Indonesia (AP) -- A 9-year-old girl has died of bird flu, bringing the number of Indonesians killed by the H5N1 virus to 45, a senior health official said Thursday.

Ai Siti Amanah died in a hospital in West Java province on Tuesday, one day after being admitted with symptoms of the disease.


"The health ministry's laboratory showed she had bird flu," said health official Nyoman Kandun, adding that the results were confirmed by a U.S.-affiliated laboratory.


The girl -- whose 17-year-old neighbor was sickened by the disease -- came from the village of Cikelet, some 150 kilometers (93 miles) southeast of the capital Jakarta. Another boy in the hamlet died before tests could be taken.


The H5N1 virus has killed at least 139 people worldwide since it began ravaging Asian poultry stocks in late 2003 -- with Indonesia tallying the highest toll, according to the World Health Organization.


Most human cases have been traced to contact with infected birds, but experts fear the virus -- which remains hard for people to catch -- could mutate into a form that spreads easily among people, potentially sparking a pandemic.


Health officials said they thought those sickened or killed by bird flu in Cikelet had come into contact with sick birds.



http://www.cnn.com/2006/HEALTH/conditions/08/16/indonesia.birdflu.ap/index.html
 
Re: INDONESIA - Garut Cluster

Re: INDONESIA - Garut Cluster

Liputan6.com, Garut: the anxious Feeling haunted the citizen of the Jojok Village, the Cikelet Village, of Pameungpeuk, the Garut Regency, West Java, followed the death of a local citizen namely Ai Siti the message (not Siti Fatimah like that was reported beforehand -- Red.).The concern covered because the child was nine years old was killed resulting from bird flu [read: the Bird Flu Patient in Garut died.The citizen's concern increasingly improved after Ismawati (not Ismayati as being written beforehand -- Red.) that also the citizen of the Jojok Village was brought to the Handsome Sadikin Hospital, Bandung, because of showing the sign was similar to bird flu.Ismawati experienced the high fever was accompanied by the cough and breathless.Relatives Ismawati said, the age child five years were sick after paying a condolence call for the death of Ai Siti Aminah [read: the Patient the Assumption of Bird Flu was reconciled to Bandung].Paman Ismawati explained, one month before the case of bird flu was solved in the Jojok Village, many chickens that were maintained by the citizen died suddenly.The citizen of the Jojok Village also increasingly restless after hearing an assumption patient of bird flu being named Umar bolted from RS Slamet.Umar was at that point brought went out by his parents because of running out of the medicating cost.Siti Fadil -lah Supari Health Minister really regretted Umar went because the patient must be still undergoing the maintenance.Although being not yet proven by the existence of the spread of the bird flu virus antarmanusia, the development of the Umar health important for the research.(TOZ/Tim Coverage 6 SCTV)</PRE>
http://www.liputan6.com/view/7,127588,1,0,1155788332.html</PRE>
 
Re: INDONESIA - Garut Cluster

Re: INDONESIA - Garut Cluster

toggletext-ed from Indonesian:

The poultry in Cikelet Positive Flu Burung
August 16, 2006

Garut, (PR). - Three poultries in the area of the Cikelet Subdistrict, Kab. Garut was stated positive bird flu by the West Javanese Service of Province Livestock Breeding from results of the inspection in a serologis manner or the blood test. On the condition, the Garut Regional Government planned to carry out the extermination of poultries (depopulation) poultries around the Village and Kec. Cikelet, Garut south.

That it was stressed the Section Head fisheries Livestock Breeding and Marine Kab. Garut Ir. H. Andi the Blessing, on Tuesday (15/8). "Officially Province Livestock Breeding stated results serologis against several poultry in Cikelet." Results, two among them positive contracted bird flu, he said.

In the meantime, the patient suspect bird flu was named him Siti the message (9), the citizen of the Jojoh Tipar Village, the Village and the Cikelet Subdistrict, Kab. Garut died on last Tuesday late afternoon. He died after being treated for approximately 24 hours in RSU Dr. Slamet Garut. To ascertain the cause of his death, the RSU side Dr Slamet Garut took the sample of blood and several liquid kinds from casualties's body.

According to Andi, after his side carried out the test against several poultries by means of rapid test, was known by results of the negative. However, after the inspection was carried out by means of serologis in the West Javanese Service of Province Livestock Breeding, results it was known had two tails of the poultry that was stated positive.

The two poultries, two chickens belonging to Aup the patient's positive father Umar bird flu. Whereas one duck belonging to the Sukma Aji.

http://www.pikiran-rakyat.com/cetak/2006/082006/16/0305.htm
 
Indonesia girl dies of bird flu in afflicted village

Indonesia girl dies of bird flu in afflicted village

Indonesia girl dies of bird flu in afflicted village
August 17, 2006

JAKARTA (Reuters) - A nine-year-old Indonesian girl who died this week had bird flu according to two local tests and the village where she lived is rife with the disease, the health ministry said Thursday.

The girl died on Tuesday in a hospital in West Java's Cikelet village where there are many sick and dead chickens, said Runizar Ruesin, the head of the health ministry's bird flu information centre.

Her death takes Indonesia's toll from the disease to 45, the highest of any country.

"Bird flu is rife in Cikelet. You can always find dead or sick chickens there," Ruesin told Reuters.

A 17-year-old boy in the same village has also tested positive for bird flu, but has stayed at home and refused to be treated at the main hospital in Bandung, the provincial capital to the south of Jakarta.

Contact with sick fowl is the usual mode of transmission of the H5N1 bird flu virus that is endemic in poultry in nearly all of Indonesia's provinces.

Most of the human cases in Indonesia have occurred this year and the country has been criticised for not doing enough to stamp out H5N1. The virus remains essentially an animal disease but experts fear it could spark a pandemic if it mutates into a form that can pass easily among people.

http://thestar.com.my/news/story.as...01_NOOTR_RTRJONC_0_-263903-1&sec=Worldupdates
 
Re: INDONESIA - Garut Cluster

Re: INDONESIA - Garut Cluster

http://www.forbes.com/finance/feeds/afx/2006/08/17/afx2955556.html

Indonesia probes possible cluster after 45th bird flu death
08.17.2006, 05:21 AM

JAKARTA (AFX) - Health authorities here began investigating whether a nine-year-old girl who died this week of the H5N1 strain of bird flu belonged to a cluster of human cases.

Cluster cases heighten the chance of the virus mutating to become easily transmissible between humans. Scientists fear this could spark a global pandemic with the potential to kill millions.

Ai Siti Aminah was today confirmed to have died of the H5N1 virus, which has now killed 45 Indonesians, the highest of any nation in the world.

'The tests were positive. She died of bird flu,' Nurdin, a scientist from the bird flu information centre, told Agence France-Presse.

The victim came from Cikelet, a remote area in West Java's Garut district, and lived not far from the home village of 17-year-old Umar Aup, who tested positive for the virus and remains alive.

The boy's 20-year-old cousin Misbah however died earlier this month while exhibiting signs of the virus, which has run rampant across the archipelago nation of Indonesia, the world's fourth most populous country.

Nurdin said health officials were concerned that the cases could be a cluster, though he could not confirm yet whether the girl had come into contact with the boys. The boys were known to have had contact with dead poultry.

He said a team of experts from the health ministry and the World Health Organisation (WHO) would investigate the remote area where the deaths occurred.

'A team left this morning to check if there is a cluster or not,' said Nurdin.

Aminah's samples were tested at both a national health ministry laboratory and a US-run facility, which is required before health authorities here report the death to the WHO.

The world's first lab-confirmed human-to-human transmission of bird flu occurred in Indonesia three months ago in a cluster of seven deaths, sparking serious concern among scientists.

But the slight mutation that took place in that case was determined to be insignificant.

afp/zr
 
Re: INDONESIA - Garut Cluster

Re: INDONESIA - Garut Cluster

Bird flu continued to be contagious in Cikelet, GarutBandung -- MIOL: Bird Flu was contagious in the Jojok Village, the Cikelet Village, the Cikelet Subdistrict, the Garut Regency, for a last week.Two citizens Cikelet, Ismawati, 5, and Santi, 6, was run off with to RSHS Bandung, with the clinical sign similar to bird flu.</PRE>
http://www.mediaindo.co.id/berita.asp?id=109090</PRE>
 
Re: INDONESIA - Garut Cluster

Re: INDONESIA - Garut Cluster

Posted by Okieman at the Wiki:

News News
There is more suspect cases than we thought. Apperently Aup?s cousin and three others died before samples could be taken.
Laboratory tests show a girl died of bird flu
JAKARTA (AP): A girl died of bird flu in an Indonesian village that has been hard hit by the disease, officials said Thursday, as they awaited test results for another child who fell ill inthe same area.
The death of Ai Siti Amanah raised the country?s toll from the H5N1 virus to 46 and sparked an investigation by the Health Ministry amid fears of a possible new cluster. <snip>
Health officials were looking closely at Ai?s village, Cikelet, West Java, 150 kilometers (93 miles) southeast of the capital Jakarta. There have been seven confirmed or suspected bird flu deaths or illnesses in the hamlet.
Ai?s neighbor, Umar Aup, was sickened by the H5N1 virus and Aup?s cousin and three others died before tests could be taken. <snip>
http://www.thejakartapost.com/detaillgen.asp?fileid=20060817191724&irec=0
 
Re: INDONESIA - Garut Cluster

Re: INDONESIA - Garut Cluster

Laboratory tests show a girl died of bird flu
[FONT=Arial, Helvetica]JAKARTA (AP): A girl died of bird flu in an Indonesian village that has been hard hit by the disease, officials said Thursday, as they awaited test results for another child who fell ill inthe same area.
The death of Ai Siti Amanah raised the country's toll from the H5N1 virus to 46 and sparked an investigation by the Health Ministry amid fears of a possible new cluster.
The 9-year-old died early this week, one day after being admitted to a hospital in West Java province, and laboratory test results confirmed Thursday that she had the disease, said senior health official Nyoman Kandun.
Bird flu has killed at least 140 people worldwide since it began ravaging Asian poultry stocks in late 2003, with Indonesia tallying the highest number of human deaths, according to the World Health Organization.
Most people have been infected after coming into contact with infected birds, but experts fear the virus could mutate into a form that spreads easily among humans, potentially sparking a pandemic.
Health officials were looking closely at Ai's village, Cikelet, West Java, 150 kilometers (93 miles) southeast of the capital Jakarta. There have been seven confirmed or suspected bird flu deaths or illnesses in the hamlet.
Ai's neighbor, Umar Aup, was sickened by the H5N1 virus and Aup's cousin and three others died before tests could be taken.
Officials said Thursday they were awaiting lab results for a child who was hospitalized Wednesday in West Java's capital of Bandung, where she was given the anti-viral drug Tamiflu, said Eka Sony, a health official.
"She is recovering," he said. "We are waiting for the test results to return."
Health Minister Siti Fadilah Supari said she was confident those infected in Cikelet had come into contact with chickens - scores of which have died in recent weeks. But she said authorities would carry out tests to make sure the virus was not passed from person to person, since there have been so many suspected or confirmed cases there. (**)[/FONT]

http://www.thejakartapost.com/detaillgen.asp?fileid=20060817191724&irec=0<!--<hr noshade size="1" color="#333333">-->
 
Re: INDONESIA - Garut Cluster

Re: INDONESIA - Garut Cluster

Laidback Al, on your chart, just some comments? I think case #405 & #406 might be the 2 that died without being tested. Wonder where the 3rd one is? (this is in reference to my post at 9:39).

The last three cases on the 17th resulted in deaths, so it can't be the 5 and 6 year old.
 
Re: INDONESIA - Garut Cluster

Re: INDONESIA - Garut Cluster

Commonground said:
Laidback Al, on your chart, just some comments? I think case #405 & #406 might be the 2 that died without being tested. Wonder where the 3rd one is? (this is in reference to my post at 9:39).

The last three cases on the 17th resulted in deaths, so it can't be the 5 and 6 year old.
Click to expand...

405 and 406 are confirmed cases in Jakarta area (Bekasi and Tangerang) and have nothing to do with Garut (or suspect case in Bandung).
 
Re: INDONESIA - Garut Cluster

Re: INDONESIA - Garut Cluster

Commonground said:
Ah I missed that. Thanks Dr. Niman.
Click to expand...

There are 11 cases in Indonesia this month. The first two cases were teenagers in the Jakarta area. They were hospialized in the Jakarta area and were confirmed. The only question in ther cases was shipment of samples outside of Indonesia.

The next reported case was a teenage in Garut, who also tested positive, but left the hospital. His cousin died of bird flu symptoms and they lived near each other. The next reported case was ina nearby village, She died and was also confirmed. The latest reports describe 3 more fatal cases in Garut in which no samples were collected. In addition there are two hospitalized from Garut and one from Bandung. Data from those three cases has not been released.

Thus, there are 5 fatalities in Garut, 2 in Jakarta area and one positive case that has left the hospital. No test results have been released on the three most recent hospitalized patients, who are alive.
 
Re: INDONESIA - Garut Cluster

Re: INDONESIA - Garut Cluster

It's those 3 fatal cases in Garut in which no samples were taken that have me curious. They could at least come out with who they were and what connection (if any) they had to the others. Thanks for laying it all out nicely for everyone to follow. I appreciate it.
 
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