INDONESIA - Garut Cluster Part II

[Harriet]

Suspected Indonesian bird flu victim dies, 3 others hospitalized

Suspected Indonesian bird flu victim dies, 3 others hospitalized

An Indonesian woman suspected of being infected with bird flu has died, while another three from the same West Java district were hospitalized on suspicion of contracting the deadly virus.

The woman, 35, who died Thursday night after displaying symptoms of the H5N1 virus came from Cikelet, the same district as Indonesia's latest bird flu fatality, health officials said.

"Euis Lina died Thursday night," Nurdin, a scientist from the Bird Flu Information Centre told AFP on Friday.

Three other people ? five-year-old Isma, six-year-old girl called Santi, and a 35-year-old woman called Esih ? also from Cikelet, were hospitalized Thursday evening as the health ministry launched an investigation into whether human-to-human transmission of the virus may have occurred.

"They are suspected of being infected with bird flu," said Nurdin, adding that they were being treated in isolation units in the Hasan Sadikin Hospital, in Bandung, provincial capital of West Java.

The health ministry and the World Health Organization (WHO) were dispatched Thursday to investigate the remote area for the possibility of a cluster case, after a nine-year-old girl from the district was confirmed as the country's 45th bird flu fatality.

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.

However it was not clear whether any one of other four suspected bird flu cases had any contact with the nine-year-old girl, who died earlier this week, or with 17-year-old Umar Aup, also from Cikelet, who tested positive for the virus and is still alive, said Nurdin.

All six came from the subdistrict, but lived in different villages, said Nurdin.

Aup's 20-year-old cousin Misbah, another suspected bird flu case who died earlier this month, was buried before tests could be carried out.

Indonesia has the world's highest rate of human avian influenza fatalities. The human death toll from bird flu in Indonesia has been steadily rising since its first reported case in July last year. The H5N1 virus has been found in 28 of Indonesia's 33 provinces amid criticism that it has not done enough to curb the virus' spread.

Source: Reuters

 

[Theresa42]

Re: INDONESIA - Garut Cluster Part II

I count 11 -- 13 if you include 2 siblings of Rubiah who are presenting with symptoms & are being tested:

Misbah (20M) - Rancasalak, Cikelet village - Umar's cousin - not confirmed - dead

Umar Aup (16/17M) - Rancasalak, Cikelet village - Misbah's cousin - confirmed H5N1


Ai Siti Amanah (9) - Jojok, Cikelet village - Ismawati's paternal cousin - confirmed H5N1 - dead

Ismawati 5(M?) - Jojok, Cikelet village - paternal cousin/neighbor of Ai - father Pendi, mother Omay - not confirmed


Santi (6/8F) - Jojok, Cikelet village - daughter of Iwan & Surilah - neighbor of Ai - not confirmed

Eti (35F) - Jojok, Cikelet village - not confirmed


Euis Lina (32/35?F) - Jojok(?) - (Ai's mother?) - not confirmed - dead

Dea (9F?) - Jojok village - Euis' daughter - not confirmed - dead


K (32F) - Sawah Bera village - (Osin - husband) has had fever for last 3 days - house 100 m from Ai Siti's and Ismawati's houses - only several houses away from Santi's - not confirmed - in hospital

Rubiah (?) - dead - not confirmed - 2 of Rubiah's siblings tested - they have signs of fever & breathlessness

Sardi (?) - dead - not confirmed


According to the PR article:

9 suspected cases (missing Eti & Dea):
Umar, Ai Siti Amanah (dead) - both who have tested pos
Ismawati, Santi and K - all in hospital
Euis Lina, Rubiah, Misbah, Sardi (all dead)

5 people suspected dead: Ai Siti Amanah, Euis Lina, Rubiah, Misbah and Sardi (all 5 lived near each other -- samples taken only from Euis Lina)

 

[MHSC]

Re: INDONESIA - Garut Cluster Part II

Google satellite maps shows Cikelet in a little different spot than Encarta does, according to Google Cikelet is on the river. Encarta has it a little NW of the river. It would be interesting to see if the outbreaks follow the river like they so often do. I'll try to map it out this weekend on google earth.

Here is the link for the google map. You need to page down and wait for it to load.

http://www.maplandia.com/indonesia/jawa-barat/garut/cikelet/

 

[MHSC]

Re: INDONESIA - Garut Cluster Part II

I count 11 -- 13

Last night it was 5 or 6? Double in 24 hours?!

 

[Theresa42]

Re: INDONESIA - Garut Cluster Part II

Encarta has it a little NW of the river.

I think that's Cimari that's a little NW of the river:

http://tinyurl.com/qmtk2

But still, the position is different between Google and Encarta -- Encarta places Cikelet on the river, but closer to the coast than Google. From the descriptions of how the authorities have had to drive into the mountainous area on jeeps, I'd guess Google Earth is more correct.

 

[Theresa42]

Re: INDONESIA - Garut Cluster Part II

Here's Cikelet on the coast again -- and not next to the river either -- taken from West Java Urban Development Sector Project - Asian Development Bank:
http://www.adb.org/Documents/PCRs/INO/pcr-ino-29206.pdf

 

[Johnny Yuma]

Re: INDONESIA - Garut Cluster Part II

Here is a link to a nice clickable Java map:

http://www.travelpost.com/AS/Indonesia/West_Java/Bekasi/map/6660894

 

[Theresa42]

Re: INDONESIA - Garut Cluster Part II

Here we go. It's still not a map of the hamlets involved -- but it is a map with the village area limits (within which the hamlets must be).

Solid colors = batas kecamatan / subdistrict limits (Ciketel is a light pink)

Dotted blue lines = batas desa / village limits

There are apparently 7 village areas in the Ciketel subdistrict. Unfortunately, we don't know their names from this map -- but, I'm going to guess that Ciketel village is the area surrounding the red dot labelled Ciketel. So, I think all the "hamlets" we've been hearing about are within these Ciketel village limits (I've outlined in red).

http://www.bplhdjabar.go.id/soe/garut/index.cfm

[Note: I copied this map from the .pdf file found under "Deskripsi Wilayah" -- the desktop icon with the little, green lamp.]

Again, we're talking about a very small area. The coastline of Ciketel subdistrict (not just Ciketel village) is only ca. 15-20 miles in length.

 

[Theresa42]

Re: INDONESIA - Garut Cluster Part II

Cikelet subdistrict (as of 1 Aug 2005) -

Total area 17,232 hectares / 66.5 sq miles / 172 sq km

7 Desa / villages: Cikelet, Linggamanik, Kertamukti, Cigadog, Pamalayan, Karangsari and Cijambe [now we just have to match names to places! ]

Total population - 35,954 / 209 people per sq km
Average people per desa/village - 5,136

2 doctors, no pharmacy (apotek)

http://www.garut.go.id/static/kecamatan/Cikelet.php

 

[Theresa42]

Kuraesin

Kuraesin

"K" -- Kuraesin -- is pregnant. Santi is from Sawah Bera hamlet -- the same hamlet as Kuraesin.

toggletext-ed from Indonesian:

The BIRD FLU SUFFERER in Garut improved
August 19, 2006

The assumption [suspected] patient of bird flu from Cikelet, Garut, continued to improve. A mother was pregnant, on Friday night (18/8), was reconciled to the Handsome Hospital of Sadikin Bandung. Kuraesin, the citizen of the Sawah Bera Village, Cikelet, that arrived in the Handsome Sadikin Hospital around struck 19.45 WIB. Apart From experiencing the high fever that was accompanied by the cough, the mother that was containing three months also experienced the breathing difficulty, so as to need help of oxygen.

According to the family, before Kuraesin was sick, several of his [her] neighbouring chickens died suddenly. Kuraesin was the third patient who was treated in Poinciana Tree Space, the Handsome Sadikin Hospital. Two other patients were Ismawati, the citizen of the Jojok Tipar Village, Cikelet, and Santi, the citizen of the Sawah Bera Village, Cikelet [now Santi's from Sawah Bera?].

http://www.metrotvnews.com/berita.asp?id=22514

 

[Theresa42]

Dea initially diagnosed with typhus / additional bf suspect EK (32) from Tipar hamlet

Dea initially diagnosed with typhus / additional bf suspect EK (32) from Tipar hamlet

H5N1 cluster suspected in West Java
August 19, 2006

Yuli Tri Suwarni, The Jakarta Post, Bandung

A 35-year-old suspected of having bird flu died Thursday night after being hospitalized for two hours at Dr. Slamet Hospital in Garut, West Java, an official said Friday.

Three other people who may have the disease, who come from the same village as the woman who died, were being treated at Hasan Sadikin Hospital in Bandung.

The victim, identified only as E [Euis Lina], was the mother of a nine-year-old girl, D, who died last week of what was initially thought to be typhus.

Dr. Slamet Hospital spokesman Yogi Prayogi said the woman arrived in critical condition displaying H5N1 symptoms. The hospital then compared her symptoms with her daughter's medical report.

"We earlier suspected (her daughter) of having typhus due to her high fever but then she died of shock due to acute breathing trouble," which is a bird flu symptom, he told The Jakarta Post by phone Friday.

Since D had been diagnosed with typhus, the hospital had not taken a blood sample from her. Her mother's blood was sent for testing.

The woman came from Cikelet village, where possible bird flu cases have occurred in five hamlets -- Jojok, Rancasalak, Cigandok, Sawah Bera and Tipar -- raising fears of a new cluster of the disease.

The Health Ministry and the World Health Organization (WHO) were dispatched Thursday to investigate the remote area, AFP reported.

According to Health Ministry figures, 46 Indonesians have died of bird flu since the first case diagnosed in humans here in June 2005. It is the world's highest number of fatalities.

Bayu Krisnamurthi, head of the National Committee for Avian Influenza Control and Pandemic Preparedness, has played down the cluster fears, however, saying there is no evidence of human-to-human transmission. "The cases are not clusters because they are from different hamlets," he told Reuters.

Still, the rising number of possible cases in Cikelet has kept West Java at the top of the list of provinces in the country with bird flu, a status it has had since February of this year.

The head of the West Java health office's environmental health subdivision, Fatimah Remiati, said there have been 20 confirmed human cases in nine of the province's 25 cities and regencies. The nine are Bekasi regency and mayoralty, Sumedang, Bandung, Bogor, Indramayu, Depok, Tasikmalaya and Garut.

Out of the 20, "17 have died and three others survived," Fatimah said in Bandung.

As of Friday, bird flu had killed a nine-year-old girl, identified as A [Ai Siti Amanah], on Tuesday and sickened a 14-year-old boy, identified as U [Umar], who had been taken home by his family. Four other people from the village died with symptoms of bird flu before tests could be taken.

Two other suspected victims, a five-year-old girl[?] identified as I [Ismawati] from Jojok hamlet, and an eight-year-old girl identified as S [Santi] from Sawah Bera, were recovering. They had been treated at Hasan Sadikin hospital in Bandung since Wednesday and Thursday, respectively.

Yogi said another possible bird flu sufferer, identified as 32-year-old EK from Tipar hamlet, was admitted to a Garut hospital Friday and would be immediately rushed to Hasan Sadikin Hospital.

The mother of the eight-year-old who is recovering said bird flu rumors started to spread in Cikelet after the virus killed the nine-year-old girl Tuesday. She said the villagers never had information on bird flu and never got vaccine for their livestock.

The woman, who is four months pregnant, said four out of her 15 chickens died before her daughter got sick. Instead of disposing of the dead chickens, she cooked them. "I didn't have the heart to throw them away, especially the rooster. Its meat was so delicious," she said.

The head of the West Java husbandry office's animal health subdivision, Nana M. Adnan, said three out of 14 blood samples taken from poultry in three hamlets in Cikelet tested positive for the H5N1 virus. More than 400 fowl were immediately destroyed. "We're stopping poultry transportation from and to Cikelet for a month," Nana said.

He said since the overall population in Cikelet was low, the number of villagers keeping poultry was relatively small. Rancasalak, for instance, has only 25 families. He said most kept their livestock underneath their houses.

http://www.thejakartapost.com/detailheadlines.asp?fileid=20060819.@02&irec=1

 

[Theresa42]

Re: INDONESIA - Garut Cluster Part II

12. Add:

EK (32) - from Tipar hamlet

I count 11 -- 13 if you include 2 siblings of Rubiah who are presenting with symptoms & are being tested:

Misbah (20M) - Rancasalak, Cikelet village - Umar's cousin - not confirmed - dead

Umar Aup (16/17M) - Rancasalak, Cikelet village - Misbah's cousin - confirmed H5N1


Ai Siti Amanah (9) - Jojok, Cikelet village - Ismawati's paternal cousin - confirmed H5N1 - dead

Ismawati 5(M?) - Jojok, Cikelet village - paternal cousin/neighbor of Ai - father Pendi, mother Omay - not confirmed


Santi (6/8F) - Jojok, Cikelet village - daughter of Iwan & Surilah - neighbor of Ai - not confirmed

Eti (35F) - Jojok, Cikelet village - not confirmed


Euis Lina (32/35?F) - Jojok(?) - (Ai's mother?) - not confirmed - dead

Dea (9F?) - Jojok village - Euis' daughter - not confirmed - dead


K (32F) - Sawah Bera village - (Osin - husband) has had fever for last 3 days - house 100 m from Ai Siti's and Ismawati's houses - only several houses away from Santi's - not confirmed - in hospital

Rubiah (?) - dead - not confirmed - 2 of Rubiah's siblings tested - they have signs of fever & breathlessness

Sardi (?) - dead - not confirmed


According to the PR article:

9 suspected cases (missing Eti & Dea):
Umar, Ai Siti Amanah (dead) - both who have tested pos
Ismawati, Santi and K - all in hospital
Euis Lina, Rubiah, Misbah, Sardi (all dead)

5 people suspected dead: Ai Siti Amanah, Euis Lina, Rubiah, Misbah and Sardi (all 5 lived near each other -- samples taken only from Euis Lina)

 

[HenryN]

Re: Kuraesin

Re: Kuraesin

"K" -- Kuraesin -- is pregnant. Santi is from Sawah Bera hamlet -- the same hamlet as Kuraesin.

toggletext-ed from Indonesian:

The BIRD FLU SUFFERER in Garut improved
August 19, 2006

The assumption [suspected] patient of bird flu from Cikelet, Garut, continued to improve. A mother was pregnant, on Friday night (18/8), was reconciled to the Handsome Hospital of Sadikin Bandung. Kuraesin, the citizen of the Sawah Bera Village, Cikelet, that arrived in the Handsome Sadikin Hospital around struck 19.45 WIB. Apart From experiencing the high fever that was accompanied by the cough, the mother that was containing three months also experienced the breathing difficulty, so as to need help of oxygen.

According to the family, before Kuraesin was sick, several of his [her] neighbouring chickens died suddenly. Kuraesin was the third patient who was treated in Poinciana Tree Space, the Handsome Sadikin Hospital. Two other patients were Ismawati, the citizen of the Jojok Tipar Village, Cikelet, and Santi, the citizen of the Sawah Bera Village, Cikelet [now Santi's from Sawah Bera?].

http://www.metrotvnews.com/berita.asp?id=22514

Is there anything to indicate that Eli/esih and K/Kuresin are not the same person?

 

[HenryN]

Re: INDONESIA - Garut Cluster Part II

Commentary at

http://www.recombinomics.com/News/08190601/H5N1_Garut_C2C.html

 

[HenryN]

Re: Kuraesin

Re: Kuraesin

Is there anything to indicate that Eli/esih and K/Kuresin are not the same person?

I suspect Eli, esih, K, Kuresin, and EK are all the same person.

 

[HenryN]

Re: INDONESIA - Garut Cluster Part II

<TABLE cellSpacing=0 cellPadding=0 width=465 border=0><TBODY><TR><TD class=t18>WHO, Indonesia investigate bird flu for human transmission</TD></TR><TR><TD align=right>

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Experts from the World Health Organization (WHO) and Indonesia have probed the possibility of human transmission of bird flu in Indonesia's West Java province after local test showed three persons and scores of fowls were infected by bird flu virus, Health Ministry and WHO official said here Friday.
On Thursday, two persons living in the same district with the three, were admitted to a hospital in Bandung, the capital of the province for suspicion of having avian influenza, Indonesian Health Minister Siti Fadilah Supari said, adding that hundreds of chickens suddenly died on bird flu in the district recently.
"The tests (of possible human transmission) are being conducted, " Supari told Xinhua.
She admitted that there were still many poultry raised on backyard infected by the H5N1, swarmed about the yard in the district, which could transmit the virus to human.
Director at the ministry Nyoman Kandun said that three persons from Garut district of the province, a 9-year-old girl, who died on Tuesday, a 6-year-old girl and a 17-year-old man, who were recovered, were positively infected by the avian influenza based on the local tests.
He said that the three persons had contacted with fowls, as chicken and ducks around their area were positively infected by the highly pathogenic H5N1 virus.
"A team comprising experts from WHO, Indonesian agriculture ministry, health ministry and bird flu prevention agency, has been sent (to the infected area)," he told Xinhua.
The death of the 9-year-old girl marks the country's 45th H5N1 fatality out of 59 cases, according to the health minister.
The WHO technical officer Steven Bjorge said that the organization had sent one bird flu expert along with those from the ministries of health and agriculture.
"As long as the virus circulate in the bird, there will be some still over into human," he told Xinhua.

Indonesian Agriculture Minister Anton Apriantono admitted that the virus was difficult to be totally eliminated among poultry due to the country's huge territory and large amount of back yard chicken farm.
"Remember, that Indonesia's territory is large, there are 32 millions families raising chickens, those the problem," he told Xinhua.
Regarding to the case in Garut district, he said that it was because "the virus still exist."
He said that his ministry had immediately responded on the emerging of the bird flu cases in the district, as it had earlier prepared for the possibility of the appearance of such case.
His ministry "has depopulated about thousands," of poultry in the district soon after the case appears, he said.
"Now in every region we have a quick respond teams, the team of surveillance and respond," said Anton.
Experts have said that the number of fowl culled and inoculated by the Indonesian health authorities lags far behind the total infected, which can not cut the chain of the highly pathogenic H5N1 virus transmission.
Indonesia has become the focus of international, after the finding of the biggest cluster in Karo regency of North Sumatra province, that killed seven of people linked by blood.
Indonesia has said that it could not rule out the possibility of human transmission in the vast archipelago country.
Source: Xinhua

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http://english.peopledaily.com.cn/200608/19/eng20060819_294861.html

 

[HenryN]

Re: INDONESIA - Garut Cluster Part II

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Menkes asked for the Official of the Active Community Health Centre Sosialisasikan Bird Flu Jakarta -- MIOL: Health Minister Siti Fadilah Supari asked for all the officials of the Community Health Centre so that actively menyosialisasikan various information about the bird flu virus (Avian influenza/AI)."I hoped You All, the official of the Community Health Centre, could become the envoy to send information about bird flu," said Menkes in Jakarta, on Friday night, after handing over the appreciation to 129 health powers of the model from various community health centres in Indonesia.Menkes stressed although the government has spread the leaflet and presented the advertisement of the community's service about bird flu in the print media and electronics, but up to now still many of the community's members that did not yet know exact information concerning the deadly illness."Give true information and every to the community in order to report each death of the poultry in his environment to the local Livestock Breeding Service to immediately could be followed up," he said.He explained also that if the community knew true information about bird flu then the monitoring of the illness (surveilans) will go well.Cases of bird flu to the poultry, he said, will be faster was found so as the spread of the A virus of type influenza the sub-type H5N1 to humankind could be prevented.He added also that with the capacity surveilans that strong the case of the AI infection in humankind will also be found early and immediately could be handled so as not result in fatal.The Health Minister raised that because until at this time the case of bird flu to the poultry and humankind by turns emerged in various areas in Indonesia."At this time the poultry was to 28 provinces stated has been infected by bird flu and the case of bird flu to humankind has spread in 18 provinces," he added.The number of cases that was stated positive bird flu was according to the national laboratory inspection recorded by as many as 60 cases and 46 including causing the death.(Ant/OL-03)</PRE>​

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http://www.mediaindo.co.id/berita.asp?id=109179

 

[HenryN]

Re: INDONESIA - Garut Cluster Part II

Liputan6.com, Bandung:

the assumption Patient of bird flu from the Cikelet Village, the Garut Regency, West Java, continued to improve.The woman Kuraesin that was pregnant three months were reconciled to the Handsome Sadikin Hospital, Bandung, West Java, on Friday night (18/8).

Kuraesin was the third patient who was treated in Poinciana Tree Space RS Handsome Sadikin followed two patients who also came from the Cikeket Village [read: the Patient the Assumption of Bird Flu in RSHS improved].

Beforehand casualties could be treated in RS Doctor Slamet, Garut, after being known experienced the clinical sign of the bird flu illness.Apart from the high Kuraesin fever also experienced breathless that was serious enough and needed help of the tube of oxygen.

Results of the test laboraturium on the sample of casualties's blood just was known next week.In the meantime Health Minister Siti Fadilah Supari claimed still could not confirm if Kuraesin positive bird flu will spread to the embryo who was contained by him."From the person did not spread how come," he said.Siti only decisive that indeed was gotten by pneumonia as being experienced by the other patient Santi and Ismayati, but his specimen was negative."Sometimes the virus just emerged in the third day," explained Siti.

Apart from the three patients, beforehand three other patients have been ascertained terjangkit bird flu. One of them Umar, the citizen of the Rancasalak Village, Cikelet.While Siti Fatimah and Euslina have died [read: Again, the Bird Flu Patient from Garut died].

The increase of the number of patients placed West Java was in the first place of the spreading of the bird flu virus with the number of sufferers totalling 84 people and 12 people including dying.Officially the West Javanese Health has stated bird flu as the extraordinary incident.(ADO/Patria and Guidance Divine Guidance)
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http://www.liputan6.com/view/7,127706,1,0,1155975460.html
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[HenryN]

Re: INDONESIA - Garut Cluster Part II

Metrotvnews.com, Garut:

the assumption Patient of bird flu from Cikelet, Garut, continued to improve.

Jum'at (18/8) nights, a mother that was pregnant three months were named Kuraesin, was reconciled to the Handsome Hospital of Sadikin Bandung with the condition for the high fever.Therefore, up until today the Handsome Hospital of Sadikin Bandung treats three patients who it was suspected were affected by bird flu.

Apart from Kuraesin, his two patients other was Ismayati (5 years) and Santi (8 years).The three of them, was treated in Runag the Poinciana Tree Isolation.According to the doctor who handled him, the condition for the three patients has improved.

When being asked by the condition for the embryo who was contained by Kuraesin, the doctor that handled still would consultations with the content doctor.

In the press conference on Saturday early afternoon (19/8) earlier, dilaprokan that Ismayati and Santi were stated by the bird flu negative. This information was based from results of the sample test of their blood in the Department's Research And Development of the Health in Jakarta. While the sample of Kuraesin blood was just sent to Jakarta this morning and results were just known in one or two days again.

Just was learnt, Kuraesin and Santi came from the same area, namely the Dark Red Paddy-field Village, the Tipar Village, the Cikeulet Subdistrict, Garut.

While Ismayati came from the Jojok Village, also the Cikeulet Subdistrict.

In this last village, already two people died it was suspected because of the bird flu virus.Beforehand, in this village was reported many poultries that died.()

http://www.metrotvnews.com/berita.asp?id=22533
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[Commonground]

Re: INDONESIA - Garut Cluster Part II

"I suspect Eli, esih, K, Kuresin, and EK are all the same person."

I think that K and EK are the same, as they are both pregnant, same age, same hospital. Don't know about Eli, esih, Kuresin.

Edit: "mother that was pregnant three months were named Kuraesin". That takes care of Kuresin. Now for ELI, esih.