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INDONESIA - Garut Cluster Part II

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Re: INDONESIA - Garut Cluster Part II

Theresa42 said:
Wait!!! Dr. Niman -- my head is going in circles!

Risma is a new patient! Risma is not Risman.

Risma is 4 and is from Pasir Meja. Edit: "the distance of his house with the Rancasalak Village or Jojoh approximately 6 km"

Risman, 5, the citizen of the Rancamareme Village:
http://www.flutrackers.com/forum/showpost.php?p=26434&postcount=62

Edit: You got Risma from that last article you posted: The patient ?Suspect? Bird Flu improved 4 Orang. For "improved" you need to read "increased" -- the number of suspected bf patients increased by 4 -- Risma is a new case.

I knew improved meant increased, but I thought Risman was part of the "improvement" and overlaped with the recent article, but you are correct, Risma(4) and Risman(5) appear to be two different patients
 
Re: INDONESIA - Garut Cluster Part II

niman said:
Risma(4) and Risman(5) appear to be two different patients
That leaves room, again, for Misbah and Rubiyah to be siblings to Risman (as reported in one article in PR).

And, you know, the ages of Misbah & Rubiyah (if Rubiyah was 13) fit pretty well to be brother & sister -- 20 and 13. (Risman must be the baby of the family!)

If they are all siblings, Rubiyah died first on Aug 1 -- Misbah didn't die until the 5th.

Maybe the Indonesian press isn't really dwelling on Rubiyah 'cause, of course, the two male cousins (Misbah & Umar) might have hung out together (and fed dead chickens to the dogs, as one does) -- whereas, if the locals are practicing Muslims, Rubiyah at age 13 might not have been hanging out with the boys.
 
Re: INDONESIA - Garut Cluster Part II

Theresa42 said:
That leaves room, again, for Misbah and Rubiyah to be siblings to Risman (as reported in one article in PR).

And, you know, the ages of Misbah & Rubiyah (if Rubiyah was 13) fit pretty well to be brother & sister -- 20 and 13. (Risman must be the baby of the family!)

If they are all siblings, Rubiyah died first on Aug 1 -- Misbah didn't die until the 5th.

Maybe the Indonesian press isn't really dwelling on Rubiyah 'cause, of course, the two male cousins (Misbah & Umar) might have hung out together (and fed dead chickens to the dogs, as one does) -- whereas, if the locals are practicing Muslims, Rubiyah at age 13 might not have been hanging out with the boys.

My guess is that Misbah and Umar developed symptoms on July 26, because they were both infected by Rubiyan, who died August 1 (and may be true index case for Rancasalak/Rancamareme).

Now where does Sardi live (who is the index case for?).

The WHO report seems to indicate Rubiah and Sardi were not from Rancasalak or Jojok because there were four villages involved early.
 
Re: INDONESIA - Garut Cluster Part II

niman said:
Moreover, the official did surveilans that is observation and investigation to areas that it was suspected became the spreading point of the bird flu illness. One of them, Kp./the Cigadog Village, Kec. Cikelet, Kab. Garut. At first again, Euis Lina that died resulting from the bird flu illness, was the inhabitants Kp. Cigadog.
Note that Euis Lina was not from the village of Cikelet, but rather from the village of Cigadog (one of 7 villages in Cikelet sub-district). Thus, she is not just from a hamlet neighboring those of the other cases, but from another village in the sub-district. Still probably not a far distance away.

The 7 village areas (desa) in Cikelet sub-district can be seen on this map:
http://www.flutrackers.com/forum/showpost.php?p=26351&postcount=28
 
I count 16...

I count 16...

... or possibly 18 -- with 3 or 4 siblings from one family dead or sick, all cousins to Umar who has tested positive. Sardi seems to be the earliest death, wherever he was from (or whomever he may have been related to).


Sardi (4/5M) [hat-tip, Soylent Blue!] - d. July 31 - not confirmed

***

Rubiyah (13F) [hat-tip, Soylent Blue!] - d. Aug 1 - not confirmed (2 of Rubiyah's siblings tested - they have signs of fever & breathlessness - Risman and ?) [the name Rubiyah translates as "the nun"]

Misbah (20M) - d. Aug 5 - Rancasalak, Cikelet village - Umar's cousin - not confirmed - dead [the name Misbah translates as "the lamp"]

Risman (5) - the citizen of the Rancamareme Village - in hospital [Misbah & Rubiyah are both siblings of Risman]

Another sibling? -
Dinkes West Java with Tim [team] the Department of the RI Health, also carried out the taking of the sample of the citizen's blood with the sign of the fever and breathless. Two including being the sibling the Rubiah who has died.
One is, presumably, Risman. That means there should be one more.

***

Umar Aup (16/17M) - Rancasalak, Cikelet village - cousin to Misbah, Rubiyah & Risman - confirmed H5N1


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

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


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

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


Euis Lina (32/35?F) - Cigadog village - (Dea's mother) - not confirmed - dead

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


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

(EK? (32) - may be K. - from Tipar hamlet)


Ayi Rohimat Binti Syafrudin (10) - Jojok, Cikelet village

Memen (60) - Cibeunteur, Cikelet village(?)


Risma (4F) - Pasir Maja, Cikelet village - father Taufik Soleh (24), mother Cucu (20) -- Pasir Maja ca. 6 km from either Rancasalak or Jojok/Jojoh

Yana (50) - Rancasalak, Cikelet village


Edit: This is clearly Ayi Rohimat Binti Syafrudin above -- I mistakenly added him/her twice -- should be removed! Ai Rohimah (10) Jojok/Jojoh, Cikelet village
 
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Re: INDONESIA - Garut Cluster Part II

I practically busted my eyeballs on this...I can't get it into a table format...(headache)

Name Age/Sex Relationship Origin Confirmed? Outcome

1. Dea Amalia, 9/F, Euis’ Daughter,typhus dx,died

2. Sardi 4-8/M, Cickelet,Not tested,Died

3. Rubiah (“the nun"), 13/F, Euis’Daughter, Sibling of Misbah, Risman, Dea, Cickelet, Not tested Died 1/08

4. Misbah (“the lamp”) 20/M, Sibling of Risman & Rubiyah; cousin to Umar, Rancasalak, Not tested, died 5/08

5. Umar Aup, 17/M, Cousin to Misbah, Rancasalak,Positive,“recovered”

6. Ai Siti Amanah 9/F Cousin to Ismayati, Jojok, Positive, died 15/08

7. Ismayati, 5/F, Cousin to Ai Siti, Cickelet, Negative, Stable

8. Santi, 6/F Sawa Bera, Negative, Stable

9. Euis Lina 32/F Mother of Ai Siti,?Dea Amalia,?Rubiah,?Misbah,?Risman, Cickelet, Died 17/08

10. Esih 35/F Cickelet, NYK , Died 18/08

11. Kuraesin 32/F (pregnant), Jojok, NYK, stable

12. Risman, Brother to Rubiyah and Misbah,?son of Euis Lina, NKY, ?,at home

13. EK 32/?, Tipar Hamlet, NYK, Hasan Sadikin, Garut

14.Ayi Rohimat Binti Syafrudi 10/? Jojok, NYK, Community Health Center

15. Memem, 60/? Cibeuntar Village, NYK, RSH Bandung

16. Risma 5/?, Rancmareme, NYK, RSHS Bandung Garut

17. R, 13/F, NYK




There are two other reports for Bekasi:
1. Nursifiah, 6/F, from Bekasi, confirmed H5N1, In Sulianti Sarso
2. NA, 6/F, from Bekasi
 
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Re: INDONESIA - Garut Cluster Part II

Thanks, Judy!
Judy said:
3. Rubiah (?the nun?) 13/F Euis?Daughter, Sibling of Misbah, Died Risman, Dea Cickelet Not tested 1/08
I don't think Rubiyah is Euis' daughter. Where did you see that? Do you know which article?
 
Jakarta Post: H5N1 cluster suspected in West Java

Jakarta Post: H5N1 cluster suspected in West Java

H5N1 cluster suspected in West Java


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, 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, on Tuesday and sickened a 14-year-old boy, identified as U, 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 from Jojok hamlet, and an eight-year-old girl identified as S 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.
 
Re: INDONESIA - Garut Cluster Part II

Theresa42 said:
Thanks, Judy!I don't think Rubiyah is Euis' daughter. Where did you see that? Do you know which article?


I just can't find it. There are at least two articles where the "family members" are listed together, maybe I inferred it. I'll look after some sleep.
 
Re: INDONESIA - Garut Cluster Part II

Jody said:
I just can't find it. There are at least two articles where the "family members" are listed together, maybe I inferred it. I'll look after some sleep.
Thanks, Jody! I'll keep an eye out, too.
 
Re: INDONESIA - Garut Cluster Part II

Here is my tabulation so far in chronological order. Suggest additions, changes, etc.

Clipboard03.jpg
 
Euis Lina confirmed H5N1

Euis Lina confirmed H5N1

Sunday August 20, 2006

Indonesian woman dies of bird flu in village hard hit by the virus

JAKARTA, Indonesia (AP) - An Indonesian woman died of bird flu in a village that has tallied 12 confirmed or suspected cases of the H5N1 virus, a senior health official said Sunday, as authorities stepped up their investigation into the new possible cluster of cases.

Laboratory test results confirmed that Euis Lina, 35, who died Thursday at Dr. Slamet Hospital in West Java province's Garut district, had the disease, said Nyoman Kandun, the ministry of health's director general of communicable disease control.

Her 9-year-old daughter died two weeks ago, he said, but authorities were not able to confirm in time whether she had bird flu.

The H5N1 virus has killed at least 141 people worldwide since it began ravaging Asian poultry stocks in late 2003, 46 of them in worst-affected Indonesia, according to the World Health Organization.

Most people have been infected after coming into contact with sick birds, but experts fear the virus could mutate into a form that spreads easily among humans, potentially sparking a pandemic.

Clusters of cases heighten the chance of that happening, so health workers were keeping a close eye on Cikelet - a hamlet 150 kilometers (90 miles) southeast of Jakarta - where there have been a dozen confirmed or suspected cases of bird flu.

Among them were a 4-year-old girl, a 16-year-old boy, and a 60-year-old man who were rushed to Dr. Slamet Hospital late Saturday and early Sunday after coming down with symptoms of the disease, hospital spokesman Yogi Suprayogi said.

Though worrisome, Indonesian officials at present said they believed no human-to-human transmission had occurred in West Java.

"Our team of health officials is collecting all data and information we can from the area,'' said Kandun, adding that while the Cikelet cases were "extraordinary ... the disease appears to have been spread by sick poultry.''

The latest outbreak has heightened concerns that Indonesia is a weak link in global efforts to prevent a pandemic.

The government has been criticized for not carrying out widespread slaughters of poultry, something it says it cannot afford to do.

International donors have yet to contribute "a single cent'' toward the US$900 million (euro703 million) the government has budgeted to fight H5N1 over the next three years, Coordinating Minister for People's Welfare Aburizal Bakrie complained in June.

But the government said it was doing all it could in Cikelet, slaughtering poultry and distributing anti-viral drugs to high-risk villages free of charge.-AP

http://thestar.com.my/news/story.asp?file=/2006/8/20/apworld/20060820133952&sec=apworld
 
Re: INDONESIA - Garut Cluster Part II

Indonesia steps up investigation into possible cluster of bird flu cases(updated 11:31 a.m.)

2006/8/20
JAKARTA, Indonesia (AP)

Indonesia stepped up an investigation into a possible cluster of bird flu cases in West Java province Sunday after a young boy was hospitalized with symptoms of the disease, bringing the number of suspected cases to 10.

Laboratory tests have not been completed for the 5-year-old boy, who was rushed to Dr. Slamet Hospital in Garut on Saturday after suffering from a high fever and respiratory problems. His sister passed away two weeks ago before her illness could be determined. [This is Risman (5) and Rubiyah (13).]

Both came from Cikelet, a West Java hamlet 150 kilometers (90 miles) southeast of Jakarta, where there have been eight other human cases of confirmed or suspected bird flu.

"Our team of health officials is collecting all data and information we can from the area," said Nyoman Kandun, the health ministry's director general of communicable disease control, who called the Cikelet case "extraordinary."

The H5N1 virus has killed at least 140 people worldwide since it began ravaging Asian poultry stocks in late 2003, 45 of them in Indonesia, the worst-affected country, according to the World Health Organization.

Most people have been infected after coming into contact with sick birds, but experts fear the virus could mutate into a form that spreads easily among humans, potentially sparking a pandemic.

Clusters of cases heighten the chance of that happening, so local and international health workers were keeping a close eye on Cikelet. Indonesian officials, however, said at present they believed no human-to-human transmission had occurred.

"The disease appears to have been spread by sick poultry," Kandun said.

One person is confirmed to have died of bird flu in the area and another was sickened. Officials are still awaiting laboratory test results for four patients hospitalized with symptoms of the disease, including the 5-year-old boy. Four others died before lab tests could be taken.

http://www.chinapost.com.tw/i_latestdetail.asp?id=40466
 
Re: INDONESIA - Garut Cluster Part II

Indonesian woman died of bird flu, cluster probed
Sun 20 Aug 2006 2:32 AM ET

JAKARTA, Aug 20 (Reuters) - A 35-year-old woman who died last week in an Indonesian village described as rife with bird flu was infected with the virus, according to two local tests, and a possible new cluster case is being probed, the health minister said on Sunday. The woman from the West Javan village of Cikelet -- which has seen a series of confirmed and suspected cases of bird flu in humans -- died on Aug. 17 after being treated for symptoms of the H5N1 virus.

"Euis Lina was positive, we suspect there is a possibility of cluster," health minister Siti Fadilah Supari told Reuters by telephone.

Fears that the virus had mutated into a form that could pass easily between humans heightened in May when seven people from an extended family died of the disease in Indonesia's North Sumatra.

http://today.reuters.com/News/CrisesArticle.aspx?storyId=JAK305268

Finally, someone is entertaining the possiblility of cluster(s)!:rolleyes:
 
Re: INDONESIA - Garut Cluster Part II

post #117 said:
Among them were a 4-year-old girl, a 16-year-old boy, and a 60-year-old man who were rushed to Dr. Slamet Hospital late Saturday and early Sunday after coming down with symptoms of the disease, hospital spokesman Yogi Suprayogi said.
4 yr-old girl = Risma
16 yr-old boy = ?
60 yr-old man = Memen
 
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