INDONESIA - Garut Cluster Part III

[Harriet]

Re: INDONESIA - Garut Cluster Part III

17 suspected bird flu cases found in Indonesia's Garut

Indonesian authorities have found 17 suspected bird flu cases in the West Javanese town of Garut, raising fears that a cluster case has occurred, an evening newspaper reported Tuesday.

Three sufferers have been tested positive of bird flu by local laboratory and two of them died last week as the government began to cull all chickens within the radius of 1 km from any case found in Garut, some 200 km southeast of Jakarta.

Health officials have been deployed to the area to distribute bird flu medicine and take blood samples form villagers, reported Sinar Harapan newspaper.

I Nyoman Kandun, a senior official with the Ministry of Health, said cases of chicken died allegedly from bird flu had been found in all villages in Garut over the last three months, prompting authorities to order mass cull in the area.

At least 2,505 chickens were culled during the government operations.

The government promised a compensation payment of 12,500 rupiah (1.37 U.S. dollars) for any chicken killed in the cull program.

Cikelet district was the worst hit area in which nine villages have reported bird flu case in human.

The latest casualties in Garut have raised bird flu death in the country to 46, considered to be the highest in the world.

Source: Xinhua

 

[Commonground]

Re: INDONESIA - Garut Cluster Part III

Niman at 11:59:

What's the "infusion"? The ventilator?

"The infusion of the patient has then been released."

 

[colormyquilt]

Re: INDONESIA - Garut Cluster Part III

Thanks, Commonground. Great summary by hamlet/ district.

 

[HenryN]

Re: INDONESIA - Garut Cluster Part III

The number of casualties in West Java Most, with 20 cases Positif
the Bird Flu Virus Meluas
Jakarta, (HOMEWORK).
- the Spreading of the bird flu illness increasingly wide and cruel.
Only in several months, this illness spread in 273 regencies/the city in 29 provinces.
That was the reason the Executive Director of the National Commission (Komnas) the Control of Bird Flu and Preparedness faced the influenza Pandemic, Bayu Krishnawati warned that all the sides were on the alert.
According to Bayu Krishnawati, at this time 273 regencies in 29 provinces in Indonesia were risky terjangkit the Avian infection influenza (AI).
The number of cases of the infection of the bird flu virus in humankind then tended to improve from time to time.
At this time, said Bayu, the number of patients that was stated positive (confirmed case) was infected by the bird flu virus totalling 62 people and 47 including dying.
"Needed by the movement together to overcome the spread of this illness and minimise the risk that was caused by him."
Therefore, we asked that all the prepared sides involved itself towards the prevention and the control of this illness, said Bayu.
He added, the preceptive attitude and the community's vigilance towards the spread of the virus berpatogenitas high this will grow when the community had knowledge and the understanding about the illness danger that was resulted in by the virus H5N1 this.
The section head the West Javanese Health Dr. Yudi Prewar said that the case of bird flu has in Garut been stated KLB. till yesterday, from belasan the person suspect from the Cikelet Village and the Cigadog Village, three people were ascertained positive contracted bird flu.
Therefore, said he, the number of positive sufferers bird flu in West Java reached 20 people.

http://www.pikiran-rakyat.com/cetak/2006/082006/23/0101.htm
</pre>

 

[HenryN]

Re: INDONESIA - Garut Cluster Part III

Yesterday, Space of the Public Hospital Isolation (RSU) Dr. Slamet Garut again received the patient suspect bird flu two people. The two people namely Gilang (14), the citizen of the Bald Mountain Village, the Cigadog Village, Kec. Cikelet, and Tosin (61), the citizen of the Cimangke Village, the Cijambe Village, Kec. Cikelet. Tosin has in fact been treated in RSHS Bandung. Both of them were reconciled the Cikelet Community Health Centre to RSU Garut, on Monday (21/8) approximately struck 23. 30 WIB, because of complaining breathless, the high fever, coughs, and was sick the throat. "Both of them showed signs of bird flu, moreover they experienced body heat 38-39 Celsius levels." Therefore they were reconciled by us to Garut, the Cikelet Community Health Centre headword Dr. Heri Winarto. Upon arrival at RSU Garut, both of them were at once examined. According to the Head of the Subdivision of Information and the Customer's Service RSU Garut, Yogie Prayogi, after being treated 12 hours, the health of the Support was restored. Hot and breathless has been lost. However Gilang blood leucocytes was far below normal, reached 2. 500. Whereas Tosin was reconciled to RSHS. Tosin (61), the citizen Kp. Cimangke this arrived in RSHS, on Tuesday (22/8) approximately struck 5. 30 WIB. according to the Chairman Tim the Handling of the Case of the necessary Special Infection the Maintenance and the RSHS Isolation, Dr. Hadi Jusuf, Sp. P. D. KPTI, the Tosin situation, on Tuesday early afternoon, has been stable. The temperature of his body has descended. From results x-rayed, was learnt Tosin experienced inflammation of the lungs. While being waiting for results of the test serologis in Jakarta, Hadi still could not confirm whether Tosin was attacked by the bird flu virus or not. Apart from Tosin, four patients suspect bird flu from Cikelet other that still was treated in Poinciana Tree space, that is Ismawati (5), Santi (8), Kuraesin (32), and Osin (the husband Kuraesin). They have been treated in RSHS since last week, except Osin that following Saturday (19/8). However the four patients, according to Hadi, the bird flu negative.

 

[HenryN]

Re: INDONESIA - Garut Cluster Part III

Given by Tamiflu

Pengendalian Breakingprep Penyakit Director General and environmental Sanitation (P3L) the Department of the I Nyoman Kandun Health in Jakarta stated, all the citizen of four villages was in the Cikelet Village given the tablet Oseltamivir/Tamiflu.
Medicine antivirus for this bird flu infection was given to prevent the spread of the virus H5N1 from humankind to humankind.
His side, said he, will give prophylaxis efforts with Oseltamivir, although not yet having spread proof antarmanusia.
However the step was carried out, because five patients who it was suspected were infected by bird flu in Cikelet Garut, died before could be taken the sample of his blood.
The director general explained, beforehand Oseltamivir was only given to the person that contact with the chicken was sick or with the patient was infected.
"In Cikelet, the Oseltamivir prophylaxis was given to all the citizen one day very much one tablet for 10 days."
There is 2.
400 people in Kp.
Ranca Salak, Jojoh, Ranca Mareme, and Gambir Sand that was given by Oseltamivir, said Kandun.
According to the Director General, 18 villagers Cikelet were it was suspected infected by bird flu.
Three among them namely U (17), the HOPE (9), and EL (35), was stated positive was infected by the virus H5N1 by the Body of Health Research And Development (Balitbangkes) the Department of the Health and NAMRU2 Jakarta.
Five other patients died before could be taken the sample of his blood to be checked.
"Negative," he said.
(A-112/A-156/A-83)

 

[HenryN]

Re: INDONESIA - Garut Cluster Part III

Given by Tamiflu


According to the Director General, 18 villagers Cikelet were it was suspected infected by bird flu.
Three among them namely U (17), the HOPE (9), and EL (35), was stated positive was infected by the virus H5N1 by the Body of Health Research And Development (Balitbangkes) the Department of the Health and NAMRU2 Jakarta.
Five other patients died before could be taken the sample of his blood to be checked.
"Negative," he said.
(A-112/A-156/A-83)

Any comments on who the fifth fatality is, Three of the fatalities are clearly linked to two of the known positives - M(20M) and R(13F) are cousins of U(17M) while D(9F) is the daughter of EK(35F). Is S(5) and the unnamed fatality related to HOPE(ASA 9F)?

My guess is that the first wave of fatalites was the end of July, beginning of August and those 5 fatalities infected the three positives (and several hospitalized who are testing negative).

 

[Laidback Al]

Re: INDONESIA - Garut Cluster Part III

Here are the six dead individuals I have.

 

[HenryN]

Re: INDONESIA - Garut Cluster Part III

Commentary at

http://www.recombinomics.com/News/08220603/H5N1_Cikelet_Evidence.html

 

[HenryN]

Re: INDONESIA - Garut Cluster Part III

Here are the six dead individuals I have.

View attachment 644

Two the the six are confirmed. The report indicated the were five cases that died prior to collection.

 

[Commonground]

Re: INDONESIA - Garut Cluster Part III

Here's what I have as having died prior to confirmation. This is all taken from Theresa's list, which she updates when needed. The list is in this forum.

Sardi (4/5M) d. July 31 - not confirmed
Rubiyah (13F) - d. Aug 1 - not confirmed
Misbah (20M) - d. Aug 5 - not confirmed

Then there is a quote:
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 had died.
(end quote).

One is, presumably, Risman. That means there should be one more.


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

Risma (4F) - Pasir Maja, Cikelet village - father Taufik Soleh (24), mother Cucu (20) -- Pasir Maja ca. 6 km from either Rancasaiak or Jojok/Jojoh -- Risma's sister reported died from unknown causes 2 weeks ago

 

[HenryN]

Re: INDONESIA - Garut Cluster Part III

Thousands of chickens Cikelet Dimusnahkan
on Tuesday, August 22 2006 | 21:50 WIB
The Interactive TIME, Bandung: the Section Head Province Livestock Breeding West Javanese Rachmat Setiadi said, two villages in the Cikelet Subdistrict, the Garut Regency, that tertular bird flu.
"The village Cikelet and the Cigadog Village," he said when being contacted the Time, this afternoon.
He explained, from results rapid test and the laboratory inspection was found the poultry that came from two villages was positive flattest the bird flu virus.
The discovery of the bird flu poultry at the same time the discovery of the case of humankind that was attacked by this illness.
Officially West Javanese Livestock Breeding at once carried out depopulation or the limited extermination, against the poultry in two villages.
According to him, the extermination of the new poultry totalling 2.
505 tails that came from the Cikelet Village.
As for the poultry in the Cigadog Village begins to be destroyed today.
From the Cigadog Village, the West Javanese side of the Livestock Breeding Service collect data on 1.
200 tails of the poultry.

http://www.tempointeraktif.com/hg/nusa/jawamadura/2006/08/22/brk,20060822-82371,id.html

 

[Theresa42]

Re: INDONESIA - Garut Cluster Part III

MHSC - Post #39 - Kudos to mamypoko at 04:46 at the Wiki for composing this.

I?ll give this summary a try, based on Milo?s summary. Pls anyone, feel free to correct/edit/re-do/add_info/etc.

Cikelet, Garut, Indonesia Village Uncertain

Sardi 4M, died 7/31, no tests done

Rancamareme Village

Rubiyah 13F, died 8/1, no tests done

Risman 5M, brother of Rubiyah & Misbah, 8/19 in Slamet Hospital

Rancasalak Village

Misbah 20F, sister of Rubiyah & Risman, symptoms 7/26, died 8/5, no tests done

Umar Aup 17M, cousin of Misbah, symptoms 7/26, Slamet Hospital ? home treatment, recovering, tested POSITIVE for H5N1 (WHO confirmed)

Yana 50, 8/19 in Slamet Hospital

Jojok or Jojoh Tipar Village

Ai Siti Amanah 9F, symptoms 8/1, died 8/15, tested POSITIVE for H5N1 (WHO confirmed)

Ismawati 5F, cousin of Ai Siti Amanah, 8/16 in Hasan Sadikin Bandung Hospital, locally tested NEGATIVE for H5N1

Santi 6F, 8/17 in Hasan Sadikin Bandung Hospital, locally tested NEGATIVE for H5N1

Dea 9F, daughter of Euis Lina, died at home 8/16, no tests done

Euis Lina 35F, died 8/17 in Slamet Hospital, tested POSITIVE for H5N1 (WHO confirmed)

Ai Rohimah 10F, 8/19 in local health center

Sawah Bera Village

Kuraesin 35F, 3.5mths(14wks) pregnant, 8/18 in Hasan Sadikin Bandung Hospital, recovering, tests pending

Osin 36M, husband of Kuraesin, 8/21 Hasan Sadikin Bandung Hospital

Pasir Meja Village

Risma 4F, ill since 8/16, 8/19 in Slamet Hospital, 8/20 left hospital, recovering

Gunung Sula Village, Desa Cigadog

Gilang 14M, 8/21 Pameungpeuk health centre, 8/22 transferred to Slamet hospital, seems to be recovering

Cibeunteur Village

Memen 60M, 8/19 in Hasan Sadikin Bandung Hospital

Cinangka Village, Desa Cijambe

Tosim 61M, 8/18 chickens died, 8/20 onset of symptoms, 8/22 transferred from Slamet Hospital to Hasan Sadikin Hospital

This looks good! Just to avoid any confusion -- remember that Rancamareme, Rancasalak, etc., are actually all hamlets (kampung). The "villages" (desa) in question are Cikelet, Cigadog and Cijambe.

 

[Daisy]

Re: INDONESIA - Garut Cluster Part III

I just caught this from Niman's # 59.

"Apart from being given tamiflu, also was given antibiotik for the other fever that not the virus," explained Hadi.


So, we ask, what is this other virus? Regular flu??? Doesn't sound like a good combination!

 

[wetDirt]

Re: INDONESIA - Garut Cluster Part III

I just caught this from Niman's # 59.

"Apart from being given tamiflu, also was given antibiotik for the other fever that not the virus," explained Hadi.


So, we ask, what is this other virus? Regular flu??? Doesn't sound like a good combination!

He didn't say it was a virus. He said a fever. If they are giving antibiotics, then they think it's bacterial. Maybe a secondary pneumonia.

 

[AlaskaDenise]

Re: INDONESIA - Garut Cluster Part III

He didn't say it was a virus. He said a fever. If they are giving antibiotics, then they think it's bacterial. Maybe a secondary pneumonia.

My first thought also - secondary infections.

Considering some prior Indo RESRRKKR infections were neuro, how about secondary meningitis infections?

Are there other possibilities for secondary bacterial infections - blood, liver, etc. I'm not a HCW, so don't know.

.

 

[Daisy]

Re: INDONESIA - Garut Cluster Part III

Obviously I am not a HCW either.

 

[wetDirt]

Re: INDONESIA - Garut Cluster Part III

My first thought also - secondary infections.

Considering some prior Indo RESRRKKR infections were neuro, how about secondary meningitis infections?

Are there other possibilities for secondary bacterial infections - blood, liver, etc. I'm not a HCW, so don't know.

It's not clear from the text whether they are thinking two different infectious diseases, like say, dengue plus influenza, or bacterial complications of influenza. I remember someone saying that influenza-related meningitis is viral, it's the flu virus itself rampaging through the nervous system. That can't be fixed with antibiotics. Likewise, the viral intestinal problems can't be fixed with antibiotics. but a secondary peritonitis or blood poisoning from damaged intestine could be fixed with antibiotics. He just didn't say enough to narrow it down much.

 

[AlaskaDenise]

Re: INDONESIA - Garut Cluster Part III

AL:

Yes, we have too little data to reach conclusions.

Below is an article on meningitis. Note the viral leaves little disability, while the bacterial can leave people with "severe disability caused by brain injury" - as the Karo male.

http://www.ehealthmd.com/library/meningitis/MG_causes.html

What Causes Meningitis?

<!--Do nothing with titleabbrev for now--><!--do nothing with article info for now--><!--do nothing with abstract for now--><!--do nothing with article info for now--><!--parent is article-->There are two main forms of meningitis:

• bacterial meningitis, and
• viral meningitis.

<!--parent is article-->
<!--parent is article-->Bacterial meningitis affects fewer people than the viral form, but it often results in more serious health consequences. Bacterial meningitis is fatal in 1 in 10 cases and leaves 1 in 7 survivors with a severe disability caused by brain injury.
<!--parent is article-->Bacterial meningitis
<!--parent is article-->Viral meningitis
Bacterial Meningitis

<!--parent is section-->There are several types of bacterial meningitis. Two types represent the majority of bacterial meningitis cases:

1. meningococcal
2. pneumococcal

<!--parent is section-->
<!--parent is section-->The bacteria that cause these cases are common and live in the back of the nose and throat, or in the upper respiratory tract.

<!--parent is section-->The bacteria are spread among people by coughing, sneezing and kissing. These bacteria cannot live outside the body for long, so they cannot be picked up from water supplies, swimming pools, or a building's air-conditioning system.

<!--parent is section-->Individuals can carry these bacteria for days, weeks, or months without becoming ill. In fact, about 25 percent of the population carries the bacteria. Only rarely do the bacteria overcome the body's defenses and invade the cerebra spinal fluid, causing meningitis.

<!--parent is section-->Meningococcal meningitis accounts for more than half of all cases of bacterial meningitis in the United States. Meningococcal disease is caused by bacteria called Neisseria meningitidis. There are several strains of Neisseria meningitidis. Strain B causes about 75 percent of the meningococcal cases and has the highest fatality rate.

<!--parent is section-->Pneumococcal meningitis is caused by pneumococcus bacteria, which also cause several diseases of the respiratory system, including pneumonia. It has a fatality rate of about 20 percent. It also results in a higher incidence of brain damage than other forms of the disease.
<!--parent is section-->
<!--parent is section-->Other types of bacterial meningitis include:

<!--parent is section-->Neonatal meningitis: This form affects mostly newborn babies and is caused by Group B streptococcus bacteria, commonly found in the intestines.

<!--parent is section-->Staphylococcal meningitis: This is a rare, but deadly form caused by staphylococcus bacteria. It usually develops as a complication of a diagnostic or surgical procedure.

<!--parent is section-->Haemophilus influenza type B (Hib) is caused by haemophilus bacteria. It was once the most common form of bacterial meningitis, and one of the deadliest childhood diseases. However, in 1985, an Hib vaccine was introduced into the routine immunization program for U.S. children and virtually eliminated Hib meningitis in the United States.
Viral Meningitis

<!--parent is section-->Viral meningitis is far more common than the bacterial form and, in most cases, much less debilitating. Most people exposed to viruses that cause meningitis experience mild or no symptoms and fully recover without complications. '

<!--parent is section-->The disease can be caused by many different viruses. Some of the viruses are transmitted by coughing or sneezing or through poor hygiene. Other viruses can be found in sewage polluted waters.

<!--parent is section-->Occasionally, viral meningitis will develop following the mumps or chicken pox. Mosquito-born viruses also account for a few cases each year.
<!--parent is section-->Approximately half of the viral cases in the United States are due to common intestinal viruses, or <NOBR>enteroviruses

</NOBR>. These viruses are shed in the feces and in discharges from the mouth and nose. Most people who become infected with the virus contract it through hand-to-mouth contact.

.
<!--parent is section-->

 

[wetDirt]

Re: INDONESIA - Garut Cluster Part III

I went for a quick Google rummage and came up with this:

Guillain-Barre syndrome
Introduction

Guillain-Barre (ge-YAH buh-RA) syndrome (GBS) is an inflammatory disorder in which your body's immune system attacks the nerves outside the brain and spinal cord (peripheral nerves) and, rarely, parts of the brain itself. Severe weakness and numbness in your legs and arms characterize GBS. Loss of feeling and movement (paralysis) may occur in your legs, arms, upper body and face.

GBS affects an estimated one to three in every 100,000 persons annually in the United States. It can strike any race at any age, but its incidence increases with age. GBS may occur within days or weeks after a viral infection such as influenza (flu) or diarrhea. It may be triggered by pregnancy or a medical procedure, such as a vaccination or minor surgery, or have no evident reason for developing. Because the cause of GBS is unknown, there's no way to prevent the disease from occurring.

In its most severe form, GBS is a medical emergency and may require hospitalization. Severe GBS may result in total paralysis, potentially dangerous fluctuations in heart rate and blood pressure, and inability to breathe without respiratory assistance. The muscles you use for eye movement, speaking, chewing and swallowing also may become weak or paralyzed. People with severe GBS often need long-term rehabilitation to regain normal independence, and as many as 15 percent experience lasting physical impairment. In some cases, GBS can be fatal.

Most people recover from even the most severe cases of GBS. Available treatments, if started soon after signs and symptoms appear, may lessen the severity of GBS and reduce recovery time.

GBS is an occasional influenza complication. It looks a lot like what (forgot-his-name) Ginting ? had.