• FluTrackers.com Inc. does not provide medical advice. Information on this web site is collected from various internet resources, and the FluTrackers board of directors makes no warranty to the safety, efficacy, correctness or completeness of the information posted on this site by any author or poster. The information collated here is for instructional and/or discussion purposes only and is NOT intended to diagnose or treat any disease, illness, or other medical condition. Every individual reader or poster should seek advice from their personal physician/healthcare practitioner before considering or using any interventions that are discussed on this website. By continuing to access this website you agree to consult your personal physican before using any interventions posted on this website, and you agree to hold harmless FluTrackers.com Inc., the board of directors, the members, and all authors and posters for any effects from use of any medication, supplement, vitamin or other substance, device, intervention, etc. mentioned in posts on this website, or other internet venues referenced in posts on this website.
  • We are not asking for any donations. Do not donate to any entity who says they are raising funds for us.

Indonesia H5N1 Ginting family cluster in Bandung - 05/24 - 05/27, 2006

Status
Not open for further replies.
Re: Indonesia 5/24

Re: Indonesia 5/24

Commentary

Extended Human to Human H5N1 Transmission Review

Recombinomics Commentary

May 24, 2006

"If we can't find an external source that explains all seven confirmed cases, then we have to go with the theory that this is human to human," says Peter Cordingley, the spokesperson for the WHO's Western Pacific regional headquarters. Human to human transmission within a family is believed to have occurred at least twice before, in Thailand and Vietnam, although never involving this many people. But if the 10-year-old boy was infected by a family member, and then went on to infect his father, it would represent the first known time the virus had passed from human to human to human. "It's certainly possible," says Gregory Hartl, a WHO spokesperson in Geneva.

The above comments contain qualifiers that keep the statements true, but misleading. The qualifiers are "at least" for the number of cases of human-to-human (H2H) transmission, and "known" for the number of times longer chains (H2H2H) been reported.

There has been a long list of H2H clusters. The vast majority of familial clusters have a 5-10 day gap between the disease onset date of the index case and other family members. In many instances, the index case has contact with poultry, and this link is used to discount the H5N1 in the family members. The current cluster has been acknowledged to be H2H because the poultry source has not been identified and the length of time between the disease onset date of the index case (April 27) and the most recent fatality (May 15) is long and the number of fatal cases in between is large (five plus one H5N1 confirmed survivor).

However, the number of transmission is still cloudy because WHO has failed to release the disease onset dates for the six family members between the first and last case. The incubation time for H5N1 is 2-4 days, which suggests the chain was H2H2H2H or H2H2H2H2H, which is also supported by contact hisptory in the WHO update. Both of these chains are long, but may not be the longest.

Earlier this year there were two large clusters involving several families. The first began at the end of 2005 and extended well into January. This cluster was in Turkey and confirmed cases were identified in three families of cousins. However, the WHO updates failed to indicate that the three family members were related and failed to mention the hospitalizations of family members when other family members were confirmed. Media reports suggest the index case infected his three siblings. The index case and two siblings died and were H5N1 confirmed. Cousins were at a family gathering, and they also developed symptoms and 10 family members were hospitalized. Two were placed in intensive care and tested positive for H5N1. The timing of the cases suggested that these two families represented H2H2H2H. However, these cases were followed by the hospitalization of two more cousins who also tested positive and one died. Thus the chain would then be extended to H2H2H2H2H. However, there hospitalization was followed by the hospitalization of yet another set (five) of cousins who were said to have tested negative.

The reports from Turkey stopped suddenly when the members of the fourth family were hospitalized and the number of negative cases, including the fourth sibling of the index case, raised credibility issues. However, WHO announced in January that they were planning on collecting 10,000 serum samples from contacts of the cases to determine the level of H5N1 transmission. Most patients infected with H5N1 will develop peak serum antibodies about 3 weeks after infections. Thus, samples should have been collected in late January and February. The results from that testing has not been disclosed.

Since the cases had connections with poultry. These cases were not considered as H2H (or H2H2H2H2H), but there is little reason for the cases to be focus in these three related families. In Azerbaijan, cases extended over a month, and although wild bird feathers may have led to infection of the index case, it is likely than transmission to family members over such an extended time period was a long H2H chain.

Thus, the current cluster in Indonesia may not be the longest chain, but it is the deadliest, with seven fatal cases in the eight member cluster. This may be due to a combination of a cleavage site common in Asian H5n1 isolates, coupled with a PB2 E627K polymorphism that is usually not found in birds and is almost always fatal when coupled with the H5N1 cleavage site.

Media Link

Map
 
Re: Indonesia 5/24

Re: Indonesia 5/24

http://www.bangkokpost.com/News/25May2006_news19.php

Thai team to join WHO probe
A Thai team of epidemiologists will work with the World Health Organisation (WHO) to look into a case of possible human-to-human transmission of the H5N1 strain of bird flu virus reported in Indonesia. Kamnuan Ungchusak, head of the Epidemiology Bureau, said the team will leave for Sumatra island on Sunday to work with WHO officials on the case in which seven people from the same family died of avian influenza. ''We have to closely monitor the situation in Indonesia for at least 10 days. If it gets worse, we are ready to implement preventive measures under WHO's recommendations,'' he said.


The WHO said close contacts were considered a possible source of infection among the seven victims. However, genetic sequencing of the virus showed no signs of mutation, it said.
 
Re: Indonesia 5/24

Re: Indonesia 5/24

<TABLE cellSpacing=0 cellPadding=0 width=770 border=0><TBODY><TR vAlign=top><TD class=BGTengah vAlign=top width=* colSpan=3><TABLE cellSpacing=0 cellPadding=3 width="100%" border=0><TBODY><TR><TD><TABLE cellSpacing=0 cellPadding=0 width="100%" border=0><TBODY><TR><TD colSpan=2>Tak Ada Bukti Virus H5N1 di Indonesia Bermutasi</TD></TR><TR><TD colSpan=2>
bening.gif
</TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE></TD></TR><TR vAlign=top height=300><TD width=5>
bening.gif
</TD><TD class=BGTengah vAlign=top width=485><!--tengah --><TABLE cellSpacing=0 cellPadding=3 width="100%" border=0><TBODY><TR><TD>Penulis: Teguh Rachmanto
PARIS--MIOL: Sejauh ini belum ada bukti virus flu burung jenis H5N1 yang menyebar di Indonesia telah mengalami mutasi, menyusul meninggalnya tujuh orang dalam sebuah keluarga di Sumatera Utara akibat virus itu.
Hal itu diungkapkan Direktur Jenderal Organisasi Dunia untuk Kesehatan Hewan (World Organisation for Animal Health-OIE), Rabu (25/5).
"Berdasarkan informasi yang ada, belum ada tanda-tanda virus H5N1 telah bermutasi," kata Dirjen OIE Bernard Vallat kepada wartawan.
Organisasi Kesehatan Dunia (WHO) mengatakan Rabu bahwa perpindahan virus dari manusia ke manusia mungkin terjadi di sebuah keluarga di Karo, Sumatera Utara, tapi belum ada bukti virus mematikan itu telah bermutasi dalam bentuk yang mudah berpindah.
Vallat mengatakan bahwa belum ada kekhawatiran bahwa virus itu telah berpndah antarmanusia. Tapi yang jelas, katanya, jika sejumlah tes yang dilakukan menunjukkan bahwa terjadi perubahan rangkaian genetik pada virus H5N1, maka itu akan menimbulkan pandemik baru di dunia.
Ia juga mengaku sedikit pesimistis terhadap upaya pemerintah Indonesia dalam mengatasi penyebaran virus flu burung, beda dengan upaya keras yang dilakukan Vietnam dan Thailand untuk membasmi penyebaran virus itu pada hewan dan manusia.
Di Indonesia, katanya, upaya mengatasi penyebaran virus flu burung itu hampir tak ada peningkatan, dan justru semakin parah. menurut dia, kesulitan yang dihadapi pemerintah adalah sulitnya mewajibkan pengendalian veteriner di seluruh wilayah yang tersebar di lebih dari 600 pulau.
Tahun ini tercatat 32 orang meninggal akibat virus H5N1 di Indonesia, sementara di seluruh dunia lebih dari 120 orang yang dijemput maut akibat terinfeksi virus tersebut sejak 2003. (Tr/AFP/OL-03)
</TD></TR></TBODY></TABLE>
http://www.mediaindo.co.id
</TD></TR></TBODY></TABLE>
 
Re: Indonesia 5/24

Re: Indonesia 5/24

niman said:
<TABLE cellSpacing=0 cellPadding=0 width=770 border=0><TBODY><TR vAlign=top><TD class=BGTengah vAlign=top width=* colSpan=3><TABLE cellSpacing=0 cellPadding=3 width="100%" border=0><TBODY><TR><TD><TABLE cellSpacing=0 cellPadding=0 width="100%" border=0><TBODY><TR><TD colSpan=2>Tak Ada Bukti Virus H5N1 di Indonesia Bermutasi</TD></TR><TR><TD colSpan=2>
bening.gif
</TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE></TD></TR><TR vAlign=top height=300><TD width=5>
bening.gif
</TD><TD class=BGTengah vAlign=top width=485><!--tengah --><TABLE cellSpacing=0 cellPadding=3 width="100%" border=0><TBODY><TR><TD>Penulis: Teguh Rachmanto
PARIS--MIOL: Sejauh ini belum ada bukti virus flu burung jenis H5N1 yang menyebar di Indonesia telah mengalami mutasi, menyusul meninggalnya tujuh orang dalam sebuah keluarga di Sumatera Utara akibat virus itu.
Hal itu diungkapkan Direktur Jenderal Organisasi Dunia untuk Kesehatan Hewan (World Organisation for Animal Health-OIE), Rabu (25/5).
"Berdasarkan informasi yang ada, belum ada tanda-tanda virus H5N1 telah bermutasi," kata Dirjen OIE Bernard Vallat kepada wartawan.
Organisasi Kesehatan Dunia (WHO) mengatakan Rabu bahwa perpindahan virus dari manusia ke manusia mungkin terjadi di sebuah keluarga di Karo, Sumatera Utara, tapi belum ada bukti virus mematikan itu telah bermutasi dalam bentuk yang mudah berpindah.
Vallat mengatakan bahwa belum ada kekhawatiran bahwa virus itu telah berpndah antarmanusia. Tapi yang jelas, katanya, jika sejumlah tes yang dilakukan menunjukkan bahwa terjadi perubahan rangkaian genetik pada virus H5N1, maka itu akan menimbulkan pandemik baru di dunia.
Ia juga mengaku sedikit pesimistis terhadap upaya pemerintah Indonesia dalam mengatasi penyebaran virus flu burung, beda dengan upaya keras yang dilakukan Vietnam dan Thailand untuk membasmi penyebaran virus itu pada hewan dan manusia.
Di Indonesia, katanya, upaya mengatasi penyebaran virus flu burung itu hampir tak ada peningkatan, dan justru semakin parah. menurut dia, kesulitan yang dihadapi pemerintah adalah sulitnya mewajibkan pengendalian veteriner di seluruh wilayah yang tersebar di lebih dari 600 pulau.
Tahun ini tercatat 32 orang meninggal akibat virus H5N1 di Indonesia, sementara di seluruh dunia lebih dari 120 orang yang dijemput maut akibat terinfeksi virus tersebut sejak 2003. (Tr/AFP/OL-03)

</TD></TR></TBODY></TABLE>
http://www.mediaindo.co.id

</TD></TR></TBODY></TABLE>


There was No Virus Proof H5N1 in Indonesian Bermutasi the writer: Firm RachmantoParis -- MIOL: As Far As This Is Concerned did not yet have proof of the virus of kind bird flu H5N1 that spread in Indonesia experienced the mutation, following the death of seven insiders of a family in North Sumatra resulting from the virus.That was revealed by Organisasi Breakingprep Dunia Director General for the Health of the Animal (World Organisation for Animal Health-OIE), on Wednesday (25/5)."Was based on available information, did not yet have signs of the virus H5N1 has bermutasi," said the Director General OIE Bernard Vallat to the reporter.The organisation of the Health of the World (WHO) said on Wednesday that the move of the virus from humankind to humankind possibly happened in a family in Karo, North Sumatra, but did not yet have the deadly virus proof has bermutasi in the form of that found it easy to move.Vallat said that not yet having the concern that the virus has berpndah antarmanusia.But that clear, he said, if several tests that was carried out showed that the change in the genetic series in the virus happening H5N1, then will cause pandemik just in the world.He also claimed somewhat pessimistic towards Indonesian government efforts in overcoming the spreading of the bird flu virus, unlike hard efforts that were carried out by Vietnam and Thailand to eradicate the spreading of the virus to the animal and humankind.In Indonesia, he said, efforts to overcome the spreading of the bird flu virus did not almost have the increase, and precisely increasingly serious.According to him, the difficulty that was dealt with by the government was the difficulty obliged the control veteriner all over the spread territory in more than 600 islands.This year was recorded by 32 people died resulting from the virus H5N1 in Indonesia, now all over the world more than 120 people that was picked up by the death as a result of being infected by this virus since 2003.(Tr/AFP/OL-03)</PRE>
 
Re: Indonesia 5/24

Re: Indonesia 5/24

http://english.people.com.cn/200605/25/eng20060525_268504.html
No evidence H5N1 virus mutates in Indonesia, OIE says

The World Organisation for Animal Health (OIE) said Wednesday that there is no evidence the H5N1 bird flu virus has mutated in Indonesia.

"Nothing demonstrates that the virus has mutated or recombined, " Bernard Vallat, director general of the global watchdog for veterinary standards in farm trade, told reporters.

The World Health Organisation (WHO) said earlier in the day that limited human-to-human transmission of bird flu may have occurred in the Indonesian family -- but that there was no evidence it had mutated into an easily transmissible form.

The OIE chief confirmed there was currently "no cause for concern", but didn't exclude a new epidemic event if further tests reveal significant changes to the genetic sequences of the virus.

More than 120 people have died from bird flu since it re- emerged as a threat in 2003, mostly in Asia.
Source: Xinhua
 
Re: Indonesia 5/24

Re: Indonesia 5/24

"Nothing demonstrates that the virus has mutated or recombined, "
It seems that the OIE Cheif Bernard Vallat has been reading Dr. Niman's work.

The OIE chief confirmed there was currently "no cause for concern",
Dr Niman, did he ask your permission to hijack your tagline?
 
Ginting family leave home / staying with other relatives

Ginting family leave home / staying with other relatives

Sure as h*ll hope they don't spread it on...

toggletext-ed from Indonesian:

Casualties's FAMILY LAND BIRD FLU KARO the TRAUMA
May 25, 2006

Metrotvnews.com, Tanah Karo: All of the family's member from seven citizens who were killed resulting from bird flu in the Simbelang Fortification Village, the Karo Land, North Sumatra, up to now still is fleeing to relatives's closest house. Beforehand several citizens that live in around the house of these bird flu casualties also could flee to the family's closest house. The worried generally citizen will join in tertular the bird flu virus.

When visiting the house the family of casualties of the bird flu virus, on Wednesday (24/5), the reporter Metro the TV found this house in the empty situation. According to the neighbour, casualties's family Praise Boru Ginting, Anta Boru Ginting and Dowes Ginting have for a long time been empty. They fled to several of his relatives. They the trauma with the death of his family's member. The husband from Anta Boru Ginting, Hendra Tarigan said, his house deliberate was remained because he still could not forget the wife and his child who died.

http://www.metrotvnews.com/berita.asp?id=17313
 
Re: Indonesia 5/24

Re: Indonesia 5/24

They have all scattered? And all of them could be infected. I think I need a tall scotch............make it two.
 
Last edited by a moderator:
More about the brother & sister who died in Bandung

More about the brother & sister who died in Bandung

Having trouble with toggletext -- couldn't manage to translate the whole article for some reason....

toggletext-ed from Indonesian:

2 ?Suspect? Bird Flu died
After could 18 hours were treated in RSHS Bandung
Bandung, (HOMEWORK).

Photo caption: Two nurses issued the bed to bring the patient's body "suspect" bird flu, AT (10), from Poinciana Tree Space to the Morgue Installation of RSHS Bandung, on Tuesday (23/5). The patient was named AT with his older brother, A (18), was the patient who was reconciled from the Ujungberung Hospital because breathless and feverish high. They entered RSHS, on Monday night (22/5).


Two older brothers were siblings, AT (10) and AC (18), the patient suspect the citizen's bird flu Kec. Cileunyi Kab. Bandung, died in RS Handsome Sadikin (RSHS), on Tuesday (23/5). AT died struck 14.50 WIB in Handsome Sadikin Space of the Isolation of the Hospital Poinciana Tree (RSHS) Bandung. Whereas AC died four hours at intervals of.

The managing director (the Managing Director) RSHS Dr. Cissy B. Kartasasmita, overnight said, AC died approximately struck 19.00 WIB. ?Itu temporary information that was received by me from Poinciana Tree Space, the place of the patient dirawat,? he said.

Beforehand, on Tuesday late afternoon (23/5), Cissy, announced the death of AT. ?Dengan heavy-hearted, we must announce the obituary. The patient AT died, whereas his older brother still in the condition really gawat,? said Cissy B. Kartasasmita.

The patient AT and AC began to be treated in Poinciana Tree Space on Monday (22/5) struck 21.00 WIB with the hot and breathless sign. Both of them were the reconciliation patient from RSUD Ujungberung, the Bandung City.

According to the Chairman Tim the Control of Bird Flu of RSHS Bandung, Dr. Hadi Jusuf, results of the laboratory inspection showed the level of Leucocytes the two low patients and trombosit him was rather low.

Now results of the photograph thorax showed pneumonia has crept as far as two rods of his lungs.

?Sejak on Monday night, the patient was at once given the tablet oseltamivir (Tamiflu) 150 mg. Also was given kartikosteroid to inflamasi that great and help of oxygen tinggi,? he said.

Mechanics breathing

Three hours before died to his lap, the AT breath out of breath. The attraction of the girl's small breath, that just sat in the class bench 3 primary schools, canned be heard like someone who cried. Only at intervals of some time after mechanics breathing (the ventilator) was installed, he died.


?Kita sudah memasang ventilator, tapi dia tetap tidak tertolong. Paru-parunya sudah mengalami pembengkakan,? ujar dr. Djatnika Setiabudi, Wakil Ketua Tim Penanggulangan Flu Burung RSHS Bandung.

Kondisi sang kakak, AC (18), meski telah dipasangi ventilator juga kian kritis. Sang ibu, Ny. C (47), hanya bisa menangisi kematian putri bungsunya. Namun, sebagai orang tua tunggal dengan tiga anak, ia terlihat berupaya tegar demi putra keduanya yang terbaring lemas di ruang probable .

Sembilan ayam mati

Ny. C mengakui sembilan ayam miliknya mati secara beruntun pada pekan lalu. Tiga hari setelah itu, AC yang berprofesi sebagai tukang ojek, mengalami demam dan batuk. Sang adik, AT, kemudian juga memunculkan gejala serupa.

Hanya 18 jam mendapatkan perawatan di RSHS Bandung, AT pulang dalam peti jenazah yang diantarkan ambulans. Sang paman, Adang (35), tak dapat memastikan kapan keponakan kesayangannya itu akan dimakamkan.

?Saya ke sini (RSHS) untuk menemani ibunya. Tapi sampai di sini, keponakan saya sudah meninggal. Untuk pemakaman, harus rembukan keluarga dulu,? ujarnya.

http://www.pikiran-rakyat.com/cetak/2006/052006/24/0206.htm
 
Re: Indonesia 5/24

Re: Indonesia 5/24

DB said:
"Nothing demonstrates that the virus has mutated or recombined, "

It seems that the OIE Cheif Bernard Vallat has been reading Dr. Niman's work.

The OIE chief confirmed there was currently "no cause for concern",

Dr Niman, did he ask your permission to hijack your tagline?
He is talking about reassortment. Those doing the sequencing do not know how to analyze for recombination, the can only look for reassortment because the appraoch they use (phylogentic analysis) is not sensitive enough to detect recombination).
 
Re: More about the brother & sister who died in Bandung

Re: More about the brother & sister who died in Bandung

Theresa42 said:
Having trouble with toggletext -- couldn't manage to translate the whole article for some reason....

toggletext-ed from Indonesian:

2 ?Suspect? Bird Flu died
After could 18 hours were treated in RSHS Bandung
Bandung, (HOMEWORK).

Photo caption: Two nurses issued the bed to bring the patient's body "suspect" bird flu, AT (10), from Poinciana Tree Space to the Morgue Installation of RSHS Bandung, on Tuesday (23/5). The patient was named AT with his older brother, A (18), was the patient who was reconciled from the Ujungberung Hospital because breathless and feverish high. They entered RSHS, on Monday night (22/5).


Two older brothers were siblings, AT (10) and AC (18), the patient suspect the citizen's bird flu Kec. Cileunyi Kab. Bandung, died in RS Handsome Sadikin (RSHS), on Tuesday (23/5). AT died struck 14.50 WIB in Handsome Sadikin Space of the Isolation of the Hospital Poinciana Tree (RSHS) Bandung. Whereas AC died four hours at intervals of.

The managing director (the Managing Director) RSHS Dr. Cissy B. Kartasasmita, overnight said, AC died approximately struck 19.00 WIB. ?Itu temporary information that was received by me from Poinciana Tree Space, the place of the patient dirawat,? he said.

Beforehand, on Tuesday late afternoon (23/5), Cissy, announced the death of AT. ?Dengan heavy-hearted, we must announce the obituary. The patient AT died, whereas his older brother still in the condition really gawat,? said Cissy B. Kartasasmita.

The patient AT and AC began to be treated in Poinciana Tree Space on Monday (22/5) struck 21.00 WIB with the hot and breathless sign. Both of them were the reconciliation patient from RSUD Ujungberung, the Bandung City.

According to the Chairman Tim the Control of Bird Flu of RSHS Bandung, Dr. Hadi Jusuf, results of the laboratory inspection showed the level of Leucocytes the two low patients and trombosit him was rather low.

Now results of the photograph thorax showed pneumonia has crept as far as two rods of his lungs.

?Sejak on Monday night, the patient was at once given the tablet oseltamivir (Tamiflu) 150 mg. Also was given kartikosteroid to inflamasi that great and help of oxygen tinggi,? he said.

Mechanics breathing

Three hours before died to his lap, the AT breath out of breath. The attraction of the girl's small breath, that just sat in the class bench 3 primary schools, canned be heard like someone who cried. Only at intervals of some time after mechanics breathing (the ventilator) was installed, he died.


?Kita sudah memasang ventilator, tapi dia tetap tidak tertolong. Paru-parunya sudah mengalami pembengkakan,? ujar dr. Djatnika Setiabudi, Wakil Ketua Tim Penanggulangan Flu Burung RSHS Bandung.

Kondisi sang kakak, AC (18), meski telah dipasangi ventilator juga kian kritis. Sang ibu, Ny. C (47), hanya bisa menangisi kematian putri bungsunya. Namun, sebagai orang tua tunggal dengan tiga anak, ia terlihat berupaya tegar demi putra keduanya yang terbaring lemas di ruang probable .

Sembilan ayam mati

Ny. C mengakui sembilan ayam miliknya mati secara beruntun pada pekan lalu. Tiga hari setelah itu, AC yang berprofesi sebagai tukang ojek, mengalami demam dan batuk. Sang adik, AT, kemudian juga memunculkan gejala serupa.

Hanya 18 jam mendapatkan perawatan di RSHS Bandung, AT pulang dalam peti jenazah yang diantarkan ambulans. Sang paman, Adang (35), tak dapat memastikan kapan keponakan kesayangannya itu akan dimakamkan.

?Saya ke sini (RSHS) untuk menemani ibunya. Tapi sampai di sini, keponakan saya sudah meninggal. Untuk pemakaman, harus rembukan keluarga dulu,? ujarnya.

http://www.pikiran-rakyat.com/cetak/2006/052006/24/0206.htm

Here is the rest of the translation (translation stops when quotation marks are in text)


We have installed the ventilator, but he continue to was not helped.His lungs have experienced the swelling, said Dr. Djatnika Setiabudi, Vice Chairman Tim Penanggulangan Breakingprep Flu Burung RSHS Bandung.The condition the older brother, AC (18), although being installed the ventilator also increasingly critical.The mother, NY.C (47), only could weep over the death of the daughter of his youngest child.However, as single parents with three children, he was seen made a strong effort for the sake of the son both of them that terbaring limp in space probable.Nine chickens diedNY.C acknowledged his nine property chickens died in a beruntun manner last week.Three days after that, AC that was professional as the taxi bike trade person, experienced the fever and the cough.The brother, AT, afterwards also showed the similar sign.Only 18 hours got the maintenance in RSHS Bandung, AT came home in the coffin that was delivered by the ambulance.The uncle, Block (35), could not confirm when his pet nephew will be buried.I here (RSHS) to accompany his mother.But arrive in here, my nephew has died.For the funeral, must rembukan the family previously, he said.</PRE>
 
Re: Indonesia 5/24

Re: Indonesia 5/24

DB said:
"Nothing demonstrates that the virus has mutated or recombined, "


It seems that the OIE Cheif Bernard Vallat has been reading Dr. Niman's work.

The OIE chief confirmed there was currently "no cause for concern",


Dr Niman, did he ask your permission to hijack your tagline?
Daily visits to recombinomics have topped 10,000. The major players come frequently to the site.

and a google search or recombinomics now generates over 100,000 hits

http://www.google.com/search?sourceid=navclient&ie=UTF-8&rls=GGLG%2CGGLG%3A2005-33%2CGGLG%3Aen&q=recombinomics&sa=N&tab=nw
 
Re: Indonesia 5/24

Re: Indonesia 5/24

<TABLE style="TABLE-LAYOUT: auto" cellSpacing=0 cellPadding=0 width="100%" summary="Main Page Table" border=0><TBODY><TR><TD vAlign=top><TABLE cellSpacing=10 cellPadding=0 summary="Main Content Table" border=0><TBODY><TR><TD vAlign=top align=left colSpan=2>Two generations of spread possible in Indonesia H5N1 cases

Jim Wappes
purple-speck.gif
Associate Managing Editor

May 24, 2006 (CIDRAP News) ? For the first time, evidence suggests that the H5N1 avian influenza virus may have passed from one person to another and on to a third, according to a World Health Organization (WHO) official.
Referring to the extended-family case cluster in Indonesia, the WHO's Maria Cheng told the Canadian Press (CP) yesterday, "This is the first time we have seen cases that have gone beyond one generation of human-to-human spread."
The WHO said in an online statement yesterday that analysis of viruses from patients in the cluster had shown no evidence of changes that could lead to efficient human-to-human transmission. But another WHO official expressed serious concern about the cluster.
Peter Cordingley, spokesman for the WHO's Western Pacific region, quoted in a Reuters report today, said, "This is the most significant development so far in terms of public health. We have never had a cluster as large as this. We have not had in the past what we have here, which is no explanation as to how these people became infected [in the first place]. We can't find sick animals in this community, and that worries us."
CDC director not alarmed
In a news briefing this afternoon, the director of the US Centers for Disease Control and Prevention (CDC) generally echoed the WHO's message of yesterday that the cluster appears to involve person-to-person transmission but that there is no sign of transmission beyond the cluster and no evidence of changes in the virus.
"There's a lot more science to be done, but the early indication is we're not seeing anything that would be sending up an alarm," Dr. Julie Gerberding said from Geneva, where she is attending the WHO's annual meeting. She added, "We understand we can't be complacent about this."
The cluster includes seven confirmed cases in an extended family, six of which were fatal. All of these followed a similar illness in a 37-year-old woman who died and was buried without being tested for avian flu. The WHO regards her illness as the index case.
Although other officials have said investigators have not been able to find a possible animal source for the index patient's infection, Gerberding said today, "Clearly the source of infection likely was an infected poultry exposure."
Concurring with the view that at least two generations of transmission occurred, she added, "The person who initially got the infection from poultry may have been the source of transmission to other family members, and there may have been subsequent transmission to other family members." She said the family members had close contact with one another, and there have been no infections in healthcare workers or others outside the family.
Gerberding said that a two-generation, or "person-to-person-to-person," transmission chain is significant in that it raises the "worrisome possibility" of a change in the virus, but added that investigators have not found evidence of a change.
She also said the cluster is not the first example of probable person-to-person transmission of the virus. "This probably the third example where we've seen pretty good evidence of human-to-human transmission," she told reporters.
Gerberding described the people in the cluster as "all related by blood," implying the possibility of genetic susceptibility to the virus. She said it is possible there are some people "who are more susceptible to transmission because of the unique makeup of their respiratory tract. . . . We have no evidence of this, but we have to examine that hypothesis."
The CDC head said the genetic sequencing of viruses from the cluster so far has yielded four main findings:
  • <LI class=body>The isolates are all "virtually identical," implying a single source. <LI class=body>They are susceptible to the antiviral drug Tamiflu (oseltamivir). <LI class=body>"There is no evidence of motif changes in the particular areas of the genes that are responsible for how the virus binds to the respiratory tract of people."
  • The isolates are very similar to viruses previously collected from poultry in the region.
Gerberding said the cluster occurred in "a Christian community in a pretty remote area on an outlying island." Both traditional and western medical techniques are used in the village. Contrary to some recent reports, she said the local residents have shown "enormous cooperation" with the WHO investigators, at least in the past few days.
Raising the pandemic alert level?
The Indonesian cluster has triggered talk about the possibility of the WHO's changing its pandemic alert status from phase 3 to phase 4 on its 6-phase scale, with phase 6 being a full-blown pandemic. A WHO task force would have to meet and make this decision.
"Right now," said the WHO's Cheng in a Reuters story today, "it does not look like the task force will need to meet immediately, but this is subject to change, depending on what comes out of Indonesia."
But the WHO's pandemic alert system lacks specific criteria for elevating the alert level, according to Michael Osterholm, PhD, MPH, director of the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota, which publishes the CIDRAP Web site.
"I'm personally confused about the difference in what a phase 3 and phase 4 alert level is," he said today. "The WHO has not clearly described the difference.
"That's important. I'm personally aware of a number of companies that have pegged certain levels of their pandemic flu plan based on a change from phase 3 to phase 4. And I'm not sure a change in the alert level would warrant a change in pandemic planning."
The WHO Global Influenza Preparedness Plan (see link below) defines phase 3 as "human infection(s) with a new subtype, but no human-to-human spread, or at most rare instances of spread to a close contact."
Phase 4 is characterized by "small cluster(s) with limited human-to-human transmission, but spread is highly localized, suggesting that the virus is not well adapted to humans."
The WHO plan further states, "The distinction between phase 3, phase 4, and phase 5is based on an assessment of the risk of a pandemic. . . . Factors may include rate of transmission, geographical location and spread, severity of illness, presence of genes from human strains (if derived from an animal strain), and/or other scientific parameters."
News editor Robert Roos contributed to this article.
See also:
WHO's May 23 Indonesia update
http://www.who.int/csr/don/2006_05_23/en/index.html
WHO Global Influenza Preparedness Plan
http://www.who.int/csr/resources/publications/influenza/WHO_CDS_CSR_GIP_2005_5/en/index.html

</TD></TR></TBODY></TABLE></TD><!-- end MAIN CONTENT CELL --></TR><!-- FOOTER --><TR><TD colSpan=9><TABLE cellSpacing=0 cellPadding=0 width="100%" summary=Footer border=0><TBODY><TR><TD class=footer width="100%" background=/cidrap/images/footer_stretch.gif height=9> </TD></TR></TBODY></TABLE>
http://www.cidrap.umn.edu/cidrap/content/influenza/avianflu/news/may2406cluster.html

</TD></TR></TBODY></TABLE>
 
Re: Indonesia 5/24

Re: Indonesia 5/24

...isolates are all "virtually identical" ...

But the power of one little mutation (like 92 in NS1) can make monumental differences.

I notice that they say there is no difference in transmissibility, but what about virulence? Any changes there?

When they refuse to release sequences it only gives the appearance of having something to hide. Solution? Release the sequences!

.
 
Re: Indonesia 5/24

Re: Indonesia 5/24

WHO Issues Warning About Indonesian Bird Flu Deaths
By Nancy-Amelia Collins
Jakarta
24 May 2006


The World Health Organization says the cluster of bird flu deaths in one Indonesian family this month is the most significant development to date in the spread of the virus.

Only remaining family member of seven, which has been decimated by bird flu deaths, is treated for disease in hospital, Wednesday
Only remaining family member of seven, which has been decimated by bird flu deaths, is treated for disease in hospital, Wednesday
The World Health Organization says it cannot rule out limited human-to-human transmission of the H5N1 bird flu virus, which killed seven members of one Indonesian family earlier this month.

Six of the seven family members were from one village in north Sumatra.

WHO regional spokesman Peter Cordingley in Manila says there have been groups of people infected with bird flu before, but this is the largest number in one location.

"We have seen clusters in the past and we have seen what was almost certainly (maybe) limited human to human transmission in some cases," he said. "But this is significant because it's the mother of all clusters. It's seven people, six of whom have died and possibly an eighth as well who died before samples could be taken so this is the mother of all clusters."

Cordingley says the WHO is particularly concerned because scientists cannot find a link to sick birds in these latest deaths.

"For the first time now we have people dying from this virus but we can find no source of infection outside their own family," he explained. "No dead chickens, no dying chickens, basically no animal source at all around them. So we're in a zone we've not been in before which is a large cluster and we don't understand it."

So far no human-to-human cases of avian flu have been confirmed.

And Cordingley stresses there is some positive news in this Indonesian cluster.

"We've taken samples and we've looked at them and the virus is not mutating?it shows no sign of the ability to transmit more easily between chickens and humans and no sign of any ability to transmit more effectively from human to human," he said.

Scientists fear if that happens it could cause a pandemic killing millions of people.

Bird flu has infected more than 120 people worldwide - the majority of them in Asia and a quarter of those in Indonesia - since it resurfaced in 2003.
http://www.voanews.com/english/2006-05-24-voa1.cfm
 
Re: Indonesia 5/24

Re: Indonesia 5/24

Local tests show West Java girl died of bird flu
Thu May 25, 2006 12:38 PM BST


JAKARTA (Reuters) - Local tests have confirmed an Indonesian child from the city of Bandung died of bird flu, a senior health ministry official said on Thursday.
Local results on bird flu cases are not considered definitive and need confirmation from the World Health Organisation.
I Nyoman Kandun, director-general of communicable disease control, told Reuters local tests have found one of two siblings admitted to hospital earlier this week in the West Java capital of Bandung was a positive H5N1 case.
"The younger one is positive. We are looking into the other one," he said.
The younger sibling, a 10-year old girl, died on Tuesday.
World attention is now focussed on another Indonesian family after the WHO confirmed seven members from Kubu Simbelang village in North Sumatra province were infected with the H5N1 avian influenza virus.
It is the largest known bird flu cluster since the disease re-appeared in Asia in 2003 and the WHO says limited human-to-human contact between family members might have occurred.
International and local health officials say there is no evidence the virus had mutated in the Kubu Simbelang cluster case. But the case has baffled experts because no definitive source of infection has been found.
H5N1 remains difficult for humans to catch, but experts fear it could evolve into a form passes easily from human to human, causing a pandemic that could kill millions.



http://today.reuters.co.uk/news/new...KOC_0_UK-BIRDFLU-INDONESIA.xml&archived=False
 
Re: Indonesia 5/24

Re: Indonesia 5/24

H5N1 Bird Flu Cluster in Bandung Indonesia Confirmed

Recombinomics Commentary

May 25, 2006

local tests have found one of two siblings admitted to hospital earlier this week in the West Java capital of Bandung was a positive H5N1 case.

"The younger one is positive. We are looking into the other one," he said.

The younger sibling, a 10-year old girl, died on Tuesday.

The above comments confirm H5N1 bird flu in the Bandung familial cluster. Two siblings have died, while a third is being treated at home. The number of confirmed clusters continues to make up the majority of cases in Indonesia.

Currently the large cluster in North Sumatra has captured significant attention, but the repeated and widespread outbreaks of smaller cluster is cause for concern and involves two distinct H5N1 sequences.
 
Re: Indonesia 5/24

Re: Indonesia 5/24

http://www.dose.ca/toronto/news/story.html?s_id=R1zAnC3L%2F1pgmsHX8fRGgX2rImMJZtBBdIdjWorBUkZWSa%2Fxy8ODIg%3D%3D
Indonesia puts villagers on home quarantine
JAKARTA (Reuters) - Health experts have asked 33 people in a remote Indonesian village to quarantine themselves at home after the H5N1 bird flu virus killed as many as seven members of a family there earlier this month.

Epidemiologists have failed to track down the source of infection in Kubu Simbelang village in north Sumatra and the World Health Organization said this week limited human-to-human transmission between family members might have occurred.

"There are 33 people identified as close contacts. We've asked them to observe home quarantine. That's something they are willing to do to protect themselves and their families," said Dick Thompson, spokesman for the WHO.

Meanwhile, local tests have confirmed an Indonesian child from the city of Bandung died of bird flu, a senior health ministry official said on Thursday.
Local results on bird flu cases are not considered definitive and need confirmation from the World Health Organization.

I Nyoman Kandun, director-general of communicable disease control, told Reuters local tests have found two siblings admitted to hospital earlier this week in the West Java capital of Bandung was a positive H5N1 case.
"The two of them are now positive," he told Reuters in a telephone text message.

The younger sibling, a 10-year old girl, died on Tuesday. The condition of the 18-year-old brother was not immediately clear.

But attention is still primarily focused on the Sumatran cluster, the largest to date.

Tests on samples taken from chickens, ducks and pigs -- animals that are most susceptible to the virus -- in Kubu Simbelang village and another nearby area have proven inconclusive.

Fuelling the suspicion hanging over person-to-person transmission is the unusually long time lag of 15 days between the first and the last person in the cluster falling ill.

The incubation period for the H5N1 is usually no more than seven days and if the family had been exposed to the same source, they would all have fallen ill at about the same time.

"You want to look at the dates of onset of the disease. If they are close together they may have had the same exposure," Thompson said.

The WHO has, however stressed that even if human-to-human transmission did occur, it was in a very limited way and the infection has not spread beyond the family cluster. In addition, scientific evidence has shown the virus has not mutated into one that can be easily passed among people.

H5N1 remains difficult for humans to catch, but experts fear it could evolve into a form passes easily from human to human, causing a pandemic that could kill millions.
 
Status
Not open for further replies.
Back
Top