Indonesia Human Cases - April 9, 2008 - 20th June 2008

[Gert van der Hoek]

Re: Indonesia Human Cases - April 9, 2008+

Re: Indonesia Human Cases - April 9, 2008+

Some details from Padang, West Sumatra. The family doesn?t trust the hospital. Not clear why.

The child seems to display all clinical symptoms of bird flu.

A lot of direct contacts before the child was brought to the isolation ward.


Pre-schoolers Suspect Bird Flu, Family refused to be checked

Padang - Dugaan the suspect bird flu was aimed at a pre-schooler was 1 years and 3 months old had the initials HAP, was threatened with could not be handled by the official RS. M. Djamil Padang because of the family refused for the inspection of the patient's blood, on Monday (9 - 6).

This refusal was brought forward without the clear reason.


According to information of the hospital side, to confirm whether this patient suffered bird flu or not, must join several inspections swab the throat, that was useful to know the clinical sign available to mucus and the sample inspection of blood. But the family was always silent.

Hendri, parents of the patient, said, on Monday (2/6) previous, his child could be carried to the Puti Midwife in the Laban Bungus Market.

Kamudian was carried to the other midwife, but never recovered to the end was brought to RS.M.Djamil last Friday (6/6).

These pre-schoolers could be treated for 2 hours in the Childrens Ward the hospital.

Hendri startled when the official said his child's illness was similar to the sign of bird flu, because beforehand he only thought his child only suffered the common fever.

On the official's suggestion, finally Hendri prepared his child was moved to the room of the Irna C Penyakit Dalam Isolation.

After experiencing the beginning inspection, the official found the indication of early that was similar to the sign of bird flu.

This assumption was reinforced by information of casualties's family, that said the kept chicken casualties's family had died suddenly, 4 days after the pre-schoolers suffered the fever.

Resulting from the family's refusal, the process of the patient's recuperation with the step in early took the sample of the patient's blood to be carried out by the inspection that would in sent to Balitbang Department of Health RI to was hindered.

Observation padangmedia.com up until today, several members of the family of the appearance patient accompanied casualties by using the protection implement himself, took the form of the mask, sterile clothes and the cover of the head, appropriate protap the handling of the bird flu patient while being stated suspect.

http://www.padangmedia.com/news/131/ARTICLE/4032/2008-06-09.html

 

[Gert van der Hoek]

Re: Indonesia Human Cases - April 9, 2008+

Re: Indonesia Human Cases - April 9, 2008+

Two snips from Padang, Sumatra, on the young child, suspected to have bird fu.

A child falling ill, having high fever and displaying symptoms of "breathlessness" is not extraordinary, it is normal.

(Again) some delay of the publication of the testresults.

--------------------------------------------------------------------------

- snip -


In Friday last week that, he said, And cried and hot his body was rather other. There was no assumption what what with his child's illness.

Moreover, Epi (32) the father And only expected his child the common fever. If in our village, that was named breathless normally, that was not extraordinary.

But, it is hoped true not bird flu, said the woman again.

The matter of the cost, he said, indeed must not pay in RS M. Djamil.

But, to stay long in the hospital certainly was not good, would much money that went out to eat in two kitchens.

Yesterday the doctor's words today (yesterday) results of his test were finished.


- snip -

The head of the Pelayanan Medik Field RSUP M. Djamil Padang, Dr Irayanti that was contacted mentioned, up until Tuesday (10/6) results of the test of the patient's blood that was expected to be infected by the virus H5NI that did not yet go out. Possibly 5 or 6 days more.

It was clear, the patient will continue to be treated intensively here, said Irayanti while mentioning, the sample of blood was still being checked in Balitbang Department of Health RI.

http://www.posmetropadang.com/content/view/2937/1322/

translation Influentia2

 

[Gert van der Hoek]

Re: Indonesia Human Cases - April 9, 2008+

Re: Indonesia Human Cases - April 9, 2008+

Some more snips from Padang Hopital, Sumatra

The child HAP seems to improve.

"Rapid test" said "negative", however these teste have an accuracy of 50%.

The doctors had trouble with taking samples, only after 2 days of treatment the parents allowed it. Would not be surprising if the results of the PCR-test would be negative too.



The Sample Of Blood Was Sent To The Department Of Health

Rabu, 11 Juni 2008

Padang, Padek - After three days underwent the maintenance in the room of the isolation of RSUP M. Djamil Padang, "HAP" (15 months) the patient suspect bird flu gradually from Bungus Kota Padang improved.

This condition was seen with the fall of the temperature of the body of the male child from 39 levels celsius became 37 levels celsius. Nevertheless, this patient still experienced breathless so as still needed help of breathing with oxygen.

"Generally the condition for his body was still weak, everything of the number of his leucocytes was also high, this matter signalled the existence of the infection in the patient's body. From results rapid the test that was carried out in RSUP M. Djamil Padang, results of the negative.

However in accordance with the procedure, that will become the reference was results of the PCR test, that is results of blood that verified in Balitbang Department of Health RI, said the Head of the Layanan Medik Field RSUP M. Djamil Padang, to Padang Ekspres, yesterday.

http://www.padangekspres.co.id/content/view/8785/105/

transalation dbg

 

[Gert van der Hoek]

Re: Indonesia Human Cases - April 9, 2008+

Re: Indonesia Human Cases - April 9, 2008+

Long report from website Department of Health on Bird Flu Cases, January - May 2008

http://www.depkes.go.id/index.php?option=news&task=viewarticle&sid=3128

TT is out here.

 

[Commonground]

Re: Indonesia Human Cases - April 9, 2008+

Re: Indonesia Human Cases - April 9, 2008+

Post #264:

Based on examinatiion virologist with method analyzing (genetic sequencing) by means of Badan Research and Development Health (Balitbangkes) Depkes and Organization Biology Molecular Eijkman in Jakarta, up until now virus flu burung that attack human being still [consistent/fixed/stable] H5N1. And thus, infection virus flu burung in Indonesia still from poultry toward humans. Karana that, society was appealed toward avoiding contact with poultry that sick or died suddenly and environment that polluted feces poultry. Not tend poultry in surrounding settlement when there is poultry that is sick or dead in surroundings around, immediately report to Ketua RT RW local Masyarakat also urged always to carry out behavior live clean and healthy (PHBS), look after cleanliness surroundings and guard against sign Flu, because frequently times too late patient seek service medical enhance risk death. Matter
concerning those passed on dr I Nyoman Kendun MPH Dirjen Pengendalian Disease and Sanitation Lengkungan Depkes linked by evolution handling flu burung.

According to dr Nyoman Kandun in handling flu burung government already to carry out various endeavors towards suppress number illness and death. Among to prepare house sick referral Flu Burung from formerly 44 RS become 100 RS in entire Indonesia to participate in treatment method free of charge for medical patient that anticipated suspect Flu Burung until result inspection completed done Badan Research & Development in Eijkman.

-snip-
Not translated:

Sedangkan untuk mempercepat pemeriksaan sampel dilakukan penguatan laboratorium rujukan nasional dan 8 laboratorium regional. Pemeriksaan sampel yang semula dilakukan di laboratorium rujukan WHO di Hongkong dan CDC Atlanta Amerika (sejak 2005 sampai awal Agustus 2006) maka mulai 8 Agustus 2006 penentuan konfirmasi kasus Flu burung dapat dilakukan di dalam negeri yaitu laboratorium Badan Litbangkes dan Lembaga Eijkman. Pada saat bersamaan, Menkes RI juga menetapkan bahwa data virus Flu Burung dimasukkan dalam Genebank sehingga dapat diakses oleh para ilmuan internasional.

Selain itu, pemerintah juga menyediakan obat Oseltamivir di sarana pelayanan kesehatan pemerintah seperti Puskesmas dan RS rujukan. Sedangkan untuk meningkatkan kemampuan petugas, telah dilakukan berbagai pelatihan penanggulangan Flu Burung bagi petugas medis dan paramedis serta Tim Gerak Cepat Flu Burung, kata dr. Nyoman Kandun.

Untuk meningkatkan kemampuan dalam mengantisipasi kemungkinan pandemi influenza, telah diselenggarakan simulasi penanggulangan pandemi influenza di Jembrana, Bali tanggal 25-27 April 2008 yang melibatkan Puskesmas, RS, desa wilayah penanggulangan, Bandara dan jejaring kesehatan lainnya. Ini adalah simulasi penanggulangan komprehensif pertama di dunia, dihadiri pengamat dari dalam dan luar negeri, tambah dr. Nyoman Kandun.

In period of time January - May year 2008 Depkes already to do check suspect Flu Burung to be in succession go along with 198 cases and 483 specimen. In period that same for year 2007, already carried out investigation suspect toward 479 cases and 1,025 specimen. For the moment at period of time that equal year 2006, already carried out investigation suspect flu burung sequential 302 cases and 714 specimen. Besides that also carried out investigation laboratory contact research inquiry cases confirm Flu Burung, monitoring contact cases confirmand counseling to community through various channels information which available.

Toward month May 2008, cases positive Flu Burung indicate descent 50% compared cases Flu Burung in month May 2007 and descent that sharp that is to say 88.8% compared cases Flu Burung in month May 2006. Peak highest cases flu burung found in month May 2007 because situation cluster Flu Burung largest Kabupaten Karo.

Not Translated:

Dari 12 provinsi yang terinfeksi Flu Burung, terdapat 5 provinsi yang tidak ditemukan lagi kasus Flu Burung yaitu :

Provinsi Lampung : Infeksi tahun 2005, 2 tahun 5 bulan lebih tidak ditemukan kasus
Provinsi Sulsel : Infeksi tahun 2006, 17 bulan lebih tidak ditemukan kasus
Provinsi Sumsel : infeksi tahun 2007, 5 bulan lebih tak ada lagi kasus
Provinsi Riau : Infekksi tahun -2007, 5 bulan tak ada kasus
Provinsi Bali : Infeksi bln November 2007, 6 bulan tak ada kasus.
Informasi perkembangan penanggulangan dan kasus Flu Burung, akan disampaikan secara berkala sebulan sekali. Dengan demikian masyarakat dan seluruh pemangku kepentingan dapat mengetahui upaya-upaya menyeluruh yang telah dilakukan dalam periode tersebut. Informasi akan disampaikan melalui situs www.depkes.go.id.

Berita ini disiarkan oleh Pusat Komunikasi Publik, Sekretariat Jenderal Departemen Kesehatan. Untuk informasi lebih lanjut dapat menghubungi melalui nomor telepon/faks:021-5223002 dan 52960661, atau e-mail puskom.depkes@gmail.com dan puskom.publik@yahoo.co.id.

 

[Gert van der Hoek]

Re: Indonesia Human Cases - April 9, 2008+

Re: Indonesia Human Cases - April 9, 2008+

Thank you!

 

[Shiloh]

Re: Indonesia Human Cases - April 9, 2008+

Re: Indonesia Human Cases - April 9, 2008+

Source: http://canadianpress.google.com/article/ALeqM5iLjLvzqks0dzVsIRggemVMdfp-QA

WHO says Indonesia has given assurances it will report bird flu cases

TORONTO ? A senior official of the World Health Organization says the global health agency has been assured Indonesia will continue to report human cases of, and deaths from, H5N1 avian flu as they occur.

The WHO had sought clarification from Indonesia after Health Minister Siti Fadilah Supari said last week that her country would in future only report H5N1 deaths sporadically, perhaps at six month intervals.

The suggestion was met with dismay and with warnings that Indonesia would be in violation of the International Health Regulations if Supari carries through on her threat.

That international treaty requires prompt reporting of cases of diseases such as H5N1 that have been designated as global health threats. Indonesia is a signatory to the treaty.

"We've received official notice at our WHO office in Jakarta that the minister will continue - as she has been - notifying WHO on confirmed infections under the International Health Regulations," Dr. David Heymann, assistant director general for health security and environment, said from Geneva.

"She's been clear ... that she has no intention of not conforming to the International Health Regulations. She knows what they are. She's been told what those regulations require."

Despite the assurances, it seems Indonesia may not have formally notified the WHO yet of an H5N1 death that occurred nearly a month ago.

In an interview with the Associated Press last week, Supari revealed that a teenage girl died on May 14, but the government decided not to announce her death right away.

"How does it help us to announce these deaths?" she asked in the interview.

The most recent death Indonesia reported to the WHO occurred on April 23. As of Thursday, the WHO's official case count for Indonesia was 108 deaths out of 133 confirmed cases - the highest toll of any country afflicted with the H5N1 virus.

Heymann said the WHO's country office in Jakarta may have been notified Thursday of the death and was putting the information through channels. But if that's not the case, the WHO will be asking questions.

"If that was a confirmed case, we will have to work to understand what went wrong" in the notification process, he said.

The International Health Regulations stipulate that countries must report new H5N1 cases within 24 hours of confirmation and must report important related information, such as deaths, in a timely manner.

The WHO needs the information to make an assessment of the risk the event poses. Changes in the H5N1 death rate, for instance, could signal that the virus has mutated and experts would want to study sample viruses to look for what triggered the shift.

Indonesia has been enmeshed in a dispute with the WHO for more than a year, refusing to allow outside scientists to study sample viruses until it receives assurance it will get a share of any vaccine produced from Indonesian viruses.

 

[Gert van der Hoek]

Re: Indonesia Human Cases - April 9, 2008+

Re: Indonesia Human Cases - April 9, 2008+

Department of Health in Indonesia stands up to defend their bird flu policy.

- Number of suspect cases descended sharply, short summary presented;
- Government invested a lot of money in special referral hospitals, training of medics, local laboratories;
- Two national lab's do a lot of testing; no signs of bird flu going H2H;
- Offering free medical treatment for suspect bird flu patients and offering Tamiflu to local Health Centres and Hospitals;
- More counseling in local communities.


Number of Bird Flu Suspects Descended 50%

Jakarta - government efforts to deal with the bird flu virus began to show results.

Although still was gotten by the positive case of the virus infection H5N1, the amount descended significant when against the same period last year.

From the data that was owned by the Department of the Health, the period January-May 2008 the Department of Health carried out the inspection suspect bird flu was endless towards 198 cases and 483 specimens.

In fact, in the same period 2007, the Department of Health checked suspect towards 479 cases and 1,025 specimens.

The director general of the Control of the Illness and Sanitation of Lingkungan Department of Health Dr I Nyoman Kandun MPH said, in May 2008, the positive case of bird flu descended 50 percent compared with the case of bird flu in May 2007.

Moreover, descended sharply (88, 8 percent) when compared with the case in May 2006.The peak was highest the case of bird flu happened in May 2007 because of the existence klaster biggest bird flu in the Karo Regency (North Sumatra), he said in Jakarta yesterday (12-6).

According to Kandun, in the control of bird flu, the government carried out various efforts to press the pain figure and the death. (Morbidity and mortality, ed).

Among them, prepared the reconciliation hospital from 44 to 100 hospitals all over Indonesia.

Including the free maintenance for the patient who was expected (suspect) bird flu was through to results of the inspection of being finished carried out the Litbang Body and Eijkman, he continued.

Moreover, was carried out by the inspection of the contact laboratory, case investigation konfirm bird flu, observation of case contact confirm, and counselling to the community through various information channels that were available.

Was based on the inspection virologis with the genetic analysis method by Balitbangkes Department of Health and the Biologi Molekuler Eijkman Agency in Jakarta, up to now the bird flu virus that attacked humankind still continue to H5N1.

Therefore, the spread of the bird flu virus in Indonesia still from the poultry to humankind.

He appealed to the community to avoid contact with the poultry that was sick or died suddenly and the most polluted environment the waste of the poultry.

If having the poultry that was sick or died in the environment around, immediately was reported to the local chairman RT RW, mentioned he.

At this time, said he, the government also provided Oseltamivir medicine in means of the government of the health service like the community health centre and RS reconciliation.

To increase the official's capacity, the Department of Health carried out various trainings of the control of bird flu for the medical officials and the paramedic as well as the Team of the Cepat Movement of Bird Flu.

http://www.indopos.co.id/index.php?act=detail_c&id=345500


For Original Press Release Dep of Health in Indonesian:

http://www.depkes.go.id/index.php?option=news&task=viewarticle&sid=3128

Press release in English is expected in a few days.

Preliminary translation here: http://www.flutrackers.com/forum/showpost.php?p=163300&postcount=265

List of 100 bird flu referral hospitals in Indonesia here:

http://www.flutrackers.com/forum/showthread.php?t=14212

 

[Gert van der Hoek]

Re: Indonesia Human Cases - April 9, 2008+

Re: Indonesia Human Cases - April 9, 2008+

Metro TV reporting on "HAP" , the child in Padang Hospital, West Sumatra.

This reports mentions a grand total of 63 (suspect) patients, with 2 fatalities.

Official count by Dep of Health is 4 confirmed cases, 1 died: http://www.komnasfbpi.go.id/situationupdate.html



Metrotvnews.com, Padang ; One patient suspect bird flu was treated in the Daerah Public Hospital (RSUD) Muhammad Djamil Padang, West Sumatra.

He was Hendra Andika, 1 year, the resident of the Penang village, Kelurahan Bungus Timur, of Kecamatan Bungus Telukkabung, West Sumatra.

Currently, his condition gradually improved but he was still using the infusion as well as respiratory aids.

The head of the Pelayanan Medik Field RSUD Muhammad Djamil, Irayanti said Hendra was treated after experiencing the sign of the high fever, breathless, the cough cough and flu.

His side also still was waiting for results to crush Hendra blood from the Department of Health laboratory in Jakarta. Hendra had the story of contact with the poultry.

During the last three years, RSUD Muhammad Djamil treated 63 patients, two including dying. The bird flu sufferer in general from various cities and the regency in West Sumatra and most in the Padang City, Dharmasraya, and the South Coast.

http://www.metrotvnews.com/berita.asp?id=60773

 

[Gert van der Hoek]

Re: Indonesia Human Cases - April 9, 2008+

Re: Indonesia Human Cases - April 9, 2008+

Update on HAP from local Padang press.

Aids does NOT refer to HIV, but to artificial feeding , oxygen and infusion; earlier reports said the child was very light and the girl has difficulties with swallowing food. Medicine is added (Tamiflu?).

The condition of the girl seems to improve. Lab of Dep of Health promised to report the test results by telephone as soon as possible.



http://www.padangekspres.co.id/content/view/9012/105/

The patient Suspect Bird Flu with Aids

On Friday, June 13 2008 Padang, Padek Pasien suspect bird flu had the initials "HAP" (15 months), got help nasograstik (NGT) took the form of the hose that dimasukan in the throat, as aids memasukan food in the body, yesterday.

This policy was taken by the team of the doctor, because of pre-schoolers from the Village Penang Kecamatan Bungus Telukkabung this was difficult to swallow food.

Although then was like this, generally the patient experienced the development of the temperature of the body began to be normal.

At this time indeed 'HAP', got NGT help.

This implement to help so that asupan the nutrient that was important for his body continued to be able to be fulfilled.

Because of the last three days, he had difficulty swallowing food, said the Head of the Layanan Medik Field RSUP M. Djamil Padang Irayanti to Padang Ekspres, yesterday.

This implement also helped the sweetheart this Epi Bachelor to memasukan medicine in his body.

So as ditubuh small these pre-schoolers were increasingly filled health aids.

Because of beforehand he also got help of breathing through oxygen.

In the meantime the coil of the infusion on his arms also still was installed sbagai the entry road of the liquid in his body.

Till at this time the development really was significant in the temperature of his body that no longer experiences the fever.

To breathless that was experienced by him also began to decrease, but still experienced the cough.

The RSUP side M. Djamil Padang was still being waiting for results of the PCR test that was sent the sample of his blood two days ago.

Be based on protap the handling of the bird flu patient, usually if indeed the positive patient suffered bird flu, then the side of Balitbang Department of Health immediately telephoned RSUP, to in took the special action.

http://www.padangekspres.co.id/content/view/9012/105/

 

[Gert van der Hoek]

Re: Indonesia Human Cases - April 9, 2008+

Re: Indonesia Human Cases - April 9, 2008+

Indonesia's new bird flu policy on reporting deaths leads to confusion, anger


2008-06-13


BITUNG, Indonesia (AP) - Ali Usman's wife died of bird flu 10 days ago, but he still has not been officially notified by the government. Desperate for information, he scours the newspapers, which until last month aggressively wrote about deaths in the country hardest hit by the disease, but finds nothing.

That's because of a new government policy to no longer publicize individual bird flu cases immediately _ an attempt to shift media attention that politicians say focuses too heavily on deaths instead of successes. From now on, fatalities will be announced in clusters, perhaps just a few times a year.

The news blackout worries health experts and has left government officials and people living in areas worst affected by the virus confused and frustrated.

It took The Associated Press a week to track down and confirm the June 3 death of Usman's wife, Susi Lisnawati, which raised the country's toll to 110.

Though she was suffering from classic symptoms of the disease _ breathing difficulties, coughing and high fever _ she was not kept in isolation during her two days of hospitalization or otherwise treated as a suspected bird flu patient, her husband said.

She also was given a traditional Muslim burial, her body washed and shrouded by barehanded family members, before being placed in the ground without a casket, he said.

«I'm terribly scared, I need to know what the test results were,» said Usman, a 44-year-old tailor with three sons. «The government should be intensifying public awareness.

Indonesia, which has tallied more human deaths than any other country, is seen as a potential hot spot for a pandemic because of its high density of people and large number of backyard chickens. The virus remains hard for people to catch, but experts fear it could mutate into a form easily transmitted between humans, potentially killing millions across the globe.

The World Health Organization, which has been engaged in a bitter dispute with Indonesia since early 2007 over the sharing of virus samples, said Health Minister Siti Fadilah Supari promised to keep it informed about new deaths and did not appear to be violating international health regulations with her new policy.

«Indonesia has agreed to continue notifications to WHO .... they have never said they would not do that,» said David Heymann, the U.N. agency's top flu expert, adding that it does not matter if it takes several weeks to publicize the country's official toll «as long as the virus is known about and handled properly.

Still, the lack of transparency has forced health workers, scientists and residents to rely on word of mouth and raised fears that deaths could be covered up _ especially since the government has been exclusively responsible for carrying out genetic sequencing of H5N1 viruses needed for diagnosis and risk assessment since its standoff with WHO.

Next-of-kin are still shown official test results almost immediately and Usman's case appeared to be an aberration.

But when asked for an explanation, Health Ministry spokeswoman Lily Sulistyowati said test results had come back negative and would be delivered to the family within days.

A senior ministry official, speaking on condition of anonymity because the issue has become so politically sensitive, later confirmed the tests were positive.

Four other health workers agreed, some after double-checking with the National Institute for Health Research and Development, the government laboratory that is responsible for confirmations but no longer speaks to the media.

Neighbors too were confused after seeing bird flu investigators visit Usman's house, taking blood samples from family members and handing out the antiflu drug Tamiflu, but only to his youngest son and a child living next door. Residents were asked if they had backyard fowl.

Gusti Ngurah Mahardika, a virologist at Udayana University on Bali island, said the new policy on announcements was a setback. «People will become complacent about bird flu and its threat.

http://www.pr-inside.com/print641928.htm

 

[Gert van der Hoek]

Re: Indonesia Human Cases - April 9, 2008+

Re: Indonesia Human Cases - April 9, 2008+

A huge hat-tip to the AP-reporter for digging up this new case.

Location of Bitung, North Sulawesi:

 

[Gert van der Hoek]

Re: Indonesia Human Cases - April 9, 2008+

Re: Indonesia Human Cases - April 9, 2008+

There is also a "Bitung" on Java, West of Jakarta, seems more likely to be the right one.

 

[Shiloh]

Re: Indonesia Human Cases - April 9, 2008+

Re: Indonesia Human Cases - April 9, 2008+

Source: http://www.forbes.com/feeds/ap/2008/06/13/ap5114972.html

Associated Press
Indonesia's new bird flu policy angers families

BITUNG, Indonesia -

Ali Usman's wife died of bird flu 10 days ago, but he still has not been officially notified by the government. Desperate for information, he scours the newspapers, which until last month aggressively wrote about deaths in the country hardest hit by the disease, but finds nothing.

That's because of a new government policy to no longer publicize individual bird flu cases immediately - an attempt to shift media attention that politicians say focuses too heavily on deaths instead of successes.

From now on, fatalities will be announced in clusters, perhaps just a few times a year.

The news blackout worries health experts and has left government officials and people living in areas worst affected by the virus confused and frustrated. It took The Associated Press a week to track down and confirm the June 3 death of Usman's wife, Susi Lisnawati, which raised the country's toll to 110.

Though she was suffering from classic symptoms of the disease - breathing difficulties, coughing and high fever - she was not kept in isolation during her two days of hospitalization or otherwise treated as a suspected bird flu patient, her husband said.

She also was given a traditional Muslim burial, her body washed and shrouded by barehanded family members, before being placed in the ground without a casket, he said.

"I'm terribly scared, I need to know what the test results were," said Usman, a 44-year-old tailor with three sons. "The government should be intensifying public awareness."

Indonesia, which has tallied more human deaths than any other country, is seen as a potential hot spot for a pandemic because of its high density of people and large number of backyard chickens. The virus remains hard for people to catch, but experts fear it could mutate into a form easily transmitted between humans, potentially killing millions across the globe.

The World Health Organization, which has been engaged in a bitter dispute with Indonesia since early 2007 over the sharing of virus samples, said Health Minister Siti Fadilah Supari promised to keep it informed about new deaths and did not appear to be violating international health regulations with her new policy.

"Indonesia has agreed to continue notifications to WHO .... they have never said they would not do that," said David Heymann, the U.N. agency's top flu expert, adding that it does not matter if it takes several weeks to publicize the country's official toll "as long as the virus is known about and handled properly."

Still, the lack of transparency has forced health workers, scientists and residents to rely on word of mouth and raised fears that deaths could be covered up - especially since the government has been exclusively responsible for carrying out genetic sequencing of H5N1 viruses needed for diagnosis and risk assessment since its standoff with WHO.

Next-of-kin are still shown official test results almost immediately and Usman's case appeared to be an aberration.

But when asked for an explanation, Health Ministry spokeswoman Lily Sulistyowati said test results had come back negative and would be delivered to the family within days. A senior ministry official, speaking on condition of anonymity because the issue has become so politically sensitive, later confirmed the tests were positive.

Four other health workers agreed, some after double-checking with the National Institute for Health Research and Development, the government laboratory that is responsible for confirmations but no longer speaks to the media.

Neighbors too were confused after seeing bird flu investigators visit Usman's house, taking blood samples from family members and handing out the antiflu drug Tamiflu, but only to his youngest son and a child living next door. Residents were asked if they had backyard fowl.

Gusti Ngurah Mahardika, a virologist at Udayana University on Bali island, said the new policy on announcements was a setback. "People will become complacent about bird flu and its threat."

 

[Oracle]

Re: Indonesia Human Cases - April 9, 2008+

Re: Indonesia Human Cases - April 9, 2008+

All of the search references I come up with suggests it's the N Sulawesi location, a sea port. It's relatively remote location (from Jakarta) might explain why it 'slipped under the radar' of the Indonesian authorities in the reporting of recent H5N1 cases - they wouldn't expect an case to appear in this area.

 

[sharon sanders]

Re: Indonesia Human Cases - April 9, 2008+

Re: Indonesia Human Cases - April 9, 2008+

I am sure that the location is on Java.

 

[Oracle]

Re: Indonesia Human Cases - April 9, 2008+

Re: Indonesia Human Cases - April 9, 2008+

Wouldn't it have been identified as Rangkas Bitung to differntiate it from the North Sulawesi locale?

 

[Laidback Al]

Re: Indonesia Human Cases - April 9, 2008+

Re: Indonesia Human Cases - April 9, 2008+

I am sure that the location is on Java.

There appears to be several populated places named Bitung on Java. The position noted by Dutchy is the most likely location. The area around Tangerang has had many human H5N1 cases in the past.

 

[Gert van der Hoek]

Re: Indonesia Human Cases - April 9, 2008+

Re: Indonesia Human Cases - April 9, 2008+

From post # 265, Commonground:

Dari 12 provinsi yang terinfeksi Flu Burung, terdapat 5 provinsi yang tidak ditemukan lagi kasus Flu Burung yaitu :

Provinsi Lampung : Infeksi tahun 2005, 2 tahun 5 bulan lebih tidak ditemukan kasus
Provinsi Sulsel : Infeksi tahun 2006, 17 bulan lebih tidak ditemukan kasus
Provinsi Sumsel : infeksi tahun 2007, 5 bulan lebih tak ada lagi kasus
Provinsi Riau : Infekksi tahun -2007, 5 bulan tak ada kasus
Provinsi Bali : Infeksi bln November 2007, 6 bulan tak ada kasus.

translated:

From 12 provinces that were infected by Bird Flu, was gotten 5 provinces that were not found again by the case of Bird Flu that is:

1. The Lampung province: Infection in 2005, 2 years 5 months were not more found by the case

2. The South Sulawesi province: Infection in 2006, 17 months were not more found by the case

3. The South Sumatra province: Infection in 2007, 5 months did not more have again the case

4. The Riau province: Infection in the year 2007, 5 months did not have the case

5. The Balinese province: Infection in November 2007, 6 months did not have the case.


If 5 out of 12 provinces did not have human cases again , that leaves 7 provinces where human cases were found. It is not clear which timespan we talk about. These 7 provinces are:

Province / No. of AI Positive Human Cases / No. of Fatalities

1 West Java 33 27

2 DKI Jakarta 32 27

3 Banten 25 22

4 North Sumatera 8 7

5 East Java 7 5

6 Central Java 11 10

7 West Sumatera 4 1


8 Lampung 3 0
9 South Sulawesi 1 1
10 South Sumatera 1 1
11 Riau 6 5
12 Bali 2 2

Total 133 108


Latest official publication

http://www.komnasfbpi.go.id/situationupdate.html

 

[sharon sanders]

Re: Indonesia Human Cases - April 9, 2008+

Re: Indonesia Human Cases - April 9, 2008+

I have some information on Susi Lisnawati from the AP. Thank you to AP for being so generous with your work.

May 29th - symptoms present,

May 30th - goes to clinic, initially treated for dengue & typhoid, condition continues to deteriorate,

June 1 - breathing difficulties develop,

June 2 - taken to Tangerang hospital, blood samples taken,

June 3 - dies,

June 5 - tests are positive for H5N1,

June 6 - family & neighbors get blood samples taken,

June 11 - AP visits


She was not placed in isolation in the hospital. She was buried in traditional manner with body bathing & no sealed casket. Youngest child given tamiflu. No apparent contact with poultry. She is from Tangerang.

Also, apparently, Indonesia is going to start reporting on Monday - a monthly recap of the status of bird flu deaths.