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INDONESIA - Jan 6+ General Bird Flu News

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Re: INDONESIA - Jan 6+ General Bird Flu News

Note the search dates were in the few months prior to the press release. Field testing???

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Re: INDONESIA - Jan 6+ General Bird Flu News

(yield- not sure how reliable the bold statement is, made by same guy who did recent cat study, and then released the cats!)

Half of Indonesia Bird Flu Endemic
Monday, 15 January, 2007 | 13:56 WIB

TEMPO Interactive, Jakarta: As many as 223 out of 444 regencies or cities in all of Indonesia are bird flu virus endemic areas (areas that been hit by the virus and there is always the potential for this to reoccur.

?This number is already half of the total regencies in Indonesia,? Memed Z.H., Head of Public Communication for Bird Flu Campaign Management of the Agriculture Department, told Tempo, Saturday (13/1).

According to Memed, this number which was valid up until last Friday, has risen from less than 200 regencies or cities.

So far, only three provinces are free from the deadly virus: Maluku, North Maluku and Gorontalo.

Memed explained that the bird flu endemic provinces are divided into two categories, high-risk areas and areas with low intensity cases.

These high-risk areas are the Agriculture Department's main target for vaccinations and there are only five provinces that are not included in the two categories.

Musni Suatmodjo, Director of Animal's Health at the Agriculture Department, said in November last year that the central government had distributed 48 million doses of vaccine to 14 high-risk provinces.

The department also distributed more than 191,000 rapid test kits (bird flu detectors) to 33 provinces.

The Agriculture Department, he said, does not yet have a bird flu hot spot map of all provinces.

This is because, in addition to hampered regional reports, mapping requires time and adequate human resources.

Molecular biologist of Airlangga University, C.A. Nidom, estimated that Jakarta and Tangerang are bird flu epicenters.

This hypothesis is based on the results of model simulations made by bio-informatics calculation.

This bird flu expert explained that if the government performed checks of all Jakarta inhabitants, 70 percent of them could be carrying this virus, although they are neither ill or dead.

Outbreaks of bird flu in Jakarta, Bogor, Tangerang and Bekasi are serious again.

Within a two week period, two people have died, one from Kalideres (West Jakarta) and the other from Tangerang.

http://www.tempointeractive.com/hg/nasional/2007/01/15/brk,20070115-91272,uk.html
 
Re: INDONESIA - Jan 6+ General Bird Flu News

Please pay attention to the last sentence. And interesting question about the PCR test.

The mechanism of the Spread of the Virus AI Not Yet Clear

The government must carry out the research about the mechanism of the spread of the virus Avian influenza (AI), because, until this the pattern of the spread of bird flu not yet clear.

"It did not yet have proof empirik that the direct spread" of the "bird flu virus to the human body."

Theoretically, the direct spread like that also did not make sense, said Peniliti bird flu from Unika Soegijapranata Ir Sumardi MSc, on Tuesday (16/1).

Sumardi that also the discoverer of the AI ingredients of the virus charm stressed, the spread of the virus could happen when the structure of protein between the virus and the receptor had the similarity.

The structure of AI virus protein was 2,3 alfa sialic acid.Now the structure of human protein 2,6 alfa sialic acid, so as if the structure of protein both of them were different then did not enable the spread happened.

The testing by using PCR (polimerase chain the ratio), he said, also only be based on to the structure of protein, in fact many other viruses had the structure of protein was similar H5N1.

He warned, when wanting results that were valid, to take positive AI poultry blood, afterwards direinfeksikan to the other poultry.

If the poultry evidently died, was significant indeed tertular the AI virus.
Because of having the difference of the structure of protein in both of them, he suspected had the vector or the AI virus intermediary before finally spread to humankind.

"I had the strong assumption that this vector was the ethnic group's low mammal, like the mouse," he said.

He explained, the mouse was often gotten in the house and not flattest the sun rays, whereas the AI virus when being affected by the sun rays for one minute, has died. :confused:

The other argument that was sent by Sumardi that the spread of the AI virus through the vector, because from dozens of casualties died that it was suspected was affected by the AI virus, not even one casualties from the circle or the chicken butcher of the poultry worker in fact every time they contact with the poultry.
(
http://www.suaramerdeka.com/cybernews/harian/0701/16/dar15.htm

credits Okieman
 
Re: INDONESIA - Jan 6+ General Bird Flu News

Elshinta radio 17 Jan

BIRD FLU came back MEREBAK. the Regional Government will apply the policy of the banning of the maintenance of the commercial poultry in the settlement territory, following spread him came back the bird flu virus.

Coordinating Minister for People's Welfare Aburizal Bakrie said, the regional government will immediately carry out the mapping specifically in three areas that already terjangkit the plague of bird flu, that is Banten, the Special Capital District of Jakarta and West Java to know the risky area high terjangkit the plague of bird flu.

This step must be taken because of bird flu has been in the level of the criticalness of the health.

Now Menkes Siti Prominent Supari said, was in a meeting of the special co-ordination the handling of the bird flu illness with the regional government's rank that was held last Monday (15/1) was to show how serious is this situation.

Although having the theory that mentioned that even more cluster increasingly high also the spread trend in humankind to humankind, but the fact is to at this time did not yet have the doctor or the nurse who handled the bird flu patient that tertular.

http://www.elshinta.com/v2003a/indexframe.htm
 
Re: INDONESIA - Jan 6+ General Bird Flu News

All this testing negative, reminds me of discussions we had one year ago regarding type and timing of tests. After many negatives, the delayed antibody tests showed positives.

How does that apply now in Indonesia?

From Dr. Niman's site (ONE YEAR AGO)...

http://www.recombinomics.com/News/01030601/H5N1_Turkey_Negative.html

.....Although the initial tests on the samples from the four siblings were negative for influenza, samples collect approximately 1 week after symptoms frequently give false negative results. The samples in Turkey were tested for H5N1 antibody via ELISA testing of serum, and they were tested for the genetic material (RNA) of H5N1 via PCR testing of nasal and/or throat swabs.

However, antibody levels rise through the 3rd or 4th week post symptoms, so samples collected after one weak frequently have antibodies below the detection level.

Similarly, at one week the H5N1 may have been cleared from the nose and throat. In the cases of the four siblings, their viral pneumonia symptoms would indicate the H5N1 was already in their lungs. Since no etiological agent has been identified, H5N1 is still at the top of the list of likely suspects.

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Re: INDONESIA - Jan 6+ General Bird Flu News

I think you may be on to a real possibility, at least if there are false negatives occurring, and those people are surviving, could this indicate a lower CFR and the hope that a pandemic strain will not be as severe as it appears whenconsidering only the positively confirmed caes?
 
Re: INDONESIA - Jan 6+ General Bird Flu News

JetStuuby said:
I think you may be on to a real possibility, at least if there are false negatives occurring, and those people are surviving, could this indicate a lower CFR and the hope that a pandemic strain will not be as severe as it appears whenconsidering only the positively confirmed caes?
Click to expand...

It may indicate the success of anti-viral treatment.

Last year we were saying that in the absence of another diagnosis, BF was still a possibility.

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Re: INDONESIA - Jan 6+ General Bird Flu News

AlaskaDenise said:
It may indicate the success of anti-viral treatment.

Last year we were saying that in the absence of another diagnosis, BF was still a possibility.

.
Click to expand...

In many of the posted initial test results, there is no mention of the type of test that was performed, what was sampled, nor what the causitive agent for the patient's disease was found (if any).

Thus, a couple logical questions: Is the methodology of testing for H5N1 lab samples standardized amongst countries? If not, can lack of standardization be skewing test results?
 
Re: INDONESIA - Jan 6+ General Bird Flu News

4-ABBA said:
In many of the posted initial test results, there is no mention of the type of test that was performed, what was sampled, nor what the causitive agent for the patient's disease was found (if any).

Thus, a couple logical questions: Is the methodology of testing for H5N1 lab samples standardized amongst countries? If not, can lack of standardization be skewing test results?
Click to expand...

If these Indo tests are being duplicated by the Jakarta office of NAMRU, We can trust the results.
 
Re: INDONESIA - Jan 6+ General Bird Flu News

At any rate, the number of new suspect cases seems to be slowing - is it too early to breathe a sigh of relief?

With any luck, this is just the usual rainy season spike - reflecting that the virus is now endemic in poultry in Indonesia so there's more opportunities for exposure.

Anyone care to make a prediction?
 
Re: INDONESIA - Jan 6+ General Bird Flu News

AlaskaDenise said:
All this testing negative, reminds me of discussions we had one year ago regarding type and timing of tests. After many negatives, the delayed antibody tests showed positives.

How does that apply now in Indonesia?

From Dr. Niman's site (ONE YEAR AGO)...

http://www.recombinomics.com/News/01030601/H5N1_Turkey_Negative.html

.....Although the initial tests on the samples from the four siblings were negative for influenza, samples collect approximately 1 week after symptoms frequently give false negative results. The samples in Turkey were tested for H5N1 antibody via ELISA testing of serum, and they were tested for the genetic material (RNA) of H5N1 via PCR testing of nasal and/or throat swabs.

However, antibody levels rise through the 3rd or 4th week post symptoms, so samples collected after one weak frequently have antibodies below the detection level.

Similarly, at one week the H5N1 may have been cleared from the nose and throat. In the cases of the four siblings, their viral pneumonia symptoms would indicate the H5N1 was already in their lungs. Since no etiological agent has been identified, H5N1 is still at the top of the list of likely suspects.
Click to expand...
There's more here (including a very nice graphic) on the timing of testing and getting reliable results:

http://www.flutrackers.com/forum/showpost.php?p=9899&postcount=1

And, also, like you say -- treatment with anti-virals can get in the way of reliable testing -- someone who has been infected might test neg -- so we (and they) may never know if they were really infected. Of course, it's better to be alive than be sure about test results!
 
Re: INDONESIA - Jan 6+ General Bird Flu News

Even with successful drug treatment, paired serum antibody tests (at least 14 days apart) could provide evidence of infection.
jt
 
Re: INDONESIA - Jan 6+ General Bird Flu News

Thornton said:
Even with successful drug treatment, paired serum antibody tests (at least 14 days apart) could provide evidence of infection.
jt
Click to expand...


Yes, but do we think these paired tests are being routinely conducted?
 
Re: INDONESIA - Jan 6+ General Bird Flu News

I am not seeing reports of this being done (paired sera 14 days apart for antibody testing). I have not found the protocols used by Indonesia. We do know their laboratory practices differ from the WHO guidelines. Also I do not know their protocol for Tamiflu. The WHO containment strategy was to be triggered by clusters. I have not read of a strategy for prophylaxis in an area where the avian influenza in humans is endemic and sporadic. We can only take the information that is provided like small pieces in a large incomplete puzzle.

Information we have -
1. WHO confirms 5 cases with 4 deaths.
2. Reports of suspected cases treated with unknown amount of Tamiflu, improve and discharged.
3. Four of the 5 confirmed cases are treated with Tamiflu and die.
4. One reputable lab confirms H5N1 infection in 100 stray cats.

We are not seeing health care workers as suspected cases. We are not hearing of social disruption or fear in the hospitals.

If whatever strain of influenza there is partially resistant to Tamiflu then we would see discharged cases relapsing after a few days off of Tamiflu.
jt
 
Re: INDONESIA - Jan 6+ General Bird Flu News

Thank you for your insights, jt.

The possible indiscriminate use of Tamiflu is of concern. But as you note, we have not yet seen any relapses.

I agree; it may be that HCW (Health Care Workers) will be our bellwether measure of an impending pandemic in Indonesia or wherever H5N1 becomes easily transmissible among humans.
 
Re: INDONESIA - Jan 6+ General Bird Flu News

Or to be more definite, health care worker families getting sick would indicate h2h2h2h.
 
Re: INDONESIA - Jan 6+ General Bird Flu News

Shannon said:
Or to be more definite, health care worker families getting sick would indicate h2h2h2h.
Click to expand...

exactly.gif
 
Re: INDONESIA - Jan 6+ General Bird Flu News

Thornton said:
........If whatever strain of influenza there is partially resistant to Tamiflu then we would see discharged cases relapsing after a few days off of Tamiflu.
jt
Click to expand...

So we can deduce that the Indonesia "negative" cases are probably not H5N1?

Great Chart JT.

Given the curve leading up to high antibody levels, isn't Tamiflu being stopped prior to this optimal antibody level? Is there a specific point where the antibodies are adequate to check an infection, even though they may not be at their maximum? Or does it "depend on viral load" ?

I wonder if the same timing would apply to "natural" antivirals?

It seems the Indonesian doctors have some criteria that justifies stopping anti-virals relatively soon. I wonder what that combination of factors is.

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Re: INDONESIA - Jan 6+ General Bird Flu News

Shannon said:
Or to be more definite, health care worker families getting sick would indicate h2h2h2h.
Click to expand...

Yes, the removal of "close vicinity" from the equation.

.
 
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