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Indonesia Probes Bird Flu Case for Human Transmission (Update3) Aug. 17 (Bloomberg) -- Bird flu killed a 9-year-old girl in the same area of Indonesia where a teenager caught the virus days earlier, and officials are checking for signs of human-to- human transmission, Health Minister Siti Fadilah Supari said.
The girl, from the district of Garut in West Java, died on Aug. 15 before testing positive for the H5N1 avian influenza strain. Her death marks the country's 45th H5N1 fatality. A 17- year-old man from the same village tested positive for H5N1 on Aug. 12 and is recovering in the hospital.
Genetic information from virus material collected from both patients will be analyzed for markers indicating the source of the disease, Supari told reporters in Jakarta today. H5N1 could touch off a pandemic if it starts spreading easily among people.
The study will also provide information on ``the exact type of the virus'' and help scientists understand its origin, she said. ``Indonesia is a country with a vast geography and the bird flu virus in North Sumatra is different from West Java.''
The H5N1 strain has infected 238 people, killing 139 of them since 2003, mostly in Asia. It may kill millions should it mutate into a pandemic form.
Indonesia, the world's fourth-most-populous country, surpassed Vietnam last week as the country with the highest number of human H5N1 fatalities.
The death toll may have been higher in the event a 20-year- old man, also from the Garut district, had been tested for the virus before he died of respiratory disease on Aug. 6, the World Health Organization said this week. He and the infected 17-year- old had been exposed to dead or dying poultry, the Geneva-based UN agency said on Aug. 14.
Sumatra Cluster
The Southeast Asian nation attracted international attention in May when seven members of a family from the island of Sumatra contracted the virus, six of them fatally. The cases represented the largest reported cluster of human cases and the first laboratory-proven instance of human-to-human transmission.
Clusters of cases may signal the virus is becoming more adept at infecting humans, not just birds.
Almost all human H5N1 cases have been linked to close contact with sick or dead birds, such as children playing with them or adults butchering them, according to the WHO.
Since 2003, H5N1 has infected birds in more than 50 countries. In Asia, where it first appeared, more than 220 million fowl have been culled as a consequence of outbreaks, the Food and Agriculture Organization of the United Nations said.
Thai, Laos Outbreaks
A variant of an H5N1 strain found in southern China caused outbreaks in poultry in Thailand and Laos last month, suggesting the virus was re-introduced through trade, the agency said in an e-mailed statement today.
Avian flu killed two people in Thailand during the past three weeks in provinces where the virus sickened fowl in the country's first outbreak this year. H5N1 was also found in birds on farms near the Laotian capital, Vientiane. New infections create chances for the virus to mutate into a pandemic form.
The outbreaks in Thailand's Nakhon Phanom province and across the border in Laos were caused by a variant not detected previously in either country, the FAO said.
``The virus is similar to recent isolates from southern China, suggesting that the virus spread from China to Thailand and Laos,'' the FAO said. ``Poultry trade across borders is continuing in Southeast and East Asia despite well-known risks to the governments and people in the region.''
Scientists are studying genetic sequences of H5N1 variants to spot changes that may indicate the virus is becoming more contagious and closer to setting off a pandemic. They are also trying to gauge dominant variants of the virus to speed preparations for vaccines to fight a human outbreak.
Vaccine Development
``When there are multiple lineages circulating it makes it even more challenging to predict the potential strain likely to be needed for vaccine development,'' Jennifer McKimm-Breschkin, a virologist at the Commonwealth Science and Industrial Research Organization in Melbourne, said in an e-mail.
The most recent Thai viruses will be considered when the WHO revises its recommendation on the development of human vaccines against the H5 avian flu subtype, said P.T. Jayawikramarajah, the agency's representative to Thailand.
The updated recommendation is scheduled to be released within a few weeks, Jayawikramarajah said in an e-mail today.
Genetic analyses of the virus that caused the outbreak last month in the Thai province of Phichit showed that it was the same strain circulating in the area for almost three years, the FAO said. This indicates that H5N1 is endemic in the area, it said.
``The H5N1 virus thus remained alive in central Thailand in a reservoir of birds and poultry, most probably a mix of backyard chicken, ducks and fighting cocks,'' said Laurence Gleeson, regional manager of FAO's avian flu center in Bangkok.
The girl, from the district of Garut in West Java, died on Aug. 15 before testing positive for the H5N1 avian influenza strain. Her death marks the country's 45th H5N1 fatality. A 17- year-old man from the same village tested positive for H5N1 on Aug. 12 and is recovering in the hospital.
Genetic information from virus material collected from both patients will be analyzed for markers indicating the source of the disease, Supari told reporters in Jakarta today. H5N1 could touch off a pandemic if it starts spreading easily among people.
The study will also provide information on ``the exact type of the virus'' and help scientists understand its origin, she said. ``Indonesia is a country with a vast geography and the bird flu virus in North Sumatra is different from West Java.''
The H5N1 strain has infected 238 people, killing 139 of them since 2003, mostly in Asia. It may kill millions should it mutate into a pandemic form.
Indonesia, the world's fourth-most-populous country, surpassed Vietnam last week as the country with the highest number of human H5N1 fatalities.
The death toll may have been higher in the event a 20-year- old man, also from the Garut district, had been tested for the virus before he died of respiratory disease on Aug. 6, the World Health Organization said this week. He and the infected 17-year- old had been exposed to dead or dying poultry, the Geneva-based UN agency said on Aug. 14.
Sumatra Cluster
The Southeast Asian nation attracted international attention in May when seven members of a family from the island of Sumatra contracted the virus, six of them fatally. The cases represented the largest reported cluster of human cases and the first laboratory-proven instance of human-to-human transmission.
Clusters of cases may signal the virus is becoming more adept at infecting humans, not just birds.
Almost all human H5N1 cases have been linked to close contact with sick or dead birds, such as children playing with them or adults butchering them, according to the WHO.
Since 2003, H5N1 has infected birds in more than 50 countries. In Asia, where it first appeared, more than 220 million fowl have been culled as a consequence of outbreaks, the Food and Agriculture Organization of the United Nations said.
Thai, Laos Outbreaks
A variant of an H5N1 strain found in southern China caused outbreaks in poultry in Thailand and Laos last month, suggesting the virus was re-introduced through trade, the agency said in an e-mailed statement today.
Avian flu killed two people in Thailand during the past three weeks in provinces where the virus sickened fowl in the country's first outbreak this year. H5N1 was also found in birds on farms near the Laotian capital, Vientiane. New infections create chances for the virus to mutate into a pandemic form.
The outbreaks in Thailand's Nakhon Phanom province and across the border in Laos were caused by a variant not detected previously in either country, the FAO said.
``The virus is similar to recent isolates from southern China, suggesting that the virus spread from China to Thailand and Laos,'' the FAO said. ``Poultry trade across borders is continuing in Southeast and East Asia despite well-known risks to the governments and people in the region.''
Scientists are studying genetic sequences of H5N1 variants to spot changes that may indicate the virus is becoming more contagious and closer to setting off a pandemic. They are also trying to gauge dominant variants of the virus to speed preparations for vaccines to fight a human outbreak.
Vaccine Development
``When there are multiple lineages circulating it makes it even more challenging to predict the potential strain likely to be needed for vaccine development,'' Jennifer McKimm-Breschkin, a virologist at the Commonwealth Science and Industrial Research Organization in Melbourne, said in an e-mail.
The most recent Thai viruses will be considered when the WHO revises its recommendation on the development of human vaccines against the H5 avian flu subtype, said P.T. Jayawikramarajah, the agency's representative to Thailand.
The updated recommendation is scheduled to be released within a few weeks, Jayawikramarajah said in an e-mail today.
Genetic analyses of the virus that caused the outbreak last month in the Thai province of Phichit showed that it was the same strain circulating in the area for almost three years, the FAO said. This indicates that H5N1 is endemic in the area, it said.
``The H5N1 virus thus remained alive in central Thailand in a reservoir of birds and poultry, most probably a mix of backyard chicken, ducks and fighting cocks,'' said Laurence Gleeson, regional manager of FAO's avian flu center in Bangkok.
