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Infection in brain of H5N1 survivor: "no direct link to show H5N1 virus caused [it]"

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St Michael

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http://www.bbj.hu/main/news_14389_doctors+find+infection+in+brain+of+bird+flu+cluster+survivor.html

Doctors find infection in brain of bird flu cluster survivor

14 Jul 2006 bbj.hu

Jones Ginting, the 25-year-old man suffered from headaches and fatigue a month after receiving care for bird flu, said Luhur Soeroso, head of Adam Malik hospital in the North Sumatra city of Medan, where he's staying. ?We found abscesses in several parts of his brain,? Soeroso said in Jakarta on July 13. Treatment for the H5N1 strain of avian influenza may have weakened Ginting's immune system, although there's no direct link to show the H5N1 virus caused the illness, Soeroso said. Ginting and his relatives who died of the disease in May attracted international attention because they represent the largest reported instance in which H5N1 may have been spread among people and the first evidence of a three-person chain of infection. Human cases provide an opportunity for the virus to mutate into a pandemic form that may kill millions of people. Ginting, a farmer from the village of Kubu Sembelang in Sumatra, is one of the few human cases of avian influenza in which disease of the central nervous system has been observed. The H5N1 virus has infected at least 229 people in 10 countries, killing 131 since late 2003, the World Health Organization said on its Web site July 4. ?He has been given so many drugs and antibiotics and this may affect his immune system,? Soeroso said. In most cases, severe respiratory disease is the main symptom. Ginting has responded to treatments and the abscesses in the brain have gradually reduced, Soeroso said. Diseases involving the central nervous system, including encephalitis, transverse myelitis and Guillain-Barre syndrome, have been associated with influenza in humans, according to Harrison's Principles of Internal Medicine, 13th edition. The cause of the disease isn't established, the medical book said. Ginting's 37-year-old sister is suspected of being the first family member to die from the disease. She was buried before samples were taken. The woman's two sons, a sister, another brother, a nephew and a niece died from the virus between May 4 and May 22. To make the ?restless? man, who tried to escape from the hospital, ?comfortable,? the hospital gave him a 14-inch television in his room, Nur Rasyid Lubis, deputy director of the Adam Malik Hospital, said. (Bloomberg)

http://www.cidrap.umn.edu/cidrap/content/influenza/avianflu/news/jul1406indocase.html

WHO confirms Indonesia's 53rd avian flu case

Jul 14, 2006 (CIDRAP News) ? A 3-year-old girl who died on Jul 6 near Jakarta had Indonesia's 53rd case of H5N1 avian influenza, according to test results announced today by the World Health Organization (WHO).

Meanwhile, Bloomberg news reported last night that the only survivor of a recent family cluster of avian flu cases in Indonesia is being treated for brain abscesses.

The 3-year-old girl, who was from a suburb of Jakarta, became ill on Jun 23 and was hospitalized Jul 5. The WHO said investigators found that she had handled some dead chickens 2 days before she fell ill. Samples taken from chickens in her neighborhood were positive. Investigators found no other patients with influenza-like illnesses, and they are monitoring close contacts of the girl, the agency said.

With 41 avian flu deaths, Indonesia now trails Vietnam for most deaths by only one, according to WHO statistics. Vietnam, however, has had no human cases of H5N1 since last November, while Indonesia's 53 cases have all come in 2005 and 2006.

According to the Bloomberg story, Luhur Soeroso, a doctor caring for the sole survivor of the avian flu case cluster in North Sumatra, said the 25-year-old man experienced headaches and fatigue a month after he was treated for avian flu. The patient, Jones Ginting, is hospitalized at Adam Malik Hospital in the northern Sumatra city of Medan. The cluster involved seven confirmed cases and one probable case.

"We found abscesses in several parts of his brain," Soeroso said. He suggested that antibiotics and other drugs given for avian flu might have weakened the patient's immune system, but said the brain abscesses are gradually shrinking in response to treatment.

Neurologic manifestations of H5N1 infection have been reported before, though rarely. A Vietnamese boy who died of encephalitis in 2004 was later found to have had H5N1 infection, according to a research report published last year. Encephalitis is also known to be a rare complication of ordinary influenza.
 
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