Sulawesi cluster / 14M (deceased) from South Sulawesi confirmed H5N1

[HenryN]

Re: Sulawesi cluster / 14M (deceased) from South Sulawesi confirmed H5N1

Thanks for the clarification, Dr. Niman. I was thinking they were only testing for rising titers, not seroconversion.

Either one will work. Usually there is only ONE sample, so neither can be measured. The latest case (8F from July 2005) had two samples collected 3 days apart. The old rule required a 4X increase, but the samples were collected too close together and the first sample had a titer of 320 (by both CDC and Hoing Kong). The second collection was 640, so even though both samples were screaming poistives and both WHO affiliated labs got the same result, the patient (who died, as did her father and sister and her father yielded H5N1 by both CDC and Hong Kong) was clasified as "probable"!

WHO kept the cluster as a non-cluster for over a year by denying confimation of the index case. Her 1 year old dead sister is STILL not even a probable because no sample was collected.

They have been playing the same game since January 2004, and unfortunately, the public (and politicians) remain clueless.

 

[Harriet]

Re: Sulawesi cluster / 14M (deceased) from South Sulawesi confirmed H5N1

The Ministry of Public Health declared the first avian influenza patient in third epidemic in Phichit province. Having been taken care of intensively, he is in critical condition and dengue co-infection had been suspected.

Though, the avian influenza virus infection was not ruled out, therefore, when the patient died, the phlegm had been sent to the Medical Science Department on July 24, 2006. The positive result was disclosed at 06.00 am. (July 26, 2006). So, it is likely that the patient had been infected with both avian influenza and dengue viruses, which is the first case ever in Thailand and the world.

http://thaigcd.ddc.moph.go.th/AI_pressrelease_060726_En.html




Dengue Fever

Aug. 22 (Bloomberg)

In Thailand, laboratory test results are pending on 100 patients under surveillance for possible H5N1, the Bureau of General Communicable Diseases in Bangkok said yesterday.

The country's first H5N1 case this year was missed for nine days, partly because the virus wasn't initially found in samples collected from the 17-year-old patient, and his symptoms were mistaken for dengue fever.

The teenager's H5N1 infection wasn't confirmed until two days after his death on July 24, the communicable diseases bureau said. Doctors suspected he had dengue hemorrhagic fever after a rapid test for influenza and several blood tests were all negative for avian flu.

The H5N1 virus hadn't been ruled because a week before his illness, the teenager had buried 10 dead chickens, touching the carcasses with his bare hands, the bureau said.


http://www.bloomberg.com/apps/news?pid=20601080&sid=aDxoLv6PKuM4

 

[Harriet]

Re: Sulawesi cluster / 14M (deceased) from South Sulawesi confirmed H5N1

 

[Laidback Al]

Re: Sulawesi cluster / 14M (deceased) from South Sulawesi confirmed H5N1

... I don't think there were any news reports of the these cases from Makassar in June.

However, a suspected case from Makassar was reported in the news media in early August (August 2, 2006), but most everyone was watching another possible cluster from Karo at the time.

toggletexted:

Bird flu emerged Again in Medan and Makassar
The report on the Reporter Kompas Khaerudin
Jakarta, Kompas - Dede Devia Sitepu (6), one from three bird flu patients who were treated in the central Public Hospital or RSUP Adam the Owner, Medan, was expected positive suffered bird flu.
Whereas the child was five years old had a name Great[Akbar], last Tuesday night also was brought to RS Wahidin Sudirohusodo, Makassar, as the patient suspect bird flu.
Results of the photograph torax (the chest) the patient from Medan, that showed the existence of pneumonia or the disturbance of the respiratory tract as one of the signs terjangkit the bird flu virus. . . . .

Doctor Halik Saleh, the Secretary Tim the Control of RS Wahidin Makassar Bird Flu said, Great that also experienced breathless, hot high, and coughs showed that was relevant terjangkit bird flu.
Great was the 10th patient who was treated in RS Wahidin, because suspect bird flu.
Nine other patients were stated by the negative after results of the sample inspection of blood.
Ida, the Great mother, acknowledged around three last week their seven kept chickens died suddenly.
"The chicken evidently quite positive was affected by bird flu after being checked," said the mother that beralamat in Street Cenderawasih, the District of Kunjung Mae, Mariso, Makassar, that.

http://www.kompas.com/ver1/Kesehatan/0608/02/184847.htm

 

[Sharpe]

Re: Sulawesi cluster / 14M (deceased) from South Sulawesi confirmed H5N1

However, a suspected case from Makassar was reported in the news media in early August (August 2, 2006), but most everyone was watching another possible cluster from Karo at the time.
toggletexted:
http://www.kompas.com/ver1/Kesehatan/0608/02/184847.htm

Thanks Al for looking that up for us. These are good things to know. We have to basically piece together everything (because no one else will). The case you mention is 5 weeks after the confirmed girl died. It is possible that it's one of her brothers, but I don't think so. They mention 10 people had been treated at the hospital for suspected bf at the time. You know, I don't even think that they counted this family at all in that number--they were all assumed to be dengue at the time. It just goes to show how big and widespread the problem in Indonesia is. And Promed's comment today that they hope that chikungunya doesn't join the bf-dengue mix in Indonesia appears to be very wishful, for the evidence is growing that it may already be there.

 

[Theresa42]

Re: Sulawesi cluster / 14M (deceased) from South Sulawesi confirmed H5N1

It is possible that it's one of her brothers, but I don't think so.

No -- this 6 yr-old that Al mentions is from a different area in Makassar than Akhira and her family. The 6M is from Street Cenderawasih, the District of Kunjung Mae, Mariso, while Akhira and her family are from Street Maccini Tengah. Who knows how close (or far) these two locations are though.

They mention 10 people had been treated at the hospital for suspected bf at the time. You know, I don't even think that they counted this family at all in that number--they were all assumed to be dengue at the time.

I think you're absolutely right about that, Sharpe. I don't think Akhira and her family were a part of earlier counts at all. Surprise!

 

[Sharpe]

Re: Sulawesi cluster / 14M (deceased) from South Sulawesi confirmed H5N1

I tried to figure out how far apart Mariso and Ujang Pandang (the district that Maccini Tengah is most likely in). They are apparently about 2 square km areas on the coastal part of the city. Since there are only 5 Makassar districts on the coast of the same size, that would mean that these two families mentioned are most likely at most 6 miles apart and probably less than a mile. Perhaps if someone could find a good map of Makassar, we will be able to narrow it down. This was a good resource:
http://216.239.51.104/search?q=cache:0Cjb8ZDPGf0J:sim.nilim.go.jp/ge/SURVEY2/H12%E5%A0%B1%E5%91%8A/LAPORAN/6-Makassar.doc+Kunjung+Mae,+Mariso&hl=en&gl=us&ct=clnk&cd=2&client=netscape-pp
And this is the UT map of the area:
http://www.lib.utexas.edu/maps/ams/indonesia/txu-oclc-21752461-sb50-8.jpg

In my search, I also came across an article from Makassar that I had saved earlier. In case it is of any interest, I post it below. It is regarding an anthrax outbreak in the area, and gives a little perspective.

Anthrax Outbreak in South Sulawesi

The South Sulawesi Department of Agriculture announced November 11 an anthrax outbreak in Makassar, South Sulawesi. Officials from the Department said 20 animals had died of anthrax symptoms in the area, but only four cases had been confirmed. Local authorities reportedly established a center to deal outbreak at Tamangapa Village. On November 17, health staff reportedly carried out house-to-house checks, examined more residents and took blood samples of 11 individuals suspected of having anthrax. Four of them showed superficial symptoms of anthrax. To stop the spread of the disease, local authorities reportedly enforced a ban of livestock traffic in and out the area, conducted a massive vaccination drive that included providing 65,000 doses of anthrax vaccines, and gave antibiotics to sick animals.

In early November, Minister of Agriculture Anton Supriyantono announced that anthrax is endemic in Makassar. However, the Minister admitted publicly that there are no compensation funds for affected farmers. Some farmers in the Makassar area have criticized the South Sulawesi Provincial Government’s plans to kill the sick cows because such a step would result in a financial loss for them. The Minister added that besides Makassar, he had also received reports of anthrax outbreaks in Sikka and Ende (Flores Island, East Nusa Tenggara). Apriyantono urged the province of East Nusa Tenggara to conduct a large, vaccination drive on cattle, water buffaloes, and horses in the affected areas to stop the spread of anthrax.

 

[AlaskaDenise]

Re: Sulawesi cluster / 14M (deceased) from South Sulawesi confirmed H5N1

If they have H5N1 antibodies .........After 1918, patients still had antibodies in 2004!

If I remember correctly, this decades-old antibody level is still extremely high. Isn't the due to the massive immune response necessary to conquer the disease?

Does H5N1 also have an unusually high antibody level, or has too little time passed to make this comparison?


I'm just curious as to how the 2 compare and if it indicates something significant.

.

 

[HenryN]

Re: Sulawesi cluster / 14M (deceased) from South Sulawesi confirmed H5N1

If I remember correctly, this decades-old antibody level is still extremely high. Isn't the due to the massive immune response necessary to conquer the disease?

Does H5N1 also have an unusually high antibody level, or has too little time passed to make this comparison?


I'm just curious as to how the 2 compare and if it indicates something significant.

.

The amount of H5N1 data NOT disclosed is large. It remains unclear if this data was just never collected or never released. The details on the 1000 serum samples from northern Vietnam in Feb/March 2005 has never been released. There has been no word on extensive testing in Turkey in Feb/March 2006 (some reports suggest the Turkey samples were never collected).

For the index case for Indonesia, she had a rising titer which doubled in just 3 days from 320 to 640. However, that infection was fatal and there were only two collections.

There are many patients who survived, but data has not been forthcoming. Even the fourth sibling in the index cluster in Turkey is still consodered negative by WHO (even though the first three siblings were H5N1 positive and all died)

Thus, follow-up data on H5N1 is pretty much a "state secret" as WHO works overtime to keep the number of official H2H clusters as low as possble (but H5N1 doesn't read press releases).

 

[Snowy Owl]

Re: Sulawesi cluster / 14M (deceased) from South Sulawesi confirmed H5N1

If I remember correctly, and Doctor Niman can confirm this, the 1000 serum samples from northern Vietnam where indeed sent to the CDC in U.S., what did the CDC said about those since they advocate to have a 'new spirit' of collaboration. Does anyone have some comments from the CDC about those thousand samples ???

 

[HenryN]

Re: Sulawesi cluster / 14M (deceased) from South Sulawesi confirmed H5N1

If I remember correctly, and Doctor Niman can confirm this, the 1000 serum samples from northern Vietnam where indeed sent to the CDC in U.S., what did the CDC said about those since they advocate to have a 'new spirit' of collaboration. Does anyone have some comments from the CDC about those thousand samples ???

Hanoi found many positives as did the CDC. There were several emergency meetings including the largest in Manila in May. Klaus Stohr even acknowledged that the pandemic may have begun

http://www.recombinomics.com/News/05050502/WHO_H5N1_Pandemic.html

However, there were not enough dead bodies, so WHO kept testing (Canada went to Vietnam to look at the western blots) until someone (Japan) said they were negative, but there would be more testing.

To my knowledge, the results from more testing has never been announced.

 

[Snowy Owl]

Re: Sulawesi cluster / 14M (deceased) from South Sulawesi confirmed H5N1

WHO: Flu Pandemic May Have Begun
[FONT=Arial,Helvetica]
Recombinomics Commentary[/FONT]
May 5, 2005

>> In Asia, there are hints that the virus is indeed changing. "Incomplete evidence suggests that there may be a shift in the epidemiology of the disease," says St?hr. "More clusters are being seen than last year, older people are now coming down with the diseases, and more cases are milder." Taken together, these characteristics could indicate that the virus is becoming less virulent and more infectious, he says, which could signal the start of a pandemic. <<

Klaus Stohr's comments above are the first acknowledgement by WHO that the 2005 flu pandemic may have begun. The clearest signal was the simultaneous admission of a family of five in Haiphong on March 22. All five were confirmed to be H5N1 positive and all five recovered. Earlier signals were the transmission from patients to nurse(s) in Thai Binh and the 195 commune members in Quang Binh with flu symptoms. Although samples were collected from over 30 individuals, the results have yet to be released. The same is true for the neighbors of the Haiphong family and the patients at Vietnam Sweden hospital in Thai Ninh.

1000 samples were collected, and those results were not announced either, but the shipment of samples to CDC for analysis was a very big red flag and these changes correlated with an amino acid loss, presumably in the HA cleavage site, are a clear signal that the H5N1 in northern Vietnam was a recombinant.

The virus clearly has all of its ducks in a row, and humans are simply sitting ducks, unaware or unconcerned about the looming mayhem in the fall.

http://www.recombinomics.com/News/05050502/WHO_H5N1_Pandemic.html

 

[Theresa42]

Re: Sulawesi cluster / 14M (deceased) from South Sulawesi confirmed H5N1

toggletext-ed from Indonesian:

Willingly, the Citizen of the Poultry Isolation
Sept 10, 2006

Reduced the Risk of the Spread of the Bird Flu Virus to Humankind; Dinkes Makassar took the Sample of Blood of three citizens; Kalla: the Media Too Much exaggerated the Case of the Death resulting from Burung Flu

Sungguminasa, Tribun -- The Citizen of Ujung Bulo Village, the Village Lembang Parang, the Barombong Subdistrict, Gowa, isolated the poultry (the nonpedigreed chicken) to special livestock breeding that was carried out in a self-supporting manner in this village, on Saturday (9/9).

This action was carried out to reduce the risk of the spread of the bird flu virus (H5N1) from the poultry in this region to the citizen. Around the 400's the tail of the nonpedigreed chicken was belonging to the citizen of the Bulo Tip united in one region measuring around 300 square metre.

The village head the Ujung Bulo, Mursalim, said, livestock breeding together this could accommodate around 3.000's the citizen's chicken.

According to him, this compound started from the brightness of the case of bird flu some time before. The citizen afterwards consciously gathered and produced the idea of developing livestock breeding together in a self-supporting manner.

"This livestock breeding was carried out together. The government only facilitated," he said. To cover operational, the citizen agreed eliminated 2,5 percent their chicken sales revenue.

In Makassar, the official of the Health of the Service (Dinkes) the Makassar City again took the sample of the citizen's Maccini blood following the Akhira death, the citizen Makassar that was stated positive contracted the bird flu virus.

The section head the Health of the Makassar City, Naisyah Tun Nurainah, said, the taking of the sample of the family's Akhira blood was carried out to merekayang could not be taken beforehand. Therefore, has had 12 people of the Akhira family that was taken the sample of his blood. [Plus also 3 as indicated in the headline?]

"The sample of the blood was afterwards sent by us to the Research And Development Body (Research And Development) the Department of the RI Health to be researched. This to know whether emerging the same case in one family or not," he said.

Naisyah also said, the government in fact bore all the fees of the patient's medical treatment suspect and positive bird flu. Only, during still was sick, Akhira was not yet diagnosed as the deadly illness sufferer.

"This just happened here. The patient's family spent the medical treatment cost in the government hospital (Wahidin Sudirohusodo) and died before having results of his diagnosis. Will be returned, I berkordinasi previously with the RS Wahidin side," he said.

The full sibling Akhira said, for medical treatment of his four relatives, the family spent money around Rp 10 million. For Akhira personally, at least Rp 2,5 million was finished for medical treatment.

While Vice President Jusuf Kalla pointed at the media too much exaggerated the case of bird flu that fell on several citizens, including that happened in South Sulawesi.

"If being seen from his percentage, the case of the death resulting from bird flu that the amount 48 cases were still being small compared with the case of the death because of malaria or even the TB (tubercolosis)," said Kalla during to keynote speaker in the Prevention seminar of Bird Flu (the symposium of Avian Prevention Flu) in the Senate's Space of the Hasanuddin Building of the University Rectorate (Unhas).

This seminar was the series of the warning was frozen Natalis the Hasanuddin University (Unhas) 50th that was centred on in Baruga Andi Prince Pettarani.

"The reporter wanted him to be waiting for the case of the death because of bird flu. Like that was available, immediately was busy being reported in fact like hoped had the case of the spread antarmanusia with humankind," guessed Kalla.

In this opportunity of Kalla was accompanied by South Sulawesi Governor min Syam, the Rector Unhas Prof Dr Dr Idrus A Paturusi SpBO and the United Nations Ambassador Children apostr s Fund (Unicef) for Indonesia, Gianfranco Rotigliano.

"When compared with the percentage of the number of Indonesian inhabitants that two hundred million more and that died only 48 people. That would still was small. In China could the case of the death of his bird flu was bigger but they did not publish him," said Kalla that spoke concerning the policy of the government towards the prevention of bird flu in Indonesia.

The South Sulawesi condition

Governor Amen Syam explained, several stages have been carried out by the government rank of the province for the prevention and the handling of bird flu.

Officially livestock breeding has done biosecurity that healthy aimed at preventing contact between the animal that was sensitive to bird flu and stopped the production of the bird flu virus to the poultry that tertular.

"Apart from the implementation biosecurity, also was done by the implementation of the vaccination against the healthy poultry to give immunity from the spread by the poultry that had the virus. Also through the control of the interregional especially traffic the regency, the city, and inter-province," said Amin.

The extermination action, good in a manner depopulation (the limited extermination) and stamping out (the extermination spread everywhere) also became the solution to eliminate the source of the spread of the bird flu virus.

The extermination all the poultry that was sick and healthy was done in livestock breeding tertular and all the poultries that was in a radius of one kilometre from livestock breeding that tertular.

"The government of the Province also carried out steps in the handling in part like, the formation of the control command post of the illness of the bird flu illness in the province and the regency/the city, he added."

http://www.tribun-timur.com/view.php?id=32842&jenis=Front

 

[Theresa42]

Re: Sulawesi cluster / 14M (deceased) from South Sulawesi confirmed H5N1

toggletext-ed from Indonesian:

The trauma to the Community Health Centre
Behind the Akhira Death
Sept 10, 2006

The deceased's FAMILY Akhira Wisnuliyanti (14) that often was greeted by Akhira, the citizen Street Maccini Tengah that died because positive bird flu, claimed to be the trauma memeriksakan the health in puskemas.

His article, apart from continuing to be asked for money for the buyer of medicine, they also felt they were not paid attention to by the official of the community health centre.

"I the trauma brought the family to puskasmas. Later his fate will be the same as Akhira," said Asriawati, the older brother late, when being found in his house, on Saturday (9/9).

Beforehand, the Health Service of the Makassar City asked for the Akhira family memeriksakan his health in the closest community health centre.

Akhira died after beforehand was checked in one of the community health centres in Street Maccini Tengah and afterwards was reconciled to the Wahidin Sudirohusodo Hospital with the diagnosis suffered the complication and the sign of typhus of the dengue fever illness.

Before Akhira died, the older brother Andri Winarti and his mother of Sukiah, before died with the sign that was similar with that was suffered late. Andri that had been treated in the Barabaraya Community Health Centre suffered the high and breathless fever.

For the maintenance period, Andri was always guarded by Akhira and his mother. The deceased's family suspected, the two people tertular [caught] the illness from Andri during guarded late for the maintenance period.

The cousin late, Mulati, also could be run off with to the hospital with the same sign. However Mulati was safe after getting the maintenance intensively.

The feeling of the family's Akhira trauma not only because of the death of his three families [three family members]. They also regretted the treatment of the official of the community health centre that asked for money for the buyer of medicine to them during memeriksakan the health.

"In fact I has delivered to them if we here because of being told by the health service. He said we will not be picked up the cost sepeser also because of having our family that was determined terjangkit bird flu," said Ria that was counterbalanced by Ani, relatives Akhira other.

According to Ria, during memeriksakan himself to puskemas, he was asked to pay the cost of medicine of Rp 6.000. The cost outside the registration cost of Rp 4.000. In fact, setahu Ria, the patient that memeriksakan himself because of the assumption of bird flu, was not put on the cost completely.

http://www.tribun-timur.com/view.php?id=32841

 

[Theresa42]

Re: Sulawesi cluster / 14M (deceased) from South Sulawesi confirmed H5N1

toggletext-ed from Indonesian:

The government Budget For Rp500 M. handled Burung Flu
September 10, 2006

MAKASSAR - The Indonesian Government budget for Rp500 billion in APBN especially to handle the problem of bird flu or Avian influenza (AI). Was like this it was said RI Vice President Jusuf Kalla, in the "symposium of Avian Prevention Flu" that was spread out by Unhas with Unicef in the Senate's Unhas Space, on last Saturday.

Apart from the vice-president, South Sulawesi Governor HM Amin Syam and the Head of Unicef Delegation in Indonesia Dr Gianfranco Rotigliano also appeared as the speaker. The vice-president said one of the hindrances that was dealt with by the government in handling this illness, was the understanding of the community of the AI danger that more unclear. This caused, the community occasionally reluctantly released his poultry to be destroyed.

"This bird flu was the serious problem. Indonesia in fact became the world champion and overcame Vietnam. The matter of the fund and the research were handled by the centre, whereas his implementation in the area. Therefore, the governor and the regent must coordinate mutually," stressed the Vice President in the agenda that was spread out in the series was frozen by Natalis 50th Unhas. JK explained, from 68 cases of bird flu in Indonesia, 48 people died.

South Sulawesi Governor HM Amin Syam in the opportunity could spill uneg-uneg him to JK related the handling of bird flu in South Sulawesi. "I saw friends's seriousness in the regency/the city was not yet maximal. Moreover, we needed the laboratory that was easy and close to be accessed," requested the governor.

Amin also said, South Sulawesi needed facilities and means to satisfy the requirement for the South Sulawesi vaccine totalling 29 million doses. South Sulawesi in fact needed 42 million doses, but that was available just 13 million doses. So as the vaccine was still being backward 29 million doses.

Rapid test then, he stated must be increased. At this time, each regency [in South Sulawesi] only had 20 rapid test. For the big regency, the number was very minimal. "The implement rapid test was not enough 20 for one regency," said the governor.

In South Sulawesi, beber him, 17 regencies/the city tertular AI and 6 category regencies were threatened, one of them Pangkep.

The governor also complained about the problem of the fund that from the centre that did not yet descend for the handling of bird flu in South Sulawesi. "South Sulawesi needed Rp50 billion to eradicate 5 million tails. The government of the centre also still was slow in bringing about compensation. That not to mention the community reluctantly released his poultry with the value Rp10.000 per the tail. Because of many chickens that he thought more expensive," said the governor.

When the vice-president discussed the problem of bird flu, several students carried out the peace action by distributing the leaflet. In the call in the leaflet, the student that mengatasnamakan the Alliance of the Student Unhas (AMU) that refused all the policies of the government that did not take sides with the people. They could be pursued security apparatus as far as the economic Faculty. The peace action dispersed automatically.

http://www.fajar.co.id/news.php?newsid=27289

 

[Theresa42]

Re: Sulawesi cluster / 14M (deceased) from South Sulawesi confirmed H5N1

toggletext-ed from Indonesian:

Long for the Older Brother who died
Behind the death Akhira (3-completely)
Sept 11, 2006

The Akhira Wismiyanti TRIP [departure?] for his [her] family still was covered by the mystery. Results of the sample test of blood that sentenced the girl born in February 13, 1989, positive terjangkit bird flu had not crossed in the marrow of all the family.

However several of the family's members have begun to sense the strange sign of the youngest child from eleven related this.

Two days after the Andri Winarti death (the full sibling Akhira), in the Hospital of Stella Maris, on June 15, Akhira had said if he [she] the longing met Andri.

"Akhira always said matters that was related to Andri. He [she] wanted to follow the Andri behaviour to continue to feel close," recalled one of the nephews Khira [Akhira], Ummi Kalsum.

Andri Winarti was relatives who most were close with Khira considering the difference of the age that was not far was different.

Moreover the class student three junior high school 22 Makassar this bercita-feelings continued his [her] school to the SENIOR HIGH SCHOOL 1 Makassar where Andri the school.

"Akhira really terobsesi to enter the SENIOR HIGH SCHOOL 1 followed the tracks of his [her] older brother. Love his hope was not brought about," said Ummi. The Akhira achievement in his school was classified as stable.

According to the acknowledgment of the family, several of the manager's teachers of the JUNIOR HIGH SCHOOL 22 Makassar said very sorrowful with the Akhira trip.

The teacher considered Akhira had the strong studying motivation and the high-achieving wish very high.

"His [her] class teacher really lost Khira. Moreover he [she] was classified as the student who often did not do the conduct in the class," said relatives Khira, Asriawati.

The girl's trip that lived in Street Maccini Tengah, that was still leaving the sorrow that in for his family.

Moreover, two people of their pity, Sukiah (the mother) and and Andri, before has left the businessman's family elekton that.

Wrongly the Cause Diagnosis

Of the death of the three people in succession this initially too much was not paid attention to.

Then was like this with the doctor who treated them for the recuperation period.

Initially the three people were diagnosed suffered the dengue fever illness and the sign of typhus.

To the end they died, this diagnosis continued to be maintained. The result was, the family then be sure that the death the three of them because of the two illnesses.

To the end went out official information from RI Health Minister Siti Fadilah Supari that mentioned if Akhira died because of being attacked by the virus H5N1.

Wrongly the diagnosis! So the conclusion of the Akhira family to the Tribun, late last week.

Was not wrong if the treatment that they received then was not in accordance with the standard of the sufferer's service suspect other bird flu as being isolated, was given medicine antiflu birds, et cetera.

Moreover, Ria words, one of the relatives Akhira, they initially were not paid attention to because of making use of the poor card service.

According to Ria, when undergoing the maintenance in the Hospital Dr Wahidin Sudirohusodo, they were placed the four in one room.

"If Akhira was indeed attacked by dengue fever, why there were no red spots on his [her] skin like the other sufferer. Time died, was checked by me his [her] skin, evidently indeed did not have the sign-the sign, timpal Ani," also one of the relatives Akhira.

The section head the Makassar Health, Naisyah Tun Nurainah, still could not comment many matters were wrong dianosis this.

He admitted to carrying out the co-ordination again concerning the process of the diagnosis of the three people.

http://www.tribun-timur.com/view.php?id=32920

 

[Theresa42]

Re: Sulawesi cluster / 14M (deceased) from South Sulawesi confirmed H5N1

Hat-tip, Dutchie!

toggletext-ed from Indonesian:

Fevers, Immediately to RS
The Explanation Dr Halid Saleh Sp PD, the Lecturer Unhas Cardiology and the Head of the Installation Emergency treated the RS Wahidin Sudirohusodo
Sept 11, 2006

From 9 patients who were suspected by the case suspect bird flu and had been isolated in ferns Space in RS Wahidin Sudirohusodo, all of them not there are those that entered the Probably [probable?] case stage moreover the case of confirmation.

Nine patients outside Akhira, because of his [her] doctor diagnosed dengue fever. So be not handled by us. At this time in the room of the isolation did not have the patient who spent the night.

We hope for to the community if having the indication like the fever on 38 levels that were accompanied breathless, and had the chicken that died suddenly around the house immediately brought to the hospital.

Here we had the team of the control of bird flu that consisted of the director, operational and the consultant.

Every time had the patient who was suspected by the case suspect, this patient will go through several channels. Among them, to space triase in the part treated the emergency and was handled by the team of the director. Apart from the physical inspection will also be carried out by the laboratory inspection.

Results of the inspection in space triase will be considered by the consultant whether the patient was severed for the isolation or not. If being isolated, the patient suspect will be brought to ferns Space. The maintenance of this patient will be handled by the operational team.

To avoid bird flu that tepenting was the chicken coop must always bersi. Sebisa possibly avoided contact with the poultry, as well as reported to the community health centre, the hospital or the related service if having the poultry or humankind there it was suspected is one that is affected bird flu.

http://www.tribun-timur.com/view.php?id=33000&jenis=Liputan

 

[Sharpe]

Re: Sulawesi cluster / 14M (deceased) from South Sulawesi confirmed H5N1

Theresa, what is this article saying? Who are these nine people? Thx.

 

[Theresa42]

Re: Sulawesi cluster / 14M (deceased) from South Sulawesi confirmed H5N1

Theresa, what is this article saying? Who are these nine people? Thx.

I wish I knew, Sharpe! To me it sounds like the doc is saying that to date they've had 9 suspected bf patients in this hospital -- not including Akhira.

Their status isn't clear to me, though: "all of them not there are those that entered the Probably [probable?] case stage moreover the case of confirmation." ??

"All of them not there...." Does that mean they've been discharged? I just dunno.

I know LaidbackAl has been keeping close tabs on the Sulawesi cases. Any ideas, Al?

 

[Laidback Al]

Re: Sulawesi cluster / 14M (deceased) from South Sulawesi confirmed H5N1

I don't know of any recent H5N1 suspected cases in Makassar, South Sulawesi.

As a whole the translation seems to suggest that because Akhira was diagnosed with the dengue, she was not transferred to the the bird flu specialists at RS Wahidin Sudirohusodo. ("Here we had the team of the control of bird flu that consisted of the director, operational and the consultant".)

I read that the nine other people were probably also being treated for dengue at the same time as Akhira (June 2006). Now, there is some concern that those individual's were also infected with H5N1. [But it is not the fault of bird flu specialists at the hospital, because they weren't informed about the dengue cases].