Tuesday, August 29, 2006

NOT READY FOR PRIME TIME . . . YET




Yes, gentle readers, I have returned from my sojourn to my doctor in Missouri and have resumed my duties here at A Flu Diary. I’m pleased to note that I made it from point A to Point B and back again without hitting anything, which meets my definition of a successful car trip.


Of course, while I’ve been gone, the virus goes on undaunted. Thailand, presumably Africa, and most certainly Indonesia are all under the gun. As I was leaving a week ago the worry was that the clusters in Indonesia heralded something ominous. While something is definitely going on there, so far, it falls short of an outbreak of sustained H2H transmission.


Over at the wiki, members have been keeping track of the outbreak, gathering information from local Indonesian newspapers, relying on toggletext translations and the efforts of some native language speakers who have volunteered their time. This isn’t easy, and these newspaper reports are often confusing. Michelle in OK has posted this latest summary in http://tinyurl.com/f5uyo , and it now numbers 63 cases.

Cikelet, W. Java

  1. 7/26 - Misbah (20M) symptoms, no tests died Aug-5
  2. 7/26 - Umar Aup (17M) symptoms, to hospital 8/09, left for home treatment, + , RSUD Slamet Garut
  3. 7/27 - Santi (6F) symptoms, to hospital 8/16, released, tested negative , RS Handsome Sadikin (RSHS) Bandung (sister of Ismawati, daughter of Kuraisen & Osin, neighbor & playmate of Ai)
  4. 7/31 - Sardi (4M) died no tests died
  5. 8/1 - 0 symptoms, to hospital 8/14 + WHO confirmed, died Aug-15 , RSUD Slamet Garut
  6. 8/1 - Rubiah (13F) died no tests died
  7. 8/15 - Ismawati symptoms, to hospital 8/16, released, tested negative , RS Handsome Sadikin (RSHS) Bandung
  8. 8/15 - RL (34F) symptoms, to hospital 8/25
  9. 8/16 - Dea (9) died no tests died
  10. 8/16 - Risma (4F) symptoms, to hospital 8/19, released , RSUD Slamet Garut
  11. 8/17 - Euis Lina (35F) died + WHO confirmed, died , RSUD Slamet Garut
  12. 8/17 - Eti (35F) hospital , RS Handsome Sadikin (RSHS) Bandung (may be duplicate name/report for Kuraisen)
  13. 8/18 - Kuraisen (32F) symptoms, 3 mos. pregnant, released tested negative , RS Handsome Sadikin (RSHS) Bandung
  14. 8/19 - Ayi Rohima (10F) hospital , RS Handsome Sadikin (RSHS) Bandung
  15. 8/19 - Memen (60M) hospital , RS Handsome Sadikin (RSHS) Bandung
  16. 8/19 - Risman (5M) hospital (sibling of Rubiah & Misbah)
  17. 8/19 - Yana (50) hospital tested negative , RSUD Slamet Garut
  18. 8/20 - Gilang (14) hospital tested negative , RSUD Slamet Garut
  19. 8/20 - Risma (4) hospital
  20. 8/20 - Tosim (61M) symptoms, improving tested negative , Slamet Hospital Garut / RS Handsome Sadikin (RSHS) Bandung
  21. 8/21 - Dadan symptoms (family of Euis Lina)
  22. 8/21 - Dadan Child #1 symptoms (family of Euis Lina)
  23. 8/21 - Dadan Child #2 symptoms (family of Euis Lina)
  24. 8/21 - Osin (36M) symptoms, released, tested negative , RS Handsome Sadikin (RSHS) Bandung (husband of Kuraisen)
  25. 8/23 - Herman (21M) hospital, improving tested negative
  26. 8/23 - Rangga (6 months)
  27. 8/25 - Cicadas or Dede died suddenly after showing symptoms, chickens died also died
  28. 8/27 - Aris (10)
  29. 8/27 - Pipit (6)
  30. 8/27 - Burhan (38)
  31. 8/28 - Direct (60M), wife is Walk On, hospital, chickens owned died , RSUD Slamet Garut
  32. 8/28 - Ai Siti Fatimah hospital, critical condition transferred from community center to hospital

Bandung, W. Java

  1. 8/24 - student TK Sukowiyono hospital

Bekasi, W. Java

  1. 8/13 - Meggy or Mega Saputra died no tests died (possibly Nursifah’s mother)
  2. 8/18 - Nursifah (6F) hospital, ICU + , Sulianti Saroso Infection Hospital, Jakarta North
  3. 8/25 - Nursivah (3M) hospital, tested negative , Infection Hospital (RSPI) Sulianti Saroso

Bayongbong, W. Java

  1. 8/23 - Ari Tresna Alfajar Day or AT (14) hospitalized Wednesday , RSUD Slamet Garut

Garut, W. Java

  1. 8/27 - Hendra (21) +
  2. 8/27 - Gilang (9) +

Tulungagung, E. Java

  1. 7/22 - DA (5) DA (5) no tests
  2. 7/22 - NA (.5) NA (.5) no tests
  3. 8/25 - Lasting Goddess TK Sukowiyono (6) hospital, released 8/27, tested negative , Dr Iskak Tulungagung

Madiun City, E. Java

  • 8/25 - 5 suspects in Ponorogo
  • 8/25 - 2 suspects in Magetan

Kendari, SE Sulawesi

  1. 8/23 - Siblings hospitalized: Andika (1.5) hospitalized - released Aug-25 (siblings)
  2. 8/23 - Siblings hospitalized: Daffarial hospitalized - released Aug-25 (siblings)
  3. 8/23 - Istiwati (17) symptoms (cab driver Ambu Sao’s family)
  4. 8/23 - Nurhadayani (5) symptoms (cab driver Ambu Sao’s family)
  5. 8/23 - Ahmad Djafan (1.5) symptoms, ICU , RSUD South-East Sulawesi (cab driver Ambu Sao’s family)

Palu, Central Sulawesi

  1. 8/26 - Elis(21)
  2. 8/26 - Farah (5)
  3. 8/26 - Kiki
  4. 8/26 - ? Name (from Palu, at least 4 people in hospital, possibly more)

Palembang (Lubuklinggau), S. Sumatra

  1. 8/21 - Putri Wira Maharani (8F) hospitalized (siblings)
  2. 8/21 - Putra Wira Aditya (3.5 month M) hospitalized (siblings)

Saribudolok, North Sumatra

  1. 8/23 - K boru Saragih hospitalized Wednesday, direct contact w/ poultry, , RS H Adam the Medan Owner

Simulungun, North Sumatra

  1. 8/22 - RL or Rasmita Boru Lingga (35F) pregnant and on Tamiflu, ICU , Adam Malik Hospital Medan
  2. 8/25 - Simulungun government official , RSU Pematang Siantar

Tebing Tinggi, North Sumatra

  1. 8/26 - Fatimah (78 F) symptoms, chickens owned died , Tebing Tinggi Public Hospital, North Sumatra

Other Noteworthy Dates

  1. 8/18 - MASS TAMIFLU DISTRIBUTION,
  2. 8/25 - 215 students the Aisyiyah Kindergarten, Palu tested after 22 birds found positive

So far, this is very worrisome. Over the past year, Indonesia had reported roughly 60 cases. In the past month, that number has doubled. A number of these cases are listed as having tested negative for avian flu. Some of them, undoubtedly, are really negative. But in a high number of cases, patients test negative repeatedly, then die, and then during the post mortem have been found to be infected.


However, if this were the start of a pandemic, the number of infected after a month would number in the thousands, and so far, it doesn’t.


But each human infection is another spin of the mutation roulette wheel, another opportunity for the virus to change into a pandemic strain. It hasn’t quite found the right combination of genetic sequences yet. We can hope and pray it never does. But the virus cares nothing about our prayers. It will do what it will do, regardless.


There are also newspaper accounts telling us that the military, and health officials, are restricting the access of the press in covering this story. Villages are quarantined. Schools are closed. And doctors who are treating these patients are under observation, and not allowed back into the general population until they have passed the incubation period without incident.


So, while a pandemic may not have sprung forth from Indonesia yet, what is happening there is ominous, and bears watching.




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