# 288
Authorities in Indonesia have a medical mystery on their hands with the reported deaths of at least 22 patients in the St. Carolus Hospital near Jakarta over the past three months, all displaying symptoms consistent with SARS or Bird Flu. Thus far, there has been no diagnosis.
While I am initially skeptical that this is, indeed, H5N1, the events surrounding these deaths are curious, and so I present them here, for your perusal.
This story first gained my attention on December 28th, when it appeared on ProMED, the global electronic reporting system for outbreaks of emerging infectious diseases & toxins, run by the International Society for Infectious Diseases.
UNDIAGNOSED DEATHS - INDONESIA (JAKARTA)
REQUEST FOR INFORMATION Date: Thu 28 Dec 2006Source
The Jakarta Post, Associated Press report, Thu 28 Dec 2006 [edited]Indonesian health officials are investigating the deaths of 22 people in the capital Jakarta over a 2-month period from an unidentified illness characterized by high fever.
Samples from the patients -- all of whom died days after being admitted to St. Carolus hospital -- have been sent to the U.S.Naval Medical Research Unit 2 [NAMRU2] in Jakarta, but the cause of death remains a mystery, said Nyoman Kandun, a senior health ministry official.
"We have not been able to conclude if this is or is not a new emerging disease," Nyoman told the Associated Press on Wed [27 Dec 2006]. "But after experiencing both bird flu and SARS (Severe Acute Respiratory Syndrome) we do not want to take any chances.
"Samples were also sent to the U.S.-based Centers for Disease Control & Prevention (CDC), another health official said on condition he not be named because he is not authorized to speak to the media. Tests there were also inconclusive.
The report goes on to state that there are two other hospitals in the area, and none of them reported similar instances, and that `poisoning’ was also under consideration. Most of the patients were over the age of 40, and came from a middle class neighborhood near the hospital. No other members of their households reported symptoms.
For the past 10 days, authorities have been tightlipped over what has been going on at Saint Carolus. There have been a few newspaper accounts, but no explanations. Yesterday, the following appeared on the TIME INTERACTIVE : Jakarta website in the Indonesian language. What follows is a machine translation. A tip of the hat to Dutchie on CE for finding this one.
Carolus did not yet know the Cause of the Death 20 Pasien
on Monday, January 08 2007 | 13:40 WIB
The Interactive TIME, Jakarta:
The management of the Saint Carolus Hospital did not yet know the cause of the death 20 Jakarta residents who contracted the high fever in November last year.
"We did not yet know results of the Department of Health," said Endang Suryatno this hospital Spokesperson to the Time today.
According to Endang, the sign of the public of all the patients was feverish that was very high was accompanied by coughs.
The patient generally only could be treated one to two day.
The team of the doctor did not yet examine the patient comprehensively.
"This phenomenon rarely happened in this hospital," said Endang.
Therefore, this case was at once reported to the Department of the Health.
But Endang admitted to not yet getting results of the evaluation that was carried out by the Department of the health.
The hospital side, said Endang, suspected all the patients of contracting the sign that resembled bird flu (Avian influenza).
If true then was worried by this virus will develop more far.
"When being treated, they were united with the other patient, in the normal room," said Endang.
Nearly six weeks after the last reported death (Nov 27th), authorities still haven’t released a cause of this mystery illness.
All of this is rather curious. And despite the continual references to bird flu in the media reports, we have no tests confirming that. Unusual, since Indonesian labs, and particularly NAMRU (U.S. Naval Medical Research Lab)are very good at ferreting out the virus.
There are, of course, many diseases that can produce flu like symptoms, some of which can be quite deadly. But most should be readily detectable in lab tests, particularly given the time and resources that have been made available. So the lack of a diagnosis after this long of time is unusual.
The good news is, the deaths have reportedly ceased. Whatever this was, it has stopped, at least for the time being.
This may have nothing to do with the bird flu.
But 22 unexplained deaths, with bird flu-like symptoms, in an area where other H5N1 infections have been reported, is worth noting.
And one has to hope the local press continues to pressure the health authorities for a full explanation.
