# 2448
Dadang Hadiansyah, 32, a resident of Bandung, Indonesia died on Monday from a severe, rapidly progressing pneumonia. While originally suspected of having the H5N1 bird flu virus, his tests came back negative.
Hospital officials have announced that further tests will be done to try to determine the cause of Hadiansyah's death.
False-negatives, and to a lesser extent, false-positives are not uncommon in medical testing.
Samples must be properly collected, safely transported, and correctly processed. And even then, sometimes the tests yield incorrect results.
The administration of Tamiflu may help mask the virus, hindering detection. The virus might even be shifting slightly; enough to have affected the sensitivity of the tests.
The tests for the H5N1 virus appear to be particularly susceptible to false negatives.
In the Turkish cluster of 2006, the NEJM reported:
Before H5N1 infection was diagnosed in the eight patients, a total of 8 real-time PCR tests, 12 rapid influenza tests, and 12 ELISA tests were negative.
Negative tests, therefore, have to be taken with a grain of salt. From the comments reported in the following article, it is apparent that the H5N1 virus isn't off the table.
This from the Jakarta Post.
West Java hospital probes bird flu death
Yuli Tri Suwarni , The Jakarta Post , Bandung | Sat, 11/08/2008 11:47 AM | The Archipelago
The Hasan Sadikin General Hospital in Bandung is investigating the death of a suspected bird flu victim who died of acute pneumonia, because initial tests showed no signs of H5N1 virus infection, hospital director says.
Hospital director Cissy Rachiana Prawira said the complete test results would be available within 10 days.
Cissy said the hospital received test results from the Health Development and Research Center in Jakarta on Thursday, four days after Dadang Hadiansyah, 32, died at the hospital's isolation ward.
Dadang earned a living slaughtering chickens.
Cissy said tests conducted by the hospital's microbiology lab also showed the victim's blood and phlegm samples were H5N1 negative.
"We must continue the tests to determine the type of microorganisms that caused the sudden death because the victim had direct contact with poultry," Cissy said in Bandung on Friday.
She strongly denied Dadang's death was due to late treatment, but rather due to a delay in diagnosing the disease.
The head of the contagious disease supervision division at the Bandung Health Agency, Muhamad Songka, said field analysis conducted around the area where the victim lived on Jl. Inhoftank -- where poultry are placed in transit before being sold to markets -- had not shown whether neighbors or the victim's relatives had contracted the same disease.
Songka said he was concerned about the presence of other virus strains that may have caused the acute pneumonia, given the sudden attack.
"I think the spread of the bird flu virus is a mystery. Perhaps it was not the H5N1. We are very curious of the actual cause," Songka said.
