# 6099
One of the hazards of blogging about bird flu is that the news we get out of countries where the virus is endemic and most active (Egypt, Indonesia, China, Vietnam, Bangladesh, Cambodia) is often fragmented, contradictory, or heavily state controlled.
You soon learn that relying too much on machine translations from Arabic, Indonesian, Vietnamese, or Chinese language sources risks compounding a felony, as that can add another layer of ambiguity to what is sometimes already less than accurate local reporting.
But some days, that’s all we have to go on.
Case in point, several days ago an 18-year-old man was hospitalized in Tangerang, Indonesia suspected to have been infected by the H5N1 virus. The local papers first reported him as a bird flu suspect, then yesterday the Jakarta Globe reported that he was not infected.
Tangerang Bird Flu Scare a False Alarm
January 24, 2012A man in Tangerang thought to have bird flu has tested negative for the virus, the Health Ministry said on Tuesday.
Instead of being the end of this story, today local media is reporting that this unfortunate young man died of respiratory failure . . . and, you guessed it . . . bird flu is still suspected.
This translation comes from the always excellent Arkanoid Legent website:
After 5 days treated in isolation space bird flu, RO, 18 years, men who indicated suspect bird flu died. RO died at 12:30 pm in the isolation room bird flu Tangerang District Hospital.
"The patient died at 12.30 pm, due to respiratory failure," said Head of Public Relations Tangerang District Hospital, Achmad Muchlis to VIVAnews.com , Wednesday, January 25, 2012. Dikatakanya, since entering the room isolation, the condition of critically ill patients and no progress.
Until finally died of respiratory failure. "Until now there has been no official information related to the correct patient infected with bird flu," he said."
Although we don’t know right now with certainty that this patient died from H5N1, suspicions run high.
If sounds a bit familiar, you may recall that last week we learned of a 5-year-old girl (see Indonesian MOH Announces Bird Flu Fatality) who died from the bird flu virus after first being declared free from infection (see 5-Year-Old Brother of Bird Flu Victim Cleared by Doctors Dofa Fasila | January 10, 2012).
Testing for the H5N1 virus in Indonesia has always been difficult, particularly once a patient is placed on antivirals. We’ve seen some cases where patients tested negative up until a post-mortem exam of lung tissue could confirm the diagnosis.
Newshounds are currently watching several other suspected H5N1 cases in Indonesia, including that of a 4-year-old who died after 6 days of treatment in the hospital at Bekasi.
This translation, again, is from Arkanoid Legent:
Allegedly Infected with Bird Flu, Boy 4 Year Deaths
JAKARTA : Nazril Ilham (4) single-child couples Maimunah (25) and Mohammed Enzen (24), of Kampung Sungai Bintaro Branch 4 RT 1.1 Hurip Jaya Village, District Babelan, Dies Bekasi District. Suspected Bird Flu Nazriel.
The victim died after being treated for six days in hospital Anna Bekasi. The atmosphere of grief is still visible at the funeral home shortly after the victim was buried in the cemetery not far from his home, Wednesday (01/24/2012). Surprisingly burial victims without assisted the hospital or health department Bekasi.
Gert van der Hoek at FluTrackers has a report this morning from MetroTVnews that a hospital in North Suluwesi is treating two suspected bird flu patients.
Kandow Hospital is Treating Two Bird Flu Suspects
National / Wednesday, January 25, 2012
Metrotvnews.com, Manado: Two people are now in intensive care at the Hospital Professor Kandow in Manado, North Sulawesi. Patient origin Bolaang Mongondow and Minahasa, North Sulawesi, was allegedly exposed to bird flu.
The two residents that are 81-year-old AP, the village residents Bintauna, Bolmon District, and RP was 4 years old, a resident Kanonang, Minahasa regency. When taken to the hospital, the patient experienced high fever and shortness of breath accompanied by flu.
Previously the two patients was treated in the clinic area where each of them. Until now, both patients are still undergoing intensive care in a bird flu isolation room
MetroTVnews
While obviously suspected, we’ll have to wait for laboratory confirmation before we can know if any of these cases are due to the H5N1 virus. There are, after all, other illnesses that can mimic the symptoms of bird flu.
And it is quite possible – given the limits of testing -that for some of these cases, we’ll never know their H5N1 status with absolute certainty.
And one final example of how stories can quickly change, last Friday the Indonesian Minister of Health Endang Rahayu Sedyaningsi was quoted in the media as worrying that oseltamivir may be losing effectiveness against the Indonesian strains of bird flu (see Indonesia: MOH Suspects H5N1 May Be Gaining Antiviral Resistance).
Three days later, in what appears to be a bit of hasty `damage control’, we get a newspaper column penned by Professor Tjandra Y. Aditama, Director General of Disease Control and Environmental Health, Ministry of Health, Jakarta, Indonesia.
Oseltamivir is still OK to Overcome Bird Flu
24/01/2012
Tamiflu Oseltamivir by the brand as we know as a drug used to treat bird flu. The research data from 6 countries including Thailand, Vietnam, Cambodia, Turkey, Egypt and Indonesia showed substantial recovery.This was conveyed by the Director General of Disease Control and Environmental Health (P2PL) Ministry of Health, Prof. Dr. Tjandra Yoga Aditama SpP (K), MARS, DTM & H, DTCE to SEHATNEWS.com in Jakarta.
Of the 188 who were treated with oseltamivir, 88 or 47 percent had recovered healing. Of 56 untreated oseltamivir, 7 who recovered (or only 12%) "So there are real differences between the use of oseltamivir with that do not use drugs," said Tjandra.
Data from the World Health Organization says that of 81 cases using oseltamivir global, 21 gain in the first 2 days of fever. Of the 21 men, 18 survived, three died.
The statistics cited above appear to come from an older study of H5N1 outcomes (with and without Tamiflu treatment) conducted across several Asian nations. No cite was given, so I have not been able to run it down.
While encouraging for the global stage (as is this 2010 study), this is not the most convincing evidence that might have been offered by D.G. Aditama for the current state of antiviral sensitivity in Indonesia.
And so it goes.
We view the events in Indonesia, China, Vietnam, and other nations through a fogged and oft times distorted lens. What light that comes through can sometimes give us a hint of what is happening, but details are often absent, or badly mangled.
Welcome to the world of flu blogging and internet news hounding, where the motto is, and will probably always be:
Caveat Lector.
