# 6245
Overnight the press carried reports (see Indonesia: Sixth H5N1 death this year on Crofsblog) of a new human H5N1 infection out of Indonesia. This time, it involves a 17 year old boy from eastern Lombok island who died on March 9th.
Below you’ll find the the update from the Indonesian Ministry of Health, followed by the update from the World Health Organization.
Bird Flu Case report 188
March 26, 2012 | 9:15 am
Ministry of Health, "Directorate General of disease Control and Environmental Health" announced one new case of H5N1 have been confirmed by the Center for Biomedical and Health Technology, Balitbangkes.
Case on behalf of D (male, 17 years) who Lingsar, West Lombok regency, West Nusa Tenggara Province, is a construction worker. Dated February 28, 2012 symptoms of fever, dated March 1, 2012 cases to the health center outpatient Lingsar, and on March 4, 2012 cases treated at health centers Narmada. On March 7, 2012 cases were referred to the RSU Mataram and treated in hospital. Circumstances of the case got worse and on March 9, 2012 cases died at 23:50 pm.
Epidemiological investigations have been carried into the homes of people and the environment by the Integrated Team Ministry of Health and local health office, obtained the possibility of environmental risk factor is contact with the death of poultry (chicken) in the neighborhood.
With the increase of these cases, the cumulative number of bird flu in Indonesia since 2005 until this news was broadcast on 188 cases with 156 deaths.
Ailing Director General of Control and Environmental Health, Prof. dr. Tjandra Yoga Aditama as the focal point of the International Health Regulations (IHR) has been informed about the case to the WHO.
Avian influenza – situation in Indonesia – update
26 March 2012 - The Ministry of Health of Indonesia has notified WHO of a new case of human infection with avian influenza A(H5N1) virus.
The case is a 17 year-old male from Nusa Tenggara Barat Province. He developed fever on 28 February 2012 and sought treatment on 1 March 2012. His condition deteriorated and he was admitted to a referral hospital but he died on 9 March 2012.
Epidemiological investigation conducted by a team from the health office indicated that there were sudden poultry die-offs in his neighbourhood.
To date, of the 188 cases reported in Indonesia since 2005, 156 have been fatal.
The case fatality rate (CFR) of `known’ cases in Indonesia continues to hover just over 82%, with just 4 of the last 26 cases surviving.
What we don’t know (and is highly contested in some scientific circles) is how many cases we are missing.
While surveillance and reporting almost certainly misses some number of cases (mild and fatal), researchers have turned up very little compelling evidence to indicate that there are a lot of `mild’ cases going uncounted.
Leaving us with a CFR that – while probably artificially high – strongly suggests a significant level of lethality from the H5N1 virus.
Fortunately, the virus remains difficult for humans to acquire, as it is presently far better adapted to avian physiology.
The concern is (as has been demonstrated as being possible in the laboratory), that over time the virus will pick up the mutations it will need to adapt to a human host and spark a pandemic.
