A Farewell To BFIC

 

 

# 6062

 

I’m saddened to discover that Ida at BFIC has posted a notice on their website that they are shutting down their blog.

 

The Bird Flu Information Corner- a joint project between Kobe University in Japan and the Institute of Tropical Disease, Airlangga University, Indonesia – has been an invaluable source of information on influenza activity in Indonesia for several years.

 

Their contribution to Flublogia will be greatly missed.  Here is the announcement.

 

 

A Notification from Administrator

Posted by Ida on January 10, 2012

This activity has been managed by researchers both in Kobe University (KU), Japan, and Institute of Tropical Disease (ITD), Airlangga University, Indonesia, under the support by the “Japan Initiative for Global Research Network on Infectious Diseases (J-GRID)” program.

 

Since it has established, we tried to cover the almost all H5N1 outbreak news in animals and human. We hope this simple activity played some roles for global information sharing and for controlling/preparing to this kind of worldwide infectious disease.

 

Following to generational change, we’re closing this blog. Last but not the least, all of our gratitude to all friends who have worked on BFIC together under the kindred soul!

Watching Bali Again

 

 

UPDATED 0630 hrs 10/31 (See bottom of page)

 

 

# 5931

 

Ida at BFIC has a brief story (that I should also note has been picked up by the newshounds at The Flu Wiki and at FluTrackers) on the hospitalization and isolation of a mother and child in Bali suspected of H5N1 infection.

 

Denpasar, Bali ::: Sanglah hospital treats 2 bird flu suspects

Posted by Ida on October 30, 2011

Denpasar – A mother (42-year-old) and her daughter (10-year-old), residents of Banjar Pande, Abiansemal, Badung, treated intensively as bird flu suspect patients in Sanglah hospital. They were referred from Kapal hospital, Friday (28/10).

 

Spokesman of the hospital said the patients complained fever, and coughing. There is no history of contact with any birds. Hospital is still waiting for laboratory test for bird flu H5N1 diagnosis of both patients.

 

Patients are currently in stable condition. The fever and cough have stopped.

 

During 2011, Sanglah hospital has treated 20 bird flu suspect patients, and 2 of them tested positive H5N1 and died.

 

 

As noted in the article, of 20 suspected cases in Bali during the month of October, only 2 tested positive for the bird flu virus. Both of those died (see WHO: Indonesian Bird Flu Update #7).

 

A third case – the mother of the two children who – also died a week later, but we’ve not seen any confirmatory test results.

 

While unproven, H5N1 is strongly suspected.

 

As for the others who tested negative, the assumption is that they probably had some other illness (although it is possible – given well documented sensitivity issues with the tests - that some false-negatives may have been returned by the lab). 

 

This is a pattern we’ve seen all along, both in Indonesia and in Egypt, where only a fraction of those suspected of having the H5N1 virus ever test positive for the disease. 

 

Given the potential for spreading in the populace, it is only prudent to suspect H5N1 – and take the appropriate steps of isolation and testing of patients – in those regions where the virus is endemic.  

 

There are plenty of other viral pathogens co-circulating in these regions (ie. seasonal influenza, dengue, RSV, etc.) capable of producing `bird flu symptoms’, hence, we tend to see a great many `suspected cases’.

 

Ideally, those who tested negative would undergo serological retesting 4 weeks later to see if they’d developed H5N1 specific antibodies, but if that is being done in Indonesia, it isn’t being advertised.

 

In November of last year we saw a proposal to do just that sort of seroprevalence testing in Egypt (see A Prospective Avian Influenza Transmission Study For Egypt).

 

And last month, we saw a study that reported the results of this kind of serological testing conducted in a rural village in Thailand in 2008 (see Bangladesh To Share H9N2 Bird Flu Virus). 

 

Out of 800 villagers tested, the authors found 4.7% were seropositive for the Hong Kong H9N2 avian strain, 5.6% had antibodies to A/Thailand/676/2005 H5N1 bird flu, and 3.5% were shown to be seropositive to A/Thailand/384/2006 H5N1 .

 

Suggesting that mild or asymptomatic spread of these viruses may be going undetected in parts of Asia.

 

The simple fact that follow-up testing like this is the exception, and not the rule, is one of the reasons why there remain so many unanswered questions about how the virus transmits in humans.

 

But in many regions of the world where the virus is endemic (primarily Asia and the Middle East), a lack of political will, societal and religious customs, and economic barriers make this sort of testing extraordinarily difficult.

 

Although we continue to see isolated human infections around the world, and the virus continues to evolve (see H5N1: An Increasingly Complex Family Tree), for now H5N1 is primarily a threat to poultry.

 

The concern, of course, is that over time that could change.

 

And so the world remains at Pre-pandemic Phase III on the H5N1 virus, and we continue to watch for signs that the virus is adapting better to humans.

 

Updated 10/31/11:  Ida at BFIC has a report from the Bali Post indicating that both patients tested negative, and have been discharged (see Denpasar, Bali ::: Two suspects test negative).  A third patient – a 6 year-old with the initials JS – has been admitted for testing and treatment of a possible bird flu infection.

Referral: BFIC on Human Influenza In Indonesia

 

 

 

# 5661

 

 

Ida posting on the Bird Flu Information Corner - a joint project of Kobe University in Japan and the Institute of Tropical Disease, Airlangga University, Indonesia – has been an invaluable source of information on influenza activity in Indonesia for several years.

 

Today, via the BFIC, Ida has an excellent summary (with maps, graphs, & charts) of an article published in the Journal Microbiology and Immunology yesterday titled:

 

Virological surveillance of human influenza in Indonesia, October 2008-March 2010

Masaoki Yamaoka, Justinus F. Palilingan, Jusuf Wibisono, Resti Yudhawati, Reviany V. Nidom, Muhamad Y. Alamudi, Teridah E. Ginting, Akiko Makino, Chairul A. Nidom, Kyoko Shinya, Yoshihiro Kawaoka

Article first published online: 28 JUN 2011

DOI: 10.1111/j.1348-0421.2011.00344.x

 

 

This study is based on a collaborative work between Kobe University and Institute of Tropical Disease, Airlangga University that conducted surveillance in Surabaya from October 2008 to March 2010. 

 

Surveillance of Human Influenza in Indonesia, October 2008-March 2010

Posted by Ida on June 29, 2011

 

Since only the abstract to the study is freely available on the journal site, this summation is highly welcome.

Watching Indonesia Again

 

 

# 5634

 

 

Thanks go to Ida at the Bird Flu Information Corner – a joint project of Kobe University in Japan and the Institute of Tropical Disease, Airlangga University, Indonesia – for this report from the Indonesian media on a family in West Sumatra suspected of H5N1 infection.

 

 

Agam, West Sumatera ::: A family treated of bird flu suspicion

Posted by Ida on June 17, 2011

Agam – A family, E (43 years old) and his children, Adi (14), Gilang Ramadhan (9) and Nuzuli (5.5), from Jorong Koto Panjang Nagari Kapau, Kecamatan Tilatang Kamang, Agam, suspected of contracting bird flu H5N1 after the family’s chickens had suddenly died since Friday last week. The family started to feel sick and to have high fever since Monday. A sample of dead chickens was tested positive bird flu infection.

 

The family has been referred to Adam Malik hospital in Bukittinggi for medical examination.

 

 

The original media report indicated that 7 chickens kept as family pets began to die about a week ago, and since then the family has experienced recurrent high fevers. 

 

There are a number of other illnesses common to Indonesia that could produce similar symptoms - including seasonal influenza and dengue fever – and so their diagnosis at this time is anything but certain.

 

Until we get laboratory confirmation, these are simply `suspected cases’.

 

Unfortunately, all too often, we never get a follow up on these cases that are reported in the media.

 

 

For several years the Indonesian MOH (Ministry of Health) has been slow to provide details about human cases and has refused to share viral samples with the World Health Organization.

 

Since former Minister of Health Supari was replaced by Dr. Endang Rahayu Sedyaningsih in 2009, we’ve seen some subtle signs of greater transparency. And recently an agreement was reached on the sharing of viral samples (see WHO Announcement On Framework For Virus Sharing). 

 

Hopeful signs.

 

Although we continue to see isolated human infections in Indonesia, Egypt, and around the world - for now H5N1 is primarily a threat to poultry.

 

The virus remains poorly adapted to human physiology, and despite ample opportunities to cause illness in humans, only causes rare, sporadic infections.

 

The concern, of course, is that over time that may change.  That the virus will mutate into a form that is easily acquired and passed on by humans.

Indonesia: Recent Confirmed & Suspected Bird Flu Cases

 

 

 

# 5438

 

 

Although a bit out of the news cycle these past few weeks, H5N1 bird flu continues to plague Indonesia.

 

Aside from almost daily outbreaks in birds, we’ve seen numerous media reports of suspected human cases hospitalized and treated for H5N1.

 

Most – after days or even weeks of isolation and treatment - have reportedly tested negative for the virus, and have been sent home. 

 

Thus far, for 2011, Indonesia has reported 3 H5N1 infections to the World Health Organization, all fatal.

 

Yesterday the Ministry of Health (MOH)  announced a 4th case; An, a 22 months old female from Bekasi, West Java province  (see BFIC Indonesia ::: Ministry of Health announces additional H5N1 victim)

 

Overnight, Ida at The Bird Flu Information Corner – a joint project of Kobe University in Japan and the Institute of Tropical Disease, Airlangga University, Indonesia -  has details on two more bird flu related stories.

 

First, a another suspected bird flu fatality, followed by the resurgence of bird flu (in poultry) on the vacation destination island of Bali.

 

 

Gunungkidul, Yogyakarta ::: A dead patient suspected of contracting bird flu

Posted by Ida on March 24, 2011

Gunungkidul – A 26-year-old female named Sri Supartilah, a resident of Desa Pacarejo, Semanu, Gunungkidul died after being treated for 3 days in Sardjito hospital, Yogyakarta on Wednesday, 23 March. Patient who was a housewife, is suspected of contracting avian influenza (H5N1) infection.

 

Head of Health Service Kabupaten Gunungkidul, dr. Sri Raharto, said the cause of death is still unknown. Currently, confirmation test is undergoing by Ministry of Health.

(Continue . . . . )

 

 

 

Bali ::: Bird flu spreads in 3 municipals

Posted by Ida on March 24, 2011

Denpasar – Three municipals in Bali province that are Denpasar, Badung and Tabanan, stated positive bird flu. Mayors and municipal governments in Bali have been told to take steps for controlling the virus spread through the memo issued by the governor of Bali, Made Mangku Pastika.

 

Head of Livestock Service in Bali, Putu Sumantara said bird flu had been detected in Denpasar, Badung and Tabanan by rapid test and confirmed positive by laboratory test.

 

Following to the finding officials conducted vaccination in birds, and managed the bodies of suddenly dead chickens to be evacuated and burned.

(Continue . . . )

 

 

Indonesian officials tend to hold bird flu outbreak information very close to the vest, with their former Health Minister (Supari) having expressed the opinion back in 2008 that publically discussing H5N1 was detrimental to their nation’s image.

 

So we tend to get far less information out of Indonesia than we used to.

 

Indonesia also continues to refuse to share virus samples with the rest of the world.  

Testing for the virus, of course, has always been difficult. Indonesia requires repeated positive or negative results before they are accepted as valid.

 

All of which tends to make some observers of the bird flu situation in Indonesia a bit skeptical of the numbers we get from the MOH.

 

Although we continue to see isolated human infections, for now H5N1 is primarily a threat to poultry.

 

The virus remains poorly adapted to human physiology, and despite ample opportunities in places like Egypt and Indonesia, only causes rare, sporadic infections.

 

The concern, of course, is that over time that may change.  And so the world remains at Pre-pandemic Phase III on the H5N1 virus, and we continue to watch for signs that the virus is adapting to humans.

 

Indonesia: 4 Bird Flu Suspects Hospitalized

 

 

 

#4947

 

 

This morning - via Ida at BFIC,  Arkanoid Legent, and Dutchy at FluTrackers  - we have three reports which state that 4 of the 18 people being monitored with flu-like symptoms in the wake of a bird flu outbreak in South Sulawesi (see The Ongoing Bird Flu Flap In Indonesia) are now hospitalized.

 

At this point, laboratory confirmation of H5N1 infection has not been received, and these remain merely `suspect’ cases. 

 

The Indonesian government has displayed continued  reluctance to discuss their country’s bird flu problem  (see Indonesia To Stop Announcing Bird Flu Deaths) – so when or even if - we get official comment on this outbreak is hard to say.

 

We’ll start with a hat tip to Arkanoid Legent - who has developed into a terrific resource and one of the best news gathering sites in Flublogia. 

 

Indonesia : Four Patients Suspected Bird Flu

Another translated report from Liputan 6, bird flu patients in South Sulawesi :

" Makassar: Four suspected bird flu infected patients treated at Wahidin Sudirohusodo Hospital, Makassar, South Sulawesi. The information obtained is SCTV, on Wednesday (29 / 9), four patients consisted of two children and two adults. They are referrals from district hospitals Pinrang.

 

Pediatric patients is Savira origin and Andrian Soppeng District of Pinrang. Two other patients are from Novi and Nawir also Pinrang. Nawir and Andrew are still one family.

 

Although there is no further examination, doctors suspected bird flu because they suffer from high fever after dozens of dead pet chicken."

 

 

Ida at the Bird Flu Information Corner has this translation of a report that appeared in the Indonesian newspaper Tempo Interaktif.   This is just an excerpt, follow the link to read it in its entirety.

 

 

Makassar, South Sulawesi ::: Wahidin Sudirohusodo hospital treats bird flu suspects

Posted by Ida on September 29, 2010

Makassar – Four people are being treated in Inspection Center of Wahidin Sudirohusodo, Makassar, Wednesday 29/09. Those patients are residents of Kabupaten (municipal) Pinrang and Soppeng.

 

Three patients came from Jampue, Kecamatan Lanrisang, Kabupaten Pinrang, identified as Novi (17), Nawir (42) and Adrian (4-year-old). They were admitted to Lanrisang Pinrang hospital at 5,00 am before transferred to Makassar.

 

A 3-year-old girl, Safira, from Kabupaten Soppeng had been admitted to Wahidin Sudirohusodo hospital on the previous day.

 

The four patients are currently having high fever.

 

Director of Wahidin Sudirohusodo hospital, Andi Kalsum Patonangi said those patients were suspected to contract bird flu infection. However, hospital is still waiting laboratory confirmation of bird flu infection.

 

(Continue . . . )

 

And last, but certainly not least, we’ve this translation of a detikNews story by the indefatigable Dutchy  which indicates that the 17 year-old boy may be in the most serious condition, while the three others are slowly improving.

 

This translation is posted on this ongoing FluTrackers Thread.

 

Four Suspects Bird Flu Treated in Hospital Wahidin Sudirohusodo Makassar

Muhammad Nur Abdurrahman - detikNews
Makassar - 4 residents Pinrang and Soppeng District, South Sulawesi, was treated in hospital intensive Wahidin Sudirohusodo DR, Makassar due to high fever.

 

The four were suspected suspect bird flu.

 

Two patients, namely Nawir (42), Adrian (4), derived from Sondra Village, District Jampue. Another patient Novi (17 yrs) from Samaule Village, District Lanrisang Pinrang. While the last patient Sapphire (3), toddlers origin Paroko Village, Sub District Lilirilau Soppeng.

 

All four are now isolated on the first floor space Inpection Center Hospital Wahidin Sudirohusodo. The third patient from the previous Pinrang Lasinrang was treated in hospitals in Pinrang.

 

General & Operations Director RS Wahidin, Kalsum Patonangi, said the four patients had high fever. In the neighborhood around his house, found hundreds of dead birds.

 

"At this time the blood samples of patients still in the examination in the laboratory," said Kalsum.
Kalsum add three patients, in addition to patient Novi, conditions are slowly improving. However the three should still be monitored in a special room Inspection Center.

 

My gratitude goes to these three newshounds - along with dozens of others - who work tirelessly in and around Flublogia to find, translate, and post these stories.  

 

Much of what I do here is dependant upon their fine efforts – which is why I hat tip them at every opportunity.

 

For now, it still isn’t clear whether any of these patients are infected with the H5N1 virus, and if so, how they may have contracted it. Hopefully more details will emerge over the next couple of days. 

 

The newshounds on the Flu forums (see Newshounds: They Cover The Pandemic Front) will keep this under close watch, and you can be sure that Crof, Arkanoid Legent, BFIC, Chen Qi and I will, as well.

 

Stay tuned.

A Bad Week For Indonesian Chickens

 

 

# 4930

 

 

Although not making many headlines, according to the FAO the number of outbreaks of HPAI H5N1 between January and June of this year have already surpassed the total reported in all of 2009.

 

FAO Situation Update # 69

 

In recent weeks we’ve seen a number of fresh reports of outbreaks in poultry, and in wild birds, from around the world.  Indonesia and Egypt continue to report the most frequent occurrences. 

 

This morning Ida at the Bird Flu Information Corner - a joint effort between Kobe University in Japan and the Institute of Tropical Disease, Airlangga University, Indonesia – has several reports on outbreaks of bird flu among Indonesian chickens this week.

 

Two days ago Ida posted (follow the links to read the entire story):

 

 

Luwu Timur, South Sulawesi ::: 24,000 birds die of bird flu

Posted by Ida on September 22, 2010

Malili – Avian influenza or bird flu H5N1 attacked Kabupaten (municipal) Luwu Timur, South Sulawesi. At least twenty-four thousand birds in nine sub-districts, Kecamatan Wotu, Burau, Tomoni, Mangkutana, Tomoni Timur, Kalaena, Malili, Angkona and Wasuponda had been infected.

 

So far, the virus is not transmitted to human.

(Continue . . .)

 

 

Today, we’ve 2 more reports. 

 

The first is another report from South Sulawesi – where thousands of chickens have reportedly died, with many having been disposed of in the sea (not a good idea).

 

Pinrang, South Sulawesi ::: Thousands of backyard chickens die of bird flu

Posted by Ida on September 24, 2010

Pinrang – Thousands of backyard chickens in three sub-districts of Kabupaten (municipal) Pinrang, have suddenly died of bird flu since Monday (21/9).

 

Three affected sub-districts are Kecamatan Lanrisang, Watang Sawitto and Paleteang.

 

The outbreak is probably caused by high rain rate in this later week, said Head of Animal Health Division, Livestock Service of Pinrang, Elvi Martina. Last bird flu outbreak in Pinrang occurred in 2005, she added.

(Continue . . .)

 

Shiloh on FluTrackers  posted another translation of this report overnight, and has started a thread to follow this outbreak. 

 

Ida also has a report on what is reported to be a much smaller series of outbreaks in East Java. 

 

Tulungagung, East Java ::: Bird flu in backyard chickens

Posted by Ida on September 24, 2010

Tulungagung – Avian influenza or bird flu H5N1 broke out in Tulungagung, East Java. The possible cause is unstable weather, said Tatik Andayani, the Head of Animal Health Division, Tulungagung Livestock Service.

(Continue . . . )

 

 

Die offs in small holdings like these are often not reported to authorities – or by the media – and probably happen more often than we know.

 

Despite less-than-robust surveillance and reporting, Indonesia remains one of the most active regions in the world for H5N1 activity. 

 

This map, again from the FAO, is for activity earlier in the year.

 

 

 

While bird flu reports have been on the back burner for the past year or so, it is worth remembering that H5N1 remains in Pre-Pandemic Phase III.

 

 

 

Outbreaks occur primarily in birds, but sporadic widely scattered human cases are reported as well, particularly in Indonesia and Egypt.  

 

Most (but not all) have been linked to close contact with infected poultry or birds.

 

While the virus has yet to adapt well enough to human hosts to transmit effectively between people, scientists still worry that the virus could mutate into a pandemic strain someday.

 

Which is why we continue to monitor outbreaks like the ones listed above.

Two New Reports Out Of Indonesia

 

 

# 4905

 

 

Getting bird flu news out of Indonesia can be particularly difficult since the Health Ministry decided several years ago that constantly talking about their H5N1 problem was bad for the country’s image  (see Indonesia To Stop Announcing Bird Flu Deaths).

 

The MOH now only releases information at irregular intervals.  In 2009, we went more than 10 months between updates. 

 

In what may be a hopeful sign, this year, the MOH has been slightly more accommodating.

 

Which leaves us with monitoring local press reports which often pick up on large outbreaks in birds, and the occasional suspected human infection, and hoping that at some point we will get some kind of official confirmation of these stories.

 

Ida at the Bird Flu Information Corner - a joint effort between Kobe University in Japan and the Institute of Tropical Disease, Airlangga University, Indonesia – monitors and translates Indonesian press reports, and is one of our best sources of information.

 

Today Ida has two stories.  

 

First, the suspected Bird Flu infection of a young girl in West Kalimantan, which if you will recall, was the location of a suspected bird flu fatality in July (see Another Suspected Bird Flu Fatality In Indonesia).

 

West Kalimantan Province, Indonesia

The previous month (June), 5 children in this region were suspected of contracting bird flu, but testing revealed it to be the pandemic H1N1 virus.

 

Suspect cases of H5N1 often turn out to be something other than bird flu, since the virus’s early symptoms are consistent with a wide variety of viral illnesses common to the region. 

 

That said, here is the story on this latest suspect case.

Pontianak, West Kalimantan ::: Nine-year old girl may contract bird flu

Posted by Ida on September 16, 2010

 

A second report details steps that are being taken in Luwu Timur, South Sulawesi to try to combat an outbreak of H5N1 in domestic birds, where thousands of birds have recently died.

 

In response, the Health Service has formed a special avian influenza treatment unit in anticipation of possible human cases.

 

This story also suggests that standard control measures in Luwu Timur, such as the spraying of disinfectant, have failed to control the outbreak.

 

Luwu Timur, South Sulawesi ::: Health Service forms special point for avian influenza treatment

Posted by Ida on September 16, 2010

 

We’ll obviously be keeping close watch on these stories to see if they should develop further.

Indonesia Bird Flu Suspect

 

# 4795

 

 

While H1N1 moves into its post-pandemic phase, it is worth remembering that H5N1 remains in Pre-Pandemic Phase III.  

 

 

Outbreaks occur primarily in birds, but sporadic widely scattered human cases are reported as well, particularly in Indonesia and Egypt.  

 

Surveillance and reporting from many countries is less than ideal, and so other cases are likely occurring that we never hear about.

 

Today Ida at BFIC has a translation of a local media report of a possible human H5N1 infection in the wake of a recent outbreak among poultry.

For now, this is just a suspect case.

 

 

Bengkulu ::: Hospital treats bird flu suspect

Posted by Ida on August 10, 2010

Bengkulu – Bird flu or avian influenza H5N1 outbreak in Bengkulu which had caused hundreds of chicken death may have spread among human.

 

A resident of Lempuing, Bengkulu city with initial P (19) had been admitted to M Yunus regional hospital due to bird flu infection suspicion, Friday (6/8). Patient developed fever and sore throat after burying dead chickens few days before.

 

“We’re treating a bird flu suspect patient in an isolation unit, but we’re still not sure whether the patient has bird flu or not,” director of M Yunus hospital, dr Zulman Zuri confirmed. “For now we don’t suspect bird flu infection because patient is getting better after being treated here. We’re collecting throat swab every day for three days and send it to NHIRD, Ministry of Health laboratory. We have done chest x-ray too, but still waiting for the laboratory result,” added Zulman.

 

In the other hand, M Yunus hospital has prepared two special rooms for bird flu patient. Those room to be guarded and equipped for the safety of patients and health workers.

 

Meanwhile, Bengkulu city has been stated as bird flu exceptional area by Local Disease Control Center (LDCC). The disease has spread to three municipals (kabupaten), Betungan, Bengkulu Tengah and Kepahiang. However, Emran Kuswady, coordinator of LDCC said so far the disease had not spread to farm area.

 

Source: Indonesia local newspaper, Harian Rakyat Bengkulu

 

BFIC (Bird Flu Information Corner) is  a joint effort between Kobe University in Japan and the Institute of Tropical Disease, Airlangga University, Indonesia.

A Handful Of Morning Referrals

 

 

# 4782

 

 

While I’m away for a few days of R&R my blogging efforts are going to be a bit light.  But I’ve a brand new netbook with me (Samsung N135) and a slightly slow wireless connection . . .  so I’m able, at least, to log on and view my major sources of information.

 

Since others are doing the heavy lifting this week, a few quick referrals seemed in order.

 

Overnight Crof at Crofsblog wrote about many of the intriguing questions that are raised by the WHO’s monitoring of H5N1 cases over the years in:

 

Thinking about H5N1

 

 

Ida at the Bird Flu Information Corner has some additional details on the recently announced bird flu fatality out of Indonesia:

 

Tangerang, Banten ::: Confirmed H5N1 case

 

Along with reports of more B2B outbreaks of H5N1 in that bird flu beleaguered nation.

 

Pesawaran, Lampung ::: H5N1 in chickens

Luwu Timur, South Sulawesi ::: Thousands of birds die of bird flu

 

A very happy referral to John Solomon’s In Case of Emergency Blog where he briefly relates his return to `active duty’ in CERT after the return of his Leukemia last year.

 

Now Ready CERT Member Comes Off ‘Disabled List’ To Help Ready New Yorkers At “National Night Out”

 

Great going John.  Congratulations.

Two Reports From Indonesia

 

 

# 4685

 

 

Ida at BFIC – a joint effort between Kobe University in Japan and the Institute of Tropical Disease, Airlangga University, Indonesia – has translations of a couple of recent articles from the Indonesian press regarding two suspected incidents of bird flu.

 

As stated often in this blog, the Indonesian government is less than anxious to discuss their bird flu situation (see Indonesia To Stop Announcing Bird Flu Deaths), and rarely confirms or comments on these media reports.

 

Suspected cases, however, are simply that.   There are a number of diseases to be found in Indonesia that can produce `bird flu-like’ symptoms. 

 

Laboratory confirmation is required before a case can be attributed to the H5N1 virus.   Lab tests for bird flu, however, are not always reliable and multiple tests are required.

 

With that preface in place, the two translated reports from the Bird Flu Information Corner.

 

Boyolali, Central Java ::: A man possibly dies of bird flu

Posted by Ida on June 30, 2010

Boyolali – Syamsudin (27), a resident of Desa Paras, Kecamatan Cepogo, Kabupaten Boyolali allegedly died of bird flu/avian influenza H5N1 infection.

 

Head of Boyolali Health Service, dr Yulianto Prabowo, mentioned patient had been treated in Pandan Arang Boyolali regional public hospital before the death.

 

Patient was diagnosed as bird flu suspect, and  in critical condition that must be referred to Dr. Moewardi hospital in Solo.

 

He died during treatment in Dr Moewardi hospital and diagnosed to have respiratory infection.

 

Previously, hundreds of chickens died in Dukuh Bandung, Desa Beji, Kecamatan Andong, Boyolali. However, officials faced difficulty in diagnosing the cause of death because no dead chickens left for sample.

 

So far, no report of bird flu signs in human, but area monitoring is still ongoing.

Source: Indonesia news office, ANTARA-JATENG.

 

 

This next report concerns the isolation of 4 children who are exhibiting flu-like symptoms after exposure to sick and dying chickens in West Kalimantan.

This province is one of the few in Indonesia that has been certified as bird flu free.  In recent weeks, however, they’ve begun reporting poultry deaths.

 

 

West Kalimantan Province, Indonesia

A week ago we had a report of a 4 year-old hospitalized from this region with suspected H5N1 (see Indonesia: Bird Flu Suspect).  That child, according to this report, tested negative and has been released from the hospital.

 

Pontianak, West Kalimantan ::: 4-year-old negative bird flu. Four other children under isolation

Posted by Ida on June 30, 2010

Pontianak – Following to avian influenza (AI) outbreak in chickens, four people from different areas in Pontianak are under intensive treatment of alleged bird flu infection. Patients were reported to develop fever and flu symptoms after chickens suddenly died around their neighborhood.

 

Patients are being treated in dr Soedarso hospital, Pontianak. A patient has recovered and discharged from hospital, while four patients are still isolated, Ad (10), Ap (15), Da (10) and Wt (9). Da and Wt are cousins, and neighbors of Ap residing in Karya Bhakti street. Ad is resident of Pak Benceng of Pontianak city.

 

Head of Medic and Non-Medic Service Division, Dr Soedarso hospital, Dr Hj Tita Selati said patients had been taken care according standard procedure (protap). “They are isolated and given Tamiflu”, said Tita.

 

In the meantime, patients’ swab samples have been sent to research and development laboratory of Ministry of Health (Litbangkes) in Jakarta for bird flu confirmation.

 

Ap was referred from Gang Sehat public health center and Wt was from Purnama public health center.

 

Previously, Dd (4.5), a bird flu suspect patient in dr Soedarso had been confirmed negative by Litbangkes, and discharged from hospital.

Source: Indonesia local newspaper, Equator News

 

 

Reports such as these come out of Indonesia, and other bird-flu endemic regions, sporadically.  Some will turn out to be H5N1, while others will not.   And it is likely that some cases are never detected.

 

H2H (Human to Human) transmission of the virus remains exceedingly rare, and most of the cases still appear to be due to contract with infected birds.

Still, these reports are a valuable reminder that the H5N1 virus remains active in some parts of the world, and its potential for causing a pandemic sometime in the future has not diminished.

 

My thanks to Ida at the BFIC , and the other newshounds around the world who diligently pour through hundreds of news sources every day looking for obscure items of interest, and then translating and posting them.

Two Suspect H5N1 Cases In Indonesia

 

(Updated)

 

# 4374

 

Meanwhile, in Indonesia  . . .

 

Ida at The Bird Flu Information Corner – a joint endeavor between Kobe University, in Japan and the Institute of Tropical Disease, Airlangga University, Indonesia – has a translation of a local TV news report on two suspect H5N1 cases in the central Java town of Megelang.

 

 

 

 

 

 

Magelang, Central Java ::: Two bird flu suspect patients

Magelang – A 36-year-old woman, named Sururi, and a 16-month-old boy, named Rizki Putrawan, were treated at Unit G, Tidar Hospital in Magelang, Central Java as they suspected of contracting bird flu virus H5N1. Sururi is a resident of Desa Balarejo, while Rizki is a resident of Desa Madurekso, which both places are the name of villages in Kecamatan (sub-district) Kaliangkrik.

 

The boy’s mother said that her son had high fever of unknown cause. Rizki had been brought to public health center nearby his house before been transferred to Tidar hospital to get intensive treatment. Afterward, he had been recovered and discharged from hospital.

 

In mean time, the hospital is still treating the other suspect patient woman, Sururi.

 

Source: Indonesia regional TV, TATV.

 

 

Updated: 7:40 EST

As I posted the above translation the details seemed a bit familiar to me, but a quick search of my blog didn’t turn up a similar report.  

A few minutes ago, Commonground contacted me and let me know that Dutchy had a series of earlier reports on these cases going back to the 17th, and had posted it on FluTrackers.

 

My thanks to Commonground, Dutchy, Ida and the rest of the flu forum newshounds – without whose considerable efforts, this blog would be impossible to maintain.

Media Report: Two Indonesian Bird Flu Cases

 

 

# 4337

 

 

Ironically, on the same day that the Indonesian government announced that bird flu has been `successfully controlled’,  and the situation is `relatively stable and approaching a normal state’ - we get this report of two human infections (one fatal) from the H5N1 virus.

 

The following translation comes from Ida at BFIC.

Jakarta and Bekasi ::: Bird flu victims

February 10, 2010

Jakarta – Two bird flu victims had been tested H5N1 positive. A residents of Bekasi, West Java province, named NL, 25 years old, tested positive bird flu H5N1 infection. NL had died on 25 January 2010. Laboratory test showed positive H5N1 infection, said Tritarayati, the Head of Public Communication Center Ministry of Health. Victim was possibly infected from direct contact with birds.

 

Another victim, AD, 3 years old, a resident of Jakarta, was reported to show mild influenza like illness signs. “Laboratory test showed positive H5N1 infection. Patient has been recovered and not showing any of ILI signs,” said Tritarayati.

Source: Indonesia national newspaper, Kompas.

 

Two other translations (Google & ToggleText) of this report (hat tip Dutchy) appear on FluTrackers in this thread.

Indonesia: Another H5N1 Suspect

 

 

# 4289

 

 

From Ida at BFIC  this morning we get a translation of an article from ANTARA Jabar.     There is a little ambiguity in this report, with a reference to both Bird Flu and H1N1.   

 

The `H1N1’ reference, judging from the context of the article, would appear to be a typo.

 

This is, of course, merely a `suspected case’, based apparently on the victim’s proximity to sick or dying chickens. 

 

Arguing against this being H5N1 is the sad fact that we rarely see an H5N1 case in Indonesia in stable condition.   According to official government figures, 19 of 20 cases last year were fatal.

 

We have, of course, seen cases described as `stable’ in the past that later turned out not to be.   We’ll simply have to monitor this story to see if we learn more.

 

 

 

Garut, Indonesia

 

This from The Bird Flu Information Corner.

 

 

Garut, West Java ::: Ten-year-old girl bird flu suspect

Garut – Head of Slamet Garut regional hospital, Widjayanti Utoyo, on Monday (25/1), stated the hospital was currently treating an exceptional bird flu suspect, with initial Iis (10).

 

Patient – the resident of Kampung Cigentur, Desa Padasuka, Kecamatan Pasirwangi – was admitted to hospital on Saturday (23/1). She is currently still under treatment at isolation unit and taken care by a specialist.

 

Patient’s latest condition showed body temperature 35.5℃, pulse rate 75 and breathing rate 24. In general, she was stable while leukocyte count showed 22,200, thrombocyte 236,000 and widal test negative. Treatment will be continued at isolation unit until confirmation result from Ministry of Health laboratory in Jakarta has been issued.

 

Head of Health Service of Kabupaten Garut, Hendy Budiman, said patient had no direct contact with bird flu (H5N1 – adm) virus. Patient was stated as bird flu suspect because she lived in bird flu affected area; in particular dozens of chicken had been died within vicinity of patient’s neighborhood recently.

 

Slamet Garut regional hospital is one of seven bird flu referral hospitals in West Java province.

 

Source: Indonesia local news office, ANTARA Jabar.

 

Original article from ANTARA Jabar (in bahasa Indonesia) mentioned ‘H1N1′ instead of ‘H5N1′ to refer bird flu virus. The post above intentionally changed ‘H1N1′ into ‘H5N1′. We welcome any comment or correction regarding to this. -adm-

East Java: Checking Residents For H5N1

 

 

# 4283

 

 

Pamekasan is a regency on the island of Madura in located in East Java, Indonesia.   For the past couple of weeks we’ve been watching reports of poultry die-offs (and culling) taking place in that region.

 

This was the story 10 days ago, as reported by Ida on BFIC.

 

Pamekasan, East Java ::: Chickens die of bird flu

January 14, 2010

Pamekasan – About a hundred of chickens which were found to have suddenly died before in RT 01/06, Dusun Kebun, Desa Pademawu Timur, Kecamatan Pademawu, Pamekasan, East Java, tested positive bird flu infection.

 

Head of Livestock Service of Pamekasan, Hanfi Indrayana mentioned, those chickens had been tested positive bird flu infection by rapid test.

 

The infected chickens were showing signs such us convulsion and mucous discharge from mouth before dropped dead. Prevention and control measures had been taken by burying dead chickens, disinfection of affected area and distribution of H5N1 vaccine.

 

Source: Indonesia national newspaper, Kompas.

 

 

Of course, in Indonesia, there is nothing particularly unusual about the above story.   The H5N1 virus is rife in Indonesian poultry, and is probably endemic in other hosts as well.   Reports of bird die-offs are so common as to scarcely merit a mention in the International press.

 

Today, in a follow up article, we learn that after some delays public health officials are checking residents that were in contact with the sick and dying birds for possible H5N1 infection.

 

Again, this translation comes from Ida at the Bird Flu Information Corner.

 

Pamekasan, East Java ::: People examined for bird flu infection

January 24, 2010

Pamekasan – Health Service of Pamekasan, Madura, East Java conducted examination to residents of Desa Pademawu Timur, Kecamatan Pademawu who had direct contact with positively bird flu infected birds.

 

Head of Health Service of Kabupaten Pamekasan, Hendro Santoso, on Saturday (23/1) said the examination was done to confirm whether the deadly virus had been transmitted to human. “This is done according to standard operating procedure of the government,” he described.

 

Initial examination was done to the chicken owner, Yuni Astutik, and her family member.

 

On the other hand, Hendro also mentioned the Health Service had been delaying the examination to chicken owner and surrounding neighbors because they were waiting for rapid test result issued by the Livestock Service.

 

The locals previously complained about tardiness of the examination to the people.

 

“We afraid the deadly virus has been circulating among people in this village,”, said Rasyad, the head of neighborhood RT/RW 01/06 Dusun Kebun, Desa Pademawu Timur.

 

According to Livestock Service of Pamekasan, in Desa Pademawu Timur total 370 chickens had been tested positive bird flu infection. All of those chickens had been burned on 19 January 2010.

 

Source: Indonesia regional news office, ANTARA Jatim

 

 

Other than known exposure to infected birds, there is nothing in this article to tell us why local officials fear the virus has been circulating in the village. 

It simply may be that these checks are being conducted out of an abundance of caution, and not in response to suspected human infections.

 

 

It becomes problematic, however, sorting out possible bird flu infections when other flu-like illnesses (including H1N1) are circulating in the population.

 

This is probably one of the reasons why the CFR (Case Fatality Ratio) in Indonesia is so high (80% plus). By the time a victim realizes they have something worse than `normal flu’ and seek medical care, it is often too late to save them.

 

Since the Indonesian government has demonstrated little desire to be open and transparent about their bird flu situation we are relegated to reading, and trying to interpret, news articles like those above. 

 

The good news is, the Indonesian press still makes an attempt to cover these stories.   And we’ve got newshounds, like Ida at BFIC, and dozens of others on the flu forums, monitoring those stories.

 

If a serious outbreak erupts in some far-flung corner of the world, it is unlikely to escape their combined notice for long.

More From Indonesia

 

# 4241

 

 

Ida at the Bird Flu Information Corner has been busy translating from Bahasan language local news reports about bird flu cases in Indonesia.   Today, we’ve a report from Tangerang City – which is about 20 km west of Jakarta – of a 20 year-old bird flu suspect.

 

Tangerang is one of those areas where we’ve seen human H5N1 infections in the past.

 

First Ida’s latest report, then an excerpt from an update Ida posted to a story BFIC carried yesterday.

 

 

Tangerang, Banten ::: Hospital treats 20-year-old bird flu suspect patient

January 11, 2010

Tangerang – A bird flu suspect patient with initial D, 20-year-old, resident of Jalan Bakti RT 05/06, Pinang, Tangerang city, is treated at bird flu isolation unit of Tangerang regional hospital.

 

Head of Bird Flu Control Team of Tangerang hospital, Titin Martini said on 1 January patient developed fever up to 38℃ followed by coughing and breathing difficulty. Chest x-ray showed sign of pneumonia. Blood examination showed low thrombocyte count.

 

Patient was brought to public health center at day 5, thereafter transferred to a private hospital in Tangerang city.

 

“Initial laboratory examination figured patient may contract bird flu infection. Patient’s family said poultry rearing existed nearby their neighborhood,” added Titin.

 

Source: Indonesia national newspaper, Okezone

 

 

In a rare confirmation of positive results, this next update tells us that Arifin Achmad hospital had treated three bird flu cases over the past couple of weeks.

 

One, a toddler, died New Years Eve.  Another toddler has apparently recovered.  It is difficult to tell from this story whether one, or both, have tested positive for H5N1.

 

 

 

Pekanbaru, Riau ::: Hospital treats another bird flu suspect (Update)

(EXCERPT)

Positive.

Azizman stated since December 2009, Arifin Achmad hospital had treated three bird flu cases. Two patients were toddlers from Kabupaten Indragiri Hulu (Inhu) and the other was JF from Pekanbaru. One of the toddlers from Inhu had died last 31 December, and the other girl, also from Inhu, was tested positive H5N1 infection.

 

“Test result done by Ministry of Health showed positive bird flu,” said Azizman.

 

Test result of the patient from Inhu was issued last Friday (8/1). However, patient is now in normal condition and has been discharged from isolation unit.

“She had been allowed to return home, but because the samples showed H5N1 positive, she was then transferred to children unit,” added Azizman.

Meanwhile, Back In Indonesia . . .

 

# 4227

 

 

Once again, my Internet connection has let me down (broadband cable)  today due to – according to my ISP – the unusually cold weather here in Florida.

With the temps back above freezing, my connectivity has returned.   For now, anyway.

 

 

Luckily Ida at the Bird Flu Information Corner is operating under no such constraints, and we have four (count’em) . . .four stories out of Indonesia today on their website.   

 

As you probably are already aware, this is the time of year when we tend to see a spike in bird flu reports from around the world.

 

The first story involves 5 suspect H5N1 patients in a hospital in Dempasar, on the island of Bali in Indonesia.   

 

In 2007 there were two H5N1 deaths reported in Bali.  Given that tourism is a major component of their economy, they tend to take reports of suspect cases seriously there.

 

 

Denpasar, Bali ::: Sanglah hospital treats five bird flu suspect patients

January 7, 2010

Denpasar – Five bird flu suspect patients are being treated at Sanglah hospital. Their blood samples have been sent to Jakarta for further test, stated Head of Health Service Bali, Nyoman Suteja. However, Nyoman did not mention the identity of patients in details.

 

Those patients showed signs such as rising of body temperature and breathing difficulty. The symptoms are not specific for bird flu infection, in particular whether change recently may influence one’s health condition, added Nyoman. Currently, those patients are still treated at isolation unit.

 

One of bird flu suspect patients, with initial WR (65), resident of Banjarangkan , Kabupaten Klungkung has been suspected of contracting bird flu infection after number of chickens found to have suddenly died in close proximity of her resident.

 

(Continue . . . )

This next story comes from Central Kalimantan, or what we generally call the island of Borneo. 

Central Kalimantan ::: H5N1 outbreak in chickens (Update)

January 7, 2010

This is related, and also a correction, to the previous post “Kapuas, South Kalimantan ::: Mass chicken deaths confirmed H5N1 positive”, which mentioned bird flu outbreak in “South Kalimantan”. Kapuas is actually a municipal (Kabupaten) in “Central Kalimantan” (Kalimantan Tengah). We appologize for misleading the location of Kapuas. This post also give additional information other outbreaks in Kabupaten Pulang Pisang and Palangkaraya city (capital of Central Kalimantan). -adm-.

 

Palangkaraya – Thousands of poultries in Kabupaten Kapuas and Kabupaten Pulang Pisau,  also Palangkaraya city, in Central Kalimantan province, contracting bird flu or avian influenza (AI) virus. Vice governor of Central Kalimantan, Ahmad Dran, stated those birds possibly entered Central Kalimantan from neighboring province, Banjarmasin, South Kalimantan. To stop expansion of outbreak, regional government paused incoming poultry traffic from Banjarmasin, in mean time, poultry product needs will be supplied from Kabupaten Sampit.

(Continue . . . )

And this one from central Java.

 

Cilacap, Central Java ::: Bird flu attacks backyard chickens

January 7, 2010

Cilacap, Central Java – At least 50 backyard chickens belong to locals in Desa Karangmangu, Kecamatan Kroya found suddenly dead. Head of Agriculture and Livestock Service of Kabupaten Cilacap, Gunawan, confirmed those chickens had died of bird flu or avian influenza (AI) virus.

(Continue . . . )

 

And lastly, some more details on one of the patients in Bali.

Bali ::: 65-year-old bird flu suspect treated at Sanglah hospital

January 7, 2010

Denpasar, Bali – A bird flu suspect woman, resident of Banjar Angkan Klungkung is being treated at Sanglah hospital. The 65-year-old, with initial RR, was referred to Sanglah hospital in Tuesday (5/1) after previously had been treated at Klungkung hospital.

 

This is confirmed by the Secretary of Bird Flu Control Team of Sanglah hospital, Ken Wirashandi. “Patient is stated as bird flu suspect patient as she came with breathing difficulty. She is a chicken farmer and chickens reared at her home had died few days ago. Further investigation to the chickens showed positive H5N1 infection,” said Ken. “Patient had been ill before the chickens died, and started to have breathing difficulty after that. But, she has other sickness which causes breathing problem when it gets worse,” he added.

 

Patient is still under treatment and observation as bird flu suspect, and her condition is reported to have improved. She also has received tamiflu treatment.

(Continue . . . )

 

 

My thanks to Ida at BFIC – a joint venture between Kobe University in Japan and the Institute of Tropical Disease, Airlangga University, Indonesia – for keeping track of these bird flu developments.

 

These human cases are, of course, only suspect cases right now.   There are other plausible explanations for their symptoms, and we must await laboratory confirmation. 

 

It remains to be seen whether the recent changes in the Health Ministry of Indonesia will translate into greater transparency on the issue of H5N1.   So it is difficult to know if, or when, we will see any official updates on these reports.

Indonesia: Watching Two Bird Flu Suspects

 

 

# 4215

 

 

Last week, after nearly a year of institutional silence, the Indonesian government released an update on the number of human H5N1 infections they’ve recorded (see Indonesia: 19 H5N1 Deaths In 2009). 

 

We knew about some of these cases from the local news coverage, but since the government released no patient details, it is difficult to know which reports turned out to be accurate.

 

Nevertheless, with less than full and frequent disclosure from the Indonesian government, our only recourse is to monitor the Indonesian Press. 

 

Today, they are reporting on two suspect H5N1 infections.

 

Ida, from the Bird Flu Information Corner, brings us a translation of a story out of Riau, a frequent hotspot for H5N1 cases.

 

The report tells of two children suspected to have been infected by the virus, one is recovering, while the other has died.

 

Pekanbaru, Riau ::: Outbreak rises in Kabupaten Indragiri Hulu

January 4, 2010

Pekanbaru, Riau – Livestock service is still waiting H5N1 confirmation result from Veterinary Investigation and Diagnostic Center (BPPV) that suspected to have attacked birds in Kabupaten Indragiri Hulu, said Head of Livestock Service Riau, Patrianov.

 

Previously, dozens of backyard chickens suddenly died in two separated areas in Kabupaten Indragiri Hulu. Following to the case, at the end of December 2009, two toddlers from Kabupaten Indragiri Hulu were suspected of having bird flu infection.

 

One of the child – resident of Dusun Tuo Pelang, Kecamatan Kelayang – has died, while the other, resided in Desa Bongkal Malang, Kecamatan Simpang Kelayang is still under intensive treatment in Arifin Achmad hospital, Pekanbaru.

 

Initial rapid test to the dead chickens showed negative H5N1, however Livestock Service is still waiting more valid result from the BPPV . “We hope to get the result by Monday (4/1),” said Patrianov.

 

Indragiri Hulu has been stated as H5N1 endemic area since 2007.

 

Until November 2009, Livestock Service of Riau have recorded total 17,353 birds in Riau died of bird flu virus. The virus has infected 8 people where six of them died.

 

Source: Indonesia cybernews. http://lifestyle.id.finroll.com/component/content/article/25-berita-terkini/174086-disnak-riau-tunggu-bppv-pastikan-flu-burung.html

===AvianInfluenzaIndonesia===

 

 

Ida has additional details on the child that is recovering in another translation, you can read here.

 

BFIC is a  joint venture between Kobe University in Japan and the Institute of Tropical Disease, Airlangga University, Indonesia

Meanwhile, Back in Indonesia . . .

 

 

# 3893

 

 

It isn’t clear how the replacement of Health Minister Siti Fadillah Supari with  Endang Rahayu Sedyaningsih will affect the flow of Information out of Indonesia, but there are hopes that things will improve over the coming months.  

 

Indonesia hasn’t filed an OIE (World Organization For Animal Health) report on animal outbreaks in years, and hasn’t officially acknowledged any human infections H5N1 since late in 2008.

 

Still, by all accounts, the H5N1 virus remains uncontrolled in poultry and is a serious threat across much of that archipelago nation. Although official reports have ceased, we still get newspaper stories of bird die offs, poultry culling operations, and occasional suspected human infections.

 

These reports, unfortunately, tend to disappear into a black hole of government denial, and we rarely hear of them again.

 

Ida, at the Bird Flu Information Corner - a joint endeavor between Kobe University, Japan and Institute of Tropical Disease, Airlangga University, Indonesia – brings us translations this morning of a pair of reports of suspected human infections from the local media.

 

 

Bukittinggi, West Sumatera ::: Hospital treats two bird flu suspect patients

October 27, 2009

Bukittinggi, West Sumatera – After an idle, bird flu human suspects patients are reported from Bukitttinggi. Achmad Mochtar hospital (RSAM) in Bukittinggi is treating two bird flu H5N1 suspect patients. The condition of patients are improving.

 

Patients are BPT (7), – resident of Jalan Sukma Payakumbuh Utara – admitted to hospital on Thursday (22/10), and FR (5) – resident of Padang Data Payakumbuh – admitted to hospital on Saturday (24/10), confirmed Vice director of Medical and Treatment Service of RSAM, dr Khairul Said.

 

Both patients were referred from Adnan hospital in Payakumbuh which is one of bird flu referral hospital.

 

Currently, patients are treated at isolation unit of RSAM Bukittinggi and receiving Tamiflu.

 

Both patients have contact history with suddenly dead birds around their neighborhoods.

(Continue . . .)

Asahan, North Sumatera ::: Six-year-old bird flu suspect patient

October 27, 2009

Asahan, North Sumatera – Six-year-old bird flu suspect patient, Ayub, a resident of Dusun I Desa Air Genting, Kabupaten Asahan is being treated at Abdul Manan Simatupang, North Sumatera.

 

Patient is reported having fever subsequent to contact with suddenly dead animals. Numbers of animal were reported dead of unknown cause around patient’s neighborhood. Instead of Ayub, no other high fever in human cases is reported from the area.

 

Livestock Service of Asahan has done further investigation of H5N1 possibility to the dead animals, and resulted negative.

 

For H5N1 confirmation, Health Service of Kabupaten Asahan sent blood and serum samples of patient to be sent to Ministry of Health laboratory in Jakarta. Laboratory confirmation will be issued within 2 weeks.

(Continue . . . )

 

This time of year we expect to see an uptick in H5N1 reporting, simply because the virus has historically spread more easily during the winter and spring.  While most of our attention is focused on the H1N1 virus, it is important that we not ignore other threats.  

 

Thankfully, people like Ida at BFIC and the scores of newshounds on the Flu Forums, are keeping a close watch on the situation for us.