A Blogger’s Dilemma – What To Do About `Suspect’ Ebola Cases

 

# 9173

 

Over the past 48 hours I’m aware of perhaps a dozen suspected Ebola `scares’ around the world (outside of Western Africa) where one or more persons has displayed symptoms consistent with the disease – resulting in hospitalization and/or testing.

 

Recent locations have included Paris, Macedonia, Texas,  Brazil, and  Prague.

 

I’ve not blogged any of these cases because:

• Most, I believe, will turn out to be false alarms
• They are already well covered  by the media and Flublogia (Crofsblog, FluTrackers, the Flu Wiki)
• And realistically, there is little of value I can add beyond saying `We’ll have to wait to see’.

 

As I written before, whenever surveillance (whether for Ebola, Avian Flu, or MERS) works – we tend to see a lot of `suspect cases’ – although the vast majority will turn out to have something far less concerning – like seasonal flu, rhinovirus, or malaria.  

 

This fall and winter  – we’ve not only Ebola to screen for, it’s a fair bet we’ll see the return of MERS and avian flu – meaning that the number of `suspect cases’  in the news only likely to rise even further. 

 

If I tried to blog on each one of these reports, soon I’d have time for little else. None of this is a pledge that I won’t cover suspect cases – only that I feel I need more of a reason than `it has been reported somewhere in the world that . . . ‘ – before I’ll  write about it. 

 

If it is an extraordinarily unusual or potentially high-impact report, then yes, I may blog it.  And If I can add context, or additional value – then once again, I’ll probably include it. 

 

It’s a personal choice, but I’ll leave the reporting of individual suspect cases to those who do that sort of thing much better than I, and try to concentrate on more macro infectious disease and preparedness issues, to which I can hopefully add some value.

Ireland: HSE Statement – Suspected Ebola Case Tests Negative

Credit Wikipedia

 

 

# 8986

 

Yesterday (see HSE Statement: Ireland Testing Deceased Traveler From West Africa) we saw an investigation launched into the death of a recently arrived traveler from West Africa.  Today, the HSE has announced that tests have come back negative for Ebola.

 

22nd August 2014

HSE Statement

The HSE has confirmed that laboratory test samples for an individual, who had recently returned from Africa, has proved negative for Ebola Virus.

Infection control procedures, which had been put in place as a precautionary measure, will now be stepped down.

The HSE expressed its condolences to the individual’s family and friends for their loss.

 

It has been widely reported this week that more than 5 dozen people have been recently hospitalized, and either examined or tested for Ebola in the United States.  

 

Of those, none have tested positive for the disease.

 

Frankly, this is exactly what we want to see.  Aggressive testing, an abundance of caution, and lots of negative results.   

 

With the threat of a return of MERS this fall with the Hajj, an expected resurgence of avian flu this fall and winter in Asia, and the ongoing Ebola outbreak in Africa – we need to be prepared to see a lot of `suspect cases’ being tested both here in the United States, and around the world.  

Egypt Testing Suspected MERS-CoV Case

 

 

*** UPDATED *** 

Overnight, via both Crofsblog (see Egypt: Suspected MERS case tests negative) and FluTrackers (see post) multiple Arabic media sources are reporting that this patient tested negative for the MERS coronavirus.

 

 

# 7911

 

With the caveat that anyone recently returned from Saudi Arabia who develops pneumonia (which could be due to a variety of viral,bacterial, or fungal causes) within 10 days would be tested for the novel coronavirus, multiple reports have emerged in Egypt’s Arabic press over the past few hours regarding a woman who is in intensive care, and who is recently returned from Riyadh.

 

This is cold & flu season, and so this could be anything.  Nevertheless, appropriate precautions are being taken, tests are being conducted, and results should be known tonight or on Tuesday.

Sharon Sanders on FluTrackers has a thread with several  media reports on this case, and Crof has the story as well (LINK)  via a tweet by @MERS_inSaudi . Some excerpts include:

 

Suspicion of injury lady returning from Saudi Arabia virus ' Corona ' in Mansoura

Masry Al-Youm dialogue « Maha Rabat » Health Minister

Walid Ibrahim Taibo and Majdi

The Ministry of Health and Population, obtaining a sample of the lady suspect bird flu Pfirs , the ' Corona ' , for analysis central labs in the ministry , is expected to be completed by the analysis results and announced , on Tuesday evening.

A medical source said the ministry , Monday , said that « the Ministry of Health held a woman from the city of Mansoura Dakahlia Governorate , on suspicion of being infected with HIV Corona , a housewife (28 years), and was present in Riyadh, Saudi Arabia, to accompany her husband since 4 months and returned to Cairo since the days » .

He added that « Ms. developed symptoms of infection immediately after returning to Cairo , and was suspected of being infected with the virus, the ministry detaining hospital issued and viruses Mansoura and get a sample to be analyzed central labs , to make sure her or not, it exists now in intensive care in hospital as a result of her pneumonia » .

The Ministry of Health has got random samples of 500 pilgrims returning from Saudi Arabia after performing Hajj, in anticipation to carry them for any viruses are contagious, especially « Corona » which has spread in the Kingdom during the last period , as the ministry work Kart follow-up to a random collection of pilgrims, for a period of 10 days starting from the date of return , kart and distributed to health directorates in the governorates its Haj to follow his health during that period and detained at a hospital diets if any symptoms appear .

 

Today .. Announce the results of analyzes of the first suspected case of injury b «Corona»

Said Dr. Magdy Hegazy, Undersecretary of the Ministry of Health to Dakahlia , that the results of analyzes of samples suspected of injury in Ross "Corona", will appear on Monday evening or Tuesday morning.

The Hegazy, for " in Tu, the suspect in his suffering from severe pneumonia, and symptoms similar to Ross Corona, what summoned and put in a room isolation hospital chest Balmain Photos of in order to take the necessary precautions, and continued: "The proven his pal in Ross will conduct a comprehensive survey of its people and the region live in her to avoid the outbreak in Ross. "

The Chest Hospital Balmain pictures of detained yesterday a patient suspected of suffering by the Ross "SK" after the onset of symptoms of the disease, and impounded the Health Directorate b Dakahleya custody of the issuance of any data on the situation by conducting the necessary tests; fear of provoking public opinion, where is this is the first case.

India: Testing Suspected MERS-CoV Case

 

# 7573

 

When it comes to entertainment value, the Indian press is hard to beat, but their seldom-restrained style of reporting has taught me to favor a `watchful waiting’ attitude when it comes to their coverage of infectious diseases.

 

With that caveat, we’ve a report overnight (h/t FluTrackers) that a 40-y.o. man - recently returned from an extended stay in Saudi Arabia - has been hospitalized with signs of fever and pneumonia in Chinchpokli, a suburb of south Mumbai.

 

The patient was initially tested for H1N1, but those results came back negative (note: It isn’t clear what other types of flu were tested for).  Nevertheless, he has been placed on oseltamivir (Tamiflu ®), an antiviral therapy specifically for influenza, and is said to be `responding well’.

 

Patient samples have been sent to India’s National Institute of Virology (NIV) in Pune, for testing for MERS-CoV.  We should have some results in the next 24 hours.

 

Assuming the article is correct, and the patient is responding to oseltamivir, then that lessens (but does not obviate) the chances that this patient is infected with MERS. 

 

The latest CDC HAN Update On MERS-CoV reminds clinicians that patients can sometimes harbor dual infections; MERS and Influenza, or some other respiratory infection.

 

CDC has changed its criteria for who should be evaluated for MERS-CoV. In the previous guidance (HAN 348, dated June 7, 2013), CDC did not recommend MERS-CoV testing for people whose illness could be explained by another etiology. The new guidance states that, in patients who meet certain clinical and epidemiologic criteria, testing for MERS-CoV and other respiratory pathogens can be done simultaneously and that positive results for another respiratory pathogen should not necessarily preclude testing for MERS-CoV.

 

Here then is the link to the Times of India report on this suspected case. 

 

40-year-old man Mumbai's first suspected Gulf virus case

Sumitra Deb Roy, TNN | Aug 15, 2013, 01.28 AM IST

MUMBAI: In the first suspected case of the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in the city, a Vashi resident has been quarantined at Kasturba Hospital in Chinchpokli.

The viral respiratory illness, termed deadly because of a 60% mortality rate, is currently wreaking havoc in Gulf countries.

The 40-year-old man was admitted to the hospital's ward 30, meant for infectious diseases, on Wednesday afternoon with complaints of fever and a progressing pneumonia (inflammation of lungs). The patient had returned to India on August 12 after spending 35 days in Saudi Arabia.

(Continue . . . )

 

 

Regardless of how this particular case turns out, we need to get used to seeing these types of reports, as millions of devout Muslims are scheduled to converge on Saudi Arabia for the Hajj in October and many will return home with some kind of respiratory illness. 

Unless and until MERS-CoV becomes more transmissible, the vast majority of these cases will undoubtedly test negative for the coronavirus.

 

But it is only through detailed surveillance and testing that we can know whether the threat from this novel coronavirus is changing.

France: Update On Coronavirus Suspect Cases

 

 

# 7261

 

Welcome to the new normal, where we find ourselves waiting for hours, or sometimes even days, for test results on isolated suspected nCoV and H7N9 cases.

 

For veteran H5N1 avian flu watchers, this is familiar territory.

 

This morning the French press is reporting that three of the `contacts’ of France’s nCoV case who had displayed `symptoms’ have initially tested negative for the novel coronavirus, while the status of the fourth requires further testing. 

 

A fifth case, that of a "a man, relatively young"  with mild symptoms who is currently staying at home, is also under investigation.

 

This (machine translated) report from 20Minutes.fr.  

 

Coronavirus: A fifth suspect identified

 

Updated on May 11, 2013 at 11:06.

Health A new suspect has been identified in the entourage of the patient with the novel coronavirus, SARS close, announced Saturday the Minister of Health, Marisol Touraine.

The Minister of Health, Marisol Touraine went Saturday morning at University Hospital of Lille, where four cases of coronavirus had been suspected. The Minister announced the presence of a fifth case in the entourage of the sick patient. "A fifth case contact was identified in the entourage of the sick patient. Samples were made that we know the results at the end of the day," said the minister at a press briefing.

<SNIP>

"One hundred and twenty persons identified, three (one patient who had rubbed the patient, a doctor, a nurse), and a fourth in the 10th of May had symptoms that led to virological sampling and placing them under observation in isolation, infectious diseases service, "says the ministry. "For three people, negative results are to be confirmed by the national reference center of the Pasteur Institute in Paris."

(Continue . . .)

 

 

 

As concerns over the emergence and spread of both H7N9 and nCoV grow, we are sure to see an expanding list of `suspect cases’ isolated and tested around the world.

 

Some will have a recent travel history to Asia or the Arabian peninsula, while others may have had contact with a diagnosed case. Their symptoms may range from severe, to a mild ILI (Influenza-Like-Illness). Some may even be asymptomatic. 

 

And  not surprisingly, many will test negative.

 

Some of these `negative’ findings may be the result of deficits in the procedures; a lack of sensitivity on the part of the test, the method of sample collection, the timing of sample collection, or even problems in the shipping and handling of specimens.

 

But in all likelihood, most of these negative tests will probably be correct.

For now (and hopefully well into the future) infections with more mundane seasonal respiratory viruses (Rhinoviruses, seasonal influenza, Adenovirus, RSV etc.) far exceed the number of human infections with exotic and emerging viruses like nCoV and H7N9.  

 

We get a good example of this in Hong Kong, where from yesterday’s report Update on number of suspected human cases of avian influenza A(H7) notified to CHP we learn:

 

This brings the total number of notifications received by the CHP since March 31 of cases fulfilling reporting criteria of suspected human cases of avian influenza A(H7) to 22, and the total number of notifications not fulfilling reporting criteria to 84.

<SNIP>

"Influenza A(H7) is a statutorily notifiable infectious disease in Hong Kong. Locally, no confirmed human cases of avian influenza A(H7N9) have been recorded so far," the spokesman stressed.

 

During the first couple of weeks of the H7N9 outbreak on the mainland, every `suspect’ case tested in Hong Kong was big news. 

 

Now – and until a positive case shows up – it’s the subject of a routine daily update.

 

None of this is meant to minimize the risks of these viruses spreading, or to suggest that it isn’t prudent to isolate and test any and all suspect cases. 

 

While the odds that individual ILI case might be nCoV or avian flu may be small, health officials know it only takes one super-spreader (see Influenza Transmission, PPEs & `Super Emitters’) to jump start an epidemic.

 

But even if nCoV and H7N9 prove themselves not ready for primetime, they are unlikely to fade back into the woodwork anytime soon. Additional human cases are likely, and so limited human-to-human transmission is certainly possible.

 

Which means, concerning as they may be, we might as well start getting used to seeing headlines about the testing of suspected cases around the globe, as this is a situation we are apt to be dealing with for some time.

H7N9: Watching Jiangxi Province

Location of Jiangxi Province – Wikipedia

 

# 7189

 

Right now it’s just a `suspect’ case, and still awaiting confirmation from China’s CDC, but state media is reporting on a 69 year-old man who is in isolation at a Nanchang hospital.

If confirmed, this would signal the expansion of H7N9’s geographic range to yet another province.

 

Jiangxi's first suspected H7N9 case detected

 

English.news.cn   2013-04-25 10:28:04

NANCHANG, April 25 (Xinhua) -- The health department of east China's Jiangxi Province on Thursday reported the province's first suspected human case of H7N9 avian influenza.

 

In line with established protocol, the provincial center of disease control and prevention has sent the patient's samples to the national lab to confirm the diagnosis.

 

The patient, a 69-year-old man, has been admitted to the No. 3 Hospital in Nanchang, the provincial capital.

 

The health department has not disclosed his condition.

 

The city's disease control authority has quarantined 14 people who have had close contact with the patient. None of them have exhibited any abnormal symptoms.

 

The National Health and Family Planning Commission said in its Wednesday update that the total number of H7N9 cases reported in the mainland stood at 108, including 23 cases that have ended in death.

 

Most of the cases were reported in east China's Shanghai Municipality and the provinces of Zhejiang, Jiangsu and Anhui.

Hong Kong Testing First Suspected H7N9 Case

 

 

# 7075

 

 

Multiple media sources are reporting that Hong Kong authorities are testing a 7 year-old girl, recently returned from Shanghai - who is showing flu-like symptoms - for the new H7N9 bird flu virus.

 

It should be noted that it is still seasonal flu season in Hong Kong and Asia, which makes differentiating between common viral infections and this emerging bird flu a challenge. 

 

Given the stakes, and their history with the SARS virus of 2003, Hong Kong officials are understandably taking no chances.

 

We should have some lab results within the next few hours.

 

This from the Hong Kong Standard.

 

 

Girl, 7, becomes first suspected HK patient

A seven-year-old girl, who had visited the eastern region of China and had contact with live poultry, is suspected to be infected with the killer H7N9 virus, Health Minister Ko Wing-man said today.

 

She is in quarantine and tests will be conducted.

 

<SNIP>

 

Ko also said the government will follow standard guidelines in responding to detections of the H7 or H5 avian flu viruses in local poultry.

 

As for border protection, he said more staff will be deployed to monitor the body temperature of arrivals.

(Continue . . .)

Padang Residents Warned On Bird Flu

 

 

# 5357

 

 

Pandang, Indonesia is the capital and largest city in West Sumatra, with a population of 800,000. 

 

Over the past couple of weeks residents in at least 8 districts (Padang Barat, Padang Utara, Padang Timur, Padang Selatan, Kuranji, Lubuk Begalung, Koto Tangah and Nanggalo) have reported numerous sudden deaths among their poultry holdings.

 

 

Last week we learned of two  children in the city who had been hospitalized with `bird flu-like symptoms’ at M Djamil hospital, beginning on February 26th.

 

Admittedly, many other illnesses can mimic bird flu, including seasonal flu. So the presence of clinical `flu’ symptoms, even in conjunction with exposure to infected poultry, is hardly conclusive.

 

That number has now grown (see Padang: Bird Flu Suspect Cases Increase To 5), although we have yet to receive official word on their test results. 

 

At least one subject reportedly has tested positive via a `rapid test’ (see BFIC Padang, West Sumatera ::: A bird flu suspect rapid tests positive).

 

 

Laboratory testing for the H5N1 virus has always been difficult, particularly once antiviral therapy has been initiated.  Accordingly, Indonesian authorities require several positive and/or negative results before making a diagnosis.

 

Today we’ve several reports out of Padang which are cautioning residents over the dangers of bird flu.  First up, a story that appears in Sunday’s Jakarta Post.

 

Bird flu alert heightened in Padang city

The Jakarta Post | Sun, 03/06/2011 1:21 PM | Headlines

Residents in Padang, West Sumatra, have been warned about a possible bird flu endemic after five people were suspected of having contracted the virus.

 

“Padang residents should take precautions,” Padang Health Agency head Afrida Aziz was quoted as saying in Padang on Saturday by Antara news agency.

 

She said monitoring bird flu remained a top priority given the impact of the deadly disease, especially in the wake of reports of mass chicken deaths in the city’s eight districts.

(Continue . . . )

 

Via Ironorehopper posting on FluTrackers, we get this cautionary article from Waspada Online.

 

This report urges anyone with a high fever and recent contact with sick poultry to seek medical treatment and to notify local authorities of any sick or dying poultry (unggus).

Sunday, 06 March 2011 00:15

Beware of bird flu

PADANG - Head of the Department of Health (Health) of Padang, Afrida Aziz called on residents of Padang to be wary of bird flu disease. This was said by the Head of the City Health Office in Padang, Afrida Aziz relating five residents of Padang suspected of being infected with bird flu.

"Residents of Padang in order to remain alert to bird flu disease that attacks humans," said Chief Medical Officer Afrida Azis, in Padang, last night.

He said that bird flu remains a concern from various parties, because the disease can bring death. "City Health Office in Padang monitor bird flu endemic area for non-infectious to humans," he said.

<SNIP>

According to him, five residents are exposed to bird flu virus as a result of direct contact with poultry or chicken. "Before infected with bird flu, it is probable that five residents of Padang have direct contact with poultry around the house," he said.

(Continue . . . )

 

 

There is obviously a good deal of local concern over the poultry deaths, and suspected human infections, in Pandang.  Local `socialization’ (read: education) campaigns are underway in an attempt to reduce the risk of the spread of the disease.  

 

As far as whether any of these children are truly infected with the H5N1 virus? 

 

Although the media reports are leaning in that direction, that’s something we won’t know until official test results are released by the Indonesian Ministry of Health (MOH).

 

Stay tuned.

Vietnam: New Suspected H5N1 Case

 

 

# 4437

 

 

A hat tip to Shiloh, editor and senior moderator at FluTrackers, for picking up on this VOV (Voice of Vietnam) article regarding a new H5N1 case – this time a 3 year-old in Ho Chi Minh City.

 

Although the initial lab test came back positive for H5N1, it generally requires two positive tests before a case is declared `official’.  Hence this remains a `suspect case’ for the time being.

 

 

 

Updated : 6:36 PM, 03/16/2010

New suspected case of A/H5N1 in Ho Chi Minh City

The Ho Chi Minh City Department of Health announced a suspected case of bird flu virus on March 16.

 

The patient, a 3-year-old child from Thuan An district, Binh Duong province, was hospitalised with symptoms of petechial fever, but she then tested positive for the A/H5N1 virus and is now under quarantine for treatment at Nhi Dong hospital, Ho Chi Minh City.

 

“There are many poultry breeders around the patient’s house,” said her family.

 

The Hospital for Tropical Diseases and Pasteur Institute have sent medical experts to Nhi Dong hospital for consultation and samples have been taken for medical tests. The final result will be announced on March 17.

 

The Pasteur Institute will send officials to the patient’s living quarters for inspection and put those who have contact with her in quarantine.

Indonesia: Four Bird Flu Suspects Hospitalized

 

 

# 4382

 

 

Ida at The Bird Flu Information Corner tonight has a report out of Pangkalpinang, Indonesia regarding four kids from Kecamatan Simpangkatis who are being treated in a special unit for bird flu patients.

 

These are suspect cases, based on clinical symptoms and their proximity to recent poultry deaths.   Laboratory results are not expected for several days.

 

 

Pangkalpinang, Bangka-Belitung ::: Four bird flu suspect kids

Pangkalpinang – Four kids from Kecamatan Simpangkatis are treated in Depati Hamzah regional hospital, Pangkalpinang. Patients are placed in special unit for bird flu patients.

 

They were suspected of contracting bird flu infection as they exhibited continuous fever, said Supriyadi, Health Service official of Bangka Tengah. Patients’ family confirmed that they experienced many chicken deaths not long before.

 

The suspected kids were found during field investigation on people, which is routinely done by Simpangkatis public health centre officers when birds in the area reported to have suddenly died.

 

To anticipate any possibility of bird flu transmission to human, public health officers referred the four kids of Kecamatan Simpangkatis to Depati Hamzah regional hospital. Medical team of the hospital had collected their blood sample for bird flu test. Laboratory confirmation expected to be issued within a week.

 

Kecamatan Simpangkatis is one of sub-districts under observation of regional health service because of large bird flu H5N1 outbreak in chickens.

Source: Indonesia local newspaper, Bangka Pos.

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.

Indonesia: Banten Bird Flu Suspect

 

 

# 4346

 

 

 

The Indonesian press is reporting yet another suspected H5N1 infection, this time in the Serang regency (Banten province is divided into 4 regencies; Lebak, Pandeglang, Serang, and Tangerang).

 

This translation is from Ida at the Bird Flu Information Corner.  You can find other reports and translations by newshounds at FluTrackers in this thread, and in Flu WIki’s Indonesian thread.

 

As of now, this is simply a suspect case, as there are a number of other illnesses that can mimic H5N1 symptoms.   Lab tests are awaited.  Hopefully, those results will be made public.

 

 

Serang, Banten ::: Fifty-year-old bird flu suspect man

February 12, 2010

Cilegon, Banten – A 50-year-old man, with initial S, is treated in isolation unit of Serang regional hospital. Patient was transferred to Serang regional hospital from Grogol public health center, Cilegon.

 

Hospital’s spokesman, Yopi Triana S said that patient arrived in Serang regional hospital on Wednesday (10/1) afternoon with body temperature 37℃. According to patient’s family, S developed fever after had direct contact with suddenly died chickens nearby his house. Patient also showed common signs of bird flu infection such as, sore throat, and low of leukocyte (white blood cell) count for less than 5,000 per mL blood, added Yopi.

 

S is first bird flu suspect treated in Serang regional hospital in 2010. The hospital had treated 27 bird flu suspect patients in 2009. One of them had died before laboratory confirmed, meanwhile remaining 26 cases were negative.

 

Source: Indonesia local newspaper, Radar Banten.

Indonesia Quarantines Another Bird Flu Suspect

 

 

# 4338

 

 

Lampung, Indonesia

 

This case, like so many we hear about in Indonesia, is just suspected of having H5N1.  No laboratory confirmation has been released, and there are certainly other illnesses that could produce similar symptoms.

 

Still, given that this is the time of year when H5N1 cases become more common, and her chickens (and her neighbor’s chickens) recently died from the avian flu virus – her doctors have ample reason to be suspicious.

 

This report from the Jakarta Post.

Suspect quarantined in Lampung hospital

 

Oyos Saroso H.N. ,  The Jakarta Post ,  Bandarlampung   |  Wed, 02/10/2010 1:55 PM  |  The Archipelago

 

 

Abdul Moeloek General Hospital in Bandarlampung, Lampung, has again quarantined a patient suspected of being infected the bird flu after showing symptoms of high fever, coughing and difficulties of breathing.

 

The patient, named as Suh, was reported to have had direct contact with her chickens that had suddenly died. She burned the dead chickens and buried them near her house a few days ago.

 

Her husband Udin said thousands of chickens near his home had abruptly died in the past two weeks. "The dead chickens included 15 of mine. All the chickens in our neighborhood have died," Udin said Tuesday.

 

Laboratory tests on the dead chickens in Way Laga subdistrict showed that the birds were infected with the avian flu virus.

 

Yanuar, a doctor treating Suh, said the medical team had to wait for lab tests to determine whether she was had bird flu.

 

"Even if the results turn out to be negative, residents in Way Laga must be careful because the area is known to be a bird flu area," Yanuar said.

 

(Continue . . . )

 

Indonesian Bird Flu Suspect In Critical Condition

 

UPDATED 0900hrs EST

 

# 4236

 

 

Although the local press (Jakarta Post) is referring to this case as a `bird flu suspect’, it is important to remember that there are a plethora of possible pathogens that could be the cause of this teenager’s illness.

 

Still, the rapid decline in the patient’s condition, the time of year, and even the victim’s age are all consistent with what we would expect from an H5N1 infection.  So this is a case we will watch.

 

This report from The Jakarta Post.

 

Sunday, January 10, 2010 7:19 PM

Bird flu suspect in critical condition

Rizal Harahap ,  The Jakarta Post ,  Pekanbaru  

A 17-year-old teenager who is suspected of having contracted the H1N1 bird flu virus is in a critical condition at the Arifin Achmad regional public hospital in Pekanbaru, Riau.

 

The hospital head for bird flu control, Azisman Saad, said Sunday the teenager was receiving intensive treatment in an isolation room at the hospital.

 

“The suspect is still in a comma-like condition and is suffering from a high fever,” Azisman said.

 

He added the patient needed a machine to assist his breathing.
“A team of doctors from the Riau provincial health agency took a blood sample of the patient and will send it to the health ministry in Jakarta,” he said.

 

Evy, one of the patient’s relatives said the patient had been ill since Friday.

 

She said he had been suffering from a fever, breathing difficulties and diarrhea before fainting.

 

“We have yet to know how the patient could have been infected by the virus,” she said. (ewd)

 

 

UPDATE

Ida at BFIC has posted a translation of a different article on this patient, which provides more details, and increases the suspicion that this may be H5N1.

Pekanbaru, Riau ::: Hospital treats another bird flu suspect

January 10, 2010

Pekanbaru – Another bird flu suspect patient is treated at Arifin Achmad regonal hospital. Patient, named Jefri, 17-year-old is strongly suspected of contracting bird flu or avian influenza H5N1 virus. He is currently isolated in special unit for bird flu patient.

 

Head of Bird Flu Control Team of Arifin Achmada hospital, Azizman Saad regretted Jefri had been in severe condition at the time he was referred to Arifin Achmad hospital from Santa Maria hospital in Pekanbaru.

 

Patient showed elevated body temperature up to 37.5℃, low thrombocyte count about 8,000, and low leukocyte count about 5,000.

 

Jefry is the second bird flu suspect patient treated by Arifin Achmad hospital during 2010.

 

(Continue . . . )