Announcement

**LMonty** · May 13, 2006, 09:22 AM

Re: Bird Flu deaths raise human transmission fears

Youre right, of course, mingus. and it begs the question- over the last year or so, how many of the negatives that were never autposied and further tested really had H5N1? Due to that, IMHO; the infection rate and death toll is larger than the WHO numbers suggest.

We need these sequences. Badly. I hope we're doing something to get them. I realize the phrase is probably patented to Dr Niman,

but this cluster really is a "cause for concern", and we need to find out RTFN if the virus has changed or if the cluster is due to some unusual B2H transmission route.

The opportunities for the virus to meet and greet others just keeps growing.

**Bruce** · May 13, 2006, 09:24 AM

Re: Indonesia - Family in Karo suspected of having bf

Thanks Mingus

**Shannon Bennett** · May 13, 2006, 10:52 AM

Re: Indonesia - Family in Karo suspected of having bf

This culture will not let you do autopsies. It is seen as desecrating the dead. also, remember that they have a religious mandate to bury the dead within 24 hours. You might be able to do a lung biopsy but I seriously suspect you would not be able to do much more.

**Snowy Owl** · May 13, 2006, 11:34 AM

Re: Indonesia - Family in Karo suspected of having bf

Flu Stories: Indonesian Cluster of Human H5N1
by DemFromCT
Sat May 13, 2006 at 07:26:56 AM PDT

(Promoted by Susan)

Among the purposes of influenza surveillance is to pick up on human cases of H5N1, investigate rumors, assess the situation and put news in context. Right now, all of that is being done in Indonesia, where there is a family cluster of cases. Eight people have been diagnosed with H5N1, 4 of whom have died (and possibly a fifth case as as well).

All eight cases were from the same family. Four members of the family have died from what health officials suspect could be bird flu, said WHO spokeswoman Sari Setiogi.

Blood samples have been sent to a WHO lab in Hong Kong for analysis, Setiogi said.

The family lived in a village in the Tanah Karo district in north Sumatra.

Indonesia's death toll from the H5N1 bird flu strain stands at 25 -- the world's second-highest toll after Vietnam, according to reports from The Associated. Press.

Several fatalities were members of the same family or lived near each other.

We are following this closely, as is WHO and CDC.

* DemFromCT's diary :: ::
*

Clusters have been reported before. From Flu Wiki's cluster page:

Clusters of H5N1 infections are important because they may indicate human to human transmission of H5N1 influenza. Alternatively, they may simply indicate common exposure to the virus from an environmental source, presumably avian. A cluster here is defined as two or more individuals: 1. who are in close physical contact, 2. who become very sick with a respiratory disease, and 3. at least one of whom is a confirmed H5N1 influenza case. This is a relatively liberal definition of a cluster. It is left to the reader to evaluate the significance of the information presented here.

When such a group is brought to the attention of WHO, a team of epidemiologists is sent to look at the cases, and field studies are done to try and determine what the exposure is. From one of the ProMED moderators (ProMED is the listserv for the International Society for Infectious Diseases):

[Indonesia has continued to have cases of influenza A H5N1, some in
clusters, and these cases are likely to be confirmed. As in earlier
clusters, the likelihood is that these cases share a common exposure
rather than representing person-to-person transmission. Map showing
the location of Medan in North Sumatra:
<http://www.un.org/Depts/Cartographic/map/profile/indonesi.pdf>
Further information including virologic confirmation and genetic
testing of the viruses is awaited. - Mod.LM]

No reason for panic, but situations like this are why and how the internet can contribute; like breaking political stories, some of the first set of 'facts' turns out to be incomplete, untrue or smoke where there's fire. Separating that out is the job of the unsung heroes on the ground, some of whom leave the US and other countries on short notice just for that purpose.

While there's also some comfort in the relative quiescence of H5N1 elsewhere, the entire bird flu issue is a slow smoulder, not a flash fire at this point in time. Surveillance and precautions still need to be kept up. The ABC movie may have little to do with reality, but clusters like the one in Indonesia always have the potential to be more (or less) than they appear.

This particular cluster, along with the continued appearance of H5N1 in Africa, are why people continue to follow the story.

Tags: avian flu, bird flu, pandemic preparedness, H5N1 (all tags)

View Comments | 24 comments

Page not found - Daily Kos

http://www.dailykos.com/storyonly/2006/5/13/92016/5189

**Mingus** · May 13, 2006, 11:48 AM

Re: Indonesia - Family in Karo suspected of having bf

... said WHO spokeswoman Sari Setiogi.

Blood samples have been sent to a WHO lab in Hong Kong for analysis, Setiogi said.

...

This familiar song his sing by a WHO spokesman !

**GaudiaRay** · May 13, 2006, 12:25 PM

Re: Indonesia - Family in Karo suspected of having bf

Originally posted by Shannon

This culture will not let you do autopsies. It is seen as desecrating the dead. also, remember that they have a religious mandate to bury the dead within 24 hours. You might be able to do a lung biopsy but I seriously suspect you would not be able to do much more.

What I saw when I was there was a lot of animism masked over with Islam.
This quote below from the news about the erupting volcano in Indonesia will drive home the point that the people there in the countryside are ignornant, superstitious and incapable of thinking in the way the Western mind has been trained. Their government can do whatever the heck it wants. It's doing nothing.

Drat, I can't find the quote, but it was that locals would climb up the mtn and toss in flowers and live animals to appease he gods.

Don't kid ourselves, these people are animists culturally and stuck with Islam as the most recent conquistador's offerings to them. I know for fact that they'd take any religion to escape from the viciousness and uncontrollable experience called animism.

**Shannon Bennett** · May 13, 2006, 03:20 PM

Re: Indonesia - Family in Karo suspected of having bf

Most cultures in tropical and humid climates have religious edicts re: burying the body promptly. I will let you draw your own conclusions why.

**HenryN** · May 13, 2006, 07:04 PM

Re: Indonesia - Family in Karo suspected of having bf

Originally posted by niman

Can't get this story to come up yet. Not sure if this is a new fatality or not:

<TABLE cellSpacing=0 cellPadding=0 width=400 border=0><TBODY><TR><TD vAlign=top bgColor=#ffffee>

In a Week, Lima the Patient Suspect Bird Flu died in MedanMedan -- MIOL: already this week, five patients suspect bird flu from the Simbelang Fortification Village, the Subdistrict of three bows, the Karo Land Regency died in Adam's Public Hospital the Owner, Medan, North Sumatra.
</PRE>

</TD></TR><TR><TD colSpan=2></TD></TR></TBODY></TABLE></P>
http://www.mediaindo.co.id/berita.asp?id=99644

Medan -- MIOL: already this week, five patients suspect bird flu from the Simbelang Fortification Village, the Subdistrict of three bows, the Karo Land Regency died in Adam's Public Hospital the Owner, Medan, North Sumatra.One of the patients suspect bird flu that meningal the world was Rafael Ginting, 10, that blew out the last breath, on Saturday, struck 14.00 WIB after getting the maintenance for five days.Four patients suspect other bird flu that died that is Bony Karo-Karo, 18, Anta br Ginting, 29, Fuji br Ginting, 40 and Roy Karo-Karo, 19.Whereas the patient suspect bird flu that at this time still was treated that is Brenata br Tarigan, 1,5 and Jonnes Ginting, 25, that again was accompanied by his family after beforehand ran from the hospital.Bidang Pelayanan Medis Deputy Director and Education, RS Adam the Owner, M. Nurasyid Lubis to the Indonesian Media, justified the Rafael Ginting death."Beforehand to the patient, we have installed the implement bantua breathing, because increasingly critical."Struck 14.00 WIB, Rafael blew out the last breath, he said.According to Nurasyid, respiratory aids were also installed to Brenata br Tarigan, 1,5."His condition has also been increasingly serious."Aids have also been installed.We were still continuing to try to give the optimal maintenance, he said.Moreover, Nurasyid said till at this time did not yet accept results of the research of the Department of the Health, although being pernyatan the Organisation side of the Health of the World (WHO) that named four patients suspect bird flu that is Fuji br Ginting, 40, Anta br Ginting, 29, Roy Karo-Karo, 19 and Bony Karo-Karo, 18, positive was affected by bird flu."Until at this time we did not yet accept the statement officially from the Department of the Health and WHO good that through the facsimile or the telephone concerning results of this research."Nevertheless, we continued to give the appropriate maintenance of the current standard, he said.(YN/KN/OL-03)</PRE>

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**HenryN** · May 13, 2006, 07:40 PM

Re: Indonesia - Family in Karo suspected of having bf

The translation above describes the death of the 6th family member. There are some differences in the media reports (the report on the latest death today still as the 1.5F alive). However the deaths of six are described

May 4 40F Praise Br Ginting

May 9 19M Roy Karokaro

May 10 29F Anta Br Ginting

May 12 15M Boni Karokaro

May 12 1.8F Reneita Br Ginting

May 13 10 M Rafael Ginting

All media reports agreee that Jones Ginting is still alive. If there are 8 family members, then the 8th member, Obvious Ulina Ginting would also still be alive.

**HenryN** · May 13, 2006, 07:46 PM

Re: Indonesia - Family in Karo suspected of having bf

Liputan6.com, Medan: fatalities resulting from bird flu in Medan, North Sumatra, improved to five.

Rafael Ginting, the child 8 years, was last casualties who died after being treated for three days in Adam's Space of the Isolation of the central Public Hospital the Owner, Medan, on Saturday (13/5).

Beforehand four other casualties still Rafael relatives that is Praise Ginting, Roy Karokaro, Boni Karokaro, and Anta Ginting died, on Monday set.

With five insiders of the family's one group that died resulting from bird flu then this case increased the number cluster bird flu in Indonesia to six.

However the case in Medan this was expected cluster biggest.

Responded to this condition for Pemberantasan Breakingprep Penyakit Menular Departemen Breakingprep Kesehatan Nyoman Kandun Director General claimed to be the source of the spread of bird flu in Medan was not yet known [read: the Source of Bird Flu in Medan was not yet known].

To prevent the virus spreading, the Rafael body was wrapped by the meeting and was immediately put into the case.

The body was afterwards despatched in his village of the Simbelang Fortification Village, around 15 kilometre from Kabanjahe.

Responded to this condition villagers the Simbelang Fortification felt confused and restless following five villagers who it was confirmed died resulting from bird flu.

Officially the local Health asked for the citizen to to destroy or move their poultry to the field.

Till Saturday villagers still beraktivitas as usual.While the poultry still often was roaming about although the citizen knew bird flu especially was spread by the poultry.

(ORS/Polmart Aritonang and the Rambe Good Deed)

http://www.liputan6.com/view/7,12280...147567469.html

**HenryN** · May 13, 2006, 07:50 PM

Re: Indonesia - Family in Karo suspected of having bf

<TABLE cellSpacing=0 cellPadding=0 width=400 border=0><TBODY><TR><TD vAlign=top bgColor=#ffffee>

Liputan6.com, Medan: Although swallowing four lives, the Department of the Health did not yet know the source of the spread of bird flu in the Simbelang Fortification Village, the Subdistrict of three bows, the Karo Land Regency, North Sumatra.Results of the test to the poultry around the settlement of casualties showed the negative was infected by bird flu.Was like this was sent by Pemberantasan Breakingprep Penyakit Menular Depkes Nyoman Kandun Director General in Medan, on Saturday (13/5).According to Nyoman Kandun, the Department of Health Research And Development Body researched the sample of blood and body fluids from eight patients who were treated in Adam's central Public Hospital the Medan Owner.Results, four patients were ascertained by bird flu.This case also increased the number cluster or the bird flu sufferer in one family to six cluster.The incident was this time estimated will become cluster biggest.Nevertheless, he did not say the spread happened antarmanusia.All the positive patient bird flu came from the Simbelang Fortification Village.Three including being killed in a period of the last four days.A positive patient other, that is Jones Ginting escaped from the hospital and his existence to at this time was not yet known.Whereas casualties were killed the assumption of last bird flu was named Brenata [read: casualties the Assumption of Bird Flu in Medan improved].(TOZ/Tim Coverage 6 SCTV)</PRE>

</TD></TR><TR><TD colSpan=2></TD></TR></TBODY></TABLE>http://www.liputan6.com/view/7,12279...147567481.html

**HenryN** · May 13, 2006, 08:16 PM

Re: Indonesia - Family in Karo suspected of having bf

The Balinese declaration: from the Matter of the debt to Bird Flu
It was big that Suardana - detikcom
<EMBED align=right src=""http://ad.detik.com/images/peristiwa/prs-relion240x400.swf width=240 height=400 type=application/x-shockwave-flash border="0">Nusa Dua - KTT D-8 that took place in Nusa Dua, Bali, succeeded in adopting the Balinese Declaration as the document that the final, where in this Balinese Declaration was raised by the view D-8 on several rumours.

This matter was sent by President Susilo Bambang Yudhoyono as the Chairman D-8 in the press conference in Balinese International Convention Center, Nusa Dua, Bali, on Saturday (13/5/2006) the night.

Several rumours that was contained in the Balinese Declaration, in part about the economic gap between developed countries and the developing country.

Begun from the achievement Milennium Development Goals (MDG apostr s) in the matter of the control of poverty during 2015, trade talks that was taking place with the WTO, foreign debts, the energy crisis, Digital divide , as well as the threat of infectious diseases like bird flu, the HIV/the AIDS, malaria and the TB.

The members D-8 together with the international community, could co-operate in look for the upper solution to these rumours.

"Through this declaration also, D-8 made a plea to the international community to put the intercultural dialogue forward to promote the understanding that deeper concerning the values and the belief, but also to reinforce unity and the solidarity between the community," said SBY.

The Balinese declaration also determined various activity programs and the commitment D-8 with the view to reinforce economics and the initiative of the trade co-operation in the industrial field, finance and technology.

In KTT Bali also was signed by two important agreements, that is Preferential Trade Agreement And Multilateral Agreement among the D-8 Member States ounce Mutual Administrative Assistance in Custom Matters .

The two agreements will become the base for efforts in increasing the trade between the member countries D-8.

For KTT this, President's words, also were held Retreat The heads of state and the government that promoted the theme Promoting and Enhancing Trade and Investment among the D-8 Member Countries .

During Retreat This, explained the President, the exchange of the look method in the method happened and interpreted how the achievement of these aims, including pushing the private sector to be able to participate more was active in the co-operation D-8.

<TABLE cellSpacing=0 cellPadding=0 width=400 border=0><TBODY><TR><TD vAlign=top bgColor=#ffffee>

KTT this also put forward the trade exhibition that had taken part in by more than 300 business institutions and the forum business that put forward the leading figures of the international business."The two additional agendas to support the perpetrators of the business in countries D-8 had an opportunity to see various views and the trade opportunity, investment and rumours of other economics but also to increase the business transaction," added SBY. (ddn)</PRE>

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http://www.detiknews.com/index.php/d...416/idkanal/10 </P>

**HenryN** · May 13, 2006, 08:21 PM

Re: Indonesia - Family in Karo suspected of having bf

Casualties died Suspect Bird flu in Karo was 5 people
Khairul the Brother - detikcom
<EMBED align=right src=""http://ad.detik.com/images/peristiwa/prs-relion240x400.swf width=240 height=400 type=application/x-shockwave-flash border="0">Medan - the Case Suspect Bird flu in the Karo Regency, North Sumatra (North Sumatra) increasingly worrying. Casualties died continued to improve.

That finally, Rafael, the male child was eight years old. Therefore casualties were killed to five people.

Information that was received Detikcom In the central Public Hospital (RSUP) Adam the Owner, in Street Bungalow Medan mentioned, Rafael died on Saturday (13/5/2006) around struck 13.00 WIB, during in the maintenance in A Space of the Longing Isolation.

His body still was this installation of the hospital body. His plan on this day also will be brought to the Simbelang Village of the Fortification Village, the Subdistrict of three bows, Karo to be buried there.

"Up until now we did not yet know definitely whether the bird flu virus that caused their death." We were waiting for results of the inspection Puslitbang the Health, the Department of the Health against several samples that were taken from the body of the casualties, said M. Nur Rasyid, Deputy Director RSUP Adam the Owner of the Medical Service Field and Education.

Rafael, with several of his families began to be attacked by the illness with the sign of the fever and breathless since Thursday (4/5/2006).

However just on Monday (8/5/2006) the night, casualties were run off with to RSUP Adam the Owner. He could be treated also in RS Elizabeth, but was brought returned to RSUP Adam the Owner on Thursday night (11/5/2006),

Post the Rafael death, the side RSUP Adam the Owner said continued to undertake the procedure and the stipulation in the handling of the patient Suspect Bird flu.

Currently, the handling of the focus to two patients who still were treated there, namely Renaita Tarigan, female pre-schoolers were 1.8 years old and Jones Ginting (25).

The "condition the two patients, continued to worsen, especially Renaita, experienced the high and breathless fever." Tamiflu medicine and antibiotik the high dose was still continuing to be given to the two patients, said M. Nur Rasyid.

Jones that was the full sibling Rafael, beforehand could force left the Clear together hospital of Ulina br Ginting, the daughter was 8 years old.

However on Saturday early afternoon was taken again by the family because his condition worsened. Whereas Obviously Ulina was still being treated in the close polyclinic his house in Karo. [FONT='MS Sans Serif',Geneva,sans-serif](ddn) [/FONT]

http://www.detiknews.com/index.php/d...414/idkanal/10

**Snowy Owl** · May 13, 2006, 08:26 PM

Re: Indonesia - Family in Karo suspected of having bf

Thnak you Doctor Niman, that was the point I was trying to rise at Flu Wiki, a lot of politics is going on. The media releases since the beginning of the G8 (That is the 8 most industrial Islamist Nations), a lot of informations is getting out.

Policy hold datas most of the time as we know, but now, just as in Djibouti, politics free some datas.

We shall see China stand this week, but I certainly expect Doc Peiris to release some tense sequence in the days ahead.

cf:
Politics Medias H 5 N 1 Informations Authorised

**HenryN** · May 14, 2006, 05:34 AM

RSPI SULIANTI SAROSO treated four patients FLU of BURUNG

RSPI SULIANTI SAROSO treated four patients FLU of BURUNG
14/05/2006 12:15 - Social the Culture/Metro Siang
the Sulianti Saroso Infection Hospital, Jakarta.
(Metro the TV)
Metrotvnews.com, Jakarta: The Number Of new patients that was expected suspect bird flu in the Infection Hospital (RSPI) Sulianti Saroso, Jakarta, Ahad (14/5), numbering four people.
Three patients were treated in intensive maintenance space (ICU), one him again in the Intensive Cempaka Maintenance.
The patient beinisial "B", was four years old, was treated in ICU since May 11.
"B" became the patient with suspect bird flu because of having his family's member with initials "M." (43 years) beforehand has suffered avian influenza.
"M." became the patient suspect bird flu/because of having his property poultry that died.
"M. was" treated" in ICU RSPI Sulianti Saroso since last May 8.
Moreover, the patient with initials "Mr" (12 years) also was treated in ICU. "Mr" it was suspected suffered bird flu because his neighbour maintained the poultry.
Now the newest patient, the man had the initials "H" (27 years), was treated in Intensive Cempaka Maintenance space.
"H" it was suspected suffered bird flu because of maintaining the poultry.
()

http://www.metrotvnews.com/berita.asp?id=16630