Indonesia Human Cases - May 19 to May 21, 2006

[DB]

Re: Indonesia BF, 5/19- 5/21

http://in.today.reuters.com/news/new...archived=False

JAKARTA (Reuters) - An 18-year-old East Java shuttlecock maker has been diagnosed with bird flu, according to local test results announced on Sunday.

The Health Ministry's Director General for Disease Control, I Nyoman Kandun, told Reuters that the victim was undergoing treatment in hospital and that a sample of his blood will be sent to a Hong Kong laboratory recognised by the World Health Organisation (WHO) for further testing.

"He was working as a shuttlecock maker. We are still tracing where (the factory) got the feathers," Kandun said.

Most human cases of bird flu from the H5N1 virus are believed to stem from direct or indirect contact with infected poultry.

At least 32 people have died of bird flu in Indonesia, the second highest toll after Vietnam where 42 have died. More than half that number have died this year.

Last week the number of confirmed infections in one family on Indonesia's Sumatra island hit six, a so-called "cluster" case that raised concern about possible human-to-human transmission of the virus.

Indonesian and international officials are still investigating the case to try to determine the cause. Experts fear if human-to-human transmission developed it could lead to a pandemic.

No other members of the North Sumatra village where the family lived are known to have been infected with bird flu, the WHO has said, but the world body has not ruled out limited human-to-human transmission in the family cluster.

Bird flu has spread across Europe, Africa and Asia and has killed 123 people worldwide, the majority in east Asia, since re-appearing in 2003. Virtually all the victims caught the disease from poultry.
The H5N1 virus is endemic in much of Indonesia.

[HenryN]

Re: Indonesia BF, 5/19- 5/21

Commentary at

http://www.recombinomics.com/News/05210601/H5N1_Surabaya_Student.html

[Niko]

Re: Indonesia BF, 5/19- 5/21

Full text

Commentary at

http://www.recombinomics.com/News/05...a_Student.html

Commentary

H5N1 Confirmed in Student Teacher Cluster in Surabaya

Recombinomics Commentary
May 21, 2006

An 18-year-old East Java shuttlecock maker has been diagnosed with bird flu, according to local test results announced on Sunday.

The confirmation of H5N1 bird flu in the student in the teacher/student cluster in Surabaya is cause for concern. The teacher died earlier and the circumstances surrounding here hospitalization and death have not been described. However, the confirmation of her student raises the number of confirmed cases to two, and increases the likelihood at the other three members of the cluster have been infected with H5N1.

This cluster is in East Java and distinct from the larger cluster in North Sumatra. These clusters in addition to the clusters in and around Jakarta raise additional concerns and highlight the need for the release of the human and animal sequences sequestered at the private WHO database. Most of the human Indonesian sequences have a novel cleavage site not found in the avian isolates suggesting the human cases are not linked to poultry, increasing pandemic concerns.

I would encourage anyone, especially those new to tracking H5N1, to go to Dr. Niman's site for a great historical perspective as well as current news & commentary.

[Theresa42]

WHO bans Taiwanese journalists

More specifically, WHO bans Taiwanese journalists...it's a political thing...

WHO bans local journalists from coverning WHA meet

http://www.cna.com.tw/eng/info/twhead.php

WHO bans local journalists from covering WHA meet
United Nations regulations cited as reason for discrimination of the writers

Taiwan News, Staff Reporter
2006-05-21 Page 1
By Jenny W. Hsu
Published:

The World Health Organization on Friday rejected the applications of Taiwanese journalists to cover next week's World Health Assembly, attributing their action to United Nations procedures.

The WHO indicated that Taiwanese journalists were more than welcome to enter the health body's headquarters, but because the annual assembly meeting was being held at the U.N.'s European headquarters - the Palais des Nations - in Geneva, media accreditation would be handled according to U.N. policy.

A top WHO official who asked not to be identified pointed to the clause in the guidelines that was sidelining Taiwanese reporters.

"Journalists must present two forms of valid ID. Valid ID must include a current passport from a State recognized by the United Nations General Assembly, along with a press card, work ID, driver's license or other form of photo ID," the clause reads.

Local reporters have not always been excluded from the meeting. Prior to 2004, Taiwanese journalists could be accredited using their Republic of China passports. Since the policy was reversed, however, only those with a second passport from a country recognized by the U.N. can get a press badge.

Without formal accreditation, local journalists must sign up for an entry pass as a "member of the public" in order to witness the assembly's proceedings. A limited number of passes will be distributed on the first day of the assembly, which will be held from May 22 to 27.

Several international organizations blasted the U.N. for what they described as a "discriminatory" policy.

In a letter to U.N. Secretary-General Kofi Annan, Aidan White, the general secretary of the Brussels-based International Federation of Journalism, said "the policy of banning journalists from Taiwan from access to the WHA....discriminates against journalists, which undermines the U.N.'s commitment to free speech and which appears to be motivated by internal policies."

White went on to say that the policy, at its mildest, is "questionable."

"Private citizens of Taiwan working as journalists should not be subject to discrimination. Their responsibilities are entirely professional, not political," he wrote, adding that the WHA is one of world's premier media event and "it is a matter of humanitarian and public interest to all people."

Association of European Journalists Secretary-General Nicolass Peter Kramer criticized the policy for its unacceptable professional imbalance.

"Taiwan is one of the few countries that enjoy a high degree of freedom of press. Twenty-three million people are left uninformed because their journalists are not allowed any first hand information at the WHA," Kramer said.

The WHA is the highest decision-making body of the WHO. Admission of Taiwan as a WHA observer might be discussed during this year's meeting.

http://www.taiwannews.com.tw/etn/news_content.php?id=104402&lang=eng_news&cate_img=38&cate_rss=news_Politics

[Theresa42]

Boy dies of bf in Papua

May 19, 2006
5 Bird Flu Deaths in Indonesia Not Linked to Human Exchange
By PETER GELLING

YOGYAKARTA, Indonesia, May 18 ? World Health Organization officials said Thursday that the five avian flu deaths confirmed this week on Sumatra were probably not a result of human-to-human infection and did not suggest that the virus had mutated into a more deadly form.

Five family members were confirmed dead from the A(H5N1) strain of avian influenza by the World Health Organization on Wednesday, the largest such cluster recorded. A sixth family member died of flulike symptoms but was not tested for the virus.

Clusters like the one in Kubu Sembilang village in northern Sumatra, where the victims lived, worry health officials because they indicate that the virus may have been transmitted between humans. Health officials have long feared that such a mutation could set off a worldwide pandemic capable of killing millions.

Gina Samaan, a field epidemiologist for the World Health Organization in Kubu Sembilang investigating the recent cluster, said that the number of deaths had raised eyebrows but that so far the outbreak was similar to others in Indonesia that were caused by close contact with infected poultry.

"Current evidence doesn't suggest at all that the virus was passed between humans," she said in a telephone interview.

Agriculture Minister Anton Apriyantono said Thursday that a number of chickens, ducks and pigs in the village had tested positive for the virus. He said infected flocks of poultry would be culled immediately.

No new cases were reported beyond the Sumatra cluster, which officials said was encouraging. Investigators are scouring the village to determine why only this family had caught the disease.

Indonesia's death toll has reached 30, second only to Vietnam, which has recorded 42. Indonesia, however, has been recording bird flu deaths at a much higher rate than any other country in recent months.

Local tests indicate that a boy in the remote eastern province of Papua who died recently also had bird flu.

The latest fatalities prompted the Indonesian president, Susilo Bambang Yudhoyono, to ask Thursday for additional international financial and technical support to help terminate the spread of the disease.

The government has been hesitant to conduct mass culls, as other Asian countries have done, because it cannot compensate farmers.

Lack of public health education probably accounts for Indonesia's high fatality rate, health officials say. In April, Indonesian bird flu patients reported their symptoms an average of five days after they began, making it hard for doctors to prevent deaths.

"It is an issue of how quickly people report their symptoms," Ms. Samaan said. "But we believe health care awareness is increasing."

In Jakarta, where the majority of the Indonesian deaths have occurred, all major hospitals and even smaller health clinics have plastered bright orange-and-yellow posters on their walls detailing bird flu symptoms and treatments. Booklets have been distributed to far-flung villages throughout the country.

In the tiny village of Taman Jaya on Java's southwestern tip, villagers recently examined an informational packet from the Health Ministry, while chickens ran freely in the front door, through the kitchen and out the back door.

http://www.nytimes.com/2006/05/19/world/asia/19birdflu.html

[DB]

Re: Indonesia BF, 5/19- 5/21

"World Health Organization officials said Thursday that the five avian flu deaths confirmed this week on Sumatra were probably not a result of human-to-human infection and did not suggest that the virus had mutated into a more deadly form. "


"Agriculture Minister Anton Apriyantono said Thursday that a number of chickens, ducks and pigs in the village had tested positive for the virus. He said infected flocks of poultry would be culled immediately."

It's the same cast of characters spitting out the same lines.

This is old and incorrect information that is being repeated.

For a recap of what was said on Thursday see here.

It would be nice if the virus listened to these statements, but alas it does not.

The recent cluster in Indonesia is clearly some form of human-to-human transmission and it ceases to amaze me how they play it off as if it is not.

It is as if they are all suffering from delusions.

[HenryN]

Re: Indonesia BF, 5/19- 5/21

The writer: Faishol Taselan Surabaya -- MIOL: Other the sufferer suspect bird flu Aris Ashar, 20, from Jepara, Central Java, on Saturday (19/5) died after being treated for nine days in Budi's Hospital Noble Surabaya. With Aris's death, in Surabaya was recorded by two people who died resulting from bird flu. Beforehand, died on behalf of the Lily, 36, the citizen's year Street Pucang Anom II/27 Surabaya. Information that was accepted mentioned this patient entered RS Budi Mulya since last Tuesday (09/05) with the sign of pneumonia and breathless acute. It was increasingly old, his condition increasingly descended. After that, the side RS Budi Mulya that suspicious with the condition for casualties, did the co-ordination with RSU Dr Soetomo and Dinkes the Surabaya City and Dinkes the Province. For the maintenance suspect this bird flu, the handling that was carried out by RS Budi Mulya did not have a basis the procedure that was determined by the Department of Health, as being placed in special isolation space was mixt with the other patient. "We will be waiting up until the following Tuesday to know kepastiana whether being affected by bird flu or not." That definitely korba has been brought came home the family, Superior words one of the staffs public relations of RS Budi Noble. The body suspect bird flu, has been taken by the family to be buried in Jepara. (FL)

http://www.mediaindo.co.id

[Niko]

Re: Indonesia BF, 5/19- 5/21

Lack of public health education probably accounts for Indonesia's high fatality rate, health officials say. In April, Indonesian bird flu patients reported their symptoms an average of five days after they began, making it hard for doctors to prevent deaths.

That may be the average, but it doesn't apply to the Sumatra family cluster. The timeline doesn't support this. After the intial case died, other family members started becoming sick and sought treatment. I imagine that most people, no matter the culture or level of poverty, ignorance, etc., would seek treatment if a family member died then they began to show symptoms. This assumes that health care is available, of course. As awareness of bird flu increases, the average time before seeking treatment should go down.

[Theresa42]

Indonesia cannot rule out human-to-human transmission of bird flu

Indonesia cannot rule out human-to-human transmission of bird flu
May 22, 2006

JAKARTA (AFP) - An investigation into Indonesia's largest cluster of bird flu victims cannot yet rule out the possibility of human-to-human transmission, a health official has said.

I Nyoman Kandun, director for the health ministry's communicable disease control centre, said epidemiological investigation into a cluster of five cases in Sumatra, which health experts feared might be Indonesia's first case of human-to-human transmission of the deadly virus, was inconclusive.

"We cannot confirm that (human-to-human transmission) has occurred but we cannot rule it out," Kandun told reporters.

He added that Indonesian officials were being assisted by the World Health Organisation, and the Centres for Disease Control.

Test results from the World Health Organisation (WHO) last week confirmed that the five family members had all contracted the H5N1 virus, bringing Indonesia's bird flu death toll to 32.

Local tests on Monday confirmed that a sixth family member, a 32-year-old man, been infected with bird flu, said Kandun. [Dowes Ginting, Rafael Ginting's father?]

"He is the father of one of victims," Kandun said.

Indonesia has witnessed more bird flu deaths than any other country this year. It has the world's second highest number of fatalities since 2003, after Vietnam. Nine Indonesians who were infected have survived.

http://news.yahoo.com/s/afp/healthfluindonesia;_ylt=AurZAQIVKdPf3FqonNcpry6TvyIi;_ylu=X3oDMTBiMW04NW9mBHNlYwMlJVRPUCUl

[MHSC]

Re: Indonesia BF, 5/19- 5/21

<HR style="COLOR: #cccccc" SIZE=1> <!-- / icon and title --><!-- message -->American Tamiflu Stocks Sent To Unnamed Asian Country

Main Category: Bird Flu / Avian Flu News
Article Date: 22 May 2006 - 9:00am (PDT)

Mike Leavitt, US Health and Human Services Secretary, says US stocks of Tamiflu are being sent to a safe location in some unnamed Asian country. He said this move is to help the first line of defence in case a flu pandemic breaks out.

Many wonder why this sudden move was announced. Why is the country unnamed? Last week it was announced that 7 members of the same family in Indonesia were infected with the H5N1 bird flu strain - six of them died. The World Health Organization said it was unlikely that such a large cluster of human infections was due to human-to-human transmission. However, nobody seems to be able to locate the source of infection.

If a bunch of people get infected and authorities cannot find any birds as the source, it is not illogical to wonder whether these people may have infected each other. When the WHO says this is unlikely, but cannot offer any other explanation regarding the source of infection, people wonder.

Mike Leavitt said the Tamiflu stocks that are being moved from the USA to Asia would belong to the USA - America would control its deployment. We are told the shipment will arrive at the Asian country later this week. We don't know how many Tamiflu doses were sent.

These Tamiflu stocks will help support international containment efforts in case a flu pandemic breaks out in Asia. Mike Leavitt added that the stocks could be sent back to the USA if needed.

Mike Leavitt said the USA will have enough Tamiflu to treat one quarter of the US population in the event of a flu pandemic. However, his figures are based on some hopeful suppositions. By the end of this year the USA will have 26 million treatment courses - less than 10% of the population. By the end of 2007 it will have 75 million treatment courses - 25% of the population. As long as the pandemic does not hit before the end of 2007, in about one year-and-a-half, his supposition will be accurate. However, if it hits before that, he will be short. The USA has a population of about 290 million.

Written by: Christian Nordqvist
Editor: Medical News Today