Indonesia - Family in Karo suspected of having bf

[Snowy Owl]

Two more bird-flu patients die in Adam Malik hospital
http://news.antara.co.id/en/seenws/?id=12721

Two bird flu patients passed away in Adam Malik Hospital Medan, a spokesman of the hospital dr. Alwinsyah Abidin said here on Monday.

With the latest deaths, a total of six bird flu patients had passed away in the hospital so far, he said.

Raphael (8) died at midnight on Saturday, while Brenita Karo-karo (18 months) died on Sunday evening.

The two children suffered from high fever when they were brought to the hospital. They were later put in an isolated care unit for intensive medical treatment until they passed away.

Currently, Adam Malik Hospital is still treating another bird flu patient, namely Johanes Ginting (25), from Tanah Karo village, North Sumatra.

Coordinating Minister for People?s Welfare Aburizal Bakrie early this month said that some 401 suspects of bird flu (avian influenza) had been examined. Of the number, 330 were declared negative with the bird flu virus, 128 were still under observations and 128 had been confirmed positive with the virus.


Indonesia needs some US$900 million for a three-year program to fight Avian flu, he said, adding that the funds would be obtained from the state budget (US$50 million per year) and the private sector (US$20 million per year).

[HenryN]

Officials Study
Indonesia Bird-Flu Cluster
A Family's Cases Put Scientists
On Guard for Virus Mutations
By NICHOLAS ZAMISKA
May 15, 2006

An unusually big cluster of suspected bird-flu cases involving eight members of an extended family in Indonesia is attracting attention from local and international health officials on guard against any sign the virus may have evolved to spread easily among humans.
After attending a recent family gathering, the eight people living in the northern part of Sumatra island fell ill. Six of them have died in the past week or so, according to Nyoman Kandun, director general of disease control and environmental health at the Indonesian Ministry of Health in Jakarta.
PREVENTING A PANDEMIC

¹ • See an FAQ on avian flu², an interactive global map³ and track the latest developments in the Avian Flu News Tracker⁴.

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Local tests, which have proved highly reliable, have shown that five of those family members were infected with the H5N1 virus, a deadly bird-flu strain, although a laboratory in Hong Kong is in the process of confirming those results. Specimens from one of the six people who died weren't available.
With most similar, albeit smaller, human clusters in the past, health officials have presumed that the family members all fell ill after contracting the virus from the same sick birds -- perhaps during the slaughter or preparation of infected poultry prior to a meal -- rather than inferring human-to-human transmission.
It wasn't immediately clear whether the family members had been exposed to infected poultry. Dr. Kandun said that the family had at least a few chickens, two of which died recently, although birds often die in small numbers for reasons other than avian influenza. He said barbecued pig had been served at the family gathering.
The World Health Organization has sent an official to the family's village to investigate. "The investigation is still ongoing. It's still too early to say at this point," Sari Setiogi, a spokeswoman in Jakarta for the agency said last night, adding that this was the largest cluster she has seen. "It's a huge number of people that are living in the same place. But the possibility of environmental exposure is also there."
A nurse who attended to some of the patients also came down with an influenza-like illness, although she seems to have shown symptoms prior to treating the patients, according to Dr. Kandun. She and others in the family's village are currently being tested for the virus.
While there have been no obvious signs of poultry infected with bird flu in the area where the people died, according to Dr. Kandun, the virus has been widespread among the country's birds. Many human cases of bird flu have been confirmed in places where there have been no reported infections among poultry. Birds are known to harbor the virus without showing symptoms, and cases of the disease in birds might go undetected.
Since last year, the WHO has confirmed 33 human cases of bird flu in Indonesia. Of those, 25 have been fatal. Globally since late 2003, a total of 208 people in 10 countries have been infected, of whom 115 have died.
Transmission among people has been suspected in several cases. An investigation into one of those clusters from 2004 in Thailand led scientists to conclude that an 11-year-old girl who caught the virus and eventually died likely passed it directly to both her mother and her aunt while the two cared for her.
In that cluster, however, there was no sign that a fundamental shift in the virus's genetic code had allowed it to pass easily between humans, leading scientists to believe this was a rare, isolated case.
Write to Nicholas Zamiska at nicholas.zamiska@wsj.com⁶

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[sharon sanders]

Thank you everyone for perseverance on these developments. I want you to know that you have the freedom here to post your comments. This board will remain a place for the civil exchange of ideas.

[Snowy Owl]

The World Health Organization has sent an official to the family's village to investigate. "The investigation is still ongoing. It's still too early to say at this point," Sari Setiogi, a spokeswoman in Jakarta for the agency said last night, adding that this was the largest cluster she has seen. "It's a huge number of people that are living in the same place. But the possibility of environmental exposure is also there."

http://online.wsj.com/article/SB114760647060852360.html

[Snowy Owl]

A summary of Tanah Karo events

Many thanks to the reader who sent me the following account. I haven't found another story that put this many details together.

The following report has been cobbled together from a combination of news sources, some local to Sumatra and others international.

A large cluster of H5N1 cases among an extended family in the Indonesian province of North Sumatra, on the island of Sumatra, has health officials around the world concerned. Reports from the location have been incomplete and conflicting, but the following is the best information available as of Sunday evening.

Seven or eight members of an extended family living in a village approximately 175 kilometers south of the provincial capital of Medan were hospitalized more than a week ago with the suspected bird flu. On May 12, Pengendalian Breakingprep Penyakit, Director General of the North Sumatra Department of Health and Environmental Sanitation, confirmed that at least five of the eight suspected bird flu cases had tested positive for the H5N1 virus in local testing. Samples have been sent to a WHO affiliated lab in Hong Kong for verification.

Some local news sources stated that the family lived in the same small home, while other sources indicate that they lived close to one another in the same village, but in different homes. In any case, the family was taken to Medan (the provincial capital) for hospitalization at the RSUP (Central Public Hospital) Adam hospital.

The first death to come to the attention of the international community was Roy Karokaro, aged 19, who died Tuesday, May 9, 11 days after first showing symptoms.

His mother, Praise (or Fuji – sources are conflicting) Beru Ginting, aged 40, had died on May 4.

On Wednesday, May 10, a woman named Anta Beru Ginting, aged 29, died at the hospital at about 5 a.m. local time. Her relationship to the others has not been clearly stated, though there is some indication that she may have been a sister of Praise Ginting, and therefore aunt to Roy Karokaro. She was identified by some local sources as living in Kabanjahe, the capital of the Karo Regency (district), and not in the village where the others lived, but the accuracy of this last statement is not known.

Boni Karkaro, aged 18, brother of Roy Karokaro, died May 12.

Rafael Ginting, age 8 (some sources said 10), died Saturday, May 13, at about 2 p.m. local time, at RS Elizabeth hospital, also in Medan. This may be the individual identified by some news sources as a cousin of Roy Karkaro, “Obvious Ulina Ginting”, age 8. It is possible that the Name “Obvious” is an error resulting from the use of a machine translator to convert news reports from Indonesian into English. This also may be the source of reports that eight members of the family were hospitalized, rather than the seven for whom we have identification.

Brenata Beru Tarigan, a male child aged 18 months, was originally reported as having died on Friday, May 12. However, it was later learned that he did not die until Sunday, May 14. This date of death was confirmed Sunday by I Nyoman Kandun, director general of disease control at the health ministry.

On May 13, local media reported panic in the region (but, if there were panic, it likely was in the Karo district rather than in Medan itself). They also reported that the two surviving members of the original family were transferred to RS Elizabeth after they attempted to flee the hospital. The accuracy of these reports of attempted flight have not been verified, but it is known that the two survivors (not the toddler Brenata Tarigan) were transferred to RS Elizabeth, where one of them (Rafael Ginting) died on May 13. Other sources reported that the two were released from hospital, but hospitalized again after their conditions became worse. This last report seems far more unlikely than that they attempted to flee.

Both local and international media reported that one or more family members originally contracted the disease from contact with contaminated fertilizer. According to local sources, the family often bought manure from the Binjai and Langkat (an individual?) whose poultry had recently been found positive for the H5N1 virus.

On May 12, in addition to reporting two deaths (one of which did not happen), local sources also reported that 12 people remained hospitalized in RSUP Adam with suspected bird flu symptoms. It was not stated if these people were other relatives, friends and neighbors, or just what their exact association with them was.

These sources also reported that, worried by the spread of the disease, the provincial government of North Sumatra ordered the Karo district health service to sterilize the family’s home along with an area of 1-kilometer radius surrounding it. This also means culling or vaccinating all poultry in that area.

WHO officials in Indonesia said Sunday that tests of “livestock” in the village showed positive results for the H5N1 virus and now poultry and swine in the village are being tested. No indication was given if by “livestock” the WHO meant cattle, nor why (if it does mean cattle) these animals were tested before poultry and swine, both of which have stronger indications for infection than do cattle.

This outbreak is the largest familial cluster reported in Indonesia to date. It also may be the largest familial cluster ever reported for the H5N1 virus and has international health officials worried that the disease may be mutating to become more easily transmitted between humans.

H5N1 has been in Indonesia since 2003. The first human infections, however, were only reported in 2005.

There are many issues involved in getting news of this outbreak out of Medan and North Sumatra. First, is the problem that local news sources are all in Indonesian, which not only is a different language, but even has a different character set (alphabet) from English. Second, the accuracy of local news sources is highly questionable. Third, both hospital and government officials may not always be forthcoming with information about victims or the course of the disease.

Readers also should be aware of the following language issues with reports coming out of the North Sumatra area:
Karokaro is sometimes transliterated as Karakar or as Karo-karo.
Beru is sometimes transliterated as Boru, and is often abbreviated as Br.

http://crofsblogs.typepad.com/h5n1/2...f_ta.html#more

[HenryN]

Commentary at

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

[sharon sanders]

Henry - Thanks for the recap on the numbers in your linked commentary.

[HenryN]

Liputan6.com, Medan: the Condition two patients that it was suspected was attacked by bird flu in the Karo Land, North Sumatra began to improve.This situation quite pleasing because beforehand the Clear Boru Ginting situation and Jonnes Ginting very critical, in fact could bolt from the hospital.Was like this information that was met by SCTV in the Karo Land, recently [read: casualties the Assumption of Bird Flu in Medan improved].Obviously appeared to be fresher compared to the previous day.However, the man was 35 years old still must continue to undergo the intensive maintenance in Special Isolation Space the Public Hospital Saint Elizabeth, Medan.The spokesperson RSU Saint Elizabeth Alfred C. Satyo said, his side has taken the example of Clear blood and is currently researched in the laboratory belonging to the Health Body of the World (WHO) in Hong Kong.According to Alfred for the time being Obviously might not be visited except by the team of the doctor [read: Cluster in the Karo Land that most Big].The condition for the Jonnes health also already many increases and was treated in Isolation Space of RSU Adam the Owner, Medan.Originally Jonnes suffered the inflammation of the lungs or pneumonia and failed breathing.M. Nur Rasyid, Bidang Pelayanan Medis Deputy Director RSU Adam the Owner said the Jonnes condition has passed the critical period.(ICH)
http://www.liputan6.com/view/7,12288...147697623.html

[HenryN]

Liputan6.com, Medan: the Case of bird flu in the Karo Land, North Sumatra to cluster sixth and biggest in Indonesia.Cluster was the spread of the sub-type virus H5N1 the cause of bird flu antarmanusia that happened in the scope of the family or the certain environment.Was like this it was said Pengendalian Breakingprep Penyakit Director General and Sanitation of the I Nyoman Kandun Health of the Department's Environment, not long ago.In the Karo Land, five from eight people who it was suspected were infected was stated positive suffered the deadly illness.Officially the local Health currently researches their specimen in the laboratory of the World of the Health Body (WHO) in Hong Kong [read: the Source of Bird Flu in Medan was not yet known].Now two from eight bird flu sufferers in the Karo Land still underwent the intensive maintenance.Jonnes Ginting, villagers the Simbelang Fortification, the Karo Land currently in the critical situation and was treated in Adam's space of the Public Hospital isolation the Owner, Medan [read: Again, casualties the Assumption of Bird Flu of being killed].Whereas Obviously Boru Ginting that could bolt from the maintenance with Jonnes, yesterday, was accompanied by his family to RS Elizabeth, Medan.Generally his condition quite good although the temperature of the body still high was accompanied breathless.(ICH/Tim Coverage 6 SCTV)
http://www.liputan6.com/view/7,12286...147693544.html

[HenryN]

DPRDSU asked Gubsu "broke off" Kadinkessu", Kadis Agriculture and Livestock Breeding from his Position

Written by editorial staff

On Monday, on May 15 2006

Medan (SIB) The member's circle DPRD North Sumatra asked for Gubsu Drs Rudolf M. Pardede immediately ‘mencopot’ Kadinkessu (the Section Head the North Sumatran Health) and Kadis Agriculture and North Sumatran Livestock Breeding, because of could not overcome the case of bird flu in North Sumatra especially in Karo, in fact billions rupiah the prevention fund of the deadly virus was budgeted for in APBD North Sumatra has ‘ludes’. That was revealed by the Secretary of the joint Faction of DPRD North Sumatra Ir Edison Sianturi and F-PDIP Vice Chairman Budiman P Nadapdap, SE to the reporter, on Saturday (13/5) in Medan responded to Kadinkessu negligence and the agricultural Service and North Sumatran Livestock Breeding anticipated the entry of the virus suspeck bird flu to the area. “Kedua the Section Head must be responsible for the entry of the bird flu virus to the Karo Regency that resulted in 4 citizens of the Fortification Simbelang the Tigapanah Subdistrict died dunia,” said Wise Nadapdap. The entry of the virus that deadly that to North Sumatra, said the council's member because of Dinkessu negligence and the agricultural Service and North Sumatran Livestock Breeding, because of the government went through APBN and APBD North Sumatra budgeted for the fund billions rupiah to anticipate the case of bird flu. However evidently was regarded as trivial by the two agencies, was proven with the nonexistence of efforts to carry out the prevention, so as 4 citizens of the Simbelang Karo Fortification community became ferocity casualties of the virus Avian this influenza. Regarding that, Gubsu it was hoped immediately took the firm attitude towards Kadinkessu and the agricultural Service and Livestock Breeding by doing the removal from his position as well as accounting for billions rupiah the budget of the prevention of bird flu that was expected has ‘ludes’. The community Karo Restless In the meantime, the member the Commission of B DPRD North Sumatra Ir the Great Ginting typhoon said, post the entry of the bird flu virus in the Karo Regency caused the unrest and the very anxious feeling in the middle of the community, even the buyer of chicken in traditional taxes to descend drastic reached 80 percent. To avoid casualties's increase died resulting from this bird flu virus, the typhoon suggested to the Karo Regional Government immediately made poultry quarantine and chicken manure that came from outside the regency by doing the inspection. “Jika had the poultry that terindikasi not appropriate consumption must be destroyed, so that the health of the community could be awakened and protected, and the trade in the poultry could also be stable like biasa,” he said. According to him, the case of bird flu in fact not the new matter for the Indonesian nation, but often the regional government, both the province and the regency/the city not more preceptive did ward off prevented against spread him the virus was meant. “Jika sudah ada masyarakat yang terjangkit virus flu burung, barulah kepala daerah melakukan aksi turun ke lapangan dan menyampaikan statemen kepada masyarakat, layaknya seperti pemadam kebakaran,” ujarnya. Yang paling mengherankan dan menjadi tanda tanya besar bagi masyarakat, kata Taufan, kenapa flu burung bisa lolos ke Sumut, padahal dana pencegahan dari APBN dan APBD telah dikucurkan untuk menangkal merebaknya virus tersebut.(A13/c) Komentar Hanya pengguna yang terdaftar yang boleh menulis komentar. Silahkan login atau daftar.

http://www.hariansib.com/index.php?o...=4752&Itemid=9

[HenryN]

Sixth casualties fell, pre-schoolers Suspect Bird Flu died

Written by editorial staff

On Monday, on May 15 2006

Medan (SIB) Brenatha br Tarigan, pre-schoolers were 1.5 years old died resulting from suspect flu Birds, on Sunday at dawn (14/5) struck 01.30 WIB in isolation space of RSUP H Adam the Medan Owner. This was sixth casualties since suspect bird flu spread in the Subdistrict of three Karo bows of the Land Regency. One by one the patient suspect this bird flu had finally died. Beforehand Rafhael Ginting the child was 10 years old died, on Saturday (13/5) struck 14.00 WIB. Casualties died after beforehand experienced hot high was accompanied breathlessly. After Rafhael became fifth casualties suspect bird flu, at that time the Brenatha condition began to be critical. Rafhael entered RS H Adam the Owner Breakingprep Monday (9/5) with Trang (35) several hours after the entry 5 people from three bows. Because of not wanting to be combined with the chronic sufferer parents Rafhael moved his son to RS Elisabeth. Then the side Dinkes Regional Government the Karo Land picked up Rafhael from RS Elisabeth because only RS Adam the Owner the only reconciliation suspect bird flu. Just one night returned to RS Adam the Owner Rafhael has died. Brenatha during just entered RSUP H Adam the Medan Owner, on Monday (8/5) with 4 people suspect other still could joke cheerful. However gradually the virus H5N1 undermined his body to the end blew out the last breath, on Sunday at dawn. The process of his death same like that was experienced by casualties beforehand hot high and breathless. Saw the Brenatha condition that increasingly bad, the medical team gave help of the respirator (fentilator). Casualties have also been given Tamiflu medicine and antibiotik the high dose to eradicate available germs on his body. However the spirit of these pre-schoolers was not helped, he died to sixth casualties suspect bird flu. Deputy Director I RSU H Adam the Owner Dr HM Nur Rasyid Lubis Sp.B when being contacted by SIB, on Sunday (14/5) justified the death of the patient suspect bird flu Brenatha br Tarigan. After Brenatha died, on Sunday afternoon the team of the control suspect bird flu that was chaired by Dr M Nur Rasyid Lubis Sp.B and the related agency carried out the meeting in RSU H Adam the Owner. In the meantime, Jones Ginting (25) that could run left RS Adam the Owner again after being delivered by the family, on Saturday night (13/5). Jones and Trang left the hospital because of not wanting to be combined with suspect that critical. Therefore remained at Jones Ginting that was treated in isolation space of RS H Adam the Owner, whereas Trang did not yet come back. (C-13/d)

http://www.hariansib.com/index.php?o...=4715&Itemid=9

[HenryN]

North Sumatra was on the alert Bird Flu

Written by editorial staff

On Sunday, on May 14 2006

The discovery of the case of positive bird flu in North Sumatra, that happened in the Regency Karo became a big problem for us. This discovery was the sign would the arrival of the problem that very serious was related to the health, and of course to important homework to be handled by the North Sumatran health rank. Bird flu becomes a big threat for the world now. The world was threatened by the pandemic that spread, as happening in the HIV/AIDS. the Level of the death resulting from bird flu that very high made the problem of this illness become the horror illness. Killed him this case only one problem. The other problem precisely emerged in the ease spread him. Was based on information from WHO, this virus bearer usually is the poultry and wild birds. This problem that afterwards made bird flu become the big problem for us in Indonesia. Learnt by us that the management model and the poultry arrangement in this country were apparently chaotic and very much was easy with contamination to be good towards wild birds, the other poultry and humankind. That was the reason, Indonesia in fact was the country that very serious. Compared with the number of cases, indeed we not yet many. However compared with cluster (the group), we were most. That meant to happen the possibility of the spread that very close. And this that worried us. If the pattern of the incident have the shape of cluster, then meant signs would the occurrence of the danger that bigger already in front of our eyes. The guidance for the control of the problem of the health in fact for a long time has been known. We knew the existence of the system surveilans. Unfortunately, we always late in handling this. Surveilans was the supervision of the based illness to observation and attention continually. That was significant, was needed by human resources, the fund, the power and time to gather the data and pay attention to the development of the illness for the sake of the illness in an area. But that happened precisely was carelessness. The section head the Propsu Health beforehand even stated that the case of bird flu was not in North Sumatra. The fact is, casualties has happened. This our habit. We always seem like like “pemadam kebakaran”. The problem was approached with the pattern of the resolution for a moment, then afterwards stopped. We not alert continually, but only moved when the problem was available. And his risk like together has been seen by us, bird flu has threatened us. The spreading of bird flu will be easy to happen, considering the mobility of the poultry that very much was not controlled. For a moment, the source of the poultry that has been infected definitely crept and spread all through the territory. And could be confirmed, the control of the problem of the health resulting from bird flu became the spectre because the health power in this territory was not used to carry out the control of this problem. Sudah saatnya diperlukan langkah sigap. Otoritas kesehatan Sumut harus menjalin kerjasama dengan seluruh sektor untuk melakukan blokir kasus, baik manusia, maupun unggas. Penularan akibat masalah ini memang memerlukan kerjasama seluruh pihak. Selain itu diperlukan penanganan keadaan masyarakat. Di lokasi tempat ditemukannya kasus, masyarakat harus di tangani dengan baik, termasuk memberikan informasi yang memadai sehingga tidak terjadi ketakutan massal. Inilah kejadian flu burung pertama di Sumatera Utara. Semoga saja ini bukan awal, namun segera bisa diakhiri dan memutuskan mata rantai penularan flu burung yang semakin mengglobal (***)

http://www.hariansib.com/index.php?o...=4650&Itemid=9

[HenryN]

Four North Sumatran citizens Positive was infected by Bird Flu

Written by editorial staff

On Saturday, on May 13 2006

Jakarta (SIB) Four citizens of the Subdistrict of three lands, the Karo Regency, the North Sumatran Province (North Sumatra) that some time before was reported As suspek the infection of the bird flu virus (Avian influenza/AI) was stated positive was infected by this virus according to the research the Laboratory of the Body of Health Research And Development (Balitbangkes) the Department of the Health. “Dari eight cases that was reported five including being checked and from five that has been examined four among them positive according to results of the laboratory inspection lokal,” said Jendral Pengendalian Breakingprep Penyakit Director and Sanitation of the I Nyoman Kandun Health of the Department's Environment when being contacted by Antara in Jakarta, on Friday. However Kandun stated his side still could not give specific information about the patient's data that dperiksa and was stated positive was infected this. “Belum could because still was made by his relations scheme. This one the nephew who and this one relatives who. Any available relations darah,” he said. He added till at this time the most united team of the Department of the Health and the Pertaniam Department was still carrying out deep investigation about the case of the new bird flu infection in North Sumatra. “Tim still did the research in sana,” he said. Beforehand eight citizens of the Karo Regency that consisted of four their respective female patients F (40), A (29), RE (1,5) and T (35) as well as four their respective men R (19), J (25), RA (8) and B (35) was reported as the patient suspek bird flu. Three of the patients namely F (40), A (29) and R (19) died whereas the other patient to at this time still was treated intensively in Adam's Hospital the Owner, Medan. Health Minister Siti Fadilah Supari estimated the source of the infection of the bird flu virus (Avian influenza/AI) that it was suspected struck several citizens of the Subdistrict of three Karo Regency lands came from the waste of the poultry to manure that was used by the citizen to work the soil. “Di the Karo land his poultry was the negative and after was massaged-massaged the family evidently worked the soil made use of manure that was bought from Binjai and Langkat. The poultry in the two areas last 2005 was stated positive was infected by bird flu. Possibly from him from there because that the only one ‘link’ they with unggas,” Health Minister's words in Jakarta, on Thursday, ended the signing agenda of the text of the co-operation in the supervision of finance with the Supervision Body of Finance and the Development (BPKP). Results of the inspection of Namro University USA Dr Graham T from the Health Agency of the World of WHO UN the health field of Jakarta delegation said, susfect bird flu in the Fortification Village Simbelang the Subdistrict Tigapanah the Karo Regency was in accordance with the sample inspection of blood from casualties Roy Karokaro that died, last Monday (8/5) in RSU Adam the Owner evidently positive contracted bird flu.

Was like this the Regent's press release Karo Drs DD Sinulingga through Kabag public relations Robert Peranginangin to the reporter, on Friday (12/5) in his office, immediately after Dr Graham T brought results of the inspection of the Laboratory of Namro University United States.Dr Graham T was accompanied by the Section Head the Health, Agriculture and North Sumatran province Livestock Breeding sent results fositif him bird flu in meeting space of the Regent that was attended by the Muspida Karo element, Plt the Health Service Dr Diana br Ginting and Plt the agricultural Service Ir Sidharta Pinem and drh Jenggi Surbakti, said Kabag public relations.Explained, Boi Karokaro (17) died in RSU Adam the Owner, on Friday early afternoon (12/5) followed Anta br Ginting (29) that died, on Wednesday (10/5) and his mother Praise br Ginting died, on Wednesday, (3/5), and his uterus brother Roy Karo-Karo (19) died, on Tuesday (9/5) in May in RSU Adam the Owner.All of them could be treated a day overnight in RSU Kabanjahe.Quoted information, the RSU Kabanjahe Head, Dr Swara Ginting, that also the citizen from the Simbelang Fortification Village, terjangkit him bird flu mentioned, late last April several citizens will buy the chicken pedaging from the Centre of the Kabanjahe Market.The casualties, apart from taking part in buying this chicken also consumed him, said Robert Peranginangin imitated the statement Dr Swara Ginting.In accordance with information, the casualties could take medicine in the auxiliary Community Health Centre in his village that was handled by the midwife, Spoilt br Karo.Answered the question, Kabag public relations said, on Friday afternoon all the chicken traders in the Centre of the Kabanjahe Market and Berastagi carried out the Regent's appeal in order to do spraying of disinfectant to his livestock of the merchandise chicken.Said, all the fees were on the awareness of the trader borne by them personally.The place bought disinfectant was known by the traders, sembari added the chicken breeder that his location the radius 2,5 KM from the Simbelang Fortification Village carried out the mass extermination without compensation, said Robert Peranginangin.On that occasion, the Regent Karo instructed all the citizen of the Karo Land in order to increase vigilance in order to avoids this bird flu.When having the citizen that terindikasi immediately brought to the closest hospital.(C6/Ant/h)
http://www.hariansib.com/index.php?o...=4597&Itemid=9

[HenryN]

3 from 6 patients Suspect Bird Flu died

Written by editorial staff

On Thursday, on May 11 2006

Medan (SIB) Another the patient suspect bird flu from the Fortification Village Simbelang three bows Karo died. This patient was named Ananta br Ginting (29) died in space of the Longing isolation A on Wednesday (10/5) struck 05.00 WIB in RSUP H Adam the Owner. Therefore casualties died suspect bird flu became 3 people from 6 patients. The first patient Fuji br Ginting died, on Thursday (4/5) in RS Elisabeth Medan, afterwards the son of his eldest child of Roy Karo-karo (19) died in RSU H Adam the Owner, on Tuesday (9/5) struck 10.30 WIB. Officially the Propsu Health could not confirm whether Fuji suspect bird flu. Because of the RS Elisabeth side confirmed to the Health Service did not have their patient who died resulting from suspect bird flu. However his side continued to send his official to check again the medical data of Fuji br Ginting. According to Director RSUP H Adam the Owner Drg Armad P Daulay MKes in his press information with the Health Service, the Livestock Breeding Service and the Infokom Propsu Body, on Wednesday (10/5) in the Gubsu office, the number of patients suspect bird flu remained at 3 people. Be present at this press conference Kadis Livestock Breeding Propsu Ir the Siregar Uterus, Kadis the North Sumatran Health Dr Hj Fatni Sulani, Kaban Infokom Edy Sofyan the FOLDER and the Chairman of the team of the handling and the control of the patient suspect bird flu Dr M Nur Rasyid Lubis Sp.B (Fics). The three patients were Jones Ginting (25), Boni Karo-karo (18) and a female pre-schooler was named Renatha br Tarigan 1.5 years. SIB observation in isolation space, one of the patients Boni Karo-karo his condition was critical. To his body was installed the oxygen respiratory tract and the other detector. In fact in the meeting with the reporter in the Gubsu office, Director RSU H Adam the Owner stated the condition for the three patients was still being stable. According to Drg Armand P Daulay, Roy Karo-karo suffered breathless difficult and feverish high struck 10.30 WIB and finally died. The same sign was also experienced by Ananta br Ginting, when being done the photograph torax (the lungs) the condition for the lungs of the two casualties suffered difficult pneumonia. Anticipation that was carried out by the hospital side was to give medicine Tami Flu 3 x 75 mg to mature and for pre-schoolers was adapted to his weight, moreover the patient was also given Smotagsin medicine (anti the fever) as well as antibiotik the high dose. Both Roy and Ananta when undergoing the intensive maintenance was given teraphy oxygen. Adam's hospital the Owner provided 2 rooms of the isolation to suspect their respective bird flu the room contained 10 bed and will provide the room again to anticipate if the jump of the sufferer happening. Kadis Livestock Breeding Ir the Siregar Uterus said, the story of the sufferer suspect bird flu in this location was 2 nonpedigreed chickens belonging to Fuji died was followed by the Fuji death in RS Elisabeth. Afterwards 5 people suspect bird flu was reconciled to RSU H Adam the Owner. After getting this report on the Livestock Breeding Service did the meeting officially related the Karo Regional Government. Lalu disepakati semua unggas pada radius 3 Km dari lokasi kejadian untuk dimusnahkan. Jumlah unggas yang akan dimusnahkan berjumlah 2000 ekor dengan cara dibakar dan tiap ekor mendapat ganti rugi Rp 10.000. Namun kata Rahim, dinas terkait belum bisa memastikan apakah itu flu burung atau tidak karena masih menunggu hasil test darah korban dan unggas yang mati yang sudah dikirim ke Puslitbangkes Depkes RI yang hasilnya diketahui 2 hari kedepan. Selama ini kata Kadis Kesehatan Sumut suspect flu burung di Sumut hanya pada unggas seperti yang terjadi di Binjai, Medan Estate Deliserdang. Saat itu unggas peliharaan mati mendadak, namun suspect pada manusia belum ditemui. “Suspect pada manusia baru kita temui di Tanah Karo sekarang ini, namun hasil pemeriksaan darahlah yang memastikan apakah itu flu burung atau tidak,” kata Fatni. Kejadian di Tanah Karo sudah dilaporkan ke Gubsu Drs Rudolf M Pardede. Dinas terkait sudah mengirim tim ke lokasi dengan membawa peralatan desk infektan dan brosur-brosur tentang bahaya flu burung yang akan dibagikan kepada masyarakat. Kematian Fuji diketahui setelah keluarganya dirujuk ke RS Adam Malik. Pihak keluarga bercerita proses kematian Roy sama dengan kematian ibunya (Fuji) yaitu sesak nafas. Apalagi riwayatnya adalah kematian 2 ekor ayam secara mendadak dan mengkonsumsi daging ayam potong yang dibeli dari pasar. Baik Dinas Kesehatan dan Dinas Peternakan menolak anggapan kecolongan dengan kejadian tersebut. Fatni Sulani mengetahui kejadian itu Selasa (9/5) setelah kematian Roy dan 4 penderita lainnya. Setelah kejadian itu tim langsung dikirimkan ke lokasi dan memberi tindakan preventif. “Begitu ada kabar korban pertama meninggal di RS Elisabeth kami langsung menanyakan ke RS Elisabeth ternyata tidak ada yang suspect flu burung. kami tahu kabar tentang suspect tanggal 9, kenapa dibilang tidak koordinasi,” tegas Fatni. MENGUNGSI Isu Suspect Flu Burung semakin meresahkan masyarakat Tanah Karo, secara khusus bagi warga Desa Kubu Simbelang Kecamatan Tigapanah. Hal ini berawal, 6 pasien suspect flu burung dialami warga Desa Kubu Simbelang, 3 di antaranya telah meninggal dunia di RSU Adam Malik Medan. Darta Ginting warga Kubu Simbelang yang dimintai keterangannya, Rabu (10/5) di sela-sela mengadakan acara duka di rumah keluarga korban yang masih famili dekat dengannya, berharap agar Pemkab karo segera membuat tindakan persuasif di desanya. Selain melakukan penyemprotan, Pemkab Karo juga harus membuat tindakan pencegahan awal dengan menghadirkan tenaga-tenaga medis, ujarnya. Dari lokasi rumah korban Anta br Ginting dan Puji br Ginting yang kebetulan berdampingan rumah, ketika ditinjau langsung wartawan, Rabu (10/5), ternyata beberapa tetangganya mengungsi dari tempat tinggalnya Tarigan yang kebetulan tinggal di dekat rumah korban mengungsi ke tempat orangtuanya. Namun beberapa warga yang dimintai keterangannya menyebutkan bahwa tetangga sebelahnya takut tertular penyakit tersebut dari lingkungan rumah korban. Bahkan ada sebagian warga yang melintas di sekitar rumah korban melakukan tutup hidung, kemungkinan karena takut tertular penyakit tersebut. Siaga 24 jam Bupati Karo Drs DD Sinulingga yang dikonfirmasi melalui Kabag Humas Pemkab Karo Robert Peranginangin seusai rapat Muspida Plus, Rabu (10/5) telah memerintahkan seluruh instansi terkait agar dokter Puskesmas se- Kabupaten Karo siaga 24 jam untuk memantau adanya gejala penyakit seperti gejala flu burung serta Camat juga diperintahkan agar memonitoring warganya yang mengalami gejala tersebut. Selain itu, Bupati Karo juga telah membentuk posko di perbatasan Karo untuk mengantisipasi masuknya unggas dari luar daerah yang terjangkit flu burung. Untuk itu, Dinas Pertanian dan Peternakan bekerjasama dengan Kapolres Tanah Karo juga sekaligus melakukan pemeriksaan, bagi kendaraan yang membawa kandang unggas, akan memberlakukan standvas selama 12 jam bagi angkutan yang membawa pupuk kandang dari luar daerah. Penahanan truk pengangkut kandang unggas di perbatasan menurut Robert, agar virus yang ada dalam kandang tersebut selama 24 jam dapat mati, dan tidak aktif menularkan virus flu burung. Katanya, Dinas Kesehatan Propinsi juga akan ikut membantu dengan melakukan penyemprotan secara massal, serta melakukan penyuluhan-penyuluhan kepada seluruh masyarakat baik melalui spanduk atau poster-poster. GUBSU: BELUM DIKETAHUI PENYEBABNYA SECARA PASTI Sementara itu, untuk menyelidiki penyebabnya, Gubsu Drs Rudolf M Pardede telah menginstruksikan tim turun ke daerah tersebut dan mengirim sampel darah korban ke Pusat Penelitian dan Pengembangan Kesehatan (Puslitbangkes) Departemen Kesehatan RI. “Sampai saat ini belum diketahui secara pasti penyebab meninggalnya korban di Rumah Sakit H Adam Malik begitu juga korban yang sedang dirawat. Saat ini tindakan yang dilakukan bersifat emergency warning dan sudah ada pertemuan dengan tim Dinas Kesehatan bersama Dinas Peternakan,” kata Rudolf M Pardede kepada wartawan, Rabu (10/5) di Kantor Gubsu. Untuk menghindari keresahan dan penantian masyarakat Sumut mengenai kasus suspect flu burung tersebut, Gubsu menyatakan dalam dua minggu ini akan diketahui hasil penelitiannya secara pasti dari Puslitbangkes. Dan, dalam dua hari ini Dinas Peternakan sudah bisa memastikan apakah unggas di daerah tersebut terserang benar virus avian influenza (AI) atau tidak. PRIORITAS PENGAWASAN Sementara itu, Menteri Kesehatan dr Fadillah Supari mengatakan, dengan adanya kasus kematian warga Sumut yang dicurigai kuat sebagai suspect flu burung maka Sumut akan bisa masuk dalam daerah yang diprioritaskan untuk pengawasan flu burung di Indonesia setelah DKI Jakarta, Jabar, Jateng, Banten dan Lampung yang selama ini dikenal sebagai daerah yang paling tinggi terkena flu burung. Meski demikian menanggapi adanya kematian yang dicurigai kuat terjangkit flu burung di Sumut itu menurut Menteri hal itu masih menunggu hasil pemeriksaan di laboratorium. Menurut Menteri menyikapi hal itu pihaknya telah memerintahkan kepada instansi terkait di Sumut dan hal itu sedang dalam penelitian Dinas Peternakan Sumut yang datang ke lokasi untuk meneliti apa sebenarnya sumber penyebab infeksi. Tapi pihaknya belum tahu apakah penyebabnya memang bersumber dari pupuk. Kata Menteri, kasus flu burung akan bisa menjangkiti manusia selama masih ada unggas yang terinfeksi. Jadi sebenarnya kalau sudah ada ketahuan di daerah itu ada korban suspect flu burung menurutnya seharusnya ayam di daerah itu harus bersih. Menteri menceritakan pengalamannya di Vietnam saat terjadi kasus-kasus flu burung seluruh ayam selama enam bulan lamanya tidak ada di seluruh negeri. “Mereka itu tidak ada minta kompensasi karena unggasnya dimatikan. Karena mereka patuh pada pemerintahnya,” kata Menkes. (C13/RT/A12/C6/A6/y)

http://www.hariansib.com/index.php?o...=4489&Itemid=9

[HenryN]

2 villagers the Fortification Simbelang the Land Karo died with Gejalah was similar to Bird Flu

Written by editorial staff

On Wednesday, on May 10 2006

Kabanjahe (SIB) Villagers the Fortification Simbelang the Subdistrict three Karo Regency bows, was busy. His article, two citizens in this village, died with the sign similar to the bird flu illness. The two their respective casualties Praise br Ginting (40) and his son Roy Karo-Karo (18). Information that was received in the field mentioned, Praise br Ginting experienced was sick to last April 27 2006, with the sign of the continuous high fever to the temperature of his body reached 390 C was accompanied by coughs. The midwife the Village, Spoilt br Karo that was assigned in this village to be accompanied by the Sub-district Head three bows Drs could we Sinulingga, to the reporter, on Tuesday afternoon (9/5) said that himself could treat casualties several days in Pustu (the auxiliary Community Health Centre), afterwards saw his condition that did not improve then was reconciled to RSU Kabanjahe. Spoilt added, casualties died to last May 3 2006. Added Spoilt, second casualties Roy Karo-Karo that also the son of the uterus from Praise br Ginting after his mother died last May 3, also fell ill, afterwards immediately was reconciled to RSU Kabanjahe. Because of the illness that was suffered by him almost be the same as that was experienced by his mother, afterwards was reconciled to RS Adam the Owner, Medan. However, after several days were treated in Medan, finally Roy also died in RS Adam the Owner on May 9 2006. Responded to the existence of the assumption of the two casualties died resulting from the bird flu illness, several services the Karo Regional Government like the Health Service, the agricultural Service and Livestock Breeding, the Sub-district Head three bows and several members Subregional Police Karo descended to the field to research the truth of this assumption. Plt the agricultural Service, Ir Sidharta Pinem that was met by the reporter, on Tuesday afternoon (9/5) in the Simbelang Fortification Village was accompanied Kasubdis Livestock Breeding, drh Jenggi Surbakti after holding the meeting with the citizen in the village said, his side carried out early anticipation by making spraying of disinfectant to the available livestock animal in this village. Added, his side also suggested to all the citizen in order to destroy his poultry if being was found by signs like the fever, the palm foot the reddish swelling, the chest of the reddish swelling, foot the bleeding under skin as well as the cock's comb and fial was red bluish. Touched on whether the two casualties died it was suspected terindikasi bird flu, Sidharta Pinem still could not ascertain him. Because, Pinem words, the sample of blood both of them were taken and his inspection must be also carried out to Hong Kong. In the place was separated the Regent Karo DD Sinulingga through Kabag public relations, Robert Peranginangin when being confirmed the reporter, on Tuesday afternoon (9/5) in his office said, his side still could not confirm whether the two casualties were killed was resulted in terjangkit bird flu was in accordance with information from the Section Head the Kabupten Karo Health. Namun demikian, ungkap Robert, Pemkab Karo telah membentuk tim dalam pemberantasan perkembangan flu burung di Tanah Karo Simalem dengan berbagai unsur terkait seperti Dinas Kesehatan, Pertanian dan lainnya. Lebih lanjut dikatakan, pihaknya masih mengambil sampel darah kedua korban untuk diperiksakan ke Hongkong dan sampel tersebut telah dikirim. “Kita harus menunggu hasil pemeriksaan sampel darah tersebut untuk memastikan apakah kedua korban terindikasi penyakit flu burung,” imbuhnya. Sementara itu, pada hari yang sama, Dinas Kesehatan Provinsi Sumut juga melaporkan adanya dugaan flu burung yang menyerang satu keluarga di Desa Kubu Simbelang Kecamatan Tiga Panah Kabupaten Tanah Karo. Empat orang di antaranya masih dirawat intensif di RS Adam Malik Medan, sedang dua warga telah meninggal dunia. Mereka yang masih dirawat adalah A Br Sembiring (25), Gonta Ginting (25), Boni Karo-Karo (35) dan Prenata (1,5 tahun). Seluruhnya adalah satu keluarga dan tinggal di rumah yang sama. Menurut Kaban Infokom Provsu Eddy Syofian, sesuai informasi dari Dinkes Provsu, mereka ini mulai terserang penyakit dengan gejala demam dan sesak nafas sejak 4 Mei silam. Namun baru tanggal 8 Mei malam, korban dilarikan ke RS Adam Malik Medan. “Dari haris rontgen, terdapat gejala penomia radang paru-paru. Tapi belum bisa dipastikan apakah benar-benar mereka terserang flu burung,” tegas Eddy. Eddy menjelaskan, Dinas Kesehatan Provsu, tanpa menunggu hasil pemeriksaan Laboratorium Depkes RI di Jakarta yang membutuhkan waktu dua minggu, sudah melakukan langkah-langkah penyebaran dengan memberikan obat Tamiflu kepada pasien yang dirawat inap di RS Adam Malik Medan. Ini untuk mengatisipasi berkembangnya virus tersebut. Kata Eddy, Wakil Kepala Dinas Peternakan Provsu drh Tetty Erlina Lubis saat ini juga sedang berada di Tiga Panah bersama Direktur Kesehatan Hewan Departemen Peternakan Syamsul Bahri untuk melakukan penelitian. Namun, dari laporan sementara, belum ada unggas yang mati di kawasan tersebut. Begitupun, pihak Dinas Peternakan Provsu sudah mengambil specimen dari kotoran ternak. Sekaitan dengan ini, Gubernur Sumut Rudolf M Pardede menginstruksikan Dinas Kesehatan Provsu mengambil langkah-langkah cepat mengirimkan specimen kotoran korban ke Litbang Depkes RI di Jakarta guna memastikan apakah para korban benar-benar terserang flu burung atau tidak. Selain itu, Dinkes juga diminta untuk mengambil langkah-langkah memutus mata rantai penyebaran virus tersebut. “Meski demikian, warga jangan dulu panik. Ini masih dalam penelitian Pempropsu dan Pemkab Karo sudah mengambil langkah-langkah memutus mata rantai penyebaran virus ini. Bupati Karo juga sudah melakukan rapat lintas sektoral guna membahas persoalan ini,” kata Gubsu. (Pagi ini-red) Gubsu mengadakan rapat dengan instansi Dinas Kesehatan Provsu, Dinas Peternakan Provsu untuk mendapatkan informasi lebih lanjut dari perkembangan yang telah diinstruksikan Gubsu. (A12/C6/m)

http://www.hariansib.com/index.php?o...=4413&Itemid=9

[HenryN]

Commentary at

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

Originally Posted by niman

Commentary at

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

Commentary
Efficient Transmission of H5N1 to Karo Cluster Members

Recombinomics Commentary
May 15, 2006

Praise br Ginting experienced was sick to last April 27 2006, with the sign of the continuous high fever to the temperature of his body reached 390 C was accompanied by coughs.

The midwife the Village, Spoilt br Karo that was assigned in this village to be accompanied by the Sub-district Head three bows Drs could we Sinulingga, to the reporter, on Tuesday afternoon (9/5) said that himself could treat casualties several days in Pustu (the auxiliary Community Health Centre), afterwards saw his condition that did not improve then was reconciled to RSU Kabanjahe. Spoilt added, casualties died to last May 3 2006.

Added Spoilt, second casualties Roy Karo-Karo that also the son of the uterus from Praise br Ginting after his mother died last May 3, also fell ill, afterwards immediately was reconciled to RSU Kabanjahe. Because of the illness that was suffered by him almost be the same as that was experienced by his mother, afterwards was reconciled to RS Adam the Owner, Medan. However, after several days were treated in Medan, finally Roy also died in RS Adam the Owner on May 9 2006.

The above translation of the initial symptoms in members of the H5N1 cluster from Karo points toward human-to-human transmission. Most of the H5N1 bird flu clusters described to date have a 5-10 day gap in disease onset dates between the index case and other family members. The dates above indicate that the index case developed symptoms on April 27, 2006 and her oldest son became ill around the time of her death. That was followed by symptoms developing the other family members. Six of the eight have now died and the remaining two are hospitalized at Adam Malik or Elizabeth hospitals in Medan in North Sumatra. The dates of death for the other family members were May 10, 12, 13, 14.

The cluster is the largest reported to date in Indonesia. The efficient transfer of H5N1 from the mother to seven other family members is cause for concern.

[DB]

http://www.alertnet.org/thenews/newsdesk/L15751926.htm
Indonesia probes bird flu cluster; WHO alerted
15 May 2006 14:49:51 GMT
Source: Reuters

JAKARTA, May 15 (Reuters) - Indonesia is investigating an outbreak of H5NI bird flu in up to eight members of a North Sumatran family, six of whom have died, Agriculture Minister Anton Apriyantono said on Monday.


Five of the eight, including four of the dead, showed positive for avian flu in local tests, while three other family members were suspected cases, the minister said.


Apriyantono added that the deadly virus had not yet been found in local poultry, which is normally the source for infections in humans.


In Geneva, the World Health Organisation (WHO) said it was following the case closely because of the possibility of human-to-human infection.


Bird flu has killed 115 people, mostly in east Asia, since reappearing in 2003, with virtually all the victims catching the disease from poultry.


The United Nations' health agency is on alert for signs that the virus is mutating into one that can be easily transmitted between people, a development that could signal the start of a pandemic in which millions could die.


"It is something we are taking very seriously," said WHO spokeswoman Maria Cheng about the Indonesian case. "Any time we have a possible cluster it raises suspicions that human-to-human transmission may have occurred," she told Reuters.


Experts have in the past said that cluster cases of possible bird flu cases among family members do not mean the virus is necessarily mutating. It could be caused by the close contact normal in families. There have been a number of such examples in Vietnam and Thailand, Cheng said.


"It may be that these people had common exposure, it may be that they caught the disease taking care of family members. Right now we do not know, but it is something that has caught our attention," she said.
Cheng said WHO hoped to know more in the next few days.


An Indonesian health ministry spokeswoman said blood samples of the five people who had tested positive locally had been sent to a WHO-affiliated laboratory in Hong Kong for confirmation. Local tests are not considered definitive.


The WHO also sent a team to North Sumatra to investigate the case, said Sari Setiogi, a spokeswoman for the agency.


"So far, an examination of chickens, ducks and pigs around the victims' houses has turned out negative," Apriyantono told reporters on the sidelines of a Food and Agriculture Organisation meeting in Jakarta. "But we still have to thoroughly investigate it as it's a complicated case." (Additional reporting by Richard Waddington in Geneva)

[Bruce]

I have a peculiar way of reading this and more hassle trying to explain what I mean but here goes.
If 5/8 whatever but 6/8 are dead and 4/6 dead test positive there must be 2/6 false negatives in the dead.


4/6 = 2/3 test positive, the false negative results are 1/3 or 33.33 %

[Theresa42]

Originally Posted by Kissa

I have a peculiar way of reading this and more hassle trying to explain what I mean but here goes.
If 5/8 whatever but 6/8 are dead and 4/6 dead test positive there must be 2/6 false negatives in the dead.


4/6 = 2/3 test positive, the false negative results are 1/3 or 33.33 %

That made perfect sense. And, is not a good track record as far as their testing capabilities go....

[HenryN]

Originally Posted by Kissa

I have a peculiar way of reading this and more hassle trying to explain what I mean but here goes.
If 5/8 whatever but 6/8 are dead and 4/6 dead test positive there must be 2/6 false negatives in the dead.


4/6 = 2/3 test positive, the false negative results are 1/3 or 33.33 %

Not all have been tested (some reports indicate samples were not available from the index case).

[HenryN]

Jakarta -- MIOL: till at this time did not yet have the indication of the spread of the virus between humankind in Indonesia, although the case of the infection of the bird flu virus (Avian influenza-AI) gathered (cluster) to humankind improved.
That was raised by Pengendalian Breakingprep Penyakit Director and Sanitation of the I Nyoman Kandun Health of the Department's Environment.
"Praise the Lord until this did not yet have the indication in that direction," said Kandun to Antara in Jakarta, on Monday.
He explained apart from the case cluster the indication of the possibility of the occurrence of the spread of the infection of the bird flu virus of the beginning could be between humankind known when the same case was found in the health power that carried out contact and treated the patient with the infection of the bird flu virus.
"If having the doctor or the positive nurse and the genetic character of his virus was the same as the available virus to the patient then the big possibility happened the spread between humankind."
But until this that was not yet available, he said.
Kandun explained beforehand a nurse who carried out contact with the patient who was suspected or infected by the bird flu virus in Medan was sick and showed the similar sign of the AI virus infection but after being checked by the nurse was stated by the negative or was not infected by this virus.
The person's eleven specimens that carried out contact with the citizen who was expected and positive was infected by AI, said he, also has been checked and all of them the negative or was not infected by the virus of AI H5N1.
He said if having the indication of the spread of the bird flu virus between humankind then the area of the location of the spread will be isolated.
"If confused positive had the spread between humankind then certainly the relevant area will be blocked that the spread of the virus does not spread."
His poultries were also destroyed, he said.
It was further that he explained in order to anticipates the spreading of the infection of the virus of government bird flu will intensify the implementation of the national strategy the control of bird flu and spread invenstigasi the illness to be able to find the case of bird flu as early as possible.
The "implementation of the national strategy will be intensified."
His investigation would diekstensifkan, he said.
He also asked the community to guard against the spread of the infection and to avoid itself so that not tertular with always guarded the cleanliness himself and the environment.
"Was not difficult."
Only industriously washed the hands before consuming food, guarded the cleanliness


http://www.mediaindo.co.id/berita.asp?id=99838

[DB]

So the nurse has the same symptoms as the patients but has tested negative for H5N1.

My guess is that if they test her again they will find the virus.

[Bruce]

Thanks, sounds better already.

Originally Posted by niman

Not all have been tested (some reports indicate samples were not available from the index case).

But your last post gets my peculiar thinking going again

Originally Posted by niman

Jakarta -- MIOL: till at this time did not yet have the indication of the spread of the virus between humankind in Indonesia, although the case of the infection of the bird flu virus (Avian influenza-AI) gathered (cluster) to humankind improved...

[HenryN]

Infectious diseases It did not yet have the Indication of the Spread of Bird Flu between Humankind

Jakarta -- MIOL: Till at this time did not yet have the indication of the spread of the virus between humankind in Indonesia, although the case of the infection of the bird flu virus (Avian influenza-AI) gathered (cluster) to humankind improved. That was raised by Pengendalian Breakingprep Penyakit Director and Sanitation of the I Nyoman Kandun Health of the Department's Environment. "Praise the Lord until this did not yet have the indication in that direction," said Kandun to Antara In Jakarta, on Monday. He explained apart from the case cluster the indication of the possibility of the occurrence of the spread of the infection of the bird flu virus of the beginning could be between humankind known when the same case was found in the health power that carried out contact and treated the patient with the infection of the bird flu virus. "If having the doctor or the positive nurse and the genetic character of his virus was the same as the available virus to the patient then the big possibility happened the spread between humankind." But until this that was not yet available, he said. Kandun explained beforehand a nurse who carried out contact with the patient who was suspected or infected by the bird flu virus in Medan was sick and showed the similar sign of the AI virus infection but after being checked by the nurse was stated by the negative or was not infected by this virus. The person's eleven specimens that carried out contact with the citizen who was expected and positive was infected by AI, said he, also has been checked and all of them the negative or was not infected by the virus of AI H5N1. He said if having the indication of the spread of the bird flu virus between humankind then the area of the location of the spread will be isolated. "If confused positive had the spread between humankind then certainly the relevant area will be blocked that the spread of the virus does not spread." His poultries were also destroyed, he said. It was further that he explained in order to anticipates the spreading of the infection of the virus of government bird flu will intensify the implementation of the national strategy the control of bird flu and spread invenstigasi the illness to be able to find the case of bird flu as early as possible. The "implementation of the national strategy will be intensified." His investigation would diekstensifkan, he said. He also asked the community to guard against the spread of the infection and to avoid itself so that not tertular with always guarded the cleanliness himself and the environment. "Was not difficult." Only industriously washed the hands before consuming food, guarded the cleanliness of the environment around and guarded the cleanliness of the livestock as well as his pen we could avoid ourselves from the infection, he said. According to Kandun, the case of the infection of the bird flu virus in humankind in the Karo Regency, North Sumatra was the case cluster new bird flu and that biggest. "This was cluster just and that biggest," he said. Eight citizens of the Karo Regency, North Sumatra namely PBS (40), ABS (29), RKK (19), JG (25), BKK (35), B (1,5), RG (10) and TG (35) was reported as the patient it was suspected was infected by the bird flu virus. PBS that began to be sick on April 27 2006 entered the hospital and died in the hospital on May 4 could not be taken his specimen to be checked further by the cause of his infection. Five other patients namely ABS (died on May 10), RKK (died on May 9), BKK (died on May 12) and B (died on May 14) and JG (lived) was stated positive was infected by the AI virus by the Body of Health Research And Development (Balitbangkes) the Department of the Health.Whereas the specimen inspection of two other patients namely RG and TG, according to Kandun, was not yet finished was done.He explained also that the eight patients who it was suspected were infected by the bird flu virus in this regency had affinity relations.PBS that entered the hospital on May 4 2006 was the mother from RKK that entered the hospital on May 5 2006 and BKK that entered the hospital on May 8 as well as was the full sibling from ABS and JG that entered the hospital on May 8 2006.Whereas B was the child from ABS or the nephew from PBS.Kandun explained also that a patient that it was suspected was infected by the bird flu virus but still refused to be taken his blood specimen namely TG (35), also was the cousin from PBS.Beforehand the case of bird flu to humankind that happened to more than one person in the same area in time extension that was not far was different or that often was mentioned 'cluster the case' happened to Is (37) and his two children in the Tangerang area, Rd (36) and his nephew in Southern Jakarta, Her (21) and his nephew in Lampung, Is (19) and his brother in the Sugar Palm Hut, Tangerang, as well as N (13) and his brother E (4) in Indramayu.With this new case increase, then according to the local laboratory at this time was gotten by 42 cases of bird flu in the homeland and 32 including dying.Whereas according to the laboratory of the Health of the World of Organisation reconciliation (WHO) in Hong Kong was gotten by as many as 35 cases and 26 including dying.At this time the specimen of bird flu that just was found of cases was sent to the WHO reconciliation laboratory in Hong Kong to be confirmed.(Ant/OL-03) http://www.mediaindo.co.id/berita.asp?id=99838

[KC]

Am I following this correctly? 128 confirmed, active cases? One obvious cluster?

At what point does the number of clusters determine that a chain has started?

[Sally Furniss]

I have been trying to get this story but wont cut and paste, can some one give it a go
http://www.antara.co.id/en/seenws/?id=12721

[Mellie]

KC, read Henry's summary: http://www.recombinomics.com/News/05..._Contacts.html He caught the Wall Street Journal article.

Here's another good summary:
http://www.flutrackers.com/forum/sho...&postcount=125
from here: http://crofsblogs.typepad.com/h5n1/2...f_ta.html#more

Read the ReveresDocs comments on clusters:
http://www.flutrackers.com/forum/sho...4&postcount=20
from here:
http://effectmeasure.blogspot.com/

Snowy Owl picked up on the Indonesian cluster early on (5/2).
http://www.flutrackers.com/forum/showthread.php?t=5363
Theresa42 has been unrelenting in collecting info...

[Mellie]

AnnieZ's find: http://www.antara.co.id/en/seenws/?id=12721

May 15 16:25
Two more bird-flu patients die in Adam Malik hospital

Medan, N Sumatra (ANTARA News) - Two bird flu patients passed away in Adam Malik Hospital Medan, a spokesman of the hospital dr. Alwinsyah Abidin said here on Monday.

With the latest deaths, a total of six bird flu patients had passed away in the hospital so far, he said.

Raphael (8) died at midnight on Saturday, while Brenita Karo-karo (18 months) died on Sunday evening.

The two children suffered from high fever when they were brought to the hospital. They were later put in an isolated care unit for intensive medical treatment until they passed away.

Currently, Adam Malik Hospital is still treating another bird flu patient, namely Johanes Ginting (25), from Tanah Karo village, North Sumatra.

Coordinating Minister for People?s Welfare Aburizal Bakrie early this month said that some 401 suspects of bird flu (avian influenza) had been examined. Of the number, 330 were declared negative with the bird flu virus, 128 were still under observations and 128 had been confirmed positive with the virus.

Indonesia needs some US$900 million for a three-year program to fight Avian flu, he said, adding that the funds would be obtained from the state budget (US$50 million per year) and the private sector (US$20 million per year). (*)

Copyright © 2006 LKBN ANTARA

[DB]

"...128 had been confirmed positive with the virus..."

There it is again.