Indonesia: Human Cases 8 Oct 2008 - January 28, 2009

[HenryN]

Re: Indonesia: Human Cases 8 Oct 2008 +

Indonesia says 17 in Sulawesi not infected with bird flu
20 Nov 2008 10:48:25 GMT
<!-- 20 Nov 2008 10:48:25 GMT ## for search indexer, do not remove -->Source: Reuters

<!-- AN5.0 article title end --><SCRIPT language=JavaScript src="/bin/js/article.js"></SCRIPT></SPAN><INPUT id=CurrentSize type=hidden name=CurrentSize> <!-- Indonesia says 17 in Sulawesi not infected with bird flu --><!-- Reuters -->JAKARTA, Nov 20 (Reuters) - Bird flu has been ruled out as the cause of illness in 17 people from the same neighbourhood of Makasar in Sulawesi, Indonesia, a health ministry official said on Thursday.
The 17 were hospitalised this month after falling sick shortly after a rash of unexplained chicken deaths in the area.
"The result of the tests is negative," said Lily Sulistyowati, spokeswoman of the ministry, without giving details.
Suspected outbreaks raise concerns about rare human-to-human transmission or that the virus might have mutated into a form that can pass easily among people.
The country's largest known cluster of bird flu cases in humans occurred in May 2006 in the Karo district of North Sumatra province, when as many as seven people in an extended family died.
The World Health Organisation said at the time that limited human-to-human transmission could not be ruled out but that the virus samples from the scene did not show any significant genetic mutations.
Bird flu remains mainly an animal disease, but experts fear the H5N1 virus might mutate into a pandemic strain that would sweep the globe, possibly killing millions and hobbling economies.
Indonesia has the highest toll of any nation. Some 112 people have died because of the disease.
Last week, a health official said a 15-year-old Indonesian girl had died of bird flu in central Java, but Chandra Yoga Adhitama, acting director-general of communicable disease control, said tests showed bird flu was not responsible. (Reporting by Telly Nathalia; Editing by Sugita Katyal)

http://www.alertnet.org/thenews/newsdesk/SP170904.htm

<!-- news ## for search indexer, do not remove -->

[Gert van der Hoek]

Re: Indonesia: Human Cases 8 Oct 2008 +

Summary of the news from the Sulawesi patients.


But results rapid test influenza, six including experiencing the A illness of the influenza kind that headed to H5N1 and three among them, results of the photograph of the torax experienced bronchopneumonia, that had an opportunity also to the side of infected him the virus H5N1, explained Kurnia.

http://www.flutrackers.com/forum/showpost.php?p=190685&postcount=147

"They were taken to the hospital because of this experience fever with body temperature higher, and in the vicinity of his home found dozens of dead chickens rot with a bluish body," said a nurse at the hospital ruanga isolation Wahidin, Fatimah, Thursday.

"From the results of the examination while in the laboratory, six patients experienced a type of influenza A disease that leads to the AI and three more from the results of the photo shows the torax to bronchopneumonia, which also have the opportunity to the AI," she said.

About the chickens were found dead on the patient around the house, the head of the Office of Makassar Health Naisyah Tun Asikin said based on the results of Health Office of Makassar on the sample of dead chickens known chickens are positive to have the H5N1 virus.

http://www.flutrackers.com/forum/showpost.php?p=190710&postcount=154

, said to 10 patients suffered the same sign, namely flu, the fever, the cough and breathless.

http://www.flutrackers.com/forum/showpost.php?p=190711&postcount=155

"Rapid tests showed they may be infected with the H5N1 avian influenza virus, but we are waiting for blood test results to come back from the Hasanuddin University lab," Kurnia said.

http://www.flutrackers.com/forum/showpost.php?p=190730&postcount=160

But could be concluded by the patient did not experience leukopeni (the decline in the number of white blood cells) , obviously Plh. Director General Pencegahan of the Illness and Sanitation of Lingkungan Department of Health Tjandra Yoga Aditama to the Indonesian Media, on Thursday (13/11).

http://www.flutrackers.com/forum/showpost.php?p=190767&postcount=163

All this patient was reconciled by the Sudiang Community Health Centre to RS Wahidin since last Wednesday (12/11) after experiencing the high fever around 39.5 Celsius levels. Moreover, they also experienced breathless and the cough continually.

?Dugaan this bird flu to strengthen with respect towards 17 pasients here after hundreds of poultries in and around his environment died suddenly since a week of last,? expressed Kepala IRD RS Wahidin that also the team's member of the handling of bird flu Dr Wasis Udaya yesterday. Moreover, said Wasis, from results of the research that was carried out by the Kesehatan Service of the Makassar City of finding several poultries that died positive terjangkit the virus H5N1 that spread.

http://www.flutrackers.com/forum/showpost.php?p=190847&postcount=173

According to casualties's older brother, Ahmad Hidayat, before being run off with to the hospital, Firdaus could play with the chicken that was sick.

Last week, this chicken died. Not old afterwards Firdaus experienced the high fever that was accompanied breathless.

http://www.flutrackers.com/forum/showpost.php?p=190926&postcount=191

Dr Khalid Saleh said, all the patients who were examined in the isolation space suffered the sign bird flu.
Even, obviously Khalid, in the day of the two isolation was four that was physical him was very weak until experiencing the fever achieved 39 levels celcius, but after being carried out by the medical treatment action by giving flu medicine or tami flu gradually his condition has improved. Khalid said, to maximise the handling then in this hospital was formed the control command post, in order to facilitates the co-ordination in the handling of the patient.

http://www.flutrackers.com/forum/showpost.php?p=191010&postcount=199

Komnas/FBPI:

But in a manner logic, I saw 17 suspect this was positive, because I asked the hospital side, their illness not malaria, also not typhus, moreover, they were in the territory that was the same as the positive poultry carcass bird flu that was found.

http://www.flutrackers.com/forum/showpost.php?p=191267&postcount=227

The Health Service of the Makassar City did not want the number of sufferers suspect bird flu continued to improve. Following was treated by him 17 patients who it was suspected were attacked by this deadly illness virus, Section Head Kesehatan Makassar, Naisya T Azikin at once alerted 37 community health centres and the available hospital in this city.

The community health centre and RS that were spread in 14 subdistricts more than one Makassar had the special medical team handled bird flu. The resident could also get bird flu medicine free. "In each Community Health Centre was prepared by us the handling command post" of "bird flu." Although the command post was all over the community health centre, but was given priority to by us in the serious territory, like Biringkanaya and Manggala, said Naisya that was contacted, yesterday.

Especially stock of medicine for the bird flu illness, tamiflu, Naisya admitted to not having the problem. All the community health centre and RS had supplies that were enough during several months in the future.

http://www.flutrackers.com/forum/showpost.php?p=191329&postcount=230

"But we were grateful their condition is currently relative better." Not there is again that the temperature of his body was high or coughs, revealed Khalik.

Nevertheless, according to Khalik, still was several of the him that was given medicine by the team of the doctor. Giving of this medicine according to Khalik appropriate protap the handling of the patient suspect bird flu.

http://www.flutrackers.com/forum/showpost.php?p=191412&postcount=234

Makassar, Tribun - the Government of the South Sulawesi Province (the South Sulawesi Provincial Government) formed the Regional Commission (Komda) the Handling and the Control of Provinsi Selatan Bird Flu.

The members who were bundled into this Komda were strengthened directly by South Sulawesi Governor, Syahrul Yasin Limpo, that also acted as this Chairman Komisi in the Quality Hotel, Makassar, on Tuesday (18/11).

According to Syahrul, the plague of the bird flu illness in South Sulawesi at this time increasingly increased and South Sulawesi was one of the territories had the big risk to terjangkit this deadly virus. Moreover with the existence 17 residents Patene that at this time still was suspected terjangkit this illness.

http://www.flutrackers.com/forum/showpost.php?p=191493&postcount=235

17 patients suspect bird flu that underwent the maintenance while a week in the ferns building of RSUP Dr Wahidin Sudirohusodo, currently could sigh in relief. Results of the sample inspection of blood and the bribe (litteraly: mouthfull = mucus, ed) of the patients who were sent to the Penelitian Dan Pengembangan Kesehatan Laboratory (Litbangkes) Jakarta stated the negative.

The patient that most were still having the family's relations with Dg Nginga, continued to be isolated. But his infusion already was not installed again. All of them very healthy.

http://www.flutrackers.com/forum/showpost.php?p=191521&postcount=237

The Number Of patients suspect bird flu that was treated in the Pusat Public Hospital (RSUP) Dr Wahidin Sudirohusodo continued to increase. After beforehand enters 17 people, currently increased again with two people. They were carried his family on Tuesday (18/11). Both of them that still these children is there Ikbal (6) and Karmila (3).

http://www.flutrackers.com/forum/showpost.php?p=191725&postcount=243

�Yesterday, there were two patients who entered. Both of them still domiciled in the region was the same as the patient beforehand ,� the spokesperson's words the Team of the Handling of RSWS Bird Flu, Dr Khalik, in Makassar, on Wednesday.

One from from two patients, his condition was still experiencing the high fever and consequently, the hospital side still carried out the intensive maintenance to this patient.

Whereas the condition for the other patient already in the good condition.

http://www.flutrackers.com/forum/showpost.php?p=191806&postcount=248

[Gert van der Hoek]

Re: Indonesia: Human Cases 8 Oct 2008 +

Update from Sulawesi

On Friday, 21-11-2008

5 went home, 5 left in Isolation Space

Today Mayor Discussed Bird Flu in RS Wahidin

MAKASSAR, BKM -- the RS Wahidin Sudirohusodo Side had finally accepted results of the research of the Penelitian Dan Pengembangan Kesehatan Laboratory (Litbangkes) Jakarta against the sample of blood and the bribe 17 patients suspect bird flu. All of them were stated by the virus negative H5N1.

Referred in the results, the hospital side finally permitted came home five patients, on Thursday (20/11). While five other people were also recommended to leave isolation space. Now two new patients, namely Ikbal (6) and Karmila (3) still was isolated in ferns space. Both of them were taken the sample of blood and his bribe, furthermore was sent to Litbangkes to be checked. Especially for 17 patients who entered beforehand, has had results of his lab. All of them were stated by the negative.

Five people were permitted to come home, five other left isolation space, explained Dr Khalik Saleh, Koordinator the Control and the Prevention of Bird Flu of RSUP Dr Wahidin Sudirohusodo that was contacted yesterday afternoon.

In the meantime, Health Minister Dr Fadillah Supari that it was reported will visit to RS Wahidin saw directly the condition for the patient suspect bird flu, till the afternoon yesterday never came. Information in RS Wahidin mentioned, Menkes and the party failed came because of having the other task that was more important in Jakarta. BKM observation in the ferns building, yesterday, was seen by the physical condition for all the patients has begun to improve. There was not again the patient that diinfus.

They was not in the place of his maintenance was their respective. The patient that most children were seen playing in front of the foyer of the ferns building. Wanted sekalimaki came home, but was not yet permitted to be the same the doctor.

Therefore we still here, said Rizal, one of the patients. Following the resident's increase Sudiang that became the patient suspect bird flu, the Sub-district Head Biringkanaya, M. Yasir gave special attention of this territory. He also the routine carried out the monitoring in the endemic area of the bird flu.

Like that the implementation, on Thursday (20/11). Yasir was seen came to meet his resident. He ask for so that all the resident Biringkanaya, especially that settled in Sudiang to preceptive and increased his vigilance towards the spreading of the virus H5N1. Moreover they were also asked to maintain the cleanliness of the environment.

If having the chicken that died suddenly, immediately reported to RT or RW. Kalau necessary to the village head's office and the community health centre, he added. Mayor Makassar, A Herry Iskandar his plan will spread out the meeting in RS Wahidin today, on Friday (21/11). This meeting in order to discusses the handling of bird flu and other infectious diseases.

http://www.beritakotamakassar.com/view.php?id=21633

[HenryN]

Re: Indonesia: Human Cases 8 Oct 2008 +

Commentary

http://www.recombinomics.com/News/11180803/H5N1_Indo_Confirmation_Denial.html

[Giuseppe]

Re: Indonesia: Human Cases 8 Oct 2008 +

While the entire Sulawesi incident could be viewed as fabricated, one may highlight the striking feature of a cluster of more than a dozen of people than rapidly recovered after an undefined febrile and respiratory illness.

Since to date at least a third of human H5N1 cases - in the more favorable scenarios, for example Turkey - died even treated with oseltamivir and intensive care, one may be skeptical about the real nature of the illness of these patients hospitalized in Makassar, Sulawesi.

For a certain perspective, one could advise in that a sort of ''adverstisement'' in the light of local political confrontation, where the apparent commitment of infectious diseases hospital, sudden improvement of patients, are nothing else if a fabricated event.

In a country where not less than 80 per cent of H5N1 human cases resulted in the death of patients, I have some difficult to accept the outcome of these seventeen patients as result of a prompt and successful treatment with oseltamivir.

[HenryN]

Re: Indonesia: Human Cases 8 Oct 2008 +

While the entire Sulawesi incident could be viewed as fabricated, one may highlight the striking feature of a cluster of more than a dozen of people than rapidly recovered after an undefined febrile and respiratory illness.

Since to date at least a third of human H5N1 cases - in the more favorable scenarios, for example Turkey - died even treated with oseltamivir and intensive care, one may be skeptical about the real nature of the illness of these patients hospitalized in Makassar, Sulawesi.

For a certain perspective, one could advise in that a sort of ''adverstisement'' in the light of local political confrontation, where the apparent commitment of infectious diseases hospital, sudden improvement of patients, are nothing else if a fabricated event.

In a country where not less than 80 per cent of H5N1 human cases resulted in the death of patients, I have some difficult to accept the outcome of these seventeen patients as result of a prompt and successful treatment with oseltamivir.

In the spring of 2007 there were 18 lab confirmed H5N1 cases in Egypt. In each case H5N1 was isolated and sequences have been made public. Most were children. All but one recovered (many within a few days) after prompt treatment with Tamiflu. Same for the spring of 2005 in northen Vietnam (case fatality rate below 10%).

Mild H5N1 has been well documented, especially when promptly treated with Tamiflu.

In Indonesia the 80% case fatality rate applies to CONFIRMED cases. In Indonesia, if you recover, you don't have H5N1 (almost all case who recovered were contacts of confirmed cases).

[Giuseppe]

Re: Indonesia: Human Cases 8 Oct 2008 +

We haven't nothing to state that Makassar's suspected cluster is really a cluster of H5N1 human cases.

NO CLINICAL DESCRIPTION
NO PATHOLOGICAL FINDINGS
NO DATE ONSET
NO LABORATORY BASIC BLOOD PANEL
NO ADVANCED LAB RESULTS (aka LDH, CPK, d-dimer, protein C, INR (for disseminated intravascular coagulopathy), and liver enzymes, renal function, thorax x-rays, CT...)
ZERO CASE FATALITY RATE

Converserly, we have:

A GOOD MEDIA COVERAGE
A PROMPT COHORTING OF PATIENTS
A GUARDED ISOLATION FACILITY
PHOTO-OPS FOR REPORTERS WITH RECOVERED PATIENTS

Further, we have:

AN IMPENDING PRESIDENTIAL ELECTION
ONGOING ADMINISTRATIVE ELECTIONS
W.H.O. MEETING FOR SHARING AND BENEFITS DEFINITION

Thus, the entire incident may be fabricated.

[Treyfish]

Re: Indonesia: Human Cases 8 Oct 2008 +

Five Suspect Flu Burung released
(on November 21 2008,
MAKASSAR -- results of the sample inspection of blood for 17 patients suspect bird flu in the Wahidin Sudirohusodo Hospital (RSWS), has gone out, results; negatif.
Juru spoke about the team of the control of RSWS bird flu, Dr Khalid Saleh when being contacted via the telephone last night said, all the samples of blood that was sent to the laboratory showed the bird flu negative. On these results, five patients who have been healthy, were allowed to come home. They were Annisa, Firdaus, Rahmawati, Hasnawati, and Fauzi. The five of them the resident of the Tangki Jangang Kelurahan Sudiang Kecamatan Biringkanaya Village.
The other patient still in isolation space, but, his health has improved, including Ikbal,6, and Karmila,4, that just entered.

Was related to these results, the staff the National Commission (Komnas) Bird Flu and the influenza Pandemic (FBPI), Dr Dr Armyn Nurdin MSc to the Dawn, on Thursday, November 20 said, These results still must be confirmed again in the laboratory that was other for his accuracy. Including in the Nehri Laboratory in the Unhas School Of Medicine, or in the Laboratory of CDC Atlanta.

"If not bird flu, the doctor must explain was sick that was suffered by 19 patients." Moreover, results of the inspection of the poultry carcass in the location, positive bird flu, said Armyn.http://cetak.fajar.co.id/news.php?newsid=80035

[Gert van der Hoek]

Re: Indonesia: Human Cases 8 Oct 2008 +

Was related to these results, the staff the National Commission (Komnas) Bird Flu and the influenza Pandemic (FBPI), Dr Dr Armyn Nurdin MSc to Fajar (newspaper,ed) on Thursday, November 20 said: These results still must be confirmed again in the laboratory that was other for his accuracy.

Including in the Nehri Laboratory in the Unhas School Of Medicine, or in the Laboratory of CDC Atlanta.

"If not bird flu, the doctor must explain was sick that was suffered by 19 patients."

Interesting.

[Gert van der Hoek]

Re: Indonesia: Human Cases 8 Oct 2008 +

19 Suspect Patients Negative Bird Flu

on Friday, on November 21 2008 MAKASSAR (SINDO) ?Totalling 19 patients suspect bird flu that were treated in the Wahidin Sudirohusodo Hospital (RSWS) , ascertained the negative was infected by the bird flu virus.

This assurance was based on results of the sample inspection of blood and the mucus of the patients who were sent to the Laboratory of the Health of the Department's Research And Development (Litbangkes) RI.

? Earlier in the afternoon (on Thursday, 20/11), we have accepted results and stated this patient negative for bird flu ,? said the Spokesperson the Team of the Handling of RSWS Bird Flu Dr Khalik to SINDO, earlier the night.

With results of the laboratory this, the side him permitted came home for five patients who have undergone the maintenance for a week more in ferns space RSWS.

These five patients are, Annisa,Firdaus,Hasnawati,Fauzi, 3, and Rahmawati, 2.Mereka the resident who anxious domiciled at the Village of Tangkejangang Street Pattene RW 2 of RT 5, the Sudiang District, the Biringkanaya Subdistrict.

The condition for the five patients has improved and was permitted by us to come home respectively, said Dr Khalik.

He said, the condition 12 other patients who still were isolated already in the situation improved and will be returned gradually.

As for the name of the patient who still was isolated this, namely Nurul Awaliah, 3.6 months, Nurfadilah, 4 months, Salman, 4, the Inspiration, 2, Alif, 3 months, Desi, 5, Eki Desriani, 5 months, Irwan, 6, Saleha 12, NY Johani, 60, Nartati, 26, and Nuraeni,31.

In the meantime, the Marine Service and Endurance Food again destroyed six tails of the poultry yesterday. However, the location of the discovery of this poultry in the location other, that is in the Sudiang Raya District, Kecamatan Biringka-naya. With like that, the discovery the poultry that anxious stated positive bird anxious flu in three points.

Beforehand, 167 poultries that were destroyed were found in the Village of Tangkejangang Street Pattene RW 2 RT 5 districts of Sudiang, Kecamatan Biringkanaya.

A week ago, the poultry that died and was stated positive bird flu was again found in RT 1 RW 5 in the district and the same subdistrict. We still did penyisiran against several poultries.

Results, we destroyed this poultry because of being stated positive bird flu, said the Head of the Peternakan Dinas Kelautan Field and Pangan Makassar Yulistiawati Endurance.

His side also continues to carry out spraying of disinfectant in this location, especially in very second-hand the pen the poultry that has been destroyed some time before.

The data from RSWS mentioned, the period 2006?2007, the case suspect bird flu that was found achieved 37 cases.

From the this number, one patient was stated positive. Till november this year, RSWS handled 19 patients suspect bird flu with results of the negative.

http://www.seputar-indonesia.com/edisicetak/content/view/188907/37/

[Commonground]

Re: Indonesia: Human Cases 8 Oct 2008 +

How is it that it takes 8 days to get the results on 17 suspected cases...and less than 48 hours to get the results on 2 suspected cases?
And what are the clinical descriptions of the ones that remain in the hospital?
Assuming the whole family and surrounding neighbors were well informed of the availability of the free Tamiflu, why are the other 2 admitted? The Tamiflu should have worked well.

Also, Thank You, Dr Dr Armyn Nurdin MSc, for asking all the logical questions. It's nice to see some logic once in a while in these circumstances.

[Guest]

Re: Indonesia: Human Cases 8 Oct 2008 +

Sounds like the journalist just got the 17 who were tested and the 19 patients total confused. I do hope we get to hear more details about the tests on the other two once they're completed.

I'm glad that doctor spoke up as well. Is there any way we could leverage this incident to raise awareness about Indonesia's less-than-transparent handling of these situations?

[Commonground]

Re: Indonesia: Human Cases 8 Oct 2008 +

High fever, immediately to health

Rabu, 19-11-2008 | 14:23:27

Makassar, Tribune - The Government of Makassar team has been formed Countermeasures Extraordinary Conditions (KLB) disease. Residents of the city, suddenly suffer a high fever immediately diimbau {summoned; beckoned; called} example in the nearest health center.

The team consists of the health office, office, marine and food security, three referral hospitals, some related agencies, and all the elements muspida .

KLB team duty and to coordinate efforts to monitor the handling and prevention of bird flu, both of animals and birds to humans.

The first effort was conducted in health centers. Then the health center will refer the patient suspect bird flu to three referral hospitals, namely Hospital (Hospital) Wahidin Sudirohusodo, Faisal Islamic Hospital, and the Academic Hospital.

Locals felt the fever, especially if remain near the live poultry in area, to get directly to three hospitals reconciliation above-mentioned.

Report: Furqon Majid. majid_tribun@yahoo.com / Reuters
hat-tip bgw

[Shiloh]

Re: Indonesia: Human Cases 8 Oct 2008 +

Source: http://www.suaramerdeka.com/beta1/in...&id_news=17987

21/11/2008 19:59 wib - Daerah Aktual
Dinilai Sudah Aman, KLB Flu Burung Dicabut

Google translation:
21/11/2008 19:59 wib - Regional Actual
It is considered safe, KLB Flu revoked

Semarang, Cybernews. Status of Extraordinary Events (KLB), which defined the bird flu since some time ago, starting Friday (21/11), formally revoked. Nevertheless, vigilance over the possibility of the occurrence of avian influenza (AI) are still in flux.

It was the head of the City Health Office (DKK) from Semarang Tatik Suyarti MKes, when found in the office Suara Merdeka Jl Pandanaran 79. It is said that revocation status KLB done after the government evaluate the results and declared safe.

According''provisions stipulating that the status applies twice the incubation period, or about 14 days,''said Tatik, who accompanied Kasubdin Disease Prevention and Combat of DKK off Widoyono MPH.

Although KLB status revoked, Tatik ask, people remain wary. For, the opportunity is still open for the emergence of bird flu cases in the city of Semarang.


To anticipate that, he said, DKK improve early detection of possible emergence of bird flu. [B]It is said that the government has instructed to all health centers to perform these steps for early detection.

The doctors and nurses are required to improve the health of the sensitivity of each case with symptoms of high fever or flu. Each patient with these symptoms, should ditelisik background, ranging from the causes to the possibility of contact with poultry.

''The initial detected, it is easier to be handled. We do not want kecolongan,''he said.

In addition to health, Tatik also called for all hospitals and polyclinics to private early detection. ''We hope all polyclinics also apply the same vigilance. Each patient with fever or flu-like symptoms, it should be possible contact with poultry,''tandasnya.

Although KLB status revoked, Tatik request, the public remains wary. For, the opportunity is still open for the emergence of bird flu cases in the city of Semarang.

Case Siwalan

Asked about the development of bird flu cases in two Siwalan Tatik said, the government has conducted on blood samples of 13. Blood sample was taken from the family and neighbors DS, the victim dies declared positive of bird flu, some time ago.

Checking blood sample''that some have been completed and the result declared negative. Some others are still in the review process R & D laboratory in the Ministry of Jakarta,''said Tatik.

More specifically, DKK mengagendakan meeting with citizens, Siwalan late November this. The meeting is a continuation of similar meeting last week, as the socialization efforts of the danger of bird flu, and steps antisipasinya.

(Achiar Permana M / CN09)

[Diane Morin]

Re: Indonesia: Human Cases 8 Oct 2008 +

<TABLE style="TABLE-LAYOUT: auto" cellSpacing=0 cellPadding=0 width="100%" summary="Main Page Table" border=0><TBODY><TR><TD vAlign=top><TABLE cellSpacing=10 cellPadding=0 summary="Main Content Table" border=0><TBODY><TR><TD vAlign=top align=left colSpan=2>Indonesia says no H5N1 cases in suspicious cluster

Lisa Schnirring Staff Writer


Nov 20, 2008 (CIDRAP News) ? Indonesia's health ministry has ruled out H5N1 avian influenza in a cluster of 17 suspected cases in South Sulawesi province, countering earlier reports of positive hospital and university tests, Reuters reported today.

According to an earlier report from the Jakarta Post, the patients?all from Sudiang subdistrict and most of them children?were hospitalized in Makassar with symptoms that resembled avian influenza infection. A hospital source had said rapid tests indicated the H5N1 virus and that officials were awaiting further test results from Hasanuddin University.

A Nov 14 Reuters update on the suspected case cluster quoted Chandra Yoga Adhitama, the health ministry's acting director of communicable disease control, as saying the patients were hospitalized as a precaution after chickens died in the area. He also told Reuters that the patients' conditions were generally good and that their samples would be sent to Jakarta for testing at the health ministry's laboratory.

Then on Nov 15, the Post reported that Halik Saleh, a spokesman for the hospital's avian flu team, said the university tests also indicated the patients had the H5N1 virus but that the hospital decided not to use either institution's test results and would instead wait for results from the health ministry.

Lily Sulistyowati, a health ministry spokeswoman, told Reuters today that the patients' tests were negative for H5N1. She gave no further details.

Reports of potential H5N1 case clusters raise concern because, if confirmed, they suggest the possibility of human-to-human transmission, which would increase the risk of a pandemic.

News about human H5N1 infections in Indonesia has been sketchy since June, when the health ministry said it would no longer promptly report H5N1 cases and instead give only periodic updates. Some health officials have said the lack of timely reporting will hamper efforts to monitor the world's pandemic risk level.

On Nov 13 the country's health minister, Siti Fadilah Supari, denied media reports that a 15-year-old girl who died in central Java had avian influenza. News services had earlier cited one of the girl's doctors and a local health official as saying tests from two laboratories indicated she did have an H5N1 infection.

On some avian flu blog sites, participants have been translating reports from Indonesia's Bahasa-language media outlets to comb for new details about the suspected case cluster. According to some machine-based translations, which are sometimes difficult to follow and can be unreliable, two more patients linked to the cluster were reportedly admitted to the hospital. Also, some reports claimed that polymerase chain reaction tests by the university on the patients were positive for H5N1.

Sharon Sanders, editor-in-chief of FluTrackers, a well known Web message board that focuses on avian influenza and preparedness issues, told CIDRAP News that her community hasn't been able to determine if the 17 to 19 patients are infected with the H5N1 virus, based on all of the conflicting information.

"We simply do not know what conclusions to draw based on the recent denial by the Indonesian Ministry of Health of the apparent H5N1 death on November 7 of 15-year-old Dewi Sartika, from central Java," she said.

Sanders said the lack of transparency about the current H5N1 status in Indonesia is troublesome because the disease is endemic and current human H5N1 clinical samples are not being shared internationally. "We will continue to monitor the situation in Indonesia to ascertain, to the best of our ability, H5N1 status in Indonesia," she said.

Mike Coston, a former paramedic and author of the Avian Flu Diary blog, another well-known site for news and analysis, told CIDRAP News that media reports of supposedly positive H5N1 tests give him pause, "but on the whole, I believe the rapid recovery of all 17 suspect cases argues against these being genuine H5N1 patients."

"This highlights the folly of the Indonesian-stated policy of not confirming H5N1 cases as they occur," Coston said. "Even if these patients are negative, it makes it difficult to automatically take the government's word for it."

See also:
Nov 13 CIDRAP News report "Supari denies H5N1 caused girl's death"

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