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

[Shiloh]

Re: Indonesia: Human Cases 8 Oct 2008 +

Source: http://www.tempointeraktif.com/hg/na...147416,id.html
Kesadaran Terhadap Flu Burung Meningkat
Jum'at, 21 November 2008 | 21:16 WIB

Machine translation
The awareness towards Meningkat Bird Flu
Jum'at, on November 21 2008 | 21:16 WIB

The Interactive TIME, Jakarta :Hasil the research of nations of the Union's Body for the Child the Child (Unicef) showed the awareness of the community against preceptive bird flu experienced the increase.

That was revealed by the Harian Chief Executive of the Nasional Flu Burung Bayu Khrisnamurti Commission. "In 2008 this rose to 67 percent in 2007," said Bayu in Bird Flu discussions in Jakarta, on Friday (21/11)

This figure, said bayu, was pleasing enough. His article, in because of 2006 from 4000 respondents who were researched by Unicef, only 13 percent of the respondent that was preceptive bird flu.

On that occasion, Bayu stressed that the key to the handling of bird flu was giving of medicine that not more than 48 hours when tertular. He caused the example, results of the negative to 17 patients in Makassar. Like that it was identified tertular virrus their bird flu direct menobati him. ?Itu proved the community was successful because of results of the negative all, he added.

The response to bird flu, said the Deputy Coordinating Minister for the Economy Bidang Pertanian and Marine this, increasingly improved. The "resident at once reported when being found the poultry mati,"tandas him."

Despite this he hoped the existence of the awareness in the breeder's circle and the market. "The true and clean technique was expensive," he explained.

In the meantime, Director General Peternakan Tjeppy D Soedjana said, there was no vaccine that protected was full towards the spreading of bird flu in Indonesia. ?Sebelum the vaccine was just found, then the use of the groove H5 (the sub-type from the poultry) and H5N1 (the groove that infected humankind) was stimulated, because genetically sama,? he said.
Dianing Sari

[Shiloh]

Re: Indonesia: Human Cases 8 Oct 2008 +

Source: http://www.mediaindonesia.com/index.php?ar_id=NDU3MDM=

Jumat, 21 2008 22:54 WIB
17 PasienTerduga Flu Burung di Makassar Dinyatakan Negatif
Penulis : Lina Herlina

Google translation:
17 PasienTerduga Bird Flu in Makassar Expressed Negative
Writer: _ CluMzy _ DisStuRbAnCee

MAKASSAR - MI: 17 bird flu patients are treated at the Regional Hospital Dr. Wahidin Sudirohusodo, Makassar, South Sulawesi, states do not have the H5N1 virus. That berdasakan the results of the laboratory's Research and Development of Health (Litbangkes) Ministry of Health stated that samples of blood and mucus specimens of all patients expressed negative.

According to the spokesperson for the team coordinating the bird flu Regional Hospital Dr. Wahidin Sudirohusodo Khalid Salih, Friday (21/11), the results of blood and mucus samples of the patients received the suspect is Wahidin Hospital Health Office of South Sulawesi Province, on Thursday (20/11). After receiving the results of the laboratory, five of the 17 bird flu patients are sent home because the conditions have been improving. They are Annisa, 6, Firdaus, 6, Hasnawati, 34, Rahmawati, 2 and Fauzi Ibn Hajar, 3 months.

The rest have not been sent home because they are still awaiting a decision from a doctor returning from the deal early, because waiting kondisinysa more competitive. They are Nur Awalia, 3.6, Matan Ariel, 4 months, Salman, 6, Irwan, 6, Saleha, 2, Rohan, 60, Ilham, 2, Alif, 3, Desi, 5, Eki Reskiani, 5 months, Hartati , 26, Nuraeni, 31.

Patients who come from all Pate'ne Road, Kampong tank Jangang, Neighborhood Sudiang, Biringkanayya Sub-District, Makassar, South Sulawesi. Its intensive treatment for 10 days in isolation since dilarikan to the hospital since 12 November and as early taste of symptoms of bird flu, namely high fever, shortness of breath and the flu preceded the death of sudden tens tail poultry in the village of residents who had positive bird flu .

"Because the patients declared safe based on the results of the laboratory, they can go home," said Khaled Saleh, who is also director general of operational and Wahidin Sudirohusodo hospital, she found time in the hospital.

Khalid also add, during the handling of bird flu patients have not yet found constraints. Both sides of the supply of medicines and equipment. "Tools for handling bird flu patients complete the didrop directly from the Ministry of Health to the hospital. Among other protective tools themselves, beds, equipment and monitor fentilator, "he explained.

Meanwhile, two citizens, two other Sudiang namely Iqbal, 6, and Karmila, 4 also dilarikan to hospitals Wahidin Sudirohusodo Tuesday (18/11) because of suffering high fever. "After the doctors treated some day sentence Karmila the symptoms of dengue fever and Iqbal were just ordinary flu because the weather changes. We take it directly to the hospital because health officials in directly give referrals without first checking out after some chickens died. But this can not go home, "said Nurtati, 27, mother of Iqbal. (LN/OL-03)

[Giuseppe]

Re: Indonesia: Human Cases 8 Oct 2008 +

AVIAN INFLUENZA, HUMAN (75): INDONESIA, CLUSTER NOT
************************************************** *
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Thu 20 Nov 2008
Source: Reuters India [edited]
<http://in.reuters.com/article/worldN...36603020081120>


Indonesia says 17 in Sulawesi not infected with bird flu
--------------------------------------------------------
Bird flu has been ruled out as the cause of illness in 17 people from
the same neighbourhood of Makassar in Sulawesi, Indonesia, a health
ministry official said on Thursday [20 Nov 2008]. 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 7 people in an extended family died. The World Health
Organisation (WHO) 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 [week of 10 Nov 2008], 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.

--
Communicated by:
ProMED-mail Rapporteur Mary Marshall

[Both the single suspected human case of avian (H5N1) influenza in
central Java, and now the suspected cluster of 17 cases in Sulawesi,
described in the ProMED-mail post entitled "Avian influenza, human
(73): Indonesia, conf., cluster susp. 20081113.3573", are no longer
considered by the Indonesian Ministry of Health to be confirmed
cases. Thus the number of confirmed human cases of avian influenza in
Indonesia remains 137, of whom 112 have died.

The island of Sulawesi can be located on the map of Indonesia at
<http://www.lonelyplanet.com/maps/asia/indonesia/>.
The city of Makassar can be located using the HealthMap/ProMED-mail
interactive map at
<http://healthmap.org/promed?g=162278....913,107.621,6>.. - Mod.CP]

[see also:
Avian influenza, human (74): Indonesia, NOT 20081114.3595
Avian influenza, human (73): Indonesia, conf., cluster susp. 20081113.3573
Avian influenza, human (72): Indonesia, susp 20081110.3538
Avian influenza, human (71): Indonesia, not 20081107.3503
Avian influenza, human (70): Indonesia, susp 20081104.3473
Avian influenza, human (69): Indonesia 20080912.2855
Avian influenza, human (68): Indonesia, WHO 20080910.2831
Avian influenza, human (67): Indonesia 20080909.2818
Avian influenza, human (66): Indonesia (West Java) 20080830.2721
Avian influenza, human (65): Indonesia, reporting 20080818.2560
Avian influenza, human (64): Indonesia, CFR decline 20080813.2506
Avian influenza, human (63): Indonesia, reporting 20080812.2497
Avian influenza, human (62): Indonesia, NOT 20080810.2465
Avian influenza, human (61): Indonesia 20080806.2417
Avian influenza, human (59): Indonesia 20080803.2372
Avian influenza, human (56): Indonesia, susp 20080719.2196
Avian influenza, human (55): Indonesia, WHO 20080620.1918
Avian influenza, human (54): Indonesia 20080619.1912
Avian influenza, human (51): Indonesia, new policy 20080606.1811]
-

http://apex.oracle.com/pls/otn/f?p=2400:1001:3172662175223302::NO::F2400_P1001_BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,74863

------
...................................cp/mj/dk
</pre>

[Gert van der Hoek]

Re: Indonesia: Human Cases 8 Oct 2008 +

From Riau, it looks good.

9-Year Old Child from Sembuh Suspect Bird Flu

Saturday, November 22, 2008

CITY (RP) - A toddler NW (9), which is called a positive bird flu patients treated in hospitals and Arifin Achmad shows the development of the healing begin. Residents of Bandar Sekijing Subdistrict, Regency is mentioned parties, such hospitals may return next week.

Children third pair Suprianto and Misnia, employees of PT Guna Dodos have been getting intensive treatment at hospitals Arifin Ahmad Pekanbaru since Friday (14/11) ago. At that time, according to accounts of the parents, NW, children bungsunya is suffering a high fever. Because of the fear that something desired, the second orangtuannya directly to Pekanbaru, Friday (14/11) and the Hospital Santa Maria. However, the Hospital Santa Maria refers directly to the family treated in hospitals Arifin Ahmad Pekanbaru.

Until Friday (21/11) around 17:00 WIB, toddlers disease is reduced and is starting to eat and sleep with a voracious lelap. Of course, fathers keduaorang faithful to accompany the next two weeks.

''Initially, we experienced a high fever. Fear of something happening, we immediately bring them to hospital and treated it well. I was, however, now it starts to fade reduced. We are also grateful, the cost of treatment is also directly overcome the government,''commentator Misnia to the Riau Post, length.

When asked whether the family is to raise poultry, Misnia and Suprianto said is correct. Suprianto keep five chickens and after knowing her son attacked by bird flu, without directly Suprianto been burnt. He can not be sure whether the children infected chicken piaraannya because there has been no previous similar incidents.

Meanwhile, Azisman of caring for toddlers confirms, NW suffering from the disease is positive of bird flu. After intensive treatment is done, then slowly progress is visible. At least, two weeks ahead NW and their families can return to the village.

Currently''is still in the stage of healing. We look forward to the next two weeks could have been sent home,''he asserts.

Not Receive Health Report

Meanwhile, the Office of Health through the Head of Riau Subdinas of Health and Nutrition Drg Burhanudin Agung saying the government can not determine whether NW positive of bird flu or not because the patient's blood sample is examined laboratory center. Delivery of sample done three times. "Until now we are still awaiting the results of inspection reports the blood sample,''he said when contacted by phone provider, yesterday evening.

http://www.riaupos.com/v2/content/view/11384/46/

I am in a hurry, so it is Google translated, should be checked.

[Sally Furniss]

Re: Indonesia: Human Cases 8 Oct 2008 +

toggletext translation

9-Year Old Child from Sembuh Suspect Bird Flu

Saturday, November 22, 2008

OTA (RP) ? A the child NW (9), that was talked about as the positive patient bird flu and was treated in RSUD Arifin Achmad began to show the development of recovery.

The resident of the Bandar Sekijing Subdistrict, Kabupaten Pelalawan this was mentioned the RSUD side could come home next week.

The child of the three couples Suprianto and Misnia, the employee of this PT Guna Dodos has gotten the intensive maintenance in RSUD Arifin Ahmad Pekanbaru since last Friday (14/11).

At that time, according to the speech on parents NW, his youngest child suffered the high fever.

Because frightened of something that was not wanted, of the two happening orangtuan him immediately departed for Pekanbaru, last Friday (14/11) towards RS Saint Maria.

However the side of RS Saint Maria at once reconciled this family to be treated in RSUD Arifin Ahmad Pekanbaru.

Till Friday (21/11) around struck 17,00 WIB, the child's illness has begun to be able to have decreased and eaten ravenously and was sound asleep.

Of course, the two parents him loyal accompanied till two weeks in the future.

? Early him, our child experienced the high fever. Because frightened of something happening, we at once carried him to the hospital and were treated well.

Fortunately, currently his illness begins to gradually decreased.

We also were grateful, the medical treatment cost also at once was dealt with the government,?? the Misnia covering to Riau Pos, at length. ation:

When being asked, did the family maintain the poultry, Misnia and Suprianto said correctly the existence.

Suprianto maintained five chickens and after learning his child was attacked by bird flu, without ordered to, Suprianto at once burnt him.

He himself could not confirm whether his child contaminated the chicken piaraan him because of beforehand did not yet have the similar incident.

In the meantime, Dr Azisman that treated this child stressed, NW quite positive suffered the bird flu illness.

After being carried out by the maintenance intensively, then slowly has appeared the progress.

At least, two weeks in the future NW and his family could have come home to his village.

??During this still in the recuperation stage.

We hoped two weeks in the future already could go home,?? he said stressed.

Officially Kesehatan Terima Laporan Sementara, the Kesehatan Service of the Riau Province through the Sub- Dinas Head the Health service and the Nutrient drg Burhanudin Agung named his side still could not confirm whether NW positive bird flu or not because the sample of the patient's blood was still being checked the central laboratory.

The sending of the sample was carried out by as many as three times. ?"Until now we are still awaiting the results of inspection reports the blood sample,''he said when contacted by phone provider, yesterday evening.

[Anne]

Re: Indonesia: Human Cases 8 Oct 2008 +

http://www.thejakartapost.com/news/2...-negative.html



Saturday, November 22, 2008 3:09 PM

Bird flu suspects declared negative

Andi Hajramurni and Erwida Maulia , The Jakarta Post , Makassar/Jakarta | Sat, 11/22/2008 12:54 PM | The Archipelago
Laboratory results of 17 suspected avian flu sufferers being treated at Wahidin Sudirohusodo General Hospital in Makassar have come up negative, while two more suspected sufferers were admitted Tuesday.
Head of the South Sulawesi Health Agency, Rachmat Latief, said Friday the patients' blood and phlegm samples had been tested and found negative by the Health Ministry's research and development laboratory in Jakarta.
The agency received the results Thursday evening from the Health Ministry's Directorate General for Disease Control and Public Health, he said.
Five of the patients have been discharged from the hospital while the other 12, including three adults and nine children, were deemed not well enough to leave.
According to pediatrician Bob Wahyudi, the nine children required further treatment for breathing disorders as they were suffering from various diseases, including pneumonia and lung edema.
"The lab results were negative but the doctor's diagnosis shows the nine children still need further treatment," he said.
Three of the nine children were brothers: Salman, 5, Nurul Awaliah, 3, and Nur Fadilah, 4 months. They were diagnosed with pneumonia.
Spokesman of the hospital's bird flu team, Khalik Saleh, said the patients would only be discharged with doctor approval.
"If the doctors say they are allowed to go home, then they will go home. But if doctors demand that they get further treatment, then they will stay." he said.
"But now we are treating them for different diseases as they are not infected with the bird flu virus."
The two bird flu suspects hospitalized Tuesday are from Sudiang Raya subdistrict in Biringkanaya district. The other 17 suspects were residents of nearby areas.
The provincial health agency has sent the patients' blood and phlegm samples to the ministry's laboratory.
Rachmat warned Makassar residents to be vigilant to the threat of the virus despite the negative test results, warning the disease could pop up at any time, anywhere.
Executive director of the National Committee for Bird Flu Control and Pandemic Preparedness Bayu Krisnamurthi said the public in Makassar had been efficient in handling the threats.
"The community quickly hospitalized the patients (upon discovering that) there were dead chickens in their neighborhood, which were confirmed to be infected by the bird-flu virus," he said.
"The Makassar municipality is very cooperative so we will conduct a large bird flu pandemic simulation in March."
A number of simulations have been staged in the past, most of them in rural areas, including Jembrana in Bali and Kebumen in Central Java. Makassar will host the first major simulation in an urban area.

[Commonground]

Re: Indonesia: Human Cases 8 Oct 2008 +

13 residents have been returned

[This article gives some much needed information on the relationships of the 17 cases.
Ruslan (almost his whole family suspected of contracting bird flu)

Irwan (6) son
Three Nephews (all preschool)

Continue to be treated, have to ascertain if infected with bird flu:
Ruslan parent-in-law (father/mother in-law): Juhani
Rusian brother-in law: Saleha
2 neighhbors

?Ruslan also informed his two neighbours just was put into RSUP Wahidin Sudirohusodo as suspect bird flu. ?
(this is not clear enough to determine if it is the same 2 neighbors mentioned above)]


Suspect Flu Burung di Tangki Jangang
Sabtu, 22-11-08 | 16:02 | 22
As many as 13 from 17 residents of the Jangang Tank, Kelurahan Sudiang, of Kecamatan Biringkanaya, that beforehand it was suspected contracted bird flu finally had been returned. Was based on results of the laboratory inspection, was not found by the existence of the bird flu virus in the sample of their blood. Ruslan, one of the residents that almost all of his family was stamped suspect bird flu felt grateful.

On last Saturday, his son who was named Irwan, 6 years, as well as his three nephews that still pre-schoolers were allowed to return to the house.

Beforehand, 5 other residents have also been allowed to return to his house was their respective.

However the Ruslan parent-in-law was named Juhani, his brother-in-law of Saleha, as well as his two neighbours still continue to was in RSUP Wahidin Sudirohusodo in order to ascertains the four of them also not terjangkit bird flu. "Possibly they will go in the near future out," said Ruslan.

Ruslan admitted to since the beginning of himself being convinced the size family not terjangkit the deadly illness. He suspected the medical official from the Sudiang Community Health Centre too much was on the alert when diagnosing the illness that was suffered by his family's member.

At this time, the condition for the family's Ruslan member who could be treated has begun to improve. Only, Ruslan regretted the shortage of attention of local government apparatus. "Our family's ten days were treated, there were not even one of the local government apparatus that came," said Ruslan. Ruslan also informed his two neighbours just was put into RSUP Wahidin Sudirohusodo as suspect bird flu. The "sample" of "their blood was still being researched," he stated.

[Commonground]

Re: Indonesia: Human Cases 8 Oct 2008 +

Post #269:
[here we go again....]

In the meantime, Dr Azisman that treated this child stressed, NW quite positive suffered the bird flu illness.

vs.:

Officially Kesehatan Terima Laporan Sementara, the Kesehatan Service of the Riau Province through the Sub- Dinas Head the Health service and the Nutrient drg Burhanudin Agung named his side still could not confirm whether NW positive bird flu or not because the sample of the patient's blood was still being checked the central laboratory.

[Anne]

Re: Indonesia: Human Cases 8 Oct 2008 +

do somebody remember a test made by the CDC or WHO, one year ago or 2 : one provided known strains of influenza, of which H5N1, at well trained laboratories.
One asked them to identify the strains
There were errors. ( false negative and false positive ) : only 75 % of the strains were well identified.
I do not find the study again .
Is the Makassar laboratory well trained for H5N1 detection ?

[Commonground]

Re: Indonesia: Human Cases 8 Oct 2008 +

Post #271
I'm trying to figure this out here....I should have 4 remaining in the hospital, out of the 17. I think this is correct? Feedback welcome.

Grandparents:
Juhani (50) - stayed

Children:
Dg Nginga (mother). Husband: Rizal/Ruslan
Saleha (12) - stayed

Grandchildren:
Nurul Awaliah (3) - stayed
Nurfadillah (4 mos) - home 11/14
Salman (6/4) - stayed


Parent:
Jufri (30)

Children:
firdaus (6) home 11/20
fauzi (3 mos) - home 11/20
Ahmad Hidayat - older brother, not admitted.


Neighbors (or related??)
Sibblings
Ilham (2) - stayed
Ikbal (6) - stayed

Excerpts from Ruslan, one of the residents that almost all of his family:

As many as 13 from 17 residents finally had been returned.

On last Saturday, his son who was named Irwan, 6 years, as well as his three nephews that still pre-schoolers were allowed to return to the house.

Beforehand, 5 other residents have also been allowed to return to his house

Ruslan parent-in-law was named Juhani, his brother-in-law of Saleha, as well as his two neighbours still continue to was in RSUP Wahidin Sudirohusodo

Ruslan also informed his two neighbours just was put into RSUP Wahidin Sudirohusodo as suspect bird flu.

[Commonground]

Re: Indonesia: Human Cases 8 Oct 2008 +

If my list is accurate, some of the one's that stayed, are the ones that arrived first on 11/12. I'm also wondering now if the brother of the mother, and the grandparent were not the caregivers??

Here's my information on the ones that stayed:
Nurul Awaliah/Andia (3) (entered 08:00) (1st one sick)
Salman (6/4) (entered 08:00) Symptom onset: 11/10 (?)
Saleha (12) (entered 12:00)
Johani/Yohani (50) (entered 12:00)

Ikbal (6) (adm: 11/18) sibbling to Ilham (2)
Iiham (2) (adm: 11/13)

Karmila (4) (adm: 11/18)

[sharon sanders]

Re: Indonesia: Human Cases 8 Oct 2008 +

Thanks Commonground for the list. I think it is accurate. Maybe the first suspected patients started tami later in their treatment, since they were not suspected at the time of disease onset, than the other suspected patients so they are having a harder time recovering?

[Giuseppe]

Re: Indonesia: Human Cases 8 Oct 2008 +

An overview of recent evaluation of H5N1 testing capabilities is available at http://www.flutrackers.com/forum/showthread.php?t=85335

[Commonground]

Re: Indonesia: Human Cases 8 Oct 2008 +

An overview of recent evaluation of H5N1 testing capabilities is available at http://www.flutrackers.com/forum/showthread.php?t=85335

Can anyone give a summary in laymens terms of the above study? I don't have time to read it, and I'm not sure I would understand it when I was through......thanks in advance.

[Anne]

Re: Indonesia: Human Cases 8 Oct 2008 +

http://www.who.int/wer/2008/wer8345.pdf

Could be an explanation.. thank you very much IRO..

IRO could explain better than me, CG , what I can say approximatively :
Laboratories with training to detection , have improved their diagnosis and PCR could give false positive and false negative. It's not 100 % exact .
RT PCR is better than PCR.
False positives exists : the most frequent false-positive results reported were for influenza A virus subtype H5.



panels
The 4 panels consisted of coded samples containing
RNA at different concentrations from 5 strains representing
different genetic clades (1 and 2) of infl uenza
A(H5N1) viruses, A(H1N1) viruses and A(H3N2) viruses.
Samples that contained no virus were also included.
Details of the composition of the panels are shown in
Table 1.

( some laboratories detected "virus" , in a negatif sample, with no virus )

Comparison of laboratories? performance
on all panels
During a 2-year period from 2007 to 2008, the proportion of participants with entirely correct results increased from 65% to 77%, whereas the proportion of participants with incorrect H5 subtyping fell from 23%
to 12% and false-positive results fell from 14% to 6%
(Table 4).
False-positive results for negative samples remained
at <10% from panel 2 onward.
Of the 868 tests performed on negative samples (panel 1, 128 tests; panel
2, 332 tests; panel 3, 190 tests; panel 4, 218 tests),

32 (3.7%) tests were false-positives; the most frequent
false-positive results reported were for influenza A virus
subtype H5 (Table 5).


Factors affecting performance
There was considerable variation in the PCR protocols
applied by participants. Because of the multitude of test procedures used by a small number of participants, a meaningful statistical analysis to determine whether individual protocol is significantly better than others was not possible. However, we have compared and analysed
the use of in-house methods versus commercial
kits, and the use of conventional PCR versus real-time
PCR.Analysis showed that in 2 of 3 panels, laboratories using
real-time PCR for >1 test to detect the H5 gene demonstrated
signifi cantly better overall performance than
laboratories using only conventional PCR (panel 2,
P=0.002; panel 3, P=0.006) (Table 7).

snip
Although it is statistically impossible to
determine whether 1 set of PCR primers and probes
produced significantly better results than others, overall
analysis shows that no difference in performance was
observed between the use of in-house methods and
commercial kits.
Detecting influenza A virus in a clinical sample is a
complex, multistep procedure. Each laboratory should
have its own testing strategy using optimized protocols
for different target genes. The design of the primers and
probes alone may not explain why participants failed
to detect H5 samples, since base mismatch in some
primer and probe sets would still be able to detect all
H5 samples (data not shown). Optimization of the PCR
reaction seems to be a more important factor: this
could explain why performance among laboratories
varied even though they were using the same sources
of PCR primers and probes.