INDONESIA - Bandung Cluster, W. Java (5-8 suspected/confirmed cases at present)

[Sharpe]

Re: INDONESIA - Bandung Cluster, West Java

According to the Associated Press, Taufik has just died. May he rest in peace after his fight with this deadly disease. Best wishes to the remaining sibling.

http://www.iht.com/articles/ap/2006/09/27/asia/AS_GEN_Indonesia_Bird_Flu.php

Indonesian patient with bird flu dies, raising country's toll to 52
The Associated Press
THURSDAY, SEPTEMBER 28, 2006
JAKARTA, Indonesia A bird flu patient suspected of being a member of a new cluster of infections died Thursday, his doctor said, raising the toll in the nation hardest hit by the disease to 52.

The 20-year-old Indonesian died at 2:20 a.m. at Hasan Sadikin Hospital in Bandung city, said Hadi Jusuf.

His brother died Sunday with symptoms of bird flu before samples could be taken and his sister, hospitalized with high fever and respiratory problems, also is being treated as a suspected case.

Fatimah Resmiati, a West Java health official, suggested the siblings could represent a new family cluster of the disease. Experts closely monitor such cases for signs that the virus may have mutated into a form more easily passed between humans.

The H5N1 strain of bird flu has killed at least 147 people worldwide since it started ravaging poultry stocks in Asia three years ago, according to the World Health Organization, which has not yet updated its toll with the death of the Indonesian man.

At present it is difficult for people to catch bird flu ? with most infections being linked to close contact with infected birds or their droppings. But experts fear the virus could mutate, possibly sparking a global pandemic.

[Theresa42]

Re: INDONESIA - Bandung Cluster, West Java (2nd sibling has now died)

Oops! Posted this in the wrong thread (North Sumatra) earlier -- just moving it over here...

toggletext-ed from Indonesian:

"Might not panic"
Sept 27, 2006

KEPALA - Officially the Health of the Bandung City, Dr. H. Gunadi Sukma Bhinekas, S.M.Kes. to "GM" [Galamedia], on Tuesday (26/9) hoped, the Bandung City community, especially the citizen [*snip*] Kel. Kebonwaru, Kec. Batununggal, Bandung might not panic with the existence of the citizen of casualties suspect bird flu in this area. His article, the characteristics of the virus H5N1 (bird flu, red) did not keep towards heat of the sun.

The statement was said by Dr. Gunadi, following the citizen's local unrest on the occurrence suspect bird flu that struck the family of Ahmad Kosasih. The citizen considered, Dinkes the Bandung City not all that gave the related socialisation of the IJ death that it was suspected was affected by bird flu.

Commented on the citizen's unrest, Gunadi explained, the environment of the older brother's residence was siblings that it was suspected was affected by this bird flu because of ignoring the pattern of the healthy life.

Because, in his place he maintained the chicken, the duck, entok, and the dog. "If in the settlement, was thought by us might not maintain the poultry like that," uajr him.

When being touched on whether his side will carry out the blood test to the other citizen around the IJ house, T, and IM, he said, his side just did the blood cheque if emerging the sign of bird flu like hot, the fever, and the cough. [So, they're only going to test people in the area who present with flu-like symptoms?

"So, if having the citizen who felt the matter like that, must immediately to the hospital. Don't forgot also explained his story or information selengkap him. For example, had he held the poultry died or saw many poultries that died, all that must be explained," he revealed.

Nevertheless, Gunadi stated, his side will always carry out the monitoring to the local area, including going through the community health centre in the environment of casualties's residence. "I have then asked that the animal was there destroyed," he said.

The citizen resah

Was based on the monitoring "GM" in [*snip*] Kel. Kebonwaru, Kec. Batununggal, restless because of Dinkes and the agricultural Service (Distan) not all that menyosialisasikan on the death of one of his citizens.

Indeed on Tuesday (26/9), Distan has carried out depopulation (the extermination) the poultry that was in this territory.

However, the citizen not all that received the explanation about the danger or the spread of the bird flu virus.

According to the Chairman RT 03, Ayat Daryat (60) that was met "GM" in his residence [*snip*] was not far from the funeral parlour, he condolences on the IJ death (23) and currently his two brothers [siblings] T (20) as well as IM (16) was treated in Poinciana Tree Space of RSHS Bandung. The article did not reject, the incident seldom made restless his citizen.

"Indeed this morning from Dinkes and Disnak destroyed the poultry belonging to the citizen that was in RT 03/RW 03. However, the citizen was still being lay about the spreading of this virus, even us then was not yet given by the understanding or the explanation from the related service," said Ayat.

The similar matter was then said by the father and the two children of casualties's uterus who were treated in RSHS Poinciana Tree Space, Ahmad Kosasih (51), was not yet taken the sample of blood.

Ahmad said, his eldest child died and his youngest child for his sight never contact with the chicken or the other poultry.

"I was strange, if emang my child died resulting from bird flu, how his spread. His article my three children never contact with the poultry," added the husband [wife] Nurjanah (43) this.

http://www.klik-galamedia.com/20060927/kolomlengkap.php?kolomkode=20060927115719

[Theresa42]

Re: INDONESIA - Bandung Cluster, West Java (2nd sibling has now died)

Moving this one, too -- a comment Sharpe made on the above post:

The question of the day...

"I was strange, if emang my child died resulting from bird flu, how his spread. His article my three children never contact with the poultry," added the husband [wife] Nurjanah (43) this.

Retranslated to:

"It is strange, if my child did indeed die from bird flu, how it could have spread, because my three children never even touch poultry," added Ahmad's wife, Nurjanah (43).

[Theresa42]

Re: INDONESIA - Bandung Cluster, West Java

So, Theresa,
Would you mind summarizing all of these dozens of articles for us? Who are we talking about who are suspected patients? One dead boy, and his brother and sister. Are there other people--mother, father, grandmother, neighbor? I'm confused. Thanks.
-Sharpe

The only people involved (so far) in this cluster that I know of are the (now) two dead brothers and their younger sister who, according to initial tests, seems to not be infected with H5N1.

In Doc Niman's post above, it's mentioned that the family and some neighbors have also been tested:

Moreover, the agricultural service also took the sample of the family's blood and the neighbour Zakaria Divine Guidance [i.e. the neighbor of the dead brothers] that was stated positive terjangkit bird flu....

http://www.flutrackers.com/forum/sho...2&postcount=45

However, another report --which may be earlier than the one Doc Niman posted (I can't really tell) -- says that other people are not being tested unless they present with symptoms -- which seems really bizarre 'cause you'd think that the family and neighbors would be tested. But, the father is quoted as saying he hadn't been tested yet:

http://www.flutrackers.com/forum/showpost.php?p=34656&postcount=48

Edit: The three siblings are >>

Indra Jayakusuma (23) = Indra Jaya flowers - dead, index case, not tested
Taufik Zakaria (20) = Zakaria Divine Guidance - now also dead, tested pos
Intan Mustika (15) = Precious stone Diamond - hospitalized, initial tests reportedly indicate neg

[Sharpe]

Re: INDONESIA - Bandung Cluster, West Java (2nd sibling has now died)

Thx T.

[HenryN]

Re: INDONESIA - Bandung Cluster, West Java (2nd sibling has now died)

Thx T.

Actually, the younger sibling was positive for H1, but more tests were planned.

[Theresa42]

Re: INDONESIA - Bandung Cluster, West Java (2nd sibling has now died)

toggletext-ed from Indonesian:

22 from 25 Kab./the City in West Java Terjangkit the Virus AI
TJ Positive Flu Burung

Bandung, (PR). -

The Patient suspect bird flu, TJ (20), continued to be stated positive contracted the virus H5N1 (Avian influenza/AI) through results of the second sample test by Balitbangkes Jakarta. According to the Chairman Tim [team] the Handling of the Case of Handsome Sadikin Hospital Bird Flu (RSHS) Bandung, Dr. Hadi Jusuf, Sp. P.D.KPTI, the physical TJ condition at this time was still bad. [He has, in fact, now died. See Sharpe's post above.]

Beforehand, the Managing Director RSHS Bandung, Dr. Cissy R. Sudjana the officer said, in accordance with the procedure continue to the sample test must be carried out by three times. Beforehand, results of the first sample test showed positive results. With results of the test kesatu and second that showed positive, then the possibility of the negative in the third sample test very weak.

"Keadaan TJ was still being bad. Blood pressure was still being low, the inflammation on his lungs continued meluas,” said Dr. Hadi when being found in RSHS Bandung, on Wednesday (27/9).

As being reported, following TJ, his brother [sister], IM was stated as suspect bird flu and immediately was isolated in Poinciana Tree Space of RSHS Bandung.

The IM sample test (15), pointed out results of the negative. "Virus that attacked IM was the normal influenza virus the sub-type H1N1,” said Dr. Hadi. Despite this, the team of the doctor will continue to carry out the verification against IM.

In the meantime, the Health Service of the Bandung City together Labkes the West Javanese Province took the sample of blood from 20 people who it was known had carried out contact with TJ and IM. The 20 people consisted of the family's four members and the rest of them of the neighbours.

According to Kasubdin the Control of the Illness and environmental Sanitation Dinkes the Bandung City, Dr. Hj. Rita Verita Sri, M. M., his side was carrying out tight observation in the residence environment suspect. The observation was carried out to the radius 1 kilometre for 14 days since Sunday (25/9). ”Kalau his standard rule, that was taken the sample only that had shown the sign, but for anticipation, we took the sample from that had had the story kontak,” said Dr. Rita.

Penyemprotan

In the meantime, on Wednesday (27/9), the poultry pen belonging to the father IJ, TJ and IM, Ahmad Kosasih or that close was [*snip*] Kebonwaru districts, Kec. Batununggal Bandung, was scolded disinfektan and was sterilised.

Moreover, all the things and equipment that had been used to maintain the poultry, were burnt. “Kandang really was sterilised. And while 21 days might not be entered by who pun,” said Kadistan the Bandung City, Ir. Yogi Breakingprep Supardjo, H. M.Si.

Depopulation of the available poultry in nine RT was then carried out on the citizen's initiative. They brought his poultry was their respective to be destroyed. The number of poultries that was destroyed reached 50 tails, with dove details 24 tails, the turkey 3, the turtle-dove 5, dove birds 2, and birds kicau 10 tails.

The yogi added, most cases of positive bird flu to the poultry in the Bandung City happened to the kept poultry. "And small his possibility positive poultries came from the chicken abattoir,” he said.

Despite this, he stressed will increase the supervision in 26 TPA available in the Bandung City as anticipation efforts.

Positif

In the meantime, results of the upper serology test the sample of the poultry that was taken from the TJ residential environment, [*snip*] Kel. Kebonwaru, Kec. Batununggal Bandung, was ascertained positive terjangkit the bird flu virus. However, to ascertain the virus was H5N1, was done by the further test with the method polymerase chain reaction (PCR) that results were just known in time two days.

"Hasil positive serology, but not necessarily his virus H5N1. So, had taken part in by the following inspection that more accurate. Results it was estimated just were known tomorrow (on Thursday, 28/9),” said the Section Head West Javanese Province Livestock Breeding, Rachmat Setiadi.

The discovery of the positive case of bird flu in this Bandung City, completed the spreading of the bird flu virus in 22 from 25 cities/kab. in West Java.

Ideally, the vaccination was against the poultry carried out by four times in one year. According to Rachmat, the bird flu vaccine was late accepted the area because projek the tender that was carried out by the government of the centre just was finished early September. "Baru on last Friday this vaccine was spread to the area. Necessarily, in July already diberikan," he said.

Was based on the data of Disnak West Java, it was estimated the number of poultries totalling 30 million tails. “Namun, the poultry an amount this not necessarily lived. Therefore, was estimated by us coverage the poultry 60% among them. So, was prepared by us 18 million vaccines to one tahun,” said Rachmat.

The Bandung mayor, Dada Rosada ask for to the Bandung City community that settled in the densely populated territory, in order to not maintain the poultry. Afterwards the community was also appealed to in order to behave lived clean and healthy.

Regarding the case of bird flu, Dada also asked the health service to carry out steps in anticipation. Especially for the community that had the poultry and potential tertular bird flu, in order to be monitored. Moreover, gave Tamiflu medicine that spread in the community health centre and did counselling to masyarakat.

On the other hand, the Municipal Government also intensified the socialisation of bird flu to the community, did the poultry vaccination, spraying of the pen, and disifektan. Added, in order to be avoided and was not contaminated by the poultry of the illness bearer, avoided the purchase of the kept poultry, especially from the other city.

http://www.pikiran-rakyat.com/cetak/2006/092006/28/0102.htm

[Theresa42]

Re: INDONESIA - Bandung Cluster, West Java (2nd sibling has now died)

toggletext-ed from Indonesian:

The STRUGGLE for TAUFIK against the BIRD FLU VIRUS ended
Sept 28, 2006

Metrotvnews.com, Bandung: Taufik Zakaria, the patient that was stated positive was infected by the bird flu virus, on Thursday (28/9) at dawn earlier around struck 02.20 WIB, died in the Handsome Sadikin Hospital, Bandung, West Java. His body of plan Taufik was buried in the funeral of the family in Jolok Batu hamlet, the Sukaratu Village, the Subdistrict Banyu Resmi, the Garut Regency, West Java. Taufik will be buried was neighbouring with his older brother's grave, Indra Jaya Kusuma, that also died because of being suspected of being infected by the bird flu virus.

Before dying Taufik underwent the maintenance for five days in RSHS. Since entering, the condition for Taufik has been critical. According to the medical team, the temperature of the body high Taufik had not descended. At daybreak earlier, the Taufik body was at once despatched to the funeral parlour in Garut to be buried. In the meantime the full brother [sister of] Taufik, Intan Mustika that could be hot high and the cough up to now still is treated in RSHS Bandung in Poinciana Tree Space, special space the bird flu patient. However, the condition for Intan has it was reported improved.

With the death of Taufik, significant already six people from eight bird flu patients [totally] who had been treated in RSHS, died. Two bird flu patients who had been treated in RSHS, were stated recovered.

http://www.metrotvnews.com/berita.asp?id=25053

[Sharpe]

Re: INDONESIA - Bandung Cluster, West Java (2nd sibling has now died)

Theresa or anyone, has any relationship between this family and the other members of the Garut cluster ever been mentioned?

His body of plan Taufik was buried in the funeral of the family in Jolok Batu hamlet, the Sukaratu Village, the Subdistrict Banyu Resmi, the Garut Regency, West Java.

[Theresa42]

Re: INDONESIA - Bandung Cluster, West Java (2nd sibling has now died)

Theresa or anyone, has any relationship between this family and the other members of the Garut cluster ever been mentioned?

No, I haven't seen anything about that -- but it has, of course, crossed my mind, too. My impression is that this family is from Bandung which is not very near to Cikelet where the August Garut cluster was. If I get a chance, I want to check out where this sub-district is that the current family is from.

[Theresa42]

Re: INDONESIA - Bandung Cluster, West Java (2nd sibling has now died)

toggletext-ed from Indonesian:

IM was suspected of being attacked by most Raging Flu in the World
Sept 28, 2006

PASTEUR, (GM).-

Was different to his older brother, IM (16) the big possibility of the affected negative the bird flu virus. Only, was based on the inspection that was carried out by the team of the doctor the Handsome Sadikin Hospital (RSHS) Bandung, IM, the citizen [*snip*] Kel. Kebonwaru, Kec. Batununggal, Bandung it was suspected was affected by the virus H1N1 (Spanish flu, the most raging influenza virus in the world, red).

This matter was raised by the Chairman Tim [team] the Handling of the Case of RSHS Bird Flu, Dr. Hadi Yusuf, Sp.P.D., K.P.T.I. to the reporter in RSHS, on Wednesday (27/9).

"Was based on the inspection by the team of the doctor RSHS, the patient IM was affected by the virus H1N1. However to ascertain him, we were still being waiting for results of the Balitbangkes Laboratory inspection," said Hadi.

Concerning the condition for the patient IM, Hadi said, since entering RSHS on Monday night (25/9) up to now, his [her] condition improved. Hadi again confirmed, the patient IM only was affected H1N1. Whereas his older brother, T (20) [now dead] that was stated positive was affected by bird flu, until this his condition did not yet experience the progress. "Perhaps only his blood pressure that has begun to rise. Whereas his breath was still crowded, the temperature of the high body, and still made use of the ventilator," he explained.

Towards the condition for the patient T, Hadi stressed, the team of the doctor RSHS continued to give Tamiflu with the dose 150 mg/the tablet totalling twice a day. "Hopefully the patient T the criticalness period could pass by," he added while stressed, he still could not confirm whether the patient T was cluster from his older brother who died, IJ (23), because of could not be taken the sample of his blood.

The mother the patient T and IM, Nurjanah (43), on Wednesday early afternoon (27/9) approximately struck 12.00 WIB could see the last condition for his child. When arriving in Poinciana Tree Space, the Nurjanah face expression, his observation was empty and his two eyes appeared glistening. He also not too many commented. Nurjanah, appearance was stricken on the disaster that struck his family.

The sample darah

In the meantime, was related to the existence of the positive poultry was affected by bird flu in [*snip*] Kel. Kebonwaru, Kec. Batununggal, Bandung, the agricultural Service (Distan), on Wednesday early afternoon (27/9) did depopulation or the extermination of the poultry in this region. The citizen of enthusiastic appearance brought his kept animal was destroyed because of feeling worried his poultry terjangkit the bird flu virus.

Therefore, not surprised if Distan the Bandung City succeeded in destroying as many as 50 tails of the poultry, consisted of 6 chickens, 24 doves, 10 birds kicau, 5 turtle-dove birds, 3 turkey chickens, and 2 dove birds. Distan also took the sample of blood 11 dogs that was was not far from the patient's house T that positive was affected by bird flu.

The head Distan the Bandung City, the Yogi Supardjo said, Depopulation that was carried out was based on results of the sample inspection of the poultry totalling 13 chickens and 4 ducks, on Tuesday (26/9). From the inspection, 3 chickens and 1 tail entok positive was affected by the bird flu virus. "Actually, earlier we only carried out the vaccination." However because of the community around was enthusiastic enough, we then at once carried out the extermination of the poultry, he said.

In the same place, Dinkes the Bandung City carried out the taking of the sample of blood against 20 citizens, including parents of the patient T and IM that at this time still were treated in RSHS Bandung, of Ahmad Kosasih (55) and Nurjanah (43). Moreover, the patient's two cousins T, Santi (18) and Hani (21) as well as the close neighbours the patient was also taken the sample of his blood.

"Because of the patient T and the poultry around it positive was affected by bird flu, the patient's family T and his neighbour we took the sample of his blood," said Surveylance Dinkes the Bandung City, Wawan Setiawan in taking gaps of the sample of blood.

Wawan said, to know whether being affected by the bird flu virus or not, he will immediately send the sample of the family's blood and the patient's T neighbour to Balitbangkes RI in Jakarta. Nevertheless, up to now was not yet found by one citizen then that had the sign of the cough and breathless.

Not too much khawatir

In the meantime, the Section Head the West Javanese Health, Yudi Prewar said, he was still being waiting for results of the blood inspection IM. Pasalnya, IJ (23), the eldest child's older brother IM and T were not yet checked the sample of his blood because of dying and being buried.

"If evidently the IM inspection positive (bird flu), this the indication happened cluster bird flu. Whereas IJ could not be checked, but he has shown the sign it was suspected was affected by bird flu," he revealed.

Although later results of the sample inspection of IM blood will be stated positive bird flu, Yudi admitted to being not too worried. Because, if his parents were not affected, was indicated by the nonexistence cluster.

He explained, cluster that depended on gen. "Untuk ascertained him, he continued, the West Javanese Health Service was at this time carrying out the sample inspection of blood from the family or closest people in the T environment," more.

About Tamiflu supplies, Yudi explained, did not experience the lack. Moreover, he said, supplies still many in community health centres.

http://www.klik-galamedia.com/20060928/kolomlengkap.php?kolomkode=20060928044231

[Theresa42]

Re: INDONESIA - Bandung Cluster, West Java (2nd sibling has now died)

Theresa or anyone, has any relationship between this family and the other members of the Garut cluster ever been mentioned?

Of course, many of the cases from Garut were brought to the hospital in Bandung for treatment.

[Theresa42]

Re: INDONESIA - Bandung Cluster, West Java (2nd sibling has now died)

Theresa or anyone, has any relationship between this family and the other members of the Garut cluster ever been mentioned?

His body of plan Taufik was buried in the funeral of the family in Jolok Batu hamlet, the Sukaratu Village, the Subdistrict Banyu Resmi, the Garut Regency, West Java.

So, it sounds like this family lives in Bandung city (outlined in blue on the map) but that they have some connection to the Garut Regency (one or both parents from there?) since the two brothers are being/have been buried there in Banyu Resmi (Banyuresmi) sub-district (outlined in red on the map). If you remember, the Cikelet area, where the Garut cluster(s) were, is down near the coast...

[Sharpe]

Re: INDONESIA - Bandung Cluster, West Java (2nd sibling has now died)

Of course, many of the cases from Garut were brought to the hospital in Bandung for treatment.

The map you found (http://www.flutrackers.com/forum/sho...&postcount=152)
shows nicely where the two clusters are.

My edited version is attached. The Banyuresmi cluster is about 30 miles north of the Cikelet cluster, and is on the way to Bandung.

[Theresa42]

Re: INDONESIA - Bandung Cluster, West Java (2nd sibling has now died)

Now cut that out! Stop posting the same thing at the same time!!