Indonesia - Family in Karo suspected of having bf

[Treyfish]

Re: Indonesia - Family in Karo suspected of having bf

no.i moved to a huge farm.the owners who live elswhere,rents the land,over 100 acres ,to his granddaughters husband.hes growing corn this year.he spread bird dung fertilizer here 3 weeks after we moved here.2 days later ,the we were sick for 2 weeks.i blame the dusty fertilizer,feathers and such that were blowing around for a few weeks.you could smell it for a month.it was still cold ,so we were indoors and didnt smell it very much unless outside.100+ acre.blowing around.feathers..bird dookie.i was only pointing out we became sick after the farm was spread with the stuff.maybe a correlation between the two.possible.if so,possible on a farm there also.i knew the u.s.wasnt supposed to have h5n1 here yet,but didnt like it,knew what it could mean if it was and promptly got sick anyway . the end.

[Mellie]

Promed Mail with info -- Conflicting?

<table summary=""> <tbody> <tr> <td nowrap="nowrap" align="right">Archive Number</td> <td nowrap="nowrap" align="left">20060512.1351</td></tr> <tr> <td nowrap="nowrap" align="right">Published Date</td> <td nowrap="nowrap" align="left">12-MAY-2006</td></tr> <tr> <td nowrap="nowrap" align="right">Subject</td> <td nowrap="nowrap" align="left">PRO/AH/EDR> Avian influenza, human - worldwide (62): Indonesia, Djibouti</td></tr></tbody> </table>

http://www.promedmail.org/pls/askus/f?p=2400:1001:1381081472395460444::NO::F2400_P1001_BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,32918

AVIAN INFLUENZA, HUMAN - WORLDWIDE (62): INDONESIA, DJIBOUTI
************************************************** **********
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

In this update:
[1] Indonesia (North Sumatra)
[2],[3] Djibouti

*****
[1]
Date: Thu, 11 May 2006 03:17:23 GMT
From: Andrew Jeremijenko <andrewjenko@hotmail.com>
Source: The Jakarta Post, 11 May 2006 [edited]
<http://www.thejakartapost.com/Archiv...D=20060511.G02>


During the past week, 3 suspected bird flu patients have died in
North Sumatra, with the latest victim passing away in a Medan
hospital Wednesday morning.

According to the North Sumatra Bird Flu Prevention Team, the 3
victims, all from Kubu Simbelang village in Karo regency, died
several days after being admitted to hospitals in Medan.

The team said 3 other suspected bird flu patients are currently being
treated at Adam Malik Hospital in Medan.

Nur Rasyid Lubis, the head of North Sumatra's Suspected Bird Flu
Patient Management team, said Wednesday the 3 dead victims had eaten
chicken together.

Several days after eating the chicken, "the first, a 29-year-old man,
suspected victim experienced breathing problems and a high fever. The
same symptoms were also suffered by the 2 other victims, an
18-year-old and a 40-year-old,", Nur said.

[The first man] died at Adam Malik Hospital on Wednesday morning,
while the 2nd died at the same hospital Tuesday. This 2nd victim's
father, the 3rd man, passed away 4 May 2006 at Elisabeth Hospital.

Nur, who is also deputy director of medical services at Adam Malik,
said the hospital did everything in its power to treat the patients,
but was unable to save them.

North Sumatra Health Office chief Fatni Sulani said the office was
investigating the cases and had sent blood samples from the 3 to
Jakarta for testing.

"We expect the results of the blood tests to be completed in the next
2 weeks. For the meantime, the 3 victims are still suspected, not
positive, bird flu patients," Fatni said.

She said that North Sumatra has not had a confirmed case of bird flu in humans.

"So far, the bird flu virus in North Sumatra has only affected fowl.
After the virus was found in local birds, 13 regencies/cities have
been put on bird flu alert," Fatni said. She said the cities on bird
flu alert included Binjai, Deli Serdang, Langkat and Medan.

North Sumatra Husbandry Office head Rahim Siregar said Wednesday his
office had added Karo regency to the list of bird flu-prone areas in
the province.

"Fowl in North Sumatra have been affected by bird flu since July
2005, but there have been no confirmed cases in humans," Rahim said.

[Byline: Apriadi Gunawan]

--
Dr Andrew Jeremijenko
MBBS, MAE, FRACGP, MHA
Medical Advisor VICO
<andrewjenko@hotmail.com>

[Indonesia has continued to have cases of influenza A H5N1, some in
clusters, and these cases are likely to be confirmed. As in earlier
clusters, the likelihood is that these cases share a common exposure
rather than representing person-to-person transmission. Map showing
the location of Medan in North Sumatra:
<http://www.un.org/Depts/Cartographic...e/indonesi.pdf>
Further information including virologic confirmation and genetic
testing of the viruses is awaited. - Mod.LM]


******
[2] Djibouti
Date: Thu, 11 May 2006 15:20:58 -0400 (EDT)
From: Joe Dudley, <jdudley@eaicorp.com>
Source: Alertnet, 11 May 2006 [edited]
<http://www.alertnet.org/thenews/newsdesk/L11478047.htm>


Djibouti said on Thursday that one person had tested positive for the
deadly H5N1 avian influenza virus in the first confirmed human case
in the Horn of Africa.

"One patient and 3 domestic chickens have been detected with the H5N1
virus," Health Minister Abdallah Abdillahi Miguil said in remarks
broadcast on state television.

The U.N. World Health Organisation (WHO) in Geneva confirmed the human case.

"There is a 2-year-old girl who has been infected with H5N1. She is
alive," WHO spokesman Dick Thompson said.

The tiny country of 300 000 at the mouth of the Red Sea is along the
path of migratory birds who have been detected with the deadly strain.

The condition of the girl, who the minister said was still in
hospital, was not immediately known.

The results were tested in conjunction with the WHO at a laboratory
in Egypt, the minister said.

Miguil said that a team of scientists and doctors was meeting to plan
how to contain an outbreak and find out more about how the girl
contracted the disease.

"Investigations are to be made soon in the area where the patient is
living and elsewhere," he said.

The country has also banned the importation of chickens from other
nations, he said.

On the streets of the former French colony's capital, Djibouti,
people were worried.

"(Chicken) is my preferred dish, but now it's the choice between life
or death," street vendor Saada Ahmed said.

[Byline: Omar Hassan Awale]

******
[3] Djibouti
Date: Thu, 11 May 2006 15:20:58 -0400 (EDT)
From: Joe Dudley, <jdudley@eaicorp.com>
Source: CNN, 11 May 2006 [edited]
<http://www.cnn.com/2006/WORLD/africa...ti.birdflu.ap/>


The World Health Organization said Thursday that a baby in Djibouti
has contracted the H5N1 virus, the country's first human case of bird
flu.

"I believe the person is still alive. It's a 2-year-old girl," WHO
spokesman Dick Thompson told The Associated Press in Geneva. He said
the girl was confirmed as H5N1-positive by the U.S. Naval Medical
Research Unit 3 (NAMRU-3) in Cairo, but could not provide any further
details.

The Djibouti government confirmed the human case in the capital and
said 3 chickens also had been infected with the virus.

"Djibouti thus becomes the first country in the Horn of Africa to
have detected a human case and bird cases of H5N1," the government
said on the official Djiboutian Information Agency web site.

It was not clear from the government statement whether the case of
the chickens was related to the human case.

It also did not provide any details on the health of the girl, saying
only that she was tested after showing flu symptoms on 27 Apr 2006.

The Health Ministry said the infection occurred despite a heightened
alert, but that the government would further increase surveillance of
the disease. It told citizens to keep away from any birds showing
symptoms of sickness.

Djibouti is now the 10th country where a person has been infected
with the deadly virus. At least 207 people have contracted the
disease globally and 115 have died over the last 3 years, according
to the U.N. health agency. Virtually all the individuals were exposed
to the disease in poultry.

As of 27 Apr 2006, there had been no reports of H5N1 in poultry or
wild fowl in Djibouti, according to the Paris-based World
Organization for Animal Health.

Health experts fear the bird flu virus could mutate into a form
easily spread among people, potentially sparking a pandemic.

--
Joseph P. Dudley, Ph.D.
Chief Scientist
Biosecurity and Bioinformatics
EAI Corporation
4301 North Fairfax Drive, Suite 200
Arlington, VA 22203
<jdudley@eaicorp.com>

[Djibouti has become the 10th country that reports human case of H5N1
avian influenza infection. A map of Djibouti can be accessed at:
<http://www.lonelyplanet.com/mapshell...i/djibouti.htm>.
ProMED-mail is most grateful to both Dr Andrew Jeremijenko and Dr.
Dudley for their valuable information. - Mod.RY]
</pre>

[HenryN]

Re: Indonesia - Family in Karo suspected of having bf

<TABLE cellSpacing=0 cellPadding=0 width=400 border=0><TBODY><TR><TD vAlign=top bgColor=#ffffee>

The atmosphere of the Fortification Village, the Subdistrict of three bows, of the Karo Regency, North Sumatra, changed drastic.The Boni Karokaro death news as fourth casualties as a result of the assumption of bird flu made the citizen of panic and restless and worried.Casualties's neighbour chose to flee because frightened tertular.Moreover, children were from the Fortification Village avoided by his friends in their school.The fear of the citizen also did not subside although being done by spraying disinfektan.Why not, kept animals like the pig and the chicken still wandering.Critical him the problem of bird flu in the Karo Regency, this awakened the Government of the Deli Serdang Regency took steps in vigilance.Officially the Deli Serdang Health gave counselling to the citizen of the matter of the handling and anticipation when having the citizen who was attacked by the similar illness the bird flu virus.(BEY)</PRE>

</TD></TR><TR><TD colSpan=2></TD></TR></TBODY></TABLE>http://www.metrotvnews.com/berita.asp?id=16549

[Shannon Bennett]

Re: Indonesia - Family in Karo suspected of having bf

According to the newspapers these are the victims and their ages. I put them in order from the latest victim to the first death. Praise Br Ginting was 40 and died on May 4, the father of the two boys 18 and 19 years old. It also means that Bonny died on May 4 so his location on the list below should be just above Praise. Now we come to what doesn't add up. The hospitals say their are or I should say were 8 family members who fell ill. Their names are all listed below. ProMed says there were only three more. that leaves two unaccounted for. And the question that is on every ones mind. Who and where are the twelve who are being treated whos names have yet to be released? ProMed makes no mention of these twelve at all. I think that stink is back in Denmark again. (an allusion to one of Shakespears plays for those who are unfamiliar with the phrase.)

five dead:
Died today. Brenata child 18 months. (This may be the same person referred to as Renata Tarigan aged 1,8 in another news article)
Died May 10 Ana Br Ginting aged 29 years
Died (?) Bonny Karo-Karo 18 years.
Died May 9. Roy Karo_Karo aged 19 years
Died May 4. Praise Br Ginting age (?)

Three or four in hospital

Renata Tarigan (see above, this may be the same person as Brenata) aged 1,8
Rafael Ginting age 8 years
These are the two that fled and where hauled back
Jones Ginting aged 25 years and her child
Obviously Ulina Br Gintling aged 8.

[HenryN]

Re: Indonesia - Family in Karo suspected of having bf

<TABLE cellSpacing=0 cellPadding=0 width=400 border=0><TBODY><TR><TD vAlign=top bgColor=#ffffee>

Anticipated the plague outbreak of bird flu (Avian influenza) in several territories in the Karo Regency, North Sumatra, the local government mengintruksikan the extermination of the poultry.The area that was regarded as serious menyebaran the virus H5N1 including the Silembang Fortification Village, the Subdistrict of three bows, and the Village Kaban Ginger.Since May 4 in this village already three citizens died it was suspected was attacked by bird flu.The regent Karo Good Fortune of Daniel Sinulingga today orders the extermination of the community's poultry that it was suspected contracted bird flu.Casualties died was Ananta Beru Ginting, 29 years, the citizen Street Vetaran, Kaban Ginger; Roy Karo-karo, 19 years, and the mother Beru Ginting."Because of the spreading of the bird flu illness so progressive attacked humankind, I ordered the agricultural Service, the Health and Livestock Breeding immediately destroyed the poultry in several villages," said Sinuligga to the Time, on Friday.</PRE>

</TD></TR><TR><TD colSpan=2></TD></TR></TBODY></TABLE>http://www.tempointeraktif.com/hg/nu...-77378,id.html

[HenryN]

Re: Indonesia - Family in Karo suspected of having bf

In this week already four people died because of the bird flu virus in North Sumatra.A person among them, Bony Karo-Karo, 18, on Friday (12/5), died after being treated for four days in the Public Hospital (RSU) Adam the Medan Owner.Three other that is Anta br Ginting, 29, Fuji br Ginting, 40 and Roy Karo-Karo, 25.Whereas the patient suspect bird flu that still was treated in RSU Adam the Owner that is Brenata br Tarigan 1,5, and Rafael Ginting, 10.Their condition was also still critical.Bidang Pelayanan Medis Deputy Director and Education, RS Adam the Owner, M. Nurasyid Lubis to the Indonesian Media said, the death Bony Karo-Karo struck 13.45 WIB."His condition was indeed serious, already two days of respiratory aids were installed to Bony."His condition was increasingly serious on Friday morning.Around the afternoon, his blood pressure has been again abnormal, he said.The body of Bony Karo-Karo was at once brought by his family to the Simbelang Fortification Village, the Subdistrict of three bows, the Karo Land Regency to be buried.Nurasyid also said up to now his side does not yet accept results of the research into the sample of blood, the sample of the nose caress and the sample of the throat caress that has been sent to Jakarta."Results did not yet go out.""(YN/OL-02)."

http://www.mediaindo.co.id/berita.asp?id=99601

</PRE>


</PRE>

[HenryN]

Re: Indonesia - Family in Karo suspected of having bf

Commentary at

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

[KC]

Re: Indonesia - Family in Karo suspected of having bf

Dr. Niman,

Any concerns about the mixing of recombinants of emerging viral and bacterioligical disease?

[GaudiaRay]

Re: Indonesia - Family in Karo suspected of having bf

Commentary at

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

Five Fatal H5N1 Cases in Sumatra Raise Pandemic Concerns

Recombinomics Commentary
May 13, 2006

The fatal H5N1 bird flu infections of five family members in Karo in North Sumatra has raised pandemic concerns. 2-3 additional family members are hospitalized, but 12 other suspect patients are of even greater concern.

Media reports have provided no detail on these other 12 patients. The hospital is 170 km from the family residence, so it is unclear why there are 12 more suspect patients at the hospital in Medan. Least worrisome would be hospital quarantine due to exposure to the family. However, transporting these patients 170 km as a precaution suggests the local level; of concern is high. Media reports had described panic in the region, but the panic is more likely to be in Karo than Medan.

If the 12 are casual contacts or hospital contacts, than the cause for concern would be increased. The five fatalities have already set a record for H5N1 clusters and so far none of the family members have been discharged. Two fled from the hospital, but they have been returned to a private hospital and their current medical condition is not clear.

The family members most severely affected have died, and the spread in the dates of death suggests human-to-human transmission from the index case to the other family members. Although fertilizer may have contributed to the infection of the index case, infection of the other family members from the fertilizer seems unlikely, unless the other 12 suspect cases also are linked to the fertilizer, which originated in areas that are H5N1 positive.

In any event, more information on the 12 Indonesian suspect cases would be useful.

Media Link

Map

[HenryN]

Bird Flu deaths raise human transmission fears

Bird Flu deaths raise human transmission fears
13/05/2006 - 9:29:32 AM

Indonesian and World Health Organisation officials today were investigating eight suspected human bird flu cases, four of them fatal, in a district on Sumatra island.

WHO spokeswoman Sari Setiogi in Indonesia said tests on villagers? blood samples in northern Sumatra?s Tanah Karo district had yet to be completed.

A WHO team has ?checked the village and at this stage we can say they are still suspect at the moment,? Setiogi said.

Nyoman Kandun, head of the Health Ministry?s office of communicable disease control, said the samples have been passed on to a WHO lab in Hong Kong for confirmation.

He said the possibility of human-to-human infection ?could not be ruled out.?

Kandun said all of the suspected victims were part of a large family, with most living near each other in the same village.

?We have found negative signs of bird flu in all the livestock near where the families live, and now investigators are trying to further check livestock such as chicken, ducks and pigs there,? he said.

Indonesia?s death toll from the H5N1 bird flu strain stands at 25 ? the world?s second-highest toll after Vietnam.

Several fatalities were members of the same family or lived near each other.

Health officials closely study such groups of cases, know as ?clusters,? to see whether the virus, which currently is almost always transmitted from birds to humans, has mutated into one that can easily pass between humans ? a scenario that many fear could turn into a global human pandemic.

http://www.breakingnews.ie/2006/05/13/story258548.html#

[Bruce]

Re: Bird Flu deaths raise human transmission fears

So blood testing is the way to go nowadays, it should be a fast test for results.<o =""></o>
It was only last week when there was talk about blood serum testing.<o =""></o>

Bird Flu deaths raise human transmission fears

WHO spokeswoman Sari Setiogi in Indonesia said tests on villagers’ blood samples in northern Sumatra’s Tanah Karo district had yet to be completed.

He said the possibility of human-to-human infection ”could not be ruled out.”

[AlaskaDenise]

Re: Indonesia - Family in Karo suspected of having bf

Not sure if this is posted elsewhere, but it looks like Indo has had a change of heart regarding US military medical assistance:

http://www.military.com/features/0,15240,97020,00.html

Mercy Deployed on Proactive Humanitarian Mission

American Forces Press Service | Steven Donald Smith | May 12, 2006
<!--- End Article Title/Source/Date ---><!--- Start Article Content --->Washington D.C. - Continuing America's longstanding tradition of helping those in need, the U.S. Navy recently deployed the hospital ship USNS Mercy on a proactive humanitarian mission to Southeast Asia, the commander of the U.S. Pacific Fleet said here yesterday....



The 900-foot-long Mercy left San Diego April 24 for a five-month deployment. The ship will visit the Philippines, Indonesia, Bangladesh and East Timor. It will arrive in the southern Philippines at the end of May. The admiral made the point that the deployment is a cooperative endeavor with the host nations. "We have had an advance team working with the host nation and with the nongovernmental organizations that are already present there to determine the types of services that will be required," he said.......

.

[HenryN]

Re: Indonesia - Family in Karo suspected of having bf

Can't get this story to come up yet. Not sure if this is a new fatality or not:


<TABLE cellSpacing=0 cellPadding=0 width=400 border=0><TBODY><TR><TD vAlign=top bgColor=#ffffee>

In a Week, Lima the Patient Suspect Bird Flu died in MedanMedan -- MIOL: already this week, five patients suspect bird flu from the Simbelang Fortification Village, the Subdistrict of three bows, the Karo Land Regency died in Adam's Public Hospital the Owner, Medan, North Sumatra.</PRE>

</TD></TR><TR><TD colSpan=2></TD></TR></TBODY></TABLE></P>
http://www.mediaindo.co.id/berita.asp?id=99644

[AlaskaDenise]

Re: Indonesia - Family in Karo suspected of having bf

CNN is picking up on this one.

http://edition.cnn.com/2006/HEALTH/c...flu/index.html

Indonesia probes possible bird flu

Four of eight cases investigated were fatal



Indonesian and World Health Organization officials on Saturday were investigating eight suspected bird flu cases, four of them fatal.
All eight cases were from the same family. Four members of the family have died from what health officials suspect could be bird flu, said WHO spokeswoman Sari Setiogi..............

etc. same as prior story

[Mingus]

Re: Bird Flu deaths raise human transmission fears

So blood testing is the way to go nowadays, it should be a fast test for results.<o =""></o>
It was only last week when there was talk about blood serum testing.<o =""></o>

No, I think they look for antibody. Since H5N1 is a fast killer and than antibody response can took 2weeks to drive high titer, this is the best way to obtain false negative data.
After this, they will perform a biopsy on the dead corpse lungs and then (after 2 weeks) we will heard of posivive results from a virus culture...

We saw this many, many time
-First, a cluster
-then a negative test data (It's not bird flu!)
-then a death case
-then 2 week later a H5 positive data (we don't know if it's N1)
-closely folowed by a N1 confimation.

If the virus infect the blood, it's possible to obtain positive RT-PCR(nucleic acid detection test) test but this article who is talking about this has not gain enough coverage to bring laboratory to change theyre pactices. I dont think they will perform fast PCR test on theses bloods sample unless the scientific team who publish thoses data obtain them.

Media, (I dont know if it's just a clich? "blood sample have been sent...") often write this(I saw this tune in africa too) but the right way to perform early rapid molecular test is to obtain Nasal Swab of lung biopsy.

We should be very suspicious about media reporting this "blood sample have been sent..." song in a case of fresh cluster.