Indonesia Discussion

[Theresa42]

I believe this is Rafael Ginting's father, Dowes Ginting, that they are talking about here. And, he went home and died in the very village that the WHO was prevented from visiting....

Two more Indonesians die of bird flu
Total number of deaths in SEA country reach 34
The Associated Press (apwire)

Two more people have died of the H5N1 strain of bird flu in Indonesia, one of them belonging to a family on North Sumatra where the largest national cluster of infections has occurred, government health officials said Monday.

Indonesian Health Ministry spokesman I Nyoman Kandun told reporters in the capital, Jakarta, that a 32-year-old man, identified only as D., died in the village of Kabanjahe after refusing to take antiviral drugs and fleeing a hospital in search of alternative treatment.

Kandun said results from new preliminary testing also had uncovered two other infections, one in Jakarta and another on East Java. The victim of the Jakarta infection died May 19, he said.

The H5N1 infections in all three cases still need to be confirmed by laboratory testing in Hong Kong for the World Health Organization.

If confirmed, they would take the total number of fatalities in Indonesia to 34, the second highest in the world after Vietnam.

While Vietnam and Thailand have successfully contained the illness after serious outbreaks, Jakarta has been criticized for failing to act decisively. Infections have been reported in two-thirds of the sprawling archipelago's provinces.

The cluster in the village of Kubu Sembilang on Sumatra, previously believed to be free of the disease, has raised concerns that the virus may have mutated to a form that is easily passed between people. Health experts say such a scenario could lead to a pandemic, killing millions of people worldwide.

I Nyoman Kandun, who heads the ministry's communicable disease control center, said that transmission between humans could not yet be ruled out.

"We cannot confirm that (human-to-human transmission) has occurred but we cannot rule it out," Kandun said.

http://english.ohmynews.com/ArticleV...93712&rel_no=1

[DB]

"...identified only as D., died in the village of Kabanjahe after refusing to take antiviral drugs and fleeing a hospital in search of alternative treatment."

Can you really blame D. for fleeing the hospital to find an alternative treatment? Right now, getting infected with H5N1 in Indonesia is about a close to a death sentence as you can get. With a mortality rate close to 80% with care and hospitalization it would appear that it is pretty bleak inside the hospital so why not try something else.

I Nyoman Kandun, who heads the ministry's communicable disease control center, said that transmission between humans could not yet be ruled out.

"We cannot confirm that (human-to-human transmission) has occurred but we cannot rule it out," Kandun said.

It has been almost 4 weeks since the index case got sick and almost 3 weeks since the large family cluster where almost the entire family died and still they say "we don't know".

Poppycosh.

They know that the entire family didn't get it at the same time.

They know that they can't use the "close proximity to infected poultry" excuse because it doesn't hold water for this family cluster.

They tried the pigs, cats and dogs routine and that was a dead end.

They tried the fertlizer bit and that ended in failure.

They even went with the infected feaces possiblity and all that did was stink.

If it wasn't so serious I would be laughing.

[sharon sanders]

"And, he went home and died in the very village that the WHO was prevented from visiting..."

Yes, people need to remember that WHO only operates with the permission of the host country.

[HenryN]

On May 23 06 00:29 WIB The citizen of the Land Karo the Piece of the Chicken in DPRDSU The virus of Engineering Bird Flu received Help of the world Bank Medan, was on the alert Online

Dozens of Karo communities demonstrated to the DPRDSU building, on Monday (22/5), accused the government of intentionally engineering the plague of the bird flu virus Avian influenza (AI) to get help of finance from the world Bank. In fact till at this time, not any proof konkrit stated the poultry in Kab. The Karo land positive terjangkit the bird flu virus. The statement was raised by delegation of the poultry businessman Imanuel Ancient opposite the member DPRDSU, when taking place the plenary session of the opinion of the end of the council's member on behalf of factions. Be present there, the Chairman of the E DPRDSU Sahat Situmorang Commission, Vice Chairman Rafriandi Nasution, the member, Budi Noble got up as well as Edison Sianturi. The demonstration action was accompanied by the reduction in several tails of the chicken at the same time being cooked and eaten in front of the council's building. They said, Kab. Karo had not been announced by the government of the centre or the regional government as the source territory of the spread or tertular Avian influenza (AI). However, Menkes at once announced Karo became the territory tertular bird flu. Menkes also looked for the source reason of the spread for manure. Moreover manure originated in Riau, Langkat or Binjai also not terindikasi bird flu and for a long time has been used by the farmer. According to them, the Karo community was offended and could not receive with the common sense everything was announced by the government of the centre. The Karo community has been restless and incurred a loss by morale and materil demanded the government of the centre went through Menkes, Pemprovsu and the Karo Regional Government to send the request sorry on negligence stated Kab. Karo the territory tertular AI. They said, in order to get help of the world Bank, the willing government sacrificed the Karo community especially the poultry breeder for the interests of the group and the group created rumours of bird flu. Whereas the Treasurer FPDIP DPRDSU Zakaria got up, SH urged the government of the province and the Regional Government of Karo firm towards rumours of bird flu. The "government should not hurry to sentence the Simbelang Fortification Village became an epidemic bird flu." Must him the related service immediately deal with if true had the virus. Zakaria also regretted two researchers WHO did not arrive at the location of the occurrence of the plague of bird flu. "Emerge the suspicion, two WHO delegations were conditioned not to the location that his distance approximately 30 minutes from the Kabanjahe city." If this case was left protracted, said Zakaria, caused the social unrest and economics as well as caused a loss to the Karo community. ( m47 )

http://waspada.co.id/berita/sumut/ar...ticle_id=77357

[HenryN]

On May 23 06 00:35 WIB It was other that casualties Suspect Bird flu died Kabanjahe, was on the alert Online

One person more suspect Does Ginting bird flu, 27, villagers the Simbelang Fortification, Kec. Tigapanah the Karo Land, died on Monday (22/5) during in the trip towards RSU Kabanjahe from the Village Jandi Merry, Kec. The place umbrella of casualties carried out traditional medical treatment on the illness that was suffered by him for several days. From information that was received in the Intensive Care Unit's space (UGD) RSU Kabanjahe, casualties were accompanied by his family approximately struck 07:00. However when arriving in RSU, casualties have died. Like that arrived in the UGD room, the RSU Kabanjahe side co-operated with the WHO side Jakarta delegation that by chance was being in the Karo Land immediately identified and took the sample of blood to confirm whether casualties terindikasi bird flu. Casualties's body was at once evacuated by wrapping the body from plastic as well as putting gas anti the spreading of the virus. At that time, the RSU side did not confirm a single entered UGD space, including casualties's family, the nurse, the Doctor and the other official. Only several officials from WHO that free to enter space of the body installation. To struck 10:00, casualties's body was at once brought by the ambulance headed his village the Simbelang Fortification to be buried. Director RSU Kabanjahe Dr the Ginting SPD Voice personally that was met in RSU kabanjahe, on Monday morning did not comment when being touched on whether the casualties were true suspect bird flu. However from an amount of information that was received, casualties Does Ginting uptil now took medicine traditional to one of the villages in the Karo Land. Moreover Does Ginting it was known still was having blood relations in a sixth manner casualties susfect Bird Flu that died before. The line of the descendants of the six casualties who still were as a family their respective, of Fuji Br Ginting died on Thursday (4/5), and his two children were their respective Roy Karo Karo died (9/5) and Boni Karo-Karo (12/5), terindikasi positive Bird Flu. Whereas Does Ginting was the full brother from Fuji br Ginting that died in RSU Kabanjahe, on Monday (22/5) and his child Rafael Ginting that also terindikasi positive bird flu died on Sunday (14/5). Afterwards the brother from Does Ginting that also positive Anta Br Ginting Bird Flu died on Wednesday (10/5), and his child Brenata (1.5 years) also died positive Bird Flu. Afterwards the brother from Anta br Ginting namely Jones Ginting that during still was treated in RSU Adam the Medan Owner. From information of various sources, Does Ginting uptil now it was known in the situation was sick and took medicine traditional to one of the villages in the Karo Subdistrict of the Land Umbrella. Kabanjahe on the Monday at daybreak, because of being known by casualties's illness increasingly serious, but in casualties's trip blew out the last breath.Kabag Regional Government public relations Karo Drs Robert Perangin the wind that was confirmed the reporter breakingprep Monday early afternoon (22/5), claimed peyebab the death of casualties was not yet known positively, terindikasi the sign of Bird Flu.From information that was received in RSU casualties's illness like the sign of the bird flu virus.Like the high fever, crowded, and other.Nevertheless Robert's words, to confirm whether true casualties positive bird flu, sample blood was sent to the American Laboratory in Namroe.Public relations also admitted to from the WHO side personally coming to RSU Kabanjahe totalling four people among them Dr Yane Novina WHO delegation in Jakarta.From Jakarta, the spokesperson the Ministry of the I Nyoman Kandun Health informed the reporters in Jakarta said, the infection H5N1 in the whole of three last cases of bird flu still must be confirmed by the laboratory test in Hong Kong for the Organisation of the Health of the World (WHO). If it was confirmed, then the total of casualties's whole was killed as a result of bird flu in Indonesia reached 34 people, second highest in the world after Vietnam.In the meantime, Vietnam and Thailand succeeded in overcoming the plague after the serious spread.Jakarta was criticised because of failing to overcome the spreading of the virus.A series of infection attack was reported happened in two-divide into three the province.The discovery kluster in the Simbelang Fortification village in the Karo Land Regency, North Sumatra, recently increased the concern that the virus the possibility has bermutasi became one form that easily could move between humankind.The expert in the health said if the scenario was true then the virus will become the plague, that could kill millions of people all over the world.I Nyoman Kandun, that headed the Centre of the Supervision of Department of Health infectious diseases, said the move could not be among humankind set aside.Improved In The Meantime, Jones Ginting that at this time underwent the maintenance in RSUP Adam the Medan Owner his health began to improve and appetite ate casualties also has begun to increase.Kordinator the patient treated inap susfect bird flu Dr. Adlin Adnan, Sp THT said, during at this time the condition for the patient suspect bird flu that is, Jones Ginting has improved.However, Adam's side the Owner was still continuing to give Tamiflu medical treatment and medicine anti biotik to prevent this virus.The "Jones condition at this time had improved and been not still appeared the breathless sign."However, I did not yet know when this patient could come from the hospital home, said Adnan.( Namun melihat kesehatan korban belum juga membaik, akhirnya pihak keluarga sepakat untuk membawa korban berobat ke RSU Kabanjahe pada hari Senin subuh, karena diketahui penyakit korban semakin parah, akan tetapi dalam perjalanan korban menghembuskan nafas terakhir. Kabag Humas Pemkab Karo Drs Robert Perangin angin yang dikonfirmasi wartawan Senin siang (22/5), mengaku peyebab kematian korban belum diketahui secara positip, apakah terindikasi gejala Flu Burung. Dari keterangan yang diperoleh di RSU penyakit korban seperti gejala virus flu burung. Seperti demam tinggi, sesak, dan lainnya. Namun demikian kata Robert, untuk memastikan apakah korban benar positif flu burung, sample darah tengah dikirim ke Laboratorium Amerika di Namroe. Humas juga mengaku dari pihak WHO sendiri telah datang ke RSU Kabanjahe sebanyak empat orang di antaranya Dr Yane Novina perwakilan WHO di Jakarta. Dari Jakarta, jurubicara Kementerian Kesehatan I Nyoman Kandun memberitahu para wartawan di Jakarta mengatakan, infeksi H5N1 dalam keseluruhan tiga kasus terakhir flu burung masih perlu dikonfirmasi oleh tes laboratorium di Hongkong untuk Organisasi Kesehatan Dunia (WHO). Jika dikonfirmasi, maka total keseluruhan korban tewas akibat flu burung di Indonesia mencapai 34 orang, kedua tertinggi di dunia setelah Vietnam. Sementara itu, Vietnam dan Thailand telah berhasil mengatasi wabah itu setelah penularan serius. Jakarta telah dikritik karena gagal mengatasi penyebaran virus itu. Serangkaian serangan infeksi telah dilaporkan terjadi di dua-pertiga provinsi. Penemuan kluster di desa Kubu Simbelang di Kabupaten Tanah Karo, Sumut, baru-baru ini telah meningkatkan kecemasan bahwa virus itu kemungkinan telah bermutasi menjadi satu bentuk yang dengan mudah dapat berpindah antar manusia. Pakar kesehatan mengatakan jika skenario itu benar maka virus itu akan menjadi wabah, yang dapat membunuh jutaan orang di seluruh dunia. I Nyoman Kandun, yang mengepalai Pusat Pengawasan Penyakit Menular Depkes, mengatakan perpindahan di antara manusia tidak dapat dikesampingkan. Membaik Sementara itu, Jones Ginting yang saat ini menjalani perawatan di RSUP Adam Malik Medan kesehatannya mulai membaik dan selera makan korban juga sudah mulai meningkat. Kordinator pasien rawat inap susfect flu burung Dr. Adlin Adnan, Sp THT mengatakan, untuk saat ini kondisi pasien suspect flu burung yakni, Jones Ginting sudah membaik. Namun, pihak Adam Malik masih terus memberikan pengobatan Tamiflu dan obat anti biotik untuk mencegah virus tersebut. "Kondisi Jones saat ini sudah membaik dan tidak ada lagi kelihatan gejala sesak nafas. Namun, saya belum mengetahui kapan pasien tersebut dapat pulang dari rumah sakit," kata Adnan.( c27/k02/m11 )

http://waspada.co.id/berita/sumut/ar...ticle_id=77367

[HenryN]

Medan -- MOIL: Does Ginting, 32, the patient suspect bird flu from the Karo Regency, North Sumatra (North Sumatra) died, in the Kabanjahe Public Hospital, Karo, on Monday (22/5), struck 09.00 WIB. Does followed his child of Rafael Ginting, 10, that has died last Saturday (13/6) in RSU Adam the Medan Owner.Beforehand on Thursday (18/5), Does has suffered hot high, but the family only gave alternative medical treatment without being brought to the hospital.Finally the family brought Does to the hospital, on Monday morning, when his condition has been increasingly serious.Unfortunately could not be treated intensive, Does died.The section head the North Sumatran Health, Fatni Sulatni named the staff dinkes already to Karo to become tangled more far.The "patient indeed suspect bird flu, because he from one family that beforehand indeed was diagnosed by bird flu."""Moreover, Fatni also said them really the difficulty to the Simbelang Fortification Village, the Subdistrict of three bows, Karo because of the citizen in the village refused the team of the health that will check the citizen."They still too much were closed, so as we the difficulty."""In the meantime, dozens of people that mengatasnamakan the Community Karo Anti Bird Flu, did the action in the Office Governor North Sumatra and DPRD North Sumatra.They did not accept the government statement that named their territory tertular bird flu.They demanded the request sorry the government because it was considered has caused a loss to the Karo community in a manner morale and materil.In his action in the Building of DPRD North Sumatra, the demonstrators brought four chickens that afterwards disembelih, was fried, then was eaten.This action was held to show if in Karo did not have bird flu.In his oration, the demonstrators said resulting from this government statement, the community was discredited psychologically.Moreover they also experienced the decline in the sale turnover of the poultry.One of the Karo communities, Imanuel Ancient the sale of their chicken descended since the existence of the statement from the government about their territory that was affected by bird flu.They said will put forward the demand in a perdata manner to President, Menteri Kesehatan, North Sumatran Governor and the Karo Regent went through the Jakarta District Court the Centre.The "Karo community will demand justice," said Tangam Sinambela.(YN/OL-02).
http://www.mediaindo.co.id

[Theresa42]

toggletext-ed from Indonesian:

The spread Antarmanusia [H2H] had never happened
May 23, 2006

Although the case of bird flu was found to an extended family in the Sembilang Fortification Village, the Subdistrict of three bows, the Karo Regency, North Sumatra, the spread of the virus H5N1 or bird flu antarmanusia still could not be ascertained.

Indonesia at this time still was in the phase of three bird flu pandemics.

The director general of the Control of the Illness and environmental Sanitation Dr I Nyoman Kandun MPH to the reporter, on Monday (22/5), said, the case klaster [cluster] bird flu in Karo happened to nine people who still were having the family's relations. Seven including dying.

The department of the Health confirmed that the Karo case was bird flu although being not yet known how until bird flu happened in the territory.

The first case struck PBG (40) that experienced was sick since April 27 2006. The woman suffered the high fever was accompanied by the cough and died seven days afterwards. Two children PBG, RKK (19) and BKK (18), experienced the same thing but also died.

According to Kandun, followed afterwards five neighbours who still were having your relations [neighboring family members is how I read that] was treated in RS H Adam the Medan Owner. Three including dying. After the three of them died, other casualties following, namely D (32), on last Monday.

Results of the laboratory, manure, the land, and the chicken organ of the living chicken in the location of the case showed that serology and RT-PCR the negative. Investigation also found 11 pigs, 4 entok, 4 ducks, and manure showed results of the positive serology laboratory and RT-PCR the negative.

Explained by Kandun, it was known afterwards this family bought pork in the K Market and was processed as the roasted pig for the family's dish, last April 27. The existence of the interaction of the case of contact casualties with the source of the infection apart from the poultry, namely the pig, was the new development of bird flu in Indonesia.

The Department's data of the Health showed, during July 2006 till May 18 2006 43 cases happened that also was confirmed to the laboratory of WHO Hong Kong. Totalling 33 people including dying, in other words case fatality rate reached 76,7 percent.

The case of bird flu happened in seven provinces, namely the Special Capital District of Jakarta (11 cases, 10 died), Banten (6 cases, 5 died), West Java (13 cases, 10 died), Central Java (3 cases, 2 died), East Java (1 case died, and 1 case in confirmation of the Litbangkes Body laboratory). Moreover, the case also happened in Lampung (3 cases of the life), North Sumatra (6 cases, 5 died), and 1 case in Karo in confirmation.

The secretary of the National Commission the Control of Bird Flu and Kesiap-siagaan faced the influenza Pandemic (Komnas FBPI) Bayu Krisnamurthi says, up to now was not yet known from where bird flu in Karo came. The "status of bird flu still the III level, that is the assumption spread from the animal to humankind," he revealed.

http://www.kompas.com/kesehatan/news/0605/23/064243.htm

[DB]

"The "status of bird flu still the III level, that is the assumption spread from the animal to humankind," he revealed"

Denial is not a river in Egypt.

[Theresa42]

Indonesia struggles to track H5N1 source as two more die

2006/5/23
JAKARTA, Reuters

Health officials in Indonesia are still struggling [should read stalling! - see further down] to track down the source of a worrying family cluster of H5N1 bird flu infections as tests showed that two more people have died of the same disease.

One of the latest victims belonged to a Sumatran family, which lost several members earlier this month to bird flu, sparking fears of human-to-human transmission.

While H5N1 is still regarded as a bird disease, experts have warned for more than a year that it might mutate and pass efficiently between humans and cause a global pandemic.

"One man from the same Sumatra cluster died this morning. He is the father of the child who died on May 13. He ran away after he received Tamiflu," said I Nyoman Kandun, director general of communicable disease control at the health ministry.

"He was found in the village later but refused treatment," Kandun told reporters at a news conference.

Five of his relatives have been confirmed as bird flu deaths by the World Health Organization (WHO) which also says another family member has survived being infected with H5N1.

Another death could not be confirmed because no samples were obtained but she is considered the initial case of the cluster in Kubu Simbelang village in north Sumatra.

The woman died on May 4 but, nearly three weeks on, Indonesian experts have come no closer to finding the source of the virus.

Blood samples taken from chickens, ducks and pigs in the neighboring district of Kabanjahe -- where there was an outbreak of H5N1 in chickens in January -- have tested positive for antibodies for the H5 component for the virus.

But local scientists have yet to test the samples specifically for N1 antibodies.

Nasal swab samples of the animals tested negative for H5N1, meaning they were no longer infected.

Abdul Adjid of Indonesia's Veterinary Research Institute, which is handling the animal samples, said his laboratory would try to test the samples for N1 antibodies.

"We are trying to do the N1 tests. Maybe we will ask the WHO or the FAO (Food and Agriculture Organization) to provide (assistance) so that we can improve our ability to do that," Adjid told Reuters.

If these samples come back positive for N1 antibodies, it could mean that the animals, which are healthy and free of the disease now, were infected with H5N1 some time in the past.

http://www.chinapost.com.tw/asiapaci...GRP=C&id=82723

[Theresa42]

Indonesia's bird flu fight riddled with problems
23 May 2006 05:51:47 GMT
Source: Reuters

By Tan Ee Lyn

JAKARTA, May 23 (Reuters) - Indonesian laboratory chief Abdul Adjid sent one of his staff to a village in Sumatra to collect animal samples this month after several members of a family fell sick with the H5N1 bird flu virus and died.

The staffer came back with blood and nasal swab samples of a few ducks but failed with the pigs because he could not get anywhere near them.

"He was alone. He couldn't handle the pigs. People there were unhappy with the situation so they did not help," said Adjid of Indonesia's Veterinary Research Institute.

Those few, short sentences reflect a litany of simple, but tremendous, problems Indonesia, the world's fourth most populous country, faces in its fight against the H5N1 virus.

There's a lack of trained personnel and equipment and many Indonesians are ignorant about the disease and suspicious of government workers as well as efforts to control the virus.

Add to this a massive geographical landscape of 17,000 islands that stretch 5,000 kilometres (3,100 miles) from east to west and it makes control of any infectious disease a nightmare.

"There is substantial room for more work to be done. We are ramping up our team here to work with the Agriculture Ministry to increase personnel in the field to deal with the problem of surveillance and response to cases when they are found," said Larry Allen of the U.N.'s Food and Agriculture Organisation.

Since its first known attack on Indonesian poultry in late 2003, the H5N1 virus has wreaked havoc in terms of human lives and losses to the poultry industry. At least 32 Indonesians have died of bird flu, the second highest total in any country so far.

Some experts blame the crisis partly on Jakarta's policy against killing large numbers of fowl in infected areas.

Sick chickens are the main source for human infections worldwide and experts say the best way to prevent the virus spreading is to stamp out the disease in poultry.

But the cash-strapped government says mass culling is just too expensive and too hard to carry out in many areas of the country. Widespread culling would also meet resistance in a nation where millions keep a few birds in their yards.

For millions more, fowl are essential to their livelihoods.

While Thailand and Vietnam seem to have controlled the virus, H5N1 is believed to be endemic in almost all Indonesia's 33 provinces.

ANGRY VILLAGERS

The medical community was alarmed last week when the World Health Organisation confirmed the virus killed at least five members of a Sumatran family within a week -- the largest known cluster of H5N1 human infections.

Such "clusters" are looked on with far more suspicion than isolated infections because they raise the possibility the virus might have mutated to transmit efficiently among humans. Such a change could spark a pandemic that could kill millions.

The first victims in that cluster in Kubu Simbelang village died in early May, but three weeks on, authorities have not been able to trace the likely source.

"We cannot conclusively confirm or rule out the possibility of human-to-human transmission," said I Nyoman Kandun of the Health Ministry's communicable disease control directorate.

Animal tests have been inconclusive. Although Adjid's laboratory detected H5 antibodies in pigs, chickens and ducks in a village a short distance from Kubu Simbelang, they have yet to test for the N1 component -- something they cannot do without reference materials from the WHO.

Nasal swab samples were free of live H5N1 virus, which means the animals were not infected at the time of sampling.

But samples that are perhaps most crucial in solving the mystery -- those of chickens and pigs in Kubu Simbelang -- are missing, because villagers refused to help Adjid's staff.

Pigs are susceptible to human and bird viruses and because in Asia they are often reared in close quarters with people, they are also seen as likely sources of infection. The family cluster has wrecked the poultry industry in the wider Karo region in north Sumatra and villagers have turned on the government, accusing it of not providing enough help.

In a show of anger, about 100 Karo chicken traders tore apart live chickens with their bare hands on Monday [very intelligent...] and defiant villagers have pledged to hold a traditional feast that involves slaughtering pigs and poultry and cooking them in blood. [Give those people a Darwin award! ]

"They are disappointed that we have not been more responsive. They are not angry, just unfriendly. They are unfriendly to the people from the central government, the provincial government," said Sidharta Pinem, head of animal husbandry in Karo Regency. (With additional reporting by Achmad Sukarsono and Diyan Jari)

http://www.alertnet.org/thenews/newsdesk/JAK85152.htm

[Theresa42]

"Sweeping" = culling?

toggletext-ed from Indonesian:

The GOVERNMENT DELI SERDANG SWEEPING the POULTRY in the KARO BORDER
May 23, 2006

Metrotvnews.com, Deli Serdang: Officially Deli Serdang Livestock Breeding held sweeping against poultries in the area of the border of the Karo Land, North Sumatra. This step was taken following the death of six patients suspect bird flu and one person contracted the virus avian influenza.

On Monday (22/5), sweeping was done in the Sibolangit Subdistrict that shared directly a border with the Karo Regency, the place of the discovery of the epidemic of bird flu. All the poultry not there are those that belonging to the citizen slipped off from the injection disinfektan. Apart from disuntik, the Livestock Breeding Service was helped, also to spray the house and chicken coops by the student the Faculty of University Livestock Breeding of Muhamadiyah Medan belonging to the citizen. This policy received the positive address from the citizen. They did not object to the existence sweeping this, in fact felt was helped by the existence of this program.

According to the Section Head Deli Serdang Zulkifli Livestock Breeding, sweeping this was done after the discovery of the citizen Karo that was infected by bird flu. Zukifli stressed, sweeping as well as the poultry vaccination only not will be done in the area of the border, but all over the subdistrict in Deli Serdang.

http://www.metrotvnews.com/berita.asp?id=17214

[Theresa42]

Whole story not available yet...

toggletext-ed from Indonesian:

10 patients Suspect Bird Flu in West Java died
May 23, 2006

Around 80 patients suspect bird flu (avian influenza) was treated in several hospitals in West Java (West Java). From the number, 10 people including dying after getting the medical maintenance.

http://www.mediaindo.co.id

[Sally Furniss]

Good find Theresa. Heres the rest of it.
Bandung -- MIOL: around 80 patients suspect bird flu (avian influenza) was treated in several hospitals in West Java (West Java).
From the number, 10 people including dying after getting the medical maintenance.
The section head (Kasi) Sanitation of the Environment of the Health Service West Javanese Fatimah Resmiyati to the Indonesian Media, on Tuesday, said in fact the number of positive patients was affected by the bird flu virus was based on results of the Hong Kongese laboratory research numbering 12 people.
"However that succeeded in being rescued numbering two people."
And 10 patients including dying, said Fatimah.

The hospital that served the maintenance of the patient suspect bird flu, that is the Handsome Sadikin Hospital (RSHS) Bandung, the lung Hospital, Ciumbuleuit, Bandung, and the Cirebon regional Public Hospital.
According to Fatimah, to anticipate increasingly spread him the bird flu virus in the city and the regency in West Java, the West Javanese Health Service sent several Tamiflu pills in accordance with the requirement to several community health centres.
"Respectively the Community Health Centre was sent around 10 Tamiflu stripes."
The number could be utilised for 10 affected patients the sign (suspect bird flu), said Fatimah.
(EM/SG/OL-03)

[Sally Furniss]

Surabaya -- MIOL: Other the sufferer suspect bird flu Aris Ashar, 20, from Jepara, Central Java, on Saturday (19/5) died after being treated for nine days in Budi's Hospital Noble Surabaya.
With Aris's death, in Surabaya was recorded by two people who died resulting from bird flu.
Beforehand, died on behalf of the Lily, 36, the citizen's year Street Pucang Anom II/27 Surabaya.
Information that was accepted mentioned this patient entered RS Budi Mulya since last Tuesday (09/05) with the sign of pneumonia and breathless acute.
It was increasingly old, his condition increasingly descended.
After that, the side RS Budi Mulya that suspicious with the condition for casualties, did the co-ordination with RSU Dr Soetomo and Dinkes the Surabaya City and Dinkes the Province.
For the maintenance suspect this bird flu, the handling that was carried out by RS Budi Mulya did not have a basis the procedure that was determined by the Department of Health, as being placed in special isolation space was mixt with the other patient.
"We will be waiting up until the following Tuesday to know kepastiana whether being affected by bird flu or not."
That definitely korba has been brought came home the family, Superior words one of the staffs public relations of RS Budi Noble.
The body suspect bird flu, has been taken by the family to be buried in Jepara.
(FL)
http://www.mediaindo.co.id/berita.asp?id=100441

[HenryN]

Originally Posted by AnneZ

Good find Theresa. Heres the rest of it.
Bandung -- MIOL: around 80 patients suspect bird flu (avian influenza) was treated in several hospitals in West Java (West Java).
From the number, 10 people including dying after getting the medical maintenance.
The section head (Kasi) Sanitation of the Environment of the Health Service West Javanese Fatimah Resmiyati to the Indonesian Media, on Tuesday, said in fact the number of positive patients was affected by the bird flu virus was based on results of the Hong Kongese laboratory research numbering 12 people.
"However that succeeded in being rescued numbering two people."
And 10 patients including dying, said Fatimah.

The hospital that served the maintenance of the patient suspect bird flu, that is the Handsome Sadikin Hospital (RSHS) Bandung, the lung Hospital, Ciumbuleuit, Bandung, and the Cirebon regional Public Hospital.
According to Fatimah, to anticipate increasingly spread him the bird flu virus in the city and the regency in West Java, the West Javanese Health Service sent several Tamiflu pills in accordance with the requirement to several community health centres.
"Respectively the Community Health Centre was sent around 10 Tamiflu stripes."
The number could be utilised for 10 affected patients the sign (suspect bird flu), said Fatimah.
(EM/SG/OL-03)

Is this a cumulative number for the area, or new cases?

[Sally Furniss]

Originally Posted by niman

Is this a cumulative number for the area, or new cases?

Sorry, No idea!

[HenryN]

Mataram -- MIOL: President Susilo Bambang Yudhoyono ordered the governors, the regent and the mayor to have a preceptive attitude towards the case of bird flu.The president considered the case of bird flu did not only become the problem in the country but also by other countries."I asked for the Regional Government to preceptive towards the case of bird flu," said President Yudhoyono in Mataram, on Tuesday, when opening the Association's working meeting of the Government of all the Indonesian Province (APPSI) that will take place till this coming May 24.The Working Meeting opening ceremony three today was attended also by Governor Bank Indonesia Burhanudin Abdul, the Minister For Home Affairs Muhamad well known, the Minister For Communications Hatta Rajasa, Menkominfo Sofyan Djalil as well as NTB Lalu Serinata Governor.The speaking head of state without the text afterwards touched on the case of bird flu that happened in the Karo Regency, North Sumatra.Recently in the Karo Regency emerged the case of bird flu to one cluster that resulted in five people dying in time that very close.To the Governors who attended the Working Meeting, the President also stated his concern because originally was estimated the case of this bird flu emerged from the poultry.However evidently poultries were there stated by the negative.Afterwards emerged the suspicion to the pig animal.Originally the pig was stated by the negative, but finally was proven this animal positively became the cause of the case emergence of bird flu there.The president said, himself very worried if the case of bird flu emerged from humankind that spread the virus to other humankind, because of could cause millions of people to die.(Ant/OL-03)
http://www.mediaindo.co.id/

[Dark Horse]

Originally Posted by niman

Is this a cumulative number for the area, or new cases?

A poster named Blue Jay on another board said that these numbers were from July 2005 through the present.

[sharon sanders]

The report that is being widely used is prepared by the Indonesian government.


http://www.penyakitmenular.info/pm/default.asp

click on this link to get the chart

SITUASI FLU BURUNG DI INDONESIA

Still the numbers seem confusing as the 128 "confirmed cases" reported on May 5, 2006 by the Indonesian Minister for People seem to have been a mixture of past and present cases.

[DB]

http://www.antara.co.id/en/seenws/?id=13231

Suspected birdflu patient dies in Bandung

Bandung (ANTARA News) - One of two suspected birdflu patients here died on Tuesday after being treated at Hasan Sadikin Hospital for 18 hours.

"At, a brother of Ad, both treated at the hospital for suspected bird flu died at 2.50pm, not long after doctors put a ventilator on him," deputy chief of the hospital's team of doctors for the disease, Djatnika Setiabudhi said.

He said the two patients had experienced shock while being treated in the hospital.

Djatnika could not confirm if the two had been suffering from bird flu although they showed symptoms similar to those for birdflu such as coughing, breathing problems and high fever.

The hospital had sent their blood samples to the Health Research and Development Agency in Jakarta for a test for the disease.

The siblings were first brought to Ujungberung hospital on Monday but after is was known that they had contact with a dead chicken, they were transferred to Hasan Sadikin Hospital that night.

The condition of the two patients was already serious when they were brought to the Hasan Sadikin.

He said the condition of Ad was still very serious and a ventilator had already been put on him.(*)

[DB]

It looks like we are going to have two more cases and deaths, brothers At and Ad, after there samples get tested and most likely confirmed.

[DB]

http://www.ctv.ca/servlet/ArticleNew...hub=TopStories

Tests show no evidence of a significant mutation in the bird flu strain that killed at least six blood relatives in an Indonesian village, the World Health Organization said Tuesday.

The deaths in the village in the Karo district of North Sumatra sparked fears the virus is being transmitted from person to person.

"Sequencing ... found no evidence of genetic reassortment ... and no evidence of significant mutations," the agency said in a statement.

"The human viruses from this cluster are genetically similar to viruses isolated from poultry in North Sumatra during a previous outbreak."

The World Health Organization confirmed details of the cluster last Thursday.

A 37-year-old woman from the village of Kubu Sembelang fell ill on April 27 and died on May 4.

But it's unlikely the cause of death will ever be confirmed as no samples were taken during her illness or before her burial.

Since her death, several of the woman's blood relatives have tested positive for the virus.

On Tuesday, Indonesia's Ministry of Health confirmed that another member of the woman's extended family, her 32-year-old brother, died on May 22.

"The man is the seventh member of an extended family to become infected with the H5N1 virus and the sixth to die," the agency said.

He is also the father of a 10-year-old boy who died on May 13.

"The father was closely involved in caring for his son, and this contact is considered a possible source of infection," the agency said in a statement.

Preliminary findings indicate that three of the confirmed cases stayed overnight in a small room with the initial case when she was symptomatic and coughing frequently.

Those confirmed cases include the woman's two sons and a second brother, who is the only surviving case among infected members of this family.

"All confirmed cases in the cluster can be directly linked to close and prolonged exposure to a patient during a phase of severe illness," the WHO said.

"Although human-to-human transmission cannot be ruled out, the search for a possible alternative source of exposure is continuing."

Some doctors have suggested the cluster could mean there is some sort of genetic feature in the family's make-up that rendered its members more vulnerable to the strain.

While the source of that outbreak hasn't been officially confirmed, investigators believe the victims were engaged in the practice of defeathering swans -- an illegal activity which surviving family members may have tried to hide from authorities.

The Indonesian family cluster is the largest seen until now, but a number of other clusters among family members have been observed, most recently in Turkey and Azerbaijan.

Since late 2003, the virus has sickened at least 217 people in 10 countries, killing 123 of them, according to the WHO's May 19 count.

[HenryN]

The writer: SugengBandung -- MIOL: A patient suspect bird flu died in RS Handsome Sadikin (RSHS) Bandung, on Tuesday (23/5).Casualties, Ai Tita, 10, the citizen liked the Well-being, Cileunyi, the Bandung Regency, it was suspected was casualties family cluster bird flu, because during simultaneously, his full sibling, Ade Firman, 18, also in the critical condition.The two casualties were beforehand treated in RS the Berung Tip for one day, before being reconciled to RSHS, on Monday night (22/5).However, after being treated less than 19 hours, Tita did not remain, and died 02.50 WIB.Like was said the team's member of the handling of bird flu RSHS Polite, had been based on the medical note, since coming the two casualties in the critical condition, with the breathless complaint difficult and has experienced shock.To confirm whether both of them were infected by bird flu, sample blood was at once sent to the Departemenresearch and development hallThe Jakarta health.The mother of casualties, Cacih, 50, said, before his two children suffered the hot complaint high, several tails of the chicken were belonging to his neighbour found died suddenly.Before being brought to the hospital, his two children have experienced the hot sign high for three days.The "clinical sign both of them were similar to bird flu, so as we at once treated him in special isolation space RSHS bird flu in Flamboyant space."If being proven the clinical test showed they were infected by bird flu, both of them to cluster third that was handled the hospital after the family from Sumedang and Indramayu, firm Polite.In the meantime, the condition for Ade Firman, also still was critical.The sign that was experienced by him was the same as his brother who has died that.(SG/OL-02).
http://www.mediaindo.co.id

[DB]

Tests show no evidence of a significant mutation in the bird flu strain that killed at least six blood relatives in an Indonesian village, the World Health Organization said Tuesday.

"Sequencing ... found no evidence of genetic reassortment ... and no evidence of significant mutations," the agency said in a statement.

The key word here boys and girls is 'significant'.

In essence they have found a mutation. It just doesn't classify as significant.

What is significant? Well, I can speculate that significant means Phase 6 full blown pandemic.

I don't think they found that.

But I do believe they found a mutation that would provide for, oh say Phase 4.

"The father was closely involved in caring for his son, and this contact is considered a possible source of infection," the agency said in a statement.

Preliminary findings indicate that three of the confirmed cases stayed overnight in a small room with the initial case when she was symptomatic and coughing frequently.

"All confirmed cases in the cluster can be directly linked to close and prolonged exposure to a patient during a phase of severe illness," the WHO said.

There you have it.

Limited human-to-human transmission of H5N1.

This is coming from WHO and pretty much seals the deal.

While I cannot confirm it is Phase 4, it looks like WHO is leaning toward a public announcement of such an event.

I could be wrong, but the words speak for themselves.

[Theresa42]

Originally Posted by niman

Is this a cumulative number for the area, or new cases?

I believe it is cumulative:

http://www.penyakitmenular.info//pm/...3_14_53_55.pdf

[HenryN]

Avian influenza – situation in Indonesia – update 14

http://www.who.int/csr/don/2006_05_23/en/print.html


23 May 2006
The Ministry of Health in Indonesia has confirmed an additional case of human infection with the H5N1 avian influenza virus. The case occurred in a 32-year-old man. He developed symptoms on 15 May and died on 22 May.
The case is part of a family cluster in the Kubu Sembelang village, Karo District, of North Sumatra. The man is the seventh member of an extended family to become infected with the H5N1 virus and the sixth to die. An additional person, who was the first member of the family to fall ill, died of respiratory disease on 4 May. No specimens were taken prior to her burial and the cause of her death cannot be determined. However, as her clinical course was compatible with H5N1 infection, epidemiologists at the outbreak site include this woman as the initial case in the cluster.
The newly confirmed case is a brother of the initial case. Specimens were taken on 21 May and flown the same day to Jakarta. Tests run overnight confirmed his infection. His 10-year-old son died of H5N1 infection on 13 May. The father was closely involved in caring for his son, and this contact is considered a possible source of infection.
Although the investigation is continuing, preliminary findings indicate that three of the confirmed cases spent the night of 29 April in a small room together with the initial case at a time when she was symptomatic and coughing frequently. These cases include the woman’s two sons and a second brother, aged 25 years, who is the sole surviving case among infected members of this family. Other infected family members lived in adjacent homes.
All confirmed cases in the cluster can be directly linked to close and prolonged exposure to a patient during a phase of severe illness. Although human-to-human transmission cannot be ruled out, the search for a possible alternative source of exposure is continuing.
Both the Ministry of Health and WHO are concerned about the situation in Kubu Sembelang and have intensified investigation and response activities. Priority is now being given to the search for additional cases of influenza-like illness in other family members, close contacts, and the general community. To date, the investigation has found no evidence of spread within the general community and no evidence that efficient human-to-human transmission has occurred.
Analysis of viruses


Full genetic sequencing of two viruses isolated from cases in this cluster has been completed by WHO H5 reference laboratories in Hong Kong and the USA. Sequencing of all eight gene segments found no evidence of genetic reassortment with human or pig influenza viruses and no evidence of significant mutations. The viruses showed no mutations associated with resistance to the neuraminidase inhibitors, including oseltamivir (Tamiflu).
The human viruses from this cluster are genetically similar to viruses isolated from poultry in North Sumatra during a previous outbreak.

[DB]

To date, the investigation has found no evidence of spread within the general community and no evidence that efficient human-to-human transmission has occurred.

This is a game of words.

Efficient is a word that is applied to Phase 6, not Phase 4.

Phase 4 is clusters. Phase 4 is limited human-to-human transmission.

Phase 4 is what we are witnessing in Indonesia.

[hawkeye]

Seven Indonesian Bird Flu Cases Linked to Patients, WHO Says

May 23 (Bloomberg) -- All seven people infected with bird flu in a cluster of Indonesian cases can be linked to other patients, according to disease trackers investigating possible human-to-human transmission of the H5N1 virus.

A team of international experts has been unable to find animals that might have infected the people, six of whom have died, the World Health Organization said in a statement today. In one case, a 10-year-old boy who caught the virus from his aunt may have passed it to his father, the first time officials have seen evidence of a three-person chain of infection, an agency spokeswoman said.

Almost all of the 218 cases of H5N1 infections confirmed by the WHO since late 2003 can be traced to direct contact with sick or dead birds. Strong evidence of human-to-human transmission may prompt the global health agency to convene a panel of experts and consider raising the pandemic alert level, said Maria Cheng, an agency spokeswoman.

``Considering the evidence and the size of the cluster, it's a possibility,'' Cheng said in a telephone interview. ``it depends on what we're dealing with in Indonesia. It's an evolving situation.''

The 32-year-old father in the cluster of cases on the island of Sumatra was ``closely involved in caring for his son, and this contact is considered a possible source of infection,'' The WHO said in its statement. Three others, including the sole survivor in the group, spent a night in a ``small'' room with the boy's aunt, who later died and was buried before health officials could conduct tests for the H5N1 virus.

``All confirmed cases in the cluster can be directly linked to close and prolonged exposure to a patient during a phase of severe illness,'' the WHO said.

[DB]

In one case, a 10-year-old boy who caught the virus from his aunt may have passed it to his father, the first time officials have seen evidence of a three-person chain of infection, an agency spokeswoman said.

So we have H2H2H.

Strong evidence of human-to-human transmission may prompt the global health agency to convene a panel of experts and consider raising the pandemic alert level, said Maria Cheng, an agency spokeswoman.

This is at least Phase 4. Hopefully it won't continue going 2H.

``Considering the evidence and the size of the cluster, it's a possibility,'' Cheng said in a telephone interview. ``it depends on what we're dealing with in Indonesia. It's an evolving situation.''

It is obvious that we are dealing with at least H2H2H Phase 4 virus.

If this continues to spread we may have a Phase 5 or Phase 6.

I hope everyone has completed their preps.

[Goju]

Has anyone heard of Recombination?