Indonesia: The Latest Human Suspected & Confirmed Cases January 29 + April 6, 2009

[Commonground]

Post #204:
Sally, it is the same age, location and hospital. 2 hospitals match. So, the dates are all different. I just don't know anymore.

[Laidback Al]

Originally Posted by Commonground

Post #204:
Sally, it is the same age, location and hospital. 2 hospitals match. So, the dates are all different. I just don't know anymore.

All of the timeline events in the posts previous to 204 were relative (days of the week and elapse time). If the onset date was misrepresented or misreported (as it seems to have been in post #189) all of the relative dates would be wrong. Given the timeliness of BF reporting, It is clear that the child died this past Saturday (February 28, 2009) and we have to work back from that date, not forward from some uncertain onset date.

[Commonground]

OK, I'll edit the Summary accordingly.

[Dutchy]

Persehabatan Hospital in Jakarta usually never comments on human avian influenza cases. So the information on the girl from Depok who died , suspected avian flu, comes from other sources, in this case from her mother. It is not clear if samples were taken and send to the lab for testing.

A snip of the article posted by Sally (# 204) toggletext translated and edited:

"Because of serious breathing difficulties, the doctor afterwards gave oxygen and evaporation as help."

Because of not showing recovery she went to the Intensive Care Unit, she explained.

To get confirmation of the illness then the hospital made x-rays of Lizah and the results showed both her lungs were closed by white coloured spots.

The doctor said the ilness suffered by Liza headed to the virus of Avian Influenza or bird flu," said Mahmudin (= mother of victim,ed) .

http://www.kapanlagi.com/h/balita-me...lu-burung.html

[Dutchy]

Bodetabek is short for the name of this region : Bogor, Depok,Tangerang, Bekasi.

Bird flu Haunts Bodetabek

It was the Turn of a Depok Child to be killed

On Tuesday, March 3 2009 | 04:05 of WIB

Depok, on Monday - the Plague of bird flu increasingly equitable and haunted the Bogor resident, Tangerang, Depok, and Bekasi (Bodetabek). Casualties were killed finally was the child from Rangkapanjaya, Kota Depok, Nurliza Mahmuda (5).

The pupil TPA Asyiah this lived in the village of Situpulo RT06/08, Rangkapanjaya, the Pancoranmas subdistrict. She died on Saturday (28/2) around struck 03,00 in RS Persahabatan, Jakarta.

At almost the same time died also Andriansyah (9), from Bekasi, with the status suspect bird flu (the Kota News (1/3), hlm 6). Mahmudin Sudin, parents Nurliza, on Monday (2/3) said that before his daughter died had his three neighbouring chickens died suddenly. By the grandfather Nurliza, this chicken was burnt. A week after the incident, to be precise on Wednesday (18/2), Nurliza complained had a headache.

In the afternoon him he was brought took medicine to NY Sugi, the nurse the Jembatanserong Community Health Centre. Because of not having the change then Nurliza was carried to Bahar Medika in the Market of Lama Depok. Then was carried out by the blood test and results of the child were stated suffered typhus.

Mahmudin then brought Nurliza to RSUD Depok. ”After saw results of the laboratory, the hospital doctor of every one of my children was treated in the house because of his condition not worrying,” he said.

Disappointed with RSUD Depok, Mahmudin brought his child to RS Bhakti Yudha. In this hospital of Nurliza was tested blood through to 10 times. Results of the test mentioned the child was affected by dengue fever. However on Wednesday he was breathless and painful at the back of the waist.

After being x-rayed, by the doctor he was stated was affected by the inflammation of the lungs and was given cough medicine. On Thursday (26/2) were done by evaporation to dilute mucus in order to be able to breathe.


On Friday (27/2) were given by fumigation with the aim of could breathe. Not long afterwards, the doctor asked that Nurliza was treated in the Perawatan Khusus Unit (UPK) this hospital.

His reason this room was more sterile and his maintenance was better. In struck 11,30 Nurliza was x-rayed again. Results, some of his lungs have faded. The doctor mentioned that the child it was suspected was affected by bird flu. Because of not having equipment to overcome this illness, RS Bhakti Yudha reconciled Nurliza to RS Persahabatan, Jakarta.

” We have waited from striking 14,30 but just departed struck 19,00. This that made us disappointed. In fact had three ambulances that was parking. His words of the side of the ambulance hospital of one package. Sesampai our child in RS Persahabatan, the doctor lifted the hands because his virus has spread ,” said Mahmudin.

The guardian of the City Depok Nur Mahmudi Isma’il that could visit to parents's house Nurliza said that the child died because suspect bird flu. ”That was regretted by us did not have the resident who reported during approximately 50 pet chickens they died in the period a week, namely the date 11-18 of Februari,” Nur Mahmudi words.

” did not have the hospital that wanted to torment his patient. If RS Bhakti Yudha, they have treated Nurliza and when said suspect bird flu at once reconciled him to the other hospital ,” Nur Mahmudi words again the matter of the hospital service that made disappointed Mahmudin. (

http://megapolitan.kompas.com/read/x...ntui.Bodetabek

[Commonground]

Sesampai our child in RS Persahabatan, the doctor lifted the hands because his virus has spread ,” said Mahmudin.

Sesampai = upon arrival.

I would expect healthcare workers to have their blood drawn.

[Sally Furniss]

DEPOK - aka bird flu avian influenza (H5N1) back in the various regions. Hundreds of chickens died suddenly. Victims of any fall back. The last two people died because of bird flu is Nurliza Mahmudah (5 years) and Andry (8 years). Second suspect this bird flu died on Saturday (28 / 2).

Nurliza living in the Kampung Pulo neighborhood 6 / 8, copy Jaya district, District Pancoran Mas, Depok, West Java. Andry kampong residents is Sukamantri RT 01/03, Desa Suka Raya, Kecamatan Karang Bahagia, Kabupaten Bekasi, West Java. Three medical workers Hospital Annisa, Cikarang, Bekasi regency, West Java, that handles Andry, blood samples have been taken by the National Bird Flu Penanggulangan. They are from Suki, dr Lia, Agus and paramedics. Friday (27 / 2) night, they cared Andry. When dealing Andry, they do not wear masks, wear closed, and does not handle the isolation room.

''They close contact with the alleged victim died,''said Rudi Ruhdiat dr, head of Diseases Control and Environmental Health Office Penyehatan Bekasi City, Monday (2 / 3). Penanggulangan National Agency is also taking a blood sample and throat skillful living one house with Andry. That is, Ilyas (43), Mimin (36), mother Andry; Ana (6), younger brother Andry.

Checking the blood also carried out on seven of the Village Sukamulya, District Sukatani, Kabupaten Bekasi. Yesterday, Public Health Bekasi got a letter stating the results began to complain negatif.Nurliza sick on Wednesday (18 / 2). ''Body temperature reached 40 degrees Celsius, and his head dizzy,''said the father Nurliza, Mahmudin Sudin (35), Monday (2 / 3).

Nurliza was treated in a different place, with a diagnosis that is also different. He stated tifus affected by Medika Bahar Clinic. Hospital in Yudha Bhakti, he was treated for five days revealed a scarlet fever dengue.Mahmudin admitted sepekan before their child is sick, there are three chickens belonging to neighbors who died suddenly. Chicken''is cut and burned my father. Neighbors also took food. But, why they are not affected,''said a teacher in the religious SMUN I Depok this.

Public Health and Agriculture Depok direct spraying disinfektan to do all the poultry stalls in the area, and conducted random tests. The result is''negative,''said Kadistan Plt Depok, Depok Widyati Ryandani.Wali, Nurmahmudi Ismail, also deplore the low awareness of citizens to report cases of poultry deaths. In fact, from reports he received on February 11-18, there are about 50 dead birds in the region.

Last week, in Purwakarta, West Java, about 150 chickens died. Based on the rapid test, two dead chickens in Kampung Nenggeng, Neglasari Village, Kec Darangdan, states terindikasi infected virus flu burung.Di Takalar, Sulawesi Selatan, Jumat (27 / 2), reported that many birds die suddenly, because of suspected bird flu . At the same time, in Bojonegoro, East Java, dozens of chickens also died suddenly, supposedly because of bird flu. c88/c84/win
(-)

http://republika.co.id/koran/14/3497...erajalela_Lagi

[Dutchy]

Indonesia's bird flu death toll climbs to 119

03 Mar 2009 06:14:05 GMT

Source: Reuters

JAKARTA, March 3 (Reuters) - Four Indonesians died from bird flu in February, bringing the country's total death toll from the disease to 119, officials at the national bird flu commission said on Tuesday.

"There were four cases and all four died in February," said Bayu Krisnamurthi, head of the national bird flu commission.

Indonesian newspaper Republika also reported on Tuesday that two more deaths from the disease occurred at the weekend near the capital Jakarta -- a 5-year-old girl from Depok, and an 8-year-old boy from Bekasi.

The national commission said that samples were being tested in Jakarta to verify the cause of death in both cases.

Indonesia, which has stopped publishing updates of bird flu deaths immediately after they occur, has the highest toll from the disease of any nation.
Experts fear that the virus might mutate into a form easily passed from human to human, sparking a pandemic which could kill millions.

http://www.alertnet.org/thenews/newsdesk/JAK264055.htm

[Dutchy]

Found by Laidback All , burried on the website of Dep of Health, a snip of news, not a press release but summarised news from local press; no confirmation, however if the Dep of Health publishes this news snip, it is almost confirmation :

Bird Flu

" One died, one treated".

Tangerang - Two Tangerang residents are suspected to be infected with the bird flu virus. A person among them died on Sunday (22/2), whereas the other person up to now still is undergoing the intensive maintenance in special space bird flu of RSUD Tangerang.

The victim who died was Kaila Nabila (3), the resident of the Cilenggang Village, Rt 02/04 Kec.Serpong, the Tangerang City South, whereas a suspect suspect bird flu victim that currently still is undergoing the maintenance was Maya Suparni (15) villagers blossomed Jaya, Kec.Sepatan, Kab.Tangerang. (source : Sinar Harapan, Suara Pembaruan,23/2-09)

http://www.flutrackers.com/forum/sho...&postcount=100

[HenryN]

http://www.google.com/hostednews/ap/...i-cCwD96MF13G0

4 Indonesians die of bird flu; toll climbs to 119
By IRWAN FIRDAUS – 15 minutes ago
JAKARTA, Indonesia (AP) — Four Indonesians have died of bird flu, bringing the death toll in the country hardest hit by the disease to 119, an official said Tuesday.
Bayu Krisnamurthi, chief of the National Bird Flu Commission, said all the victims were believed to have been infected after coming into contact with sick poultry. They were from Java island and died in January and February.
Indonesia, which has been criticized in recent months for refusing to immediately make public news of human deaths and in some cases hushing them up all together, has been worst affected by bird flu since it started ravaging Asian poultry stocks in late 2003.
It accounts for nearly half the 256 human fatalities tallied worldwide, according to the World Health Organization.
So far, most human cases have been linked to contact with infected chickens. But health experts worry the H5N1 virus could mutate into a form that passes easily among humans, sparking a pandemic that could kill millions worldwide.
Indonesia is considered a potential hotspot for that to happen.
Krisnamurthi had little details about the latest deaths, saying only that two were siblings from the city of Bogor and the others were women from Bekasi and Surabaya.
Health Minister Siti Fadilah Supari has withheld almost all virus samples from WHO since January 2007, arguing that its system is unfair because her country's bird flu specimens can be used to make vaccine that would ultimately be too expensive for most Indonesians and controlled by wealthy nations.
She has since called for the creation of a global stockpile of drugs or other forms of benefit-sharing.

[HenryN]

Originally Posted by niman

http://www.google.com/hostednews/ap/...i-cCwD96MF13G0

4 Indonesians die of bird flu; toll climbs to 119

Krisnamurthi had little details about the latest deaths, saying only that two were siblings from the city of Bogor and the others were women from Bekasi and Surabaya.

Cluster from Bogor

http://www.recombinomics.com/News/02...r_Cluster.html

Hospitalized paramedics linked to Surabaya

http://www.recombinomics.com/News/02...aramedics.html

[HenryN]

Four dead from bird flu in Indonesia: official

29 mins ago
AFP – A young girl stands next to a chicken at a market in Denpasar. Four people have died of bird flu in the …





JAKARTA (AFP) – Four people died of bird flu in the first two months of this year in Indonesia, the country hardest hit by the disease, the head of the national bird flu committee said onTuesday.
"(The) four cases confirmed are in January and February," Bayu Krisnamurthi told AFP, without providing further details.
Officials earlier confirmed that a five-year-old girl from Bekasi district east of Jakarta died on January 2, but it was not clear if she was among the four deaths reported by Krisnamurthi.
Health Minister Siti Fadilah Supari did not reply to requests to confirm the deaths and the health ministry's official bird flu death toll stood unchanged at 115 on Tuesday.
The health ministry stopped announcing bird flu deaths on a case by case basis in 2008 and only tells the public of confirmed cases weeks or months after a victim has died.
The H5N1 virus typically spreads from birds to humans through direct contact, but experts fear it could mutate into a form easily transmissible between humans, with the potential to kill millions in a pandemic.

[Treyfish]

On Tuesday, 03-03-2009 of Suspect Flu Burung Kembali Mewabah Satu Anak was Sasaran
MAKASSAR, Upeks -- Other the resident was forced to have to be treated intensively as a result of being indicated suspect bird flu, Faradillah (7 th) the resident of this Maros regency was forced to have to be reconciled to RSUD Wahidin Sudiro Husodo after beforehand got the maintenance in RS Salewangang Maros. Dr Halid Sp Pd, one of the doctors who handled the case of this bird flu justified the existence of one patient that suspect bird flu and while undergoing the intensive maintenance diruang the RSUD Wahidin Sudiro Husodo ferns isolation. "Is it true that had the patient suspect bird flu that was treated here since last February 28." This patient of a child was 7 years old that was reconciled by RS Salewangang because has been still could not be handled by the hospital side, obviously him. This patient, continued Dr Halid, was indicated suspect because the patient experienced the sign of the headache and the temperature of the quite high body reached 39.5 of C. "Setelah was treated intensive, the condition" for the "patient has increasingly improved, today" (2/2 yesterday, red-) the temperature" of "his body has descended 37,5'C. Meski Begitu perekembangan him will continue to be monitored," he said. http://www.ujungpandangekspres.com/view.php?id=31773

[sharon sanders]

From February 15th:

"..Emil Agustiono, Vice Chairman Pelaksana Harian the Nasional Pengendalian Committee of Bird Flu and Menghadapi Pandemi Influenza Preparedness (Komnas FBPI) in the implementation press conference of the Nasional Simulasi Workshop of the Pandemi Influenza Response in the Batu City yesterday. Emil's words, Indonesia was in the first level from five countries that were attacked by the bird flu illness. Since 2005 is till now recorded had 145 sufferers of the bird flu illness in Indonesia, 119 people or among them died..."

http://www.flutrackers.com/forum/sho...5&postcount=98

[HenryN]

Commentary

http://www.recombinomics.com/News/03...ndo_Spike.html

[sharon sanders]

hat tip Senior Moderator Fla Medic -
Indonesian Official: Four More Bird Flu Fatalities



# 2856


Overnight the International press has reported that the head of the Indonesian Bird Flu Commission, Bayu Krisnamurthi, revealed that the death toll in Indonesia from bird flu had increased to 119 cases.

This is an increase of 4 fatalities since the last numbers were provided to the WHO (World Health Organization) on January 22nd.

There are reasons to believe, however, that this latest tally may be several weeks old.

On February 11th and 12th, newshounds on both FluTrackers and the Flu Wiki picked up on local media reports of statements attributed to a couple of local officials that the new tally stood at 145 cases and 119 deaths.

On Flutrackers, posts #96, #97, and #98 (Hat tip Dutchy & Fla1) on this thread have local media reports attributing these new numbers to the local head of UNICEF, Jinung D Kritanto, and to Emil Agustiono, Vice Chairman Executive Committee of Komnas FBPI.

And that was three weeks ago.

The issue was `discussed' on the flu forums, but no follow up ever came from the Health Ministry, and the WHO never updated their numbers.



Today's announcement (Xinhua has it, for some reason, as 117 deaths) of 119 deaths has yet to be reflected in the WHO's numbers. Perhaps later today, assuming that Depkes - The Indonesian Health Ministry - plans to confirm these numbers.

First this, from the Associated Press, then some discussion.

Mar 3, 3:55 AM EST
4 Indonesians die of bird flu; toll climbs to 119
By IRWAN FIRDAUS
Associated Press Writer
JAKARTA, Indonesia (AP) -- Four Indonesians have died of bird flu, bringing the death toll in the country hardest hit by the disease to 119, an official said Tuesday.

Bayu Krisnamurthi, chief of the National Bird Flu Commission, said all the victims were believed to have been infected after coming into contact with sick poultry. They were from Java island and died in January and February.

Indonesia, which has been criticized in recent months for refusing to immediately make public news of human deaths and in some cases hushing them up all together, has been worst affected by bird flu since it started ravaging Asian poultry stocks in late 2003.



Krisnamurthi had little details about the latest deaths, saying only that two were siblings from the city of Bogor and the others were women from Bekasi and Surabaya.
(Continue . . .)

The `siblings from Bogor' would appear to be Ruslani (30) and his sister Nurul, who both died in mid January. A third sibling, Ridwan (35), was reportedly suffering from a high fever and refused medical treatment.

Details on this incident are here.

We've never heard anything, one way or the other, about the fate of the 3rd sibling.

The `woman from Surabaya' is most likely ST (18) who died at Dr Sutomo hospital in Surabaya in late January.

After her death, we received word (see Indonesia: Health Care Workers Quarantined) that a doctor and 4 paramedics of Dr Sutomo hospital Surabaya were quarantined due to severe flu-like symptoms.

Two tested negative for H5N1, but as of Feb 22nd, 3 were supposedly still in critical condition.

Once again, we've heard no follow up to this report.

Pinpointing the 4th victim, a woman from Bekasi, becomes more difficult. Over the past two months there have been multiple reports of suspected cases from that city.

Hopefully we'll get more details when the WHO updates their information.

Of course, the actual number of human H5N1 infection in Indonesia is unknown. (bolding and underlining here - Fla1)

These are just the `officially recognized' cases.

[sharon sanders]

From Niman commentary above (bolding and underlining Fla1)

"....This high case fatality rate strongly suggests that milder cases are not report, either because they test negative because of titers lowered by treatment, or they are not tested at all because they are misdiagnosed or self medicated at home, which has been described for many suspect cases. Indeed, many of the fatal cases die within hours of being transferred to an infectious disease hospital after local treatment at home, clinics, or smaller local hospitals and fatally infected family members linked to lab confirmed cases have been misdiagnosed as having lung inflammation, dengue fever, or typhus. The recent Tangerang case was diagnosed as dengue fever, and the recent Bogor case was diagnosed as having dengue fever and typhus prior to lung x-rays and reports of contact with dead or dying poultry, which then led to the H5N1 diagnosis.

The spike in H5N1 cases in the Jakarta area increases concerns that the number of H5N1 in Indonesia in general and the Jakarta area in particular, are markedly higher that the recently announced confirmed cases....."

[mixin]

Here's what the WHO lists as one of the 2 confirmed cases this year; although the other death occurred in Dec. 2008.

"The second case, a 5-year-old female from Bekasi City, West Java Province developed symptoms on 23 December 2008, was hospitalized on 27 Dec 2008 and died on 2 January 2009. The investigation indicated that she visited a wet market to buy chicken meat and eggs two days prior to symptom onset. Contacts were placed under medical observation, where none developed illness."

[ironorehopper]

Although hemorrhages are often reported during clinical course of avian influenza in humans (usually, there is blood discharge from trachea or in vomit material) one may also suspect that - as in the region dengue fever is widespread - other conditions may contribute to these clinical features.

Further, it is also likely that high case fatality rate of human cases of avian influenza in Indonesia may be caused by concurrent health conditions of patients, such as dengue, chikungunya, tubercolosis.

Unfortunately, no pathological results of necroscopic examinations are available in order to know microbiological findings on tissue culture and for a comprehensive understanding of avian influenza human clinical course in Indonesia.

So, when clinicians diagnosticate dengue fever in people often lately stated as H5N1 infected, it may be well possible that diagnosis is not faulty, but that really the two conditions were present.

I don't understand the lack of data about pathological and microbiological findings on human indonesian bird flu cases and international health agencies are not helping us to undestand better the situation.

Perhaps, a clear picture of clinical course and possible worsening effect of other infectious diseases or malnourishment in Indonesian could help to save more lives.

Are there people who are hearing out there?

[Dutchy]

Strict monitoring like now in Bekasi, normally is done when there is a positive human avian influenza case. This is a strong indication of A. being tested positive.

Bird Flu Patient Case, Dozens Of Bekasi Residents Monitored

On Tuesday, March 03 2009 |

The Interaktif TIME, Bekasi: the Team of the Control of Bird Flu of Kabupaten Bekasi, West Java, named the total 33 residents of the Sukamantri Village, Desa Suka Raya, of Kecamatan Karang Bahagia, was supervised specially.

They who were involved in close contact less than one metre with casualties died, said the member the Team of the Control of Bird Flu of Kabupaten Bekasi, Heru Hermawan, to the Time in the location of the bird flu incident, on Tuesday (3/3).

Totalling 33 residents the majority family's A, 8 years, the patient was expected by bird flu that died, last Saturday. Apart from them, some also the medical official who treated the victim.

From the family among them, I, 43 years; Ms, 36 years; I, 4 years; and N.

Now from the medical officials among them, the owner of the clinic of Kartika Medika that was not far from casualties's house, IL and T.

According to Heru, the supervision was carried out twice the incubation period or 17 days had been counted since A died.

The aim is, continued Heru, prevented transmission of the virus avian kind influenza H5N1 from the poultry to humankind and from humankind to humankind.

Do not there are those that complained was sick as being sick the chicken was affected by bird flu, the fever, the cough and crowded ," he said. But they not necessarily were positive bird flu.

Results of the identification of the source of bird flu that was carried out by the Team of the Control of Bird Flu of Kabupaten Bekasi concluded the spreading of bird flu against the poultry in 2009 this happened in two territories: the Sukatani Subdistrict and the Setu Subdistrict.

The cause is, said Heru, the management of the poultry was not good. The chicken was maintained illegally, and his pen adhered to walls of the house was left dirty. The attack figure to the poultry in the territory was high, said Heru.

http://www.tempointeraktif.com/hg/la...162936,id.html

[Muscade]

Bekasi, West Java ::: Bird Flu Eradication Team watches 33 residents.

March 4, 2009

Bird Flu Eradication Team watches 33 residents.

Bekasi – Total 33 residents of Kampung Sukamantri, Desa Suka Raya, Kecamatan Karang Bahagia, Bekasi West Java are observed by Bird Flu Eradication team of Kabupaten Bekasi. These people are known to have close (less than 1 meter distance) contact. From 33 observed residents, most of them are victim’s family and relatives and also health care workers. From victim’s family that under observation are Ilyas (43); Mimin Setiawati (36); Ismawati (4) and Nanang. Health care workers, as Kartika Medika clinic’s owner, Ipah Latifza and Tarmizi are also observed.

“Monitoring will be done during 17 days or two times incubation period since Ardiansyah casualty. The purpose is to prevent transmission of avian influenza H5N1 virus from bird to human or human to human”, says Heru Hermawan, team member of Bird Flu Eradication Kabupaten Bekasi. During 2009 bird flu spreading in poultries reported on two areas in Bekasi, they are Kecamatan Sukatani and Kecamatan Setu.

Source: Indonesia local newspaper, Pikiran Rakyat. http://www.pikiran-rakyat.com/index.php?mib=news.detail&id=62416

===AvianInfluenzaIndonesia===
http://birdflucorner.wordpress.com/

[Commonground]

Hospital Doctor Annisa Doubtful They contracting Bird Flu

Monday, March 02, 2009 | 17:35 WIB

TT Version:

The head of the Service of Medis Rumah Sakit Annisa Kabupaten Bekasi, Dr Rina, said two doctors and an official who were taken the sample of his blood was still going to work. They also did not suffer the sign was sick the high fever, the cough and breathless. The "taking" of the "sample" of "blood in accordance with the standard" of the "Health of the Service that obliged each medical official after handling the bird flu patient must carry out the blood test," said Dr Rina, when being contacted on Monday (2/3). Concerning the assumption of the occurrence of the spread, Rina was not convinced. The test of blood of the sample laboratory was still being carried out the Penanggulangan Nasional Body of Bird Flu. Results will be known two weeks more. He acknowledged the use of the medical implement like the mask, clothes were closed, and isolation space, not there is because they only carried out the beginning inspection. After that, the patient was reconciled to the Persahabatan Hospital, Jakarta Timur.

Moreover, the medical inspection that was carried out against the patient was expected by bird flu, A, 8 years, also were carried out in normal inspection space. A died Ahad (1/3) then. "We did not provide isolation space because the patient must be at once reconciled," said Rina. The head of the Control of the Illness and Sanitation of Lingkungan Rudi Ruhdiat said his side monitored for two weeks to three medical officials. If emerging the complaint was sick, they were asked immediately to report. "We asked the Hospital side to report if the medical team had the complaint," he said.

According to Rudi, the spread could through hingus [ingus = mucus] casualties who were inhaled through air. "Only indeed might not infected because we were still waiting for results" of the "laboratory test," he said to answer the matter of the indication of the spread of bird flu from the patient to the doctor.

[Laidback Al]

4 Indonesians die of bird flu; toll climbs to 119

Krisnamurthi had little details about the latest deaths, saying only that two were siblings from the city of Bogor and the others were women from Bekasi and Surabaya.

The original news article announcing 119 dead from bird flu was published on February 11, so all four of these individuals would have to have been deceased prior to February 11.

As noted by Niman and Fla Medic the two siblings from Bogor would be Ruslani, who died about Jan 16, 2009 and his sister, Nural Hikmah, who also died on Jan 16, 2009. The woman from Surabaya was Sutini who died Jan 24, 2009. The fourth individual, a woman from Bekasi, is difficult to identify. From Commonground’s posted on Feb 16, 2009 (see below), the only death in Bekasi prior to February 12 was the young child NAD who died on Jan 2, 2009. This individual however was included in the official WHO tabulation for Indonesia on Jan 22, 2009. There will have to be further clarification on the individual that died from bird flu in Bekasi between Jan 2, and Feb 11, 2009.

Although this report is only now appearing on major wire services, it is only current through Feb 11, 2009. As noted in this thread, since mid February there have been several other individuals highly suspected with bird flu, mostly children, and several have died.

Bekasi

Nad (5) Adm: 1/2 From: Bekasi. Hospital: RSPI Sulianti Saroso. Recon: RS Hermina Bekasi on 12/27. Onset sym: 12/23. Bought chickens at the market for parents. Her cat died after eating the chicken she bought. Died: 1/2. Confirmed Positive.

Sukatani (in Bekasi)
2/14: Sukamulya Village. Rt 13/6. 30 Residents hot high & breathless. Given Tamiflu. Blood drawn from all 30.
2/15: 6 people infected.
2/16: Two Families (derived from 6 reported yesterday)
NY Ita: Mother
Syahroni (43): Father
Ipin (10) Child Being treated at Comm. Hlth. Ctr.
Family owned 19 Chickens

2nd Family:
Sri Rahaya
Jema
Arni

Mohamad Doas (possible suspect)

http://www.flutrackers.com/forum/sho...7&postcount=75

[HenryN]

Commentary

http://www.recombinomics.com/News/03...1_Indo_CC.html

[sharon sanders]

Thank you everyone.

[Dutchy]

snip from long article, testing is going on of samples of the girl Nurul from Depok:

In the meantime, the side of Plt Head Health Section Hardiono said that the sample of Nurul blood was still continuing was researched by Health Service Depok and Health Service Provinsi West Java.

Hopefully the assumption suspect this bird flu did not develop became positive bird flu. We were still being waiting for results for four days in the future, he said.

He explained the sign of bird flu of the beginning indeed was difficult to be diagnosed because of resembling the sign of flu and the common fever.

The exception when the case of the death of the poultry in this environment happening, said Hardiono.

http://www.monitordepok.com/news/ber...ama/30713.html

[Commonground]

Post #236...Dutchy I just happened to finish that long article. Took me a half hour...here it is:

Depok: One Child Died

03-Mar-2009

RANGKAPAN JAYA, MONDE: Nuruliza Mahmudah the daughter (5) the resident of the Village of Setu Asih Pulo RT 06/08 No 1 district of Rangkapan Jaya Pancoranmas died, on Saturday (on February 28). Nurul it was suspected suffered bird flu or suspect bird flu. On Monday (on February 23), Nurul suffered hot high and was reconciled to RS Bhakti Yudha. While five days underwent the maintenance of the child was diagnosed suffered dengue fever. The father Nurul, Mahmudin Sudin said results x-rayed showed that on his child's lungs was gotten by white circles small that increasingly the day increasingly grew. “Dokter said had the indication that headed to flu burung,” he said.

Finally the side of RS Bhakti Yudha reconciled Nurul to RS Persahabatan that had facilities was more complete. The family complained about the slowness of the car ambulance that will be used to carry the patient. Finally Nurul was carried to RS Persahabatan on Friday anxious (on February 27) used ambulance belonging to RS Bhakti Yudha. Mahmudin that also Chairman Asosiasi of this Honorer Teacher said that the side of RS Bhakti Yudha made him disappointed with carried out the taking of the daughter's blood in ten points on his daughter's body. “Saya did not have the heart to see my daughter's body was full of the former injection to take blood,” he said while terisak.

When undergoing the maintenance in RS Persahabatan, the doctor in this RS said that the Nurul condition still could be helped if this bird flu diagnosis more previously was proven. “We regretted slow him RS Bhakti Yudha in diagnosing the illness that was suffered by the daughter us,” said Mahmudin. RS Persahabatan said that they have lifted the hands and said that the Nurul life expectancy remained at 50%. Mahmudin was still having difficulty trusted that his daughter was affected by bird flu. He said indeed a week beforehand had 50 chickens that died. However, the resident that burnt was not affected by the impact anything in fact had also the resident who ate chicken that died this.

The mother of casualties, Elisa, claimed still did not believe the daughter of his youngest child currently has not. “Saya still believed not believed. This the dream or the reality? His process was too fast. “Not yet had the assurance of our daughter died because of bird flu because of not yet having positive or negative results. However, from perlakuann him quite like that. The hospital side wrapped rapid an put our daughter's body in fact they not dared to every that bird flu.

Visited by Mayor

While Depok Mayor Nur Mahmudi Isma’il ended visited the residence of casualties's family sent up until yesterday the medical side did not yet determine that Nurul was affected by bird flu or just was limited suspect bird flu. “Masih needed the research of the hospital side to determine whether this bird flu or not. Distan also has taken sample from the available poultry around.

However, the Mayor really regretted why the resident did not report the existence of the incident died suddenly around 50 poultries on February 11-18 2009. “Seharus him after having the maximal incident 24 hours, the sample of blood was from the poultry that died suddenly taken to be researched. Now the matter of the refusal that was carried out by the RSUD side, according to Walikot, because the RSUD condition indeed was full of the patient DBD. Whereas the side of RS Bhakti Yudha also in fact carried out the maintenance.

When being questioned by the matter of the wrong existence of the diagnosis, the Mayor said that the indication of an illness occasionally had the characteristics of the resemblance so as to need the further research to ascertain him. Nur Mahmudi also delivered that although not yet having the provisions of the final, the patient suspect bird flu that died indeed must was treated like bird flu casualties to prevent the spread. “Jika had the poultry that died suddenly and really, the resident was hoped for immediately reported to the related service to receive the handling immediately.

In the meantime, the side of Plt Section Head Kesehatan Hardiono said that the sample of Nurul blood was still continuing was researched by Dinkes Depok and Dinkes Provinsi West Java. “hopefully the assumption suspect this bird flu did not develop became positive bird flu. We were still being waiting for results for four days to in the future,” he said. He explained the sign of bird flu of the beginning indeed was difficult to be diagnosed because of resembling the sign of flu and the common fever. “Excluding when the case of the death of the poultry in the environment happening infected,” Hardiono words.

The head of the Penyehatan Lingkungan Ani Rubiani Field said that like that had the case of the death of the resident's poultry it was hoped to immediately reported. Officially Kesehatan will open the command post for two weeks to monitor. “Kami opened the post in RW Siaga,” Ani words.

[HenryN]

Indonesia reports 4 H5N1 deaths

Lisa Schnirring Staff Writer

Mar 3, 2009 (CIDRAP News) – An Indonesian health official said today that four more people have died of H5N1 avian influenza over the past month, as an Indonesian newspaper reported two more deaths possibly due to the disease.

Bayu Krisnamurthi, head of Indonesia's National Bird Flu Commission, gave few details about the four victims . Two were siblings from the city of Bogor in West Java province, and the two others were women from Bekasi, a suburb of Jakarta, and Surabaya in East Java province, the Associated Press (AP) reported today.

If the World Health Organization (WHO) confirms the cases, the country's count will rise to 145 cases and 119 deaths. For now, the total stands at 141 cases and 115 deaths.

Krisnamurthi said all four of the victims were believed to have had contact with sick poultry. He told Reuters that all four died in February.

Mike Coston, who authors the Avian Flu Diaryblog, provided a round-up today of additional details about the four cases, based on information that he and flu reporters at the FluWiki and FluTrackers blog sites have gleaned over the past several weeks from Indonesian media reports and other online sources.

He wrote that the siblings from Bogor appear to have been a 30-year-old man and his sister who died in mid January. A third sibling reportedly had a high fever, but refused medical treatment. The woman from Surabaya was most likely an 18-year-old who died at Sutomo Hospital in Surabaya in late January, Coston wrote. He added that five healthcare workers there were reportedly quarantined with severe flulike symptoms, but there was little follow-up news other than that two of them tested negative for the H5N1 virus.

Several reports of suspected H5N1 cases have come out of Bekasi over the past 2 months, making it difficult to infer the identity of the Bekasi woman mentioned in Krisnamurthi's total today, Coston wrote.

Indonesia's last H5N1 cases were reported on Jan 22. One was in a 29-year-old woman from Tangerang district in Banten province who died in mid December, and the other was in a 5-year-old girl from Bekasi who got sick in late December and died on Jan 2.

Last June, Indonesia announced that it would no longer provide immediate announcements of individual avian flu deaths, opting instead to give periodic updates.

In other developments, the Indonesian Republika newspaper today reported two more H5N1 deaths, both which occurred over the weekend near Jakarta, Reuters reported. The patients were a 5-year-old girl from Depok and an 8-year-old boy from Bekasi. The National Bird Flu Commission said the children's samples were sent to Jakarta to confirm the cause of death.

Indonesia has had more H5N1 cases and deaths than any other nation. The WHO's current global H5N1 count, which doesn't yet reflect the four Indonesian case-patients, stands at 409 cases, 256 of them fatal.

See also:
Mar 3 Avian Flu Diary blog post
Jan 21 CIDRAP News story "2 Indonesian cases push global H5N1 death toll over 250"
WHO global H5N1 case count

[HenryN]

Originally Posted by niman

Indonesia reports 4 H5N1 deaths

Lisa Schnirring Staff Writer

Mar 3, 2009 (CIDRAP News) – If the World Health Organization (WHO) confirms the cases, the country's count will rise to 145 cases and 119 deaths. For now, the total stands at 141 cases and 115 deaths.

The above is a rather curious wording for the process of WHO confirmation. WHO no longer independently confirms cases in Indonesia (in the past NAMRU-2 in Jakarta confirmed cases and then sent samples out to WHO regional affiliated labs in Atlanta (CDC) and Hong Kong (HKU).
It would appear that at this time updates and revised case counts just require Indonesian approval.

[sharon sanders]

Congratulations to the news analysts!

"...Mike Coston, who authors the Avian Flu Diary blog, provided a round-up today of additional details about the four cases, based on information that he and flu reporters at the FluWiki and FluTrackers blog sites have gleaned over the past several weeks from Indonesian media reports and other online sources...."