Bird Flu Watch

Indonesian woman dies from bird flu

Link: Indonesian woman dies from bird flu�|�Science&Health�|�Reuters.co.uk.

An Indonesian woman who bought a live chicken from a market died from bird flu on Christmas Day, the Health Ministry bird flu centre said on Wednesday, taking the total number of deaths from the disease in Indonesia to 94. The 24-year-old woman from Jakarta who died on Tuesday morning had tested positive for bird flu after being treated for several days in a hospital, said an official at the centre. "The woman bought a live chicken in the market and slaughtered the chicken there before taking it home. But we're still investigating the cause," the official said.

4th Indonesian dies of Bird Flu

Link: Science News Article | Reuters.com.

Indonesia's Health Ministry said on Tuesday testing confirmed that a man who died in September was positive for bird flu. A total of seven people have been confirmed infected with H5N1. The three survivors included two members of an extended family, but both had come into contact with dead chickens, Hariadi Wibisono, a senior official at the ministry, said when asked if human-to-human transmission might have occurred.

UN hopes to deploy Indonesia bird flu teams in weeks

Link: Reuters AlertNet.

The U.N. food agency hopes to start sending teams across Indonesia's main island of Java from late next month to test backyard chickens for bird flu to reduce the rate of infection and stamp out viral hot spots. Peter Roeder, an animal health officer heading an emergency team from the Food and Agriculture Organisation (FAO), said on Tuesday the aim was to develop a rapid response to infection that could involve culling birds or vaccination. Underscoring the tough task ahead for animal health workers who will go house to house searching for infected backyard poultry, Roeder said 30 million households in Indonesia were raising around 200 million chickens.

Indonesia confirms 2 more cases

Link: Promed.

The Ministry of Health in Indonesia has confirmed 2 additional cases of human infection with H5N1 avian influenza. The 1st newly confirmed case is a 4-year-old boy from Sumatra Island in Lampung Province. He developed symptoms on 4 Oct 2005, was hospitalized, recovered fully, and has returned home. This case is the nephew of the 21-year-old man from Lampung, who was reported on 10 Oct 2005. Although the 2 cases are related and lived in the same neighborhood, human-to-human transmission is considered unlikely. The 2nd newly confirmed case was a 23-year-old man from Bogor, West Java. He was hospitalized on 28 Sep 2005 and died on 30 Sep 2005. Epidemiological investigations uncovered exposure to infected poultry as the likely source of infection in both cases. To date, Indonesia has reported 7 human cases of H5N1 avian influenza. 4 of these cases were fatal.

Indonesians fear human to human transmission

Link: Bloomberg.com: Asia.

In Indonesia, tests are being done to see if the father and the son have avian influenza, Health Minister Siti Fadilah Supari said in a phone interview. ``They are both suspected cases,'' Supari said. ``If they are confirmed, it would be the third cluster in Indonesia where blood-related people contracted bird flu. If the cases become more widespread, human-to-human infection could be suspected.'' Indonesia reported its first bird flu cases in humans on July 20, after a man and his two daughters died from the H5N1 virus, the deadliest known form of the illness. The second grouping was an eight-year-old boy who is healthy even as he tested positive for bird flu. He is the nephew of a 37-year-old woman who died from the same disease.

Indonesia Neglected Bird Flu Until Too Late, Experts Say

Link: Indonesia Neglected Bird Flu Until Too Late, Experts Say.

Indonesian officials covered up and then neglected a spreading bird flu epidemic for two years until it began to sicken humans this summer, posing a grave threat to people well beyond the country's borders, according to Indonesian and international health experts. Unlike Southeast Asian countries that began to see human cases almost as soon as avian influenza was identified in their poultry, Indonesia had a generous head start to prevent an outbreak among people. But since July, it has registered more human cases than any other country, including three deaths confirmed by international testing. Influenza specialists agree that the actual number of human cases is higher and expect it to rise with the approach of the rainy season.

US to help Indonesia

Link: Daily News.

U.S. Health and Human Services Secretary Mike Leavitt on Monday promised $3.15 million (USD) to Indonesia to help the country battle bird flu, which has killed more than 60 people in Southeast Asia. "No nation is adequately prepared for avian flu," Leavitt said. "The U.S. position is that if it happens anywhere, then there is a risk everywhere."

Australia to donate bird flu aid [October 13, 2005]

Link: The Australian:

FOREIGN Minister Alexander Downer will today commit Australian aid worth up to $10 million to help Jakarta improve its ability to deal with bird flu as he finishes up a three-day visit to Indonesia. The money will help Indonesia improve its capacity to deal with the virus, as well as put in place early warning and identification systems. Australia will provide the extra assistance after sending a team of experts to audit Indonesia's capability to deal with the bird flu threat last week. Mr Downer is also hoping he may be able to reschedule a meeting with Indonesian President Susilo Bambang Yudhoyono, who cancelled yesterday due to illness.

H5N1 Positive Ragunan Zoo Vistor Raises Concerns

Link: H5N1 Positive Ragunan Zoo Vistor Raises Concerns.

Whereas the Ageng condition (2) that was treated in space of the roses isolation, results of his PCR inspection showed the negative, whereas his serology was positive. "He probabel birds flu." This from results of the first lab, we were again waiting for results of the second lab inspection that his sample was taken last October 8, he said. The above case is a 2 year-old who visited Ragunan Zoo on September 11.  Transfer to RS Sulianti Saroso was on September 24.  Because the transfer was so long after exposure, the PCR test was negative.  However, the long delay in testing allowed antibody levels to rise to the level of detection.  If the October 8 collection is four fold higher than the earlier collection, the baby will be a confirmed case, based on the WHO definition requiring a four fold increase in titer. There have been no confirmed cases in zoo visitors, although several have had H5N1 antibodies.  It is likely that many of the zoo visitors were PCR negative because they were tested late.  For mild cases that developed from casual contact, PCR positive results may require an early collection.

Jakarta - the mistakes being made

Link: Massive H5N1 Infections at Ragunan Zoo in Jakarta Indonesia.

Vital insight - find much more at the link above

Although H5N1 is widespread, testing is minimal.  In the neighborhood of the first cluster, only 3 chickens were reported tested.  Similarly, in the closest sub-district the reported tests were also limited to 3 chickens.  This testing is absurd and designed to generate negatives for inclusion in press releases.  In two more Tangerang sub-districts where testing was somewhat expanded, H5N1 was readily detected in swine and poultry.

The number of human cases continues to mount, and the number of false negatives is exceedingly high.  Only one of the three infected family members in the initial cluster were PCR positive.  Thus, far there has only been one additional PCR positive case although several patients with symptoms also have H5N1 antibodies.

The testing in Indonesia is scandalously poor.  The H5N1 positive swine in Tangerang was largely ignored. After 3 members of a government worker died, very limited testing and culling was done.  When another government office worker died, a press conference cited negative tests in a 100 meter radius that excluded the chicken slaughterhouse 100 meters from the victims house.