Indonesia Hits 100 Again

Via ProMED-mail: Reuters reports that Indonesia has hit its hundredth bird flu death.

A 23-year-old Indonesian woman from East Jakarta has died from bird flu, taking the country's death toll to 100, according to a report from Indonesia's bird flu information centre on Monday.
The woman died on Sunday and two separate laboratory tests confirmed she contracted H5N1, the report said.
Earlier on Monday, a 9-year-old Indonesian boy who had tested positive for bird flu died, the health ministry said in a statement.

Bird Flu Hits 200

Via ProMED-mail: AFP reports Indonesia's 85th bird flu fatality, for a total of 200 bird flu deaths worldwide.

The plantation worker died at 2:00 pm (0700 GMT), the doctor treating him at the state general hospital in the city of Pekanbaru, Azizman Daad, told AFP.
A health ministry official earlier confirmed that the man was infected with the deadly H5N1 virus, after two tests came back positive.
H5N1 is endemic in birds across nearly all of Indonesia.
The archipelago nation has now reported 106 cases overall, including the 85 deaths.
Daad said it was not clear whether the man had come into contact with infected poultry, but he had bought two live chickens at a local market.

Indonesia Hits 100

Via ProMED-mail: the WHO reports that Indonesia has reported its 100th human case of bird flu and 80th bird flu fatality.

A 26-year-old male from Riau Province developed symptoms on 3 June, was hospitalized on 6 June and died in hospital on 12 June. Investigations into the source of his infection indicate exposure to sick and dead poultry.

Cat Flu

Via ProMED-mail: New Scientist reports on the implications of widespread H5N1 infection among Indonesia's cats.

Chairul Anwar Nidom of Airlangga University in Surabaya, Indonesia, told journalists last week that he had taken blood samples from 500 stray cats near poultry markets in four areas of Java, including the capital, Jakarta, and one area in Sumatra, all of which have recently had outbreaks of H5N1 in poultry and people.
Of these cats, 20 per cent carried antibodies to H5N1. This does not mean that they were still carrying the virus, only that they had been infected - probably through eating birds that had H5N1. Many other cats that were infected are likely to have died from the resulting illness, so many more than 20 per cent of the original cat populations may have acquired H5N1.
[...]
Osterhaus emphasises that the cat infections still pose a potential threat. "We know the 1918 pandemic was a bird flu virus that adapted to mammals in some intermediate mammalian host, possibly pigs," he says. "Maybe for H5N1 the intermediate host is cats." If similar percentages of cats are infected at every outbreak location, there must have been many thousands of cat infections since the virus emerged, compared to 267 confirmed cases in humans. Every sick cat is a chance for the virus to adapt, and with renewed outbreaks this year in birds, people or both in China, Indonesia, Japan, South Korea, Hong Kong, Vietnam, Thailand, Egypt and Nigeria, it is getting plenty of such chances.

Don't Sue the Messenger

ProMED-mail reprints The Jakarta Post on yet another howler from Indonesia:

The parents of 3 young children from North Sumatra's Karo regency who were earlier reported as exhibiting classic bird flu symptoms plan to sue the provincial administration and the central government for saying their children most likely had bird flu.

I believe this is the same area where angry poultry workers drank chicken blood to protest earlier diagnoses. Suing is, at least, more sanitary.

The Family Cluster Expands

The World Health Organization reports that a seventh case, and sixth fatality, has been added to the family cluster of avian influenza in North Sumatra, Indonesia. The evidence points toward person-to-person transmission. On the bright side:

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).

Bird Flu on the Move

Via ProMED-mail: Although the suspected Romanian case has been disproved, avian influenza has recently been confirmed in Djibouti, the first human case in the Horn of Africa, and in 5 members out of eight suspected cases in one family in Indonesia.

The WHO has sent a team to the area near Medan. The agency said it was on alert for signs the virus is mutating into one that can be easily transmitted between people, a development that could signal the start of a pandemic in which millions could die.
Such a mutation could occur anywhere there is bird flu, the WHO says.
Mr Kandun said authorities were still trying to identify the source of the virus in the cluster case in Kubu Simbelang village in Karo regency, about 50km south of Medan.
But an Indonesian agriculture official who declined to be named told Reuters tests had shed no light on the case.
"There is a big question mark. Blood samples from all kinds of animals from chickens, ducks, geese, birds, pigs, cats and dogs turned out negative so far. Manure has also been checked.
The result is negative," the Jakarta-based official said.

Bird Flu Confirmed in Indonesia

Via ProMED-mail: Reuters reports that Indonesia has confirmed three deaths from avian influenza.

Last month, Indonesia reported its first human case in a poultry worker, but the man did not develop symptoms and is healthy.
The agriculture ministry has reported sporadic H5N1 virus outbreaks killing more than nine million fowl in 21 provinces, out of a total of 33, across the archipelago since late 2003.
Indonesian policy favours vaccinating animals rather than culling to stop the spread of bird flu, due to lack of funds to compensate farmers.
The World Health Organisaton has questioned the effectiveness of vaccines and say culling is the best weapon.
The virus has already jumped species in Indonesia and was discovered in pigs in May on densely populated Java island.

Tsunami Tetanus

Tetanus has taken health care workers in Indonesia by surprise, according to this report from Banda Aceh.

Tsunami-borne Measles

I wasn't expecting measles to be the first flashy disease of the tsunami-set, but as usual, ProMED-mail has set me straight. Both Indonesia and India report cases.