Two stories coming from Indonesia -- appearing only in the nation's language and subject to machine translation errors -- nonetheless cast a new and ominous shadow over breaking events in the archipelago nation of 18,000+ islands.
First, a breaking story, translated with great skill by Flu Wiki poster History Lover.
New Study Says Avian Influenza Virus Has Mutated http://www.suarakary...Wednesday, 5 September 2007 Yogyakarta (Suara Karya) : Although human to human contagion has not arrived, Avian Influenza virus definitely had mutated to make the virus more easily adaptable with the human body. Team Captain of National Bird Flu Handling Regional Commission Jateng/DIY, drh Prof Charles Rangga Tabbu MSc PhD, Tuesday ( /9), formulated a careful examination of the product that experienced an arrangement change present in the virus' amino acid. This change makes the virus more easily adaptable to humans. It gives an example, bird flu virus that is in finch birds, at the dissociation protein site becomes two subunits, experienced amino acid that is able to adapt to human breathing channels. According to Professor Charles who is also Dean of the Physician Faculty of Domestic Animals UGM, this change happened on viruses that were taken from chickens and ducks. Same matter changed in careful isolation in Institute Pertanian Bogor (IPB), Universitas Udayana, and some universitas that have domestic animal faculty physicians.
"This has mutated," he said.
He firmly protested that the so-called bird flu virus has spread human to human. According to him, the Karo, Sumat case was not human to human contagion Karo, except that they were properly infected from a common source.
"The only last power different from the human body, finally illness also changed," said Charles. Virus change was also anticipated to be H5N1, because it has ceased attack on bird type, but also on other domestic animals, like pigs. Nevertheless this question needs further perusal. "This problem certainly needs epidemiological study that affect all areas, particularly domestical animal physican areas and human areas," he said. (b Sugiharto)
http://www.suarakarya-online.com/news.html?id=181308
A differing report comes from the English-language Jakarta Post. It includes a well-placed jab at the Health Ministry from veterinarian and physician Mangku Sitepoe.
Chicken sole bird flu source: Expert
National News - July 14, 2006
Tb. Arie Rukmantara, The Jakarta Post, Jakarta
Saying chickens are the only known source of bird flu infection in Indonesia so far, animal health experts Thursday urged the government to focus more on combating H5N1 among poultry.
Longtime veterinarian and physician Mangku Sitepoe said although veterinarians had found H5N1 in wild fowls, pigs, flies, birds and water, the source of all human infections in the country thus far had been chickens.
"After compiling and studying research done by veterinarians throughout the country, it is only sick chickens that have been able to transmit the virus to humans so far," he said.
Charles Rangga Tabbu of Yogyakarta-based Gadjah Mada University (UGM) supported Mangku's analysis, saying H5N1 in other animals had not yet mutated into a form that infects humans.
He argued the fight against bird flu should focus on reducing the virus' circulation among chickens. He urged the government to invest more human and financial resources in the animal health sector to stop the disease before it "spills over" to other species.
"The infection of other animal species should be halted as best we can," he said.
Experts believe some animals, such as pigs, could function as a so-called "mixing vessel", allowing H5N1 to mutate into a form that more readily infects humans.
Mangku also believes that the highly pathogenic virus might have already mutated into forms that are more easily transmissible within certain groups of humans.
"The virus has been circulating for some period of time here, it must have been changing into other forms," he said at a national veterinary congress here Thursday.
"I wonder why the Health Ministry is still denying it, while the World Health Organization has admitted it is possible," said the expert on animal-to-human diseases, who is also a member of the National Commission on Bird Flu.
Late last month the WHO stated that its investigation into a cluster of bird flu cases in North Sumatra, where the virus killed seven members of a single family in May, showed that H5N1 had probably passed between family members there but had not evolved into a more widely transmissible form.
The Health Ministry has consistently rejected the statement, saying that the virus transmission is still in the animal-to-human phase.
However, Mangku could not explain why, if the virus had mutated, it could only pass between blood relatives.
"I guess there is something related with genetics, but we ought to do some research on that," he said.
Charles, however, insisted that the virus had not mutated into a form that could more easily pass from human to human.
"What I do know is that the disease has become endemic among chickens raised on small farms and in backyards," said the dean of the UGM Veterinary School.
http://www.thejakartapost.com/yesterdaydetail.asp?fileid=20060714.H06
The strain of H5N1 in Indonesia is clade 2.1, which is unique to the island. It is not the Qinghai strain, also known as clade 2.2, which has marched with impressive speed across all of Europe, most of Asia outside of Thailand and Vietnam, all the way to the Middle East and sub-Saharan Africa. Scientists such as Dr. Henry Niman have concluded awhile back that clade 2.1 had split, with a quantifiable avian reservoir and a different reservoir attacking humans. In other words, in Indonesia, the H5N1 attacking birds and the H5N1 attacking people were different. Apparently, Professor Charles Rangga Tabbu has reached a similar conclusion. This explains why people are able to easily pick up the virus from poultry -- the virus has changed its binding affinity away from bird stomachs and toward human epithelial cells in the respiratory tract. This is a giant step toward a more efficient transmission from human to human, because the more easily H5N1 infects people, the greater the opportunity for dual infections to occur -- and thus, the chance magnifies greatly that a reassortant virus could emerge.
The principal thing we always hear is that it is difficult for humans to contract the virus from fowl. As we have seen time and time again across the planet, that infection is getting easier and easier. And now, from the font of all current bad news regarding H5N1, we see that the Indonesian scientific community is working the problem and sharing its findings with all who will listen.
A second post on Flu Wiki describes the Indonesian government's efforts to create additional surge capacity -- 10,000 new hospital beds, to be exact. Now, Indonesia has malaria, dengue, H5N1, typhoid -- you name it, they have it. But this news, coming on top of the scientific disclosures; the Tamiflu blanket on Palau Tabuan; and the ongoing problems on Bali, all point to an increasingly worrisome situation.
http://kompas.com/ver1/Kesehatan/0709/04/130257.htm
Yesterday the Assistant Director-General for Communicable Diseases at the WHO, Dr. David Heymann, was in Canberra, Australia. Heymann is an American who graduated from Penn State and Wake Forest. His remarks have not drawn the gasps of surprise that you would presume would emanate from the global news media, but was picked up by FLA_MEDIC again. Here is the news story:
WHO Warns Bird Flu Pandemic More Likely Than Not
The World Health Organization (WHO) has warned that a bird flu pandemic is likely.
Head of the communicable diseases department of WHO, Dr David Heymann, said in Canberra, Australia Wednesday that his organization had evidence that the H5N1 (bird flu) virus was now communicable between human and human. (Bold mine).
Dr Heymann said because of international travel and the short time the infection will take to travel from person to person, it was not a question of if a pandemic would occur but when.
"Because of international travel and the speed with which people might be infected, [people] in one part of the world can come to another part of the world still in the incubation period of a disease and the develop signs and symptoms of that disease once they are home," he said.
He warned health workers in contact with those who had contracted the virus saying, "Fortunately [thus far] health workers have not been infected with H5N1 from their patients, it's been much closer contact than that, it's been home care where family members may not know the means of protecting themselves as they help those who are sick," he said.
Another version of the story can be found at: http://www.abc.net.au/news/stories/2007/09/06/2025407.htm
The level of "chatter" coming from Australia and Indonesia is increasing, and the tone is becoming more and more severe.
Scott McPherson
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