Indonesia about to reach grim milestone in bird flu fight
Scott McPherson
in Politics and government, influenza and infectious diseases
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It is hard to imagine any situation anywhere in the world knocking India off the Bird Flu Radar. But it has happened. And it is our old friend Indonesia that has caused the temporary shift in global bird flu attention.
While much of the world's attention (as well as my own attention) was focused on the events in West Bengal, quietly the situation in Indonesia was worsening as well. But while there are no confirmed human cases of H5N1 in India to date, the exact opposite is happening in Indonesia, where no less than three people have tested positive for H5N1 in the past week -- and a fourth test is probably a fait accompli.
This sudden increase in H5N1 cases and deaths makes it literally a matter of days -- maybe hours -- before Indonesia reaches the 100-death level from H5N1. That is a distinction that the country certainly does not want, but cannot avoid.
From today's Reuters wire:
Indonesia boy dies of bird flu, making death toll 99
JAKARTA, Jan 28 (Reuters) - A 9-year-old Indonesian boy who had tested positive for bird flu died on Monday, the health ministry said in a statement, taking the country's death toll from the deadly disease to 99.
The boy from the outskirts of Jakarta died at the Sulianto Saroso hospital on Sunday after being treated in different hospitals for two weeks, said Joko Suyono, an official at the ministry's bird flu information centre.
It was not known how the boy contracted the disease.
Indonesia has had the highest number of human deaths from bird flu of any country.
A 31-year-old woman and 32-year-old man hospitalised at Persahabatan hospital for fever and respiratory problems also tested positive for the deadly H5N1 virus on Monday, the ministry said.
According to the statement, the woman lived in East Jakarta near a poultry slaughterhouse that kept many fowl believed to be the source of her H5N1 infection.
The man from Tangerang, west of Jakarta, is believed to have contracted H5N1 from his neighbour's pet doves, the ministry said.
Contact with sick fowl is the most common way of contracting bird flu, endemic in bird populations in most of Indonesia.
Although bird flu remains an animal disease, experts fear the virus could mutate into a form easily passed from human to human and kill millions.
Authorities are also expecting genetic test results to come back for a fourth case, a 23-year-old housewife from East Jakarta, who died on Sunday from bird flu symptoms.
Suyono said there are no obvious explanation for the sudden surge of cases. "We need to carry more tests and investigation first to be really sure." (Reporting by Adhityani Arga; Editing by Sugita Katyal and Jerry Norton)
There have also been reports of scores of Indonesians being sent to hospital with bird flu symptoms. Fortunately, and as is usually the case, most people test negative for H5N1 and are sent home. After all, Indonesia is a regular Wal-Mart of infectious disease, including dengue, chikungunya, malaria, you name it. And thousands of people are afflicted and die annually from the aforementioned maladies.
But it's the H5N1 positives -- and the location of the positives -- that tell the complete story. As you can see from the (above) excellent map of Indonesian human H5N1 cases maintained by intrepid flu poster Dutchy, there are areas where H5N1 is not just indigenous in poultry -- the disease has taken a liking to infecting humans in significant numbers as well,
The four new human cases are distributed as follows: One from East Jakarta; one from West Jakarta; one from Tangerang, which has been the subject of several of my posts over the past few months; and one from West Java.
What also appears to be happening is that the Case Fatality Rate in Indonesia seems to be inching higher.
In the meantime, Vietnam has also reported a new case of H5N1 -- and death -- in a 32-year old male, located about fifty miles northwest of Hanoi. Fujian H5N1 (Clade 2.3 or 2.3.4, if you prefer) is suspected.
In the meantime, India is importing enough Tamiflu to make Roche's quarter, and there is absolutely no end in sight to the infestation of poultry in the region, which includes neighboring Bangladesh. China is culling birds again by the tens of thousands, and Thailand and Turkey are again reporting infestations of H5N1 in poultry.
When the media reports began to appear, talking about the "milder" bird flu situation, I think many of us scoffed openly at any insinuation that H5N1 was receding from either the bird population or the potential for pandemic. Now, in just a few weeks, H5N1 has absolutely exploded back upon the world scene.
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