Scott McPherson's Web Presence

Lampung, a province at the southern tip of the Indonesian island of Sumatra, is currently at the center of a lot of intense speculation today.  That is because the intrepid bloggers/posters/lay translators at the various flu sites have identified a growing number of suspected H5N1 human cases that have not, as of yet, been picked up by the local media.  But in the aggregate, these reports taken as one signify yet another possible human bird flu cluster on Sumatra.

I want to note the excellent work veteran poster MomCares has done over at www.Curevents.com to put a timeframe together regarding the Lampung situation.  Here it is:

Timeline – Pangang, Lampung

2/5 – chickens (as many as 45) began dying suddenly in Batu Suluh Village, Kelurahan Way Laga

3/9 – Some villagers start experiencing symptoms, including high fever, breathless, coughs, and bloody nose. Imas and Sanpidi’s symptoms start after eating a sick chicken that had died.

3/11(?) – Santibi {Sanpidi} (43) and his child Imas Supriana (10), go to the Waylaga Panjang Community Health Centre.

3/12 – Santibi and Imas transferred to RSU Abdul Moeloek (RSUAM).

Officials of the Panjang Community Health Centre pick up 8 more suspects from their homes in an ambulence.

They were Imas's (10) two brothers Adi Sutihat {Tihat} (8 ) and Ahmad Dani (8 months); a father and the child, Nurdin (52) and Hariyanto {Ariyanto} (11); afterwards Aminah (20), Febi {Fedi, Fitri} (2), Karniti {Aniti} (42), and Lala {Lola}) (20).

All of them are given Tamiflu at the community health centre -- except Karniti and Lala -- who refused to be taken to the hospital and immediately came home.

The remaining 6 are taken to RSUAM (for a total of 8 suspects in hospital).

3/12 evening -- Sanpidi and Imas bolted from the hospital at around 21,30, apparently because of money concerns, plus they weren’t immediately treated.

3/13 morning – Officials from the Community Health Centre picked up Sanpidi and Imas and returned them to the hospital, assuring them that the cost of care would be borne by the regional government.

3/14 -- Two suspects, Lola (2) and Karnati (52) test positive on VCR.

3/14 -- D {Bayu} (22), a new suspect from Rajabasa Subdistrict, is brought to RSUAM.


SUMMARY of LAMPUNG SUSPECTS, in RSUAM intensive care

1) Sanpidi (43M)
2) Imas (10M), son of Sanpidi
3) Adi Sutihat (8M), son of Sanpidi
4) Dani (8 months), son of Sanpidi

5) Nurdin (52M)
6) Hariyanto (11M), son of Nurdin

7) Aminah (20)
8) Fedi (2)
9) Aniti {Karniti} (42) -- TESTED POSITIVE on VCR
10) Lala {Lola) (20) -- TESTED POSITIVE on VCR

11) D {Bayu} (22)

So to recap, we seem to have some eleven suspected cases, and the local press is reporting that two cases have positive field tests. 

Machine translation, as the dean of flu bloggers Crof points out, is a hit-or-miss proposition.  Inflections are lost when the machines try to talk to each other and convert languages.  The syntax jumbles and one has to look at several sentences together, in order to deconstruct and then reconstruct intent and true meaning.

But there are some cases where the facts shine through the language barriers.  In the Internet age, and specifically in what we IT pros call the Web 2.0 age, collaboration becomes the norm.  So it is that on flu sites such as FluTrackers, CurEvents and Flu Wiki, and/or via email, multiple posters can come together and work collaboratively on a translation, or on research, or just to joke around and stay in contact (Crof and FLA_MEDIC, howdy) and compare notes.

In my own opinion, this collaboration will be how we unearth the Next Pandemic.  It is precisely this kind of cooperation, across the globe, spanning multiple national borders, mountain ranges, and entire oceans, that will help discover Cluster Zero.  Cluster Zero may start in a region of the world that is only covered by regional newspapers printed in Malay, or Arabic, or Hausa, or Chinese.  Or maybe a brave blogger will come up for air and alert the world as to what is happening On The Ground in their province.  But the bloggers and posters will find him or her, or will find the note in the regional press and translate it and tell the world what seems to be going on.

As we all know, the Mainstream Media reads blogs, and our ambassadors are more and more frequently asked to participate in Mainstream Media events regarding bird flu in this country and abroad.  The bloggers and, more importantly, the posters themselves are, in my opinion, just as important to global surveillance on H5N1 as the field WHO and OIE reps who constantly move from village to village, looking for the Next Big Bug.

Twenty-first century flusite posters and translators are to disease what the civilian "skywatcher" program was to World War II   They are the volunteers who constantly and relentlessly watch the global press for any indication that the conditions have changed, the H5N1 virus has mutated, and the countdown has begun.  They are looking for that virus "silhouette" that matches the outline of the enemy.  This time, the silhouette is too small to see.  But it is there.

These posters and bloggers also help ensure transparency of the public health system.  What worries me almost as much as an outbreak of human H5N1 is the certainty that when and how an announcement will be made will become, at its essence, a political decision.  Precious time may be lost while decision-makers debate how to best "spin" the bad news.  We frequently see lapses in H5N1 risk communication big enough to drive a Humvee through.  If something happens somewhere and we are among the first to know, we don't go off half-cocked.  In the military vernacular, we "lean our men forward" and wait.  But we wait prepared and aware of the situation, so as not to be caught off-guard.

So while we look at Lampung and wait for more news, raise a glass to those who take the time to do all this translation, research and grunt work.  Without them, this would be a pretty bland blogsite.  Thanks, gang.