Aug 2, 2006 (CIDRAP News) – Seven people in Karo district of North Sumatra, Indonesia, are being treated for suspected H5N1 avian influenza, raising concern that the disease may have resurfaced near where human-to-human transmission was documented in an extended family in May.
The Associated Press (AP) reported today that Indonesian health officials said the suspected cases fall into two clusters, one involving two sisters and the other consisting of three family members and two of their neighbors.
Three of the patients are children who are believed to have been infected by chickens, the AP reported. The children include 10- and 6-year-old sisters and an 18-month-old boy who is their neighbor. Reuters news service reported today that the children were hospitalized yesterday.
Blood samples were taken from the patients when they were admitted to Adam Malik hospital in Medan, health ministry official Hariadi Wibisono told the AP. Tests have not yet confirmed the H5N1 infection, but the patients are being treated as if they have the disease. Luhur Soeroso, who is treating the patients, told the AP that the seven patients have fever, cough, and other symptoms that have been associated with avian flu.
In the North Sumatra case cluster in May, seven of eight family members tested positive for H5N1 avian flu, and only one family member survived. The cluster, believed to be the largest to date, marked the first documented instance of person-to-person transmission and the first three-person chain of infection, the World Health Organization said in June. Person-to-person transmission has been listed as possible or likely in several other case clusters.
Indonesia’s official avian flu toll is 54 cases with 42 deaths, which ties it with Vietnam for the most deaths. All of Indonesia's human H5N1 cases have occurred since mid-2005.
Elsewhere in Indonesia, animal health officials on the resort island of Bali said hundreds of dead chickens have tested positive for H5N1 infection, according to an AP report yesterday. Health official I Gusti Hgurah Sandjaja said the outbreak involved 300 chickens, with no indications of any human cases. The AP report said health workers culled a large number of ducks and chickens on Bali earlier this year after several birds became ill.
In Thailand, avian flu outbreaks seem to be spreading south, as evidenced by suspicious deaths of chickens in Lop Buri province in the lower central region, according to a report today in The Nation, a Thai newspaper. A 61-year-old woman in the province fell ill with avian flu–like symptoms after her backyard chickens died, said the report. The woman was admitted yesterday to Ban Mi Hospital, where a preliminary avian flu test came back positive, the newspaper said. Confirmatory tests are pending.
According to a Web site of the Thai Ministry of Health, 144 patients from 24 provinces, mostly in the north, were on a watch list for avian flu as of yesterday.
Jun 23 CIDRAP News article "H5N1 mutation showed human transmission in Indonesia"