Indonesia reports 69th H5N1 case

Sep 29, 2006 (CIDRAP News) – Indonesia reported its 69th H5N1 avian influenza case today, in the 21-year-old sister of an 11-year-old boy who died of the same disease on Sep 18.

The woman from the Tulungagung district of East Java tested positive for H5N1 today, 4 days after she was hospitalized, according to a Bloomberg News report. The World Health Organization (WHO) confirmed her 11-year-old brother's case on Sep 25.

The WHO had reported that poultry in the boy's household began dying in the month prior to symptom onset, and poultry deaths continued in his neighborhood.

An Indonesian official said it was unlikely that the woman caught the virus from her brother. "They're genetically susceptible to the virus, which they were both exposed to from infected poultry," health ministry official I Nyoman Kandun told Bloomberg. He said there was no evidence that the virus was passed from one sibling to the other.

Meanwhile, a 20-year-old man cited by the WHO as Indonesia's 68th case died yesterday, the WHO said. He is the 52nd Indonesian to die of the illness.

The man was one of three siblings in Bandung, West Java, who had flu symptoms at the same time, which sparked concern about possible person-to-person transmission. His 23-year-old brother died Sep 24, and the WHO said H5N1 infection was suspected in his case, but it couldn't be confirmed because no samples were taken. Both men had fed dead chickens to their dogs, and there was evidence of H5 infection in household birds.

The 15-year-old sister of the two men was hospitalized Sep 25 with a fever and cough and was hospitalized in stable condition, the WHO said on Sep 27. Initial tests pointed to normal seasonal flu rather than avian flu, the agency said. Indonesian health officials yesterday ruled out person-to-person transmission of H5N1 among the three siblings, according to an Agence France-Presse report.

On Java island, avian flu disease may have infected a quarter of backyard poultry in some of the country's most densely populated areas, according an Indonesian veterinary official quoted in a Bloomberg News report today.

Musny Suatmodjo, Indonesia's director of animal health, said random tests on Java, where the virus is most prevalent, detected the H5N1 strain in as much as 27% of fowl and caged birds. He gave no details about how many birds were tested or when the survey was done.

"The backyard sector is the weakest link," he told Bloomberg News. "The survey of hotspots in the backyard sector showed almost every flock has been previously infected," though not all birds showed symptoms."

In other avian flu news, China has shared some long-awaited samples of the H5N1 virus from birds, and many scientists are hailing the move as a breakthrough in cooperation, a WHO official said yesterday.

The Chinese Ministry of Agriculture sent the samples, taken from some of the thousands of wild birds that died at Qinghai Lake in April 2005, to the US Centers for Disease Control and Prevention (CDC) in Atlanta, according to a Reuters report yesterday.

WHO scientist Michael Perdue told a news briefing that the samples are the first bird specimens from China in two and a half years and will help researchers understand the origin of an H5N1 strain that later circulated in Turkey and Africa. The strain is genetically different from the one that moved through other parts of Asia, including Indonesia, Thailand, and Vietnam.

The lake where the samples were collected is an important layover point for migratory birds in the remote northern Qinghai province, the Reuters report said.

In March, China had promised to send up to 20 poultry samples to a WHO-affiliated laboratory outside the country. Samples were delayed because of reported communication lapses and disagreements between China and the CDC about the protocol and logistics for mailing the samples. However, the CDC said the problems were resolved in early September.

Perdue said CDC officials expected to receive the samples yesterday, and he hoped the shipment would include additional animal samples requested from China, Reuters reported.

"We have to wait to see exactly what they shipped," he said.

China had not shared avian flu virus samples from poultry since late 2004, according to recent news reports. Poultry H5N1 viruses, especially those from China, are needed to develop vaccines and drugs.

See also:

Sep 28 WHO statement
http://www.who.int/csr/don/2006_09_28/en/index.html

Sep 27 WHO statement
http://www.who.int/csr/don/2006_09_27a/en/index.html

Sep 25 WHO statement
http://www.who.int/csr/don/2006_09_25/en/index.html

Sep 11 CIDRAP News article "Way cleared for China to share H5N1 samples"

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