Indonesia considers autopsies for H5N1 victims

Apr 3, 2007 (CIDRAP News) – Indonesia's national avian influenza commission has recommended that the health ministry conduct an autopsy on each person who dies of H5N1 avian flu to learn more about how the disease affects the body, the Jakarta Post reported today.

Though experts say multiple organ failure plays a role in avian flu deaths, there are no data on humans, Bayu Krisnamurthi, chairman of the National Commission for Avian Influenza and Pandemic Preparedness, told the Post.

Postmortem examination has confirmed the role of multiple organ failure in chickens, and autopsies are needed to determine if the disease also spreads beyond the lungs in humans, Krisnamurthi said. However, he added that autopsies require careful consideration because the practice carries religious, social, and legal ramifications. Religious strictures are the main reason families refuse to allow autopsies, Krisnamurthi said.

The commission has authority only to make recommendations to the health ministry, the newspaper reported. "We hope the ministry takes this call seriously," he said.

In another development, Indonesia's trade minister said today the country was considering teaming up with Egypt to produce a human H5N1 flu vaccine, according to a Reuters report.

"Indonesia and Egypt have bird flu cases. But Egypt has more advanced pharmaceutical experience and has produced a variety of vaccines," Mari Pangestu told Reuters after a meeting with Egypt's trade delegation. "Thus, the possibility for cooperation is wide open."

In February Indonesia, amid a standoff with the World Health Organization (WHO) over sharing its H5N1 virus samples, signed a memorandum of understanding with US vaccine producer Baxter International about possible future collaboration or supply agreements.

However, on Mar 27 Indonesia agreed to resume sharing its H5N1 virus samples with the WHO, under conditions designed to give the country control over which vaccine manufacturers get access to seed viruses made from the samples.

Also today, officials in Egypt told the WHO they had ruled out the possibility of human-to-human transmission in the case of a brother and sister who were recently found to have avian flu, Reuters reported. The boy, age 4, and his sister, 6, are from Qena governorate, about 416 miles south of Cairo, according to WHO reports.

Both children had been exposed to poultry that was infected with the H5N1 virus, the Reuters report said.

"We have heard from the Ministry of Health that human-to-human transmission has been ruled out," WHO spokesman Greg Hartl told Reuters.

The brother and sister are among five Egyptian children in whom H5N1 infections were recently confirmed. All are hospitalized in stable condition, Reuters reported.

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