WHO confirms Indonesia's 53rd avian flu case

Avian Influenza (Bird Flu)

Jul 14, 2006 (CIDRAP News) – A 3-year-old girl who died on Jul 6 near Jakarta had Indonesia's 53rd case of H5N1 avian influenza, according to test results announced today by the World Health Organization (WHO).

Meanwhile, Bloomberg news reported last night that the only survivor of a recent family cluster of avian flu cases in Indonesia is being treated for brain abscesses.

The 3-year-old girl, who was from a suburb of Jakarta, became ill on Jun 23 and was hospitalized Jul 5. The WHO said investigators found that she had handled some dead chickens 2 days before she fell ill. Samples taken from chickens in her neighborhood were positive. Investigators found no other patients with influenza-like illnesses, and they are monitoring close contacts of the girl, the agency said.

With 41 avian flu deaths, Indonesia now trails Vietnam for most deaths by only one, according to WHO statistics. Vietnam, however, has had no human cases of H5N1 since last November, while Indonesia's 53 cases have all come in 2005 and 2006.

According to the Bloomberg story, Luhur Soeroso, a doctor caring for the sole survivor of the avian flu case cluster in North Sumatra, said the 25-year-old man experienced headaches and fatigue a month after he was treated for avian flu. The patient, Jones Ginting, is hospitalized at Adam Malik Hospital in the northern Sumatra city of Medan. The cluster involved seven confirmed cases and one probable case.

"We found abscesses in several parts of his brain," Soeroso said. He suggested that antibiotics and other drugs given for avian flu might have weakened the patient's immune system, but said the brain abscesses are gradually shrinking in response to treatment.

Neurologic manifestations of H5N1 infection have been reported before, though rarely. A Vietnamese boy who died of encephalitis in 2004 was later found to have had H5N1 infection, according to a research report published last year. Encephalitis is also known to be a rare complication of ordinary influenza.

See also:

Jul 14 WHO update on Indonesian situation
http://www.who.int/csr/don/2006_07_14/en/index.html

Jun 22 CIDRAP News article "WHO concludes H5N1 likely spread within family"

Feb 16, 2005, CIDRAP News article "Avian flu caused encephalitis in Vietnamese boy"

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