WHO confirms three more H5N1 cases in Indonesia

Avian Influenza (Bird Flu)

Sep 8, 2006 (CIDRAP News) – The World Health Organization today recognized three more cases of H5N1 avian influenza in Indonesia, including one reported by the government yesterday and two dating back to 2005.

The case reported by Indonesia yesterday was in a 14-year-old girl from Makassar in South Sulawesi province. After exposure to poultry near her home, she became ill Jun 18 and died Jun 24, the WHO said. Her case was identified through Indonesia's routine flu surveillance program.

Recognition of the two 2005 cases follows the recent revision of the WHO's H5N1 case definitions. The cases previously did not meet the definition for a serologically confirmed H5N1 infection, the agency said.

One of the cases from 2005 was that of an 8-year-old girl from Tangerang, outside Jakarta, the WHO said. She fell ill Jun 24, 2005, and died the following Jul 14. Her case was part of a family cluster reported to the WHO in July 2005.

The cluster included the 8-year-old, her father, and her 1-year-old sister, all of whom died in July 2005. Theirs were the first cases of H5N1 illness reported in Indonesia.

Indonesian officials said at the time that all three family members had the virus. Until now, the WHO had recognized only the case in the father. In today's statement the WHO said nothing about the reported case in the 1-year-old girl.

The other newly confirmed case from 2005 was in a 45-year-old man from Magelang in Central Java province, the WHO said. He became ill Nov 25, 2005, after contact with sick chickens, but he later recovered.

The WHO said recognition of the two cases from 2005 reconciles its H5N1 case count for Indonesia with that of the Indonesian Ministry of Health. The official count is 63 cases with 48 deaths, the most deaths of any country. Vietnam has had the most cases, 93, but only 42 were fatal.

The global H5N1 toll has now reached 244 cases with 143 deaths, according to the WHO.

The reason for the late reporting of the South Sulawesi girl's case was that avian flu was not suspected when clinical samples were taken, according to an Indonesian official quoted in an Agence France-Presse (AFP) report yesterday. The samples were later forwarded to the health ministry's laboratory for avian flu testing, said Runizar Roesin of the national avian flu center.

Indonesia confirmed the girl's case on the basis of its own local tests, rather than waiting for confirmation by the WHO reference lab in Hong Kong, the AFP story said.

Sari Setiogi, WHO spokesperson in Indonesia, said that Jakarta can now confirm H5N1 cases after two local tests are positive, according to AFP.

See also:

Sep 8 WHO statement
http://www.who.int/csr/don/2006_09_08a/en/index.html

Revised WHO definitions for human H5N1 cases

Jul 21, 2005, CIDRAP News story "WHO: confirmation of H5N1 awaited in 2 Indonesian cases"

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