Indonesia: the epicenter & time bomb. All Indonesia posts here, please

[Deepwater]

For those of you who have not been following what is going on in Indonesia, this is really cause for concern. Dr. Revere's Effect Measure Blogspot summarizes it well on May 19.

http://www.effectmeasure.blogspot.com

What to do about Indonesia? The fourth most populous country in the world, where 26 of 33 of the provinces have reported poultry outbreaks with H5N1, swine may be infected asymptomatically and 40 confirmed cases with 31 deaths, all make Indonesia the current epicenter of bird flu. Its government is struggling and is so far incapable of doing the investigations needed to keep a close eye on the evolution of this fast mutating virus.
(snip)

Two things are now quite clear. (1) The bird flu situation in Indonesia is serious and better scientific information is urgently needed but it collection is being obstructed by the Indonesian government. (2) The Indonesian authorities are not competent to handle this.

While the bird flu pot bubbles and threatens to boil over in Indonesia, there is no one in the kitchen.

[Deepwater]

May 20, 2006

Bird flu cases in Indonesia raise questions about pandemic containment plan

By HELEN BRANSWELL

(CP) - A worrisome cluster of human cases of H5N1 avian flu in a remote village in Indonesia is raising serious questions about the feasibility of an international plan to try to stop an emerging pandemic at source.
(snip)
But the outbreak in Indonesia, where disease investigators have been met with fear and suspicion, illuminates the enormous challenges the pandemic SWAT team would face in trying to snuff out a nascent pandemic strain before it could spread from its place of origin to sweep the globe.

http://cnews.canoe.ca/CNEWS/World/2006/05/20/1590247-cp.html

[Deepwater]

WHO and CDC are doing their best to downplay the very alarming events in Indonesia. At least the WHO has been forced into admitting someithing it wouldn't in the past: there were other clusters that were human-to-human (H2H). Unfortunately, we are victims of government "information management." That is, these two agencies, the U.N.'s World Health Organization (WHO) and the U.S. 's Center for Disease Control (CDC) are notorious for mixing science and medicine with politics. Currently, they want you "to prepare" but not be alarmed, even though they are alarmed and their press releases are weasel-worded.

Full article:
http://www.effectmeasure.blogspot.com

[Deepwater]

May 26 (Bloomberg) -- Dowes Ginting died of bird flu this week in the arms of his wife in the back of a jeep as he was taken to the hospital. For three days he had evaded doctors seeking to test him for the virus that killed him and at least six of his Indonesian relatives, including his son.
(snip)
Ginting fled local health authorities and sought care from a witch doctor, I Nyoman Kandun, director general of disease control with the Indonesian Health Ministry, told reporters in Jakarta on May 22.

Full article:

http://www.bloomberg.com/apps/news?pid=10000080&sid=aiu7Xi_3TZEY&refer=asia

[BFD - v2.0]

This just gets scarier and scarier.

[bikerduck]

JAKARTA, Indonesia - Indonesia averaged one human bird flu death every 2 1/2 days in May, putting it on pace to soon surpass Vietnam as the world's hardest-hit country.
Full article:
http://news.yahoo.com/s/ap/20060601/ap_on_he_me/indonesia_bird_flu_10

[daffle]

Originally posted by BFD - v2.0
This just gets scarier and scarier.

No sht, BD. We may have dodged this particular bullet in Indonesia, but the gun is loaded with plenty more. The pot is boiling over in Indonesia and there is no one in the kitchen.

[bikerduck]

JAKARTA (AFP) - The World Health Organisation (WHO) has admitted it was having difficulty identifying the source of bird flu infection in a case where seven people in the same family died of the virus.

Full Article
http://news.yahoo.com/s/afp/20060601/hl_afp/healthfluindonesia_060601125422

[simply quiet]

Originally posted by daffle


No sht, BD. We may have dodged this particular bullet in Indonesia, but the gun is loaded with plenty more. The pot is boiling over in Indonesia and there is no one in the kitchen.

I feel that way too, about no one in the kitchen. When I was watching the earthquake videos last week, I was listening to see if that was an area they were concerned about. I never did hear, but I did hear them begging for help and money for recovery from the quake damage. Too bad we couldn't barter a bit here, and say ok...we will help you recover, but you gotta let us in to your records etc. regarding this virus.

[bikerduck]

June 16 (Bloomberg) -- Jones Ginting, the only survivor of seven members of an Indonesian family infected with bird flu, is being investigated for rare neurological symptoms associated with the illness.

Magnetic resonance imaging (MRI) scans of Ginting's brain are being checked for signs of infection, said Nur Rasyid Lubis, deputy director of the Adam Malik Hospital. He said the scans were taken late yesterday at the hospital in Medan, the capital of Indonesia's North Sumatra province.

``It's not yet clear whether he's suffering from a brain infection,'' Lubis said in a telephone interview today.

If confirmed, Ginting would be one of few human cases of avian influenza in which disease of the central nervous system has been observed. Doctors are studying the H5N1 avian flu strain to improve treatments and prevent illness. Human H5N1 cases provide opportunity for the virus to mutate into a pandemic form that may kill millions of people.

Full Article

http://www.bloomberg.com/apps/news?pid=10000080&sid=aTPHBJsepp2Q

[bikerduck]

The government has admitted its bird flu information campaign has failed to improve public awareness about the deadly disease.

Director general of communicable diseases control I Nyoman Kandun said Thursday a lack of public awareness about the seriousness of the disease had played a part in causing the nation's high rate of human deaths from bird flu.
(snip)

Kandun said villagers' fierce objections to the government's plan of a mass poultry cull in Tanah Karo, North Sumatra, proved the government's public awareness campaign had failed.

Full Article:
http://www.thejakartapost.com/detailnational.asp?fileid=20060616.H02&irec=2

[bikerduck]

JAKARTA, Indonesia - The World Health Organization has concluded that human-to-human transmission likely occurred among seven relatives who developed bird flu in Indonesia.
In a report obtained Wednesday by The Associated Press, WHO experts said the cluster's index case was probably infected by sick birds and spread the disease to six family members. One of those cases, a boy, then likely infected his father, it said.

Seven of the eight relatives died last month, but one was buried before samples could be taken to confirm bird flu infection.

"What is happening in Indonesia? That is the No. 1 question," said Bayu Krishnamurthi, Indonesia's national bird flu coordinator. "With all of these limited resources — human, financial, institutional — what should we do?"

Full Article

http://news.yahoo.com/s/ap/20060621/ap_on_he_me/indonesia_bird_flu_3

[Deepwater]

Bird Flu Transmission Is Proven in Indonesia (Update1)
June 23 (Bloomberg) -- Bird flu was spread directly between members of an Indonesian family in the first laboratory- confirmed case of human-to-human transmission of the lethal virus, a World Health Organization official said.

``We have seen a genetic change that confirms in a laboratory that the virus has moved from one human to another,'' Thompson said in an interview. The change in the virus ``doesn't seem to have any significance in terms of the pathology of the disease or how easily it's transmitted,'' he said. (yeah, right)

Full article:
http://www.bloomberg.com/apps/news?pid=10000080&sid=a_g3QljBkLwE&refer=asia#

[Deepwater]

Even though bird flu is breaking out once again in Thailand and Vietnam, Indonesia has everyone's attention. Several days ago, it appeared as though two new family clusters were found in the Karo lands of North Sumatra, where in May of this year, human-to-human-to-human transmission was confirmed.

One more bullet dodged in Indonesia, but the gun is still loaded and cocked.

[Deepwater]

Indonesian Woman Dies of Bird Flu, 12 Others Infected
Contributed by Tom Harrison| 20 August, 2006 19:06 GMT

Confirmation that a 35-year-old Indonesia woman who died last week was infected with the H5N1 virus has stoked concern that a new bird flu cluster case may have emerged in the country. Tests have confirmed that an a 35-year-old Indonesian woman, Euis Lina, died last week of bird flu, health officials have announced. Twelve other residents of the Cikelet subdistrict of West Java are known to be infected.

Two weeks ago, Lina's nine-year-old daughter died after becoming ill with similar symptoms, but authorities have not confirmed bird flu in her case.

The situation is especially worrisome because of Cikelet's location about 90 miles from Jakarta -- the largest city in Indonesia, with a population close to 9 million.

Full Article:
http://health.dailynewscentral.com/content/view/2388/

[Deepwater]

For a thrilling in-country radio broadcast on H5N1 you should go to chad bouchard`s homepage:

http://jakartachad.blogspot.com/

[Deepwater]

Corruption in the Indonesia is widespread and legendary. Consequently, donor nations need to be careful that there is a clear plan and auditing of the spending. For example, just recently the U.S. gave several million in hospital protective gear for nurses and doctors. (Deepwater)

SINGAPORE: The World Bank has announced a US$15 million grant to Indonesia to help it fight against bird flu.

Indonesia has so far suffered 65 human cases, of which 49 were fatal - the world's highest death toll.

Jakarta says it needs US$250 million to fight the virus.

But little of the international money pledged to help battle the virus has so far been received, said a United Nations bird flu coordinator.

Dr David Nabarro, Senior UN System Influenza Coordinator, said: "Indonesia is a country with a great deal of avian flu virus, high pathogenic H5N1 virus, and it is important that Indonesia is able to implement avian influenza surveillance and response programmes throughout the country.

"Indonesia badly needs money to continue to spread its avian influenza control efforts throughout the 440 districts in the country. The money that is being discussed today is a small amount, but it is an important amount that is going to make a difference."

http://www.channelnewsasia.com/stories/singaporelocalnews/view/230895/1/.html

[Deepwater]

This article by Dr. Henry Niman is very important, but it has a lot of scientific detail that most people are unfamiliar with, so I'm going to snip to just the parts that most people can grasp:

"Sequences" and "isolates" refer to the genetic samples of the virus.

The concern is that the hidden H5N1 reservoir is a mammal, possibly a cat, dog, rat, pig, etc. If so, that means that the virus is quickly adapting itself to mammals which are then, in turn, passing it on to people. The number of clusters and likley human-to-human cases, and mild cases which go undetected, suggests that the virus is adapting itself to humans. Once it does fully adapt and becomes easily transmissable, a pandemic strain will emerge.

Hidden H5N1 Reservoir Raises Pandemic Concerns in Indonesia
Recombinomics Commentary
September 17, 2006

Sequence analysis of H5N1 sequences from birds and patients in Indonesia provides compelling evidence that the human infections are linked to a hidden reservoir. The evidence had been building throughout the year because the sequences from the human isolates did not match the sequences from poultry isolates....so the origins of virtually all human bird flu cases were not clear. (if genetic info from human cases doesn't indicate they got the virus from birds, then where did they get it from?)
(snip)

The match failures in poultry isolated in the same location as the human cases strongly point toward a hidden reservoir.,,, These isolates are from multiple locations, including Jakarta, West Banten, Bekasi and Garut.

The human isolates have a number of polymorphisms [genetic elements]...., highlighting the role of migratory birds.... There are no wild bird H5N1 sequences from Indonesia. Similarly, there is a lack of mammalian sequences. The only non-human close match on Java is from a cat, but that is the only public cat sequences. H5N1 has been reported from a dog as well as wild and domestic cats in Thailand as well as a variety of mammals in Europe and the Middle East....

The surveillance in these other mammals, as well as humans not linked to dead or dying poultry has been poor. The number of familial clusters in Indonesia is high and WHO has recently acknowledge the possibility of human-to-human transmission in Karo and West Sumatra. Gaps in disease onset dates indicate human-to-human transmissions within families are common. In several instances, such transmission has produced mild cases. These transmissions coupled with the poultry match failures suggest that the level of undetected H5n1 in human populations is significant.

Full Article:
http://www.recombinomics.com/News/09170601/H5N1_Indonesia_Hidden.html

[Uriel]

http://www.physorg.com/news107534305.html


“The containment strategy was implemented late in the game, so it could have been just luck that the virus burned out,” Longini said. “It went two generations and then just stopped, but it could have gotten out of control. The world really may have dodged a bullet with that one, and the next time we might not be so lucky,” he said.