Posted on 05/24/2006 5:25:34 AM PDT by Momaw Nadon
JAKARTA, Indonesia - The U.N. health agency described the deaths of six Indonesian family members from bird flu as the most important development in the spread of the virus since 2003, saying it is investigating whether the disease has spread from person to person.
"We have a team down there, they are examining what is going on and they can't find an animal source of this infection," said Peter Cordingley, spokesman for the Western Pacific region of the World Health Organization.
"This is the first time that we've been completely stumped" by a source for the infection, he said.
Six of the seven people in an extended family in northern Sumatra who caught the disease have died, the most recent on Monday. WHO is investigating whether the H5N1 strain of bird flu was spread among family members, though it said Wednesday there was no evidence the virus had mutated to a form that will spread more easily between humans, possibly sparking a pandemic.
Steven Bjorge, the WHO team leader in the village of Kubu Sembelang, said none of the poultry in the area had tested positive for the H5N1 bird flu virus.
"We're not surprised that there is possible human-to-human transmission," Bjorge said. "The thing we're looking for is whether it's sustained beyond the immediate cluster."
Isolated cases of very limited human-to-human transmission have been documented — including one in Thailand involving a mother and child — but such cases do not mean a pandemic flu strain has emerged. There was no indication the Sumatra infections had spread to anyone outside the family.
Still, the scenario worries scientists.
"No matter what's going on at this stage, it's a limited transmission between members of the same family," Cordingley said from Manila, Philippines.
"What we are looking out for is any sign of this virus going outside of this family cluster into the general community, that would be very worrying. We haven't seen any signs of that yet."
Bird flu has killed 124 people worldwide, more than a quarter of them in Indonesia. So far, most human cases have been traced to contact with infected poultry.
Bjorge said the virus that infected the family members was genetically the same as the one found circulating in the area earlier. Tests are still being carried out on poultry in the village.
Peter Roeder, an animal health expert from the U.N. Food and Agriculture Organization in Rome, said tests so far had been negative for the virus, but antibodies were found in some specimens taken from chickens and ducks.
It's unclear, however, whether they were infected at the time the family members fell ill. They could have been sickened much earlier or developed antibodies after vaccination, he said, adding that no immunization records were available.
Dead poultry was also found in an area outside the village, but test results for those birds have not yet come back, said Roeder, who has worked closely with Indonesia to strengthen poultry surveillance and response to bird flu outbreaks.
Bjorge said the woman first believed to be infected worked as a vegetable vendor in a market where live poultry was sold.
Experts are trying to determine if that's where she became infected. The woman, who died May 4, was never tested for the H5N1 virus, but WHO considers her part of the family cluster. The woman's 25-year-old brother is the only family member still living after being infected.
"All confirmed cases in the cluster can be directly linked to close and prolonged exposure to a patient during a phase of severe illness," the WHO said in a statement on its Web site.
Bjorge said some samples have been taken from villagers, but that local authorities have resisted working with outside health experts. WHO has enlisted local villagers to help monitor the village for anyone experiencing flu-like symptoms.
If anyone is found to have even mild symptoms, they will be quarantined and given the anti-bird flu drug Tamiflu, he said.
UPDATE - OB1
WHO sees no mutation in Indonesia bird flu strain
Tue 23 May 2006 12:17 PM ET
Source: Reuters
GENEVA, May 23 (Reuters) - The World Health Organisation (WHO) said on Tuesday that tests had shown no evidence of a significant mutation in the bird flu strain that killed at least six people in North Sumatra.
The death of the group, one of the largest clusters to occur since the disease re-emerged in 2003, had triggered fears that it could be evolving to become more easily transmissible between people.
"Sequencing ... found no evidence of genetic reassortment ... and no evidence of significant mutations," the agency said in a statement.
I think we need to know when this happened and what the incubation period for H5N1 is. If the incubation period has passed, this is a curiousity; if it hasn't, this could still be a problem.
Having spent some time in the Far East, I don't know how one lives in countries such as China and Indonesia without exposure to poultry. All the markets where people go to purchase their food have live poultry. And not only the markets, but many restaurants keep a supply of live poultry and other animals in cages outside the front door of the restaurant. What's amazing to me is that only 124 people have died since exposure to poultry is so common.
"Officials 'stumped' by Indonesian bird flu"
Over at DU.
"Officials 'stumped' by Indonesian bird flu.
Bush's Fault"
LOL!
"This is the first time that we've been completely stumped" by a source for the infection, he said.
This has the unfortunate effect of making it sound like they are trying to 'make' an animal source for every infection, no matter what.
"All confirmed cases in the cluster can be directly linked to close and prolonged exposure to a patient during a phase of severe illness," the WHO said in a statement on its Web site.
OK, so there's no threat, then, right?
Read this:
If anyone is found to have even mild symptoms, they will be quarantined and given the anti-bird flu drug Tamiflu, he said.
That's a little extreme, if there is no human-to-human contact except by caring for others in the last stages of infection.
Now check out this link
The US is shipping a stockpile of Tamiflu to Indonesia.
And see also this
Excerpts include: "This is the first time we have seen cases that have gone beyond one generation of human-to-human spread," Cheng told The Canadian Press.
It was reported, for instance, that the man who died on May 22 refused to take Tamiflu. He fled from the investigators and authorities and lived on the run, sheltered by friends, for the final four days of his life.
As little Tommy Daschle would have put it, "I am deeply troubled."
Keep an eye on it, folks.
Unless thats precisely why its uncommon. Milkmaids dont develop smallpox...
Thread worth reading.
Interesting that she was told to keep 28 gallons of water, per person (two gallons per person per day for two weeks).
Sounds like they expect a boil water order for some reason. Infrastructure would have to be down, for that.
If there is going to be a "true" quarantine, then you would be out of power and utilities as they don't run by themselves.
Reminds me though, I need a few more gallons of water.
Yes, that's my point. Sounds like that's the plan...a true quarantine.
Better late than never ping...
oops.
So... has H5N1 officially made the H2H jump or no?
This sounds like the source of the 'mysterious' out-break in Indonesia. Why her and not more people, don't know.
Dozens quarantined in Indonesian bird flu village
Source: Yahoo news - 1 hour, 7 minutes ago
Health experts in an Indonesian village hit by an unprecedented bird flu outbreak have asked more than 30 people to quarantine themselves to contain any potential further spread, officials said.
People who had close contact with any of seven relatives who have died since last month in the North Sumatran village are being monitored for signs of illness, World Health Organisation (WHO) spokesman Dick Thompson told AFP.
"The focus right now is contact tracing, identifying those people who may have been in contact with this cluster," Thompson told AFP by telephone. "We will monitor their health and encourage them to self-quarantine themselves."
A day after another WHO spokesman, Peter Cordingley, said the UN body was "stumped" about the original source of the infection, Thompson said that contact with an infected bird was now considered the likely cause.
Cordingley also on Wednesday described the outbreak as "the mother of all clusters", but Thompson stressed there was evidence that the virus had not mutated into a form that could be more easily spread from humans to humans.
"From what we see, it takes very close and maybe prolonged contact with a sick individual," for someone to catch the virus, Thompson said.
Thompson said while Indonesia's cluster was the biggest so far, there had been "maybe four to five" close-contact infections since the outbreak of bird flu in late 2003 that has gone on to kill 124 people in nine countries worldwide, 33 of them in Indonesia.
He said samples of the virus taken from the cluster of victims had been sequenced in a Hong Kong laboratory and had not shown any signs of mutation into a more contagious form.
The WHO has sent a 10-member team to Kubu Sembelang village, Karo District, to identify those who had close contact with the family. So far more than 30, including more relatives, have been traced and asked to quarantine themselves.
"We will monitor them for a week or two to see if they become sick. If they do they will immediately be put in isolation in a hospital," Thompson said.
The group under watch might be given Tamiflu, an anti-flu drug that has shown some effectiveness in reducing the mortality rate of avian flu when administered in the early stages of the sickness, he added.
Bird flu tests would be carried out on anyone who showed signs of sickness. Six people in the family have been confirmed to have been infected with H5N1, while the WHO has concluded the first person in the family to die was also a bird flu victim although she was buried before tests could be carried out.
The cases have brought Indonesia's bird flu death toll to 33, with 22 of those this year.
http://news.yahoo.com/s/afp/20060525/wl_asia_afp/healthfluindonesia_060525053755
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