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AVIAN INFLUENZA, HUMAN (60): INDONESIA (BALI), FATAL, SUSPECTED
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A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
[1]Date: Mon 10 Oct 2011Source: Jakarta Globe [edited]
http://www.thejakartaglobe.com/news/bal ... flu/470592


Bali officials are on alert again after 2 children at Denpasar's
Sanglah General Hospital were diagnosed with the H5N1 strain of avian
influenza. Five- and 10-year-old siblings, resident in Bangli
district, were admitted to the hospital on Friday night [7 Oct 2011]
with symptoms of avian influenza and placed in isolation. The
hospital's medical and nursing director, Anak Agung Ngurah Jaya
Kusuma, said on Sunday [9 Oct 2011] that the children had been in
direct contact with dead poultry around their house and were treated
at a local health clinic before being brought to Sanglah.

Officials are still waiting for results of further tests from Udayana
University and the Health Ministry.

Bali Animal Husbandry Agency head Putu Sumantra said a team had been
deployed to Bangli, but preliminary results showed no trace of H5N1
[presumably in poultry - Mod.CP]. He said that given the preliminary
test, he was not ready to conclude that the birds had died of avian
influenza. "Nevertheless, we remain vigilant. Some of the dead birds
have been sent for further lab tests; the area has been sterilized,
and we have taken samples from family members," he said.

A total of 2 people died of the virus in 2007 and 2008 [in Bali], but
the province has still not enacted a 2005 gubernatorial regulation
banning the import of poultry into the island from other areas.
Denpasar agricultural quarantine chief Saiful Muhtadin said many
attempts have been made to smuggle poultry into Bali, especially
through Padangbai and Gilimanuk harbors.

[Byline: Made Arya Kencana]

--
Communicated by:
Nati Elkin

******
[2]
Date: Mon 10 Oct 2011
Source: Avian Flu Diary [abridged & edited]
http://afludiary.blogspot.com/2011/10/b ... -bali.html


Roughly 48 hours ago [8 Oct 2011], FluTrackers posted an Indonesian
MetroTV report on 2 children (a 5-year-old boy and a 10-year-old boy)
hospitalized on Friday [7 Oct 2011] with severe respiratory symptoms
on the resort island of Bali. Given their reported contact with
chickens and the endemic nature of the H5N1 virus in Indonesia, bird
flu was immediately suspected. Over the next 2 days, the news hounds
on FluTrackers and Flu Wiki posted more than 24 translated reports on
these 2 children, and yesterday [9 Oct 2011], we learned that
preliminary testing indicated bird flu, and that both children were on
respirators.

This morning [10 Oct 2011], we have had word that both children have
died and that H5N1 has been confirmed. While a number of news reports
are reporting these deaths, TEMPO Interaktif seems to have the most
details. The TEMPO Interactive reports that the 2 children from
Tembuku Village, Bangli, Bali allegedly died from bird flu early
Monday morning [10 Oct 2011]. The bodies of the brothers are still
stored at the General Hospital Center for Sanglah.

According to other reports, prophylactic Tamiflu is being provided to
family members and close contacts of these boys, and the community has
been told that Tamiflu will be provided to anyone who had contact with
sick or dead chickens.

All of this is highly reminiscent of the events of August 2007, when
an outbreak of H5N1 killed 2 women (and was suspected in the death of
one of the women's 5 year-old daughter) on the island of Bali. Bali,
with a population of just under 4 million, is a popular international
tourist destination, although its reputation has suffered in recent
years due to outbreaks of bird flu, dengue, and rabies.

A number of countries, including the US and Australia, have issued
travel health warnings for Bali and for the rest of Indonesia [with
respect to risk of rabies virus infection - Mod.CP]. Although news
reports of bird flu outbreaks and human cases in Indonesia have
declined over the past couple of years, the virus remains endemic in
that country and continues to mutate and spread.

Reporting and surveillance in Indonesia, as in much of the world,
leaves much to be desired, so while Indonesia reports 146 total deaths
from the H5N1 virus, the actual number is unknown. With these 2 new
deaths, a good deal of attention will be focused on Bali over the next
couple of days to see whether additional cases show up.

[Byline: Michael Coston]

--
Communicated by:
ProMED-mail Correspondent Mary Marshall

[ProMED-mail acknowledges receipt of another report with similar
information from Dr. Andri Jatikusumah, M.Sc., Direktur Eksekutif,
Center for Indonesian Veterinary Analytical Studies (CIVAS), Jl.RSAU.
No 4, Atang Sanjaya, Kemang Bogor.

Reports of human cases of avian influenza A/(H5N1) virus infection
from Indonesia have not always been confirmed by laboratory diagnosis
at a WHO-accredited institution. While the 2nd report announcing the
death of the 2 siblings states that the diagnosis of avian influenza
A/(H5N1) virus infection has been confirmed, the 1st report states
that it is not yet certain that the deaths of the domestic poultry in
the village where the children lived were the result of avian
influenza virus infection. Further information is awaited.

Denpasar in Bali, Indonesia can be located in the HeathMap/ProMED-mail
interactive map at: http://healthmap.org/r/1j_3. - Mod.CP]


See Also

Avian influenza, human (59): transmission in mammals 20110926.2921
Avian influenza, human (58): H5N1 2.3.2.1 clade, WHO 20110902.2682
Avian influenza, human (57): alert 20110829.2654
Avian influenza, human (56): Cambodia (KC) 20110819.2525
Avian influenza, human (55): data analysis 20110811.2439
Avian influenza, human (54): Egypt, WHO 20110810.2427
Avian influenza, human (53): Cambodia, Egypt 20110803.2338
Avian influenza, human (52): Cambodia (BM) 20110729.2279
Avian influenza, human (45): Indonesia (JK), WHO 20110603.1700]
.................................................arn/mpp/cp/msp/mpp

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Commentary

http://www.recombinomics.com/News/10171 ... angli.html

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The victim died from bird flu in Bali, is increased.
Biological mother of two children who died from bird flu in Bali, died at his home. Before burial, the officers took a blood sample suspected suspect bird flu in the village Jehem Tembuku Bangli district of Bali. The victim is the mother of two children who a few days ago died in hospital Sanglah Bali positive result contracted bird flu. He experienced symptoms of fever and heat, although the results of his blood tests last week declared negative burung.Ia flu died two days after leaving the hospital treatment room Bangli. Relatives and families of victims, including her husband, wept as the bodies were taken to ambulans.Jenazahnya treated like a suspect's body bird flu. The whole etugas wear sterile clothing and cover the bodies obliged to use a mask. Anticipating the spread of the H5N1 virus, Department of Health and Husbandry Bangli, spraying disinfectant around the victim's home. The remaining birds are still alive immediately burned en masse.

http://news.mnctv.com/index.php?option= ... &Itemid=14

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Commentary

http://www.recombinomics.com/News/10171 ... gli_3.html

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Sanglah HOSPITAL TREATING BACK 3 PATIENT suspect bird flu. THIRD NOW TREATED IN INTENSIVE SPECIAL DISEASES SAL.

http://www.balitv.tv/btv2/index.php/new ... ainmenu-27

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Bali – Sanglah hospital treated 3 bird flu suspect patients, said the spokesman of Sanglah hospital in Bali, Ken Wirashandi.

Two patients, each from Bangli and Puriraja, were tested negative by laboratory examination.

One patient from Tabanan was admitted to hospital early on Monday (17/10), and currently under intensive treatment.

http://birdflucorner.wordpress.com/2011 ... lu-supect/

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Bangli - overwrite melancholy story of a family in Bangli regency, Bali. After two children died as infected with bird flu virus, now the mother followed. Ni Wayan Purnami died (30) this morning. Purnami departure was quite surprising, especially family just lost a KRA (5) and WA (10) Sanglah Hospital in Denpasar on Sunday, October 9, 2011. Grief enveloped families living in Banjar Antugan, Jehem Village, District Tembuku. Had rumors, the victim dies because of bird flu virus. But it was denied Kadis Ranch Bangli, Anak Agung Ngurah Samba, which confirms the results of laboratory tests negative mention of victims of bird flu. "We have confirmed the results of laboratory tests in Sanglah Hospital, Lab Biomol Udayana University, and Kes RI R & D Lab. The result of bird flu negative patients, "said Samba when contacted Legal, Monday (10/17/2011). Until now, it did not yet know the cause of death of the victim. "The cause of death needs to be pursued with survailance action," continued the Samba. He explained that the post-death of her two children, Purnami shock and his health continued to decline. In fact, he had rushed to the local health centers and hospitals Bangli. From the medical record is known, the victim had complained of cough and shortness of breath, so it should be two days in the hospital. Only, when asked to be referred to the appropriate procedure Sanglah Hospital stay for further treatment, the victim actually declined. Further tests carried out as previously alleged victim was in contact with bird flu positive patients should be referred to the Sanglah Hospital. "He even refused to even a vague from the hospital until she died, "said Samba. As is known KRA (5) and WA (10) was treated in Sanglah Hospital, Denpasar, on Friday, October 7th. But they did not survive and died on the same day Sunday, October 9 at night. Known KRA still in school in the Kindergarten, while her brother sat on the bench WA 5 th grade at Jehem Banjar, District Tembuku. In the hospital records, the last bird flu case resulted in two deaths occurred in Bali in 2007

http://news.okezone.com/read/2011/10/17 ... -meninggal

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Indonesia - Mother of 2 children who died last week of bird flu, died too

machinetranslation

"Increase Bird Flu death toll '

The [number of] victims died from bird flu in Bali, is increased.

Biological mother of two children who died from bird flu in Bali, died at her home. Before burial, the officers took a blood sample suspected suspect bird flu in the village Jehem Tembuku Bangli district of Bali.The victim is the biological mother of two children who a few days ago died in hospital Sanglah Bali positive result contracted bird flu. She experienced symptoms of fever and heat, although the results of her blood tests last week declared negative bird flu . She died two days after leaving the hospital treatment room Bangli.

Relatives and families of victims, including her husband, wept as the bodies were taken to be treated like a corpse ambulans.Jenazahnya suspect bird flu. The whole etugas wear sterile clothing and cover the bodies obliged to use a mask.

Anticipating the spread of the H5N1 virus, Department of Health and Husbandry Bangli, spraying disinfectant around the victim's home. The remaining birds were still alive immediately burned en masse.


http://news.mnctv.com/index.php?option= ... &Itemid=14

SOP for Indonesia

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