Four Human Bird Flu Infections In Indonesia Confirmed

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Main Category: Bird Flu / Avian Flu
Article Date: 28 May 2006 - 8:00 PDT

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A Hong Kong laboratory, which is recognized by WHO, has confirmed four cases of bird flu infection among humans in Indonesia. These include a 10-year-old girl from Bandung, an 18-year-old male shuttlecock maker from Surabaya, East Java, a 39-year-old person from Jakarta, and a 43-year-old person from Jakarta.

Authorities say the source of infection for the girl is most likely sick birds and infected feathers for the shuttlecock maker. It is thought the source for the other two was also infected birds, but confirmation for this still being awaited.

The 10-year-old girl and the 39-year-old died.

So far, 35 people have died of bird flu infection in Indonesia.

The young girl's 18-year-old brother also died. Initial tests indicated he had bird flu. However, follow up tests from the Hong Kong labs showed he did not. He had bird-flu infection like symptoms.

Seven members of one family died of bird flu infection last week. Most likely, an eighth family member, who also died, had bird flu. The woman was buried before samples could be taken, so we will never know whether or not she was infected with bird flu. Scientists who analysed the virus samples from this family cluster say the virus has not shown changes or traits which would indicate it has learnt how to infect humans more efficiently. For a human pandemic to start, the H5N1 bird flu virus strain must learn how to transmit effectively from human-to-human - it must mutate. Tests indicate this has not happened.

An H5N1 infected person can infect another human if that human is in continuous, close physical contact. The eight family members who got sick all shared a tiny room - they slept together in this room. Most likely, say WHO scientists, one person got infected from a sick bird, and then transmitted to the other family members. It is important to stress that if human-to-human transmission in this family cluster took place it does not mean the virus has learnt to do anything new. It has always had the ability to pass from human-to-human in this kind of situation (close, continuous physical contact).

We know that many of the eight people who became infected had had been caring for their sick relative(s) in this small room.

Even though inspectors have combed the area where this family cluster lived for signs of sick birds, they have not found any. It is a calculated guess the source was from a sick bird. Not finding a source does not mean there wasn't one. In Indonesia there has been criticism that authorities respond very late to reports, and sometimes not at all. It is possible that when experts arrived to search for the source, that the sick chickens had been disposed of and the area cleaned.

This cluster of seven, or eight, is the largest one found so far. There have been some other smaller ones. Researchers have noticed that only blood relatives become infected in a cluster - not in laws or spouses. This suggests a genetic susceptibility. This may explain why there are hardly any reports of nurses and other health care professionals catching bird flu from sick patients - even though they have been in close, physical contact with them.

Roche, the makers of Tamiflu, have flown 9,500 treatment doses to Indonesia as a precautionary measure after person-to-person transmission was suspected. Protective gear was also flown out. A Roche spokesman said this measure is standard practice. If after two weeks it is clear that the human transmission stayed within that family of eight, then the Tamiflu doses will be flown back. Europe and USA have stockpiled an emergency supply of 3 million Tamiflu doses to combat human bird flu outbreaks in any part of the world where human transmission may be evolving.

Tamiflu is an antiviral, it is not a vaccine. It is effective if given to an infected patient early on during his/her illness.

Written by: Christian Nordqvist
Editor: Medical News Today


Copyright: Medical News Today
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