Indon bird flu case: consider the source

The report of another bird flu death from Indonesia wouldn't seem to be "news." In a way, the fact it isn't "news" is news but we'll put that aside for the moment. Another thing about the story that isn't news is that the victim is a young person from the city of Jakarta, not a resident from a poor rural household living cheek by jowl with poultry:

The Health Ministry has confirmed that a West Jakarta shop attendant died of the bird flu Friday, increasing the country's human death toll from the virus to 86.

Ministry spokeswoman Lily Sulistyawati said test results for the latest bird flu victim, AR, were released Monday.

Indonesia has the highest number of human bird flu infections in the world, at 107.

The latest victim, 21-year-old AR, was admitted to Sumber Waras Hospital, West Jakarta on Sept. 25 with respiratory problems. Two days later he was moved to the intensive care unit.

"AR spent a week at home before being admitted to the hospital because the onset of the infection is like a common cold. His respiratory problems began on Sept. 18.

"He must have been in a bad condition when he was eventually hospitalized," Lily said.

Of the country's 86 human fatalities, 26 have been from Greater Jakarta.

It is believed AR caught the H5N1 virus from infected poultry.

Officials from the Health Ministry and the Agriculture Ministry were immediately deployed to AR's neighborhood in Basmol housing complex, Rawa Buaya, West Jakarta, to conduct blood tests on AR's immediate family members and neighbors and to search for infected poultry.

"AR was a shop attendant and did not keep chickens in his backyard. There was such a small risk of him contracting the bird flu but our team is now checking the neighborhood for the source of the virus," the official said. (Jakarta Post)

The Indonesian officials believe "AR caught the H5N1 virus from infected poultry." Why? Because they always believe that. They don't want to talk about or contemplate the alternative that there is either another reservoir or AR got the disease from another person (the Indonesians have denied this has ever happened, scientific evidence to the contrary). So they will hunt around the neighborhood until they find some backyard poultry or a market or some other source they can blame the infection on. They might even be right.

But I sure don't count on the Indonesian authorities to be independent, objective and dispassionate observers.

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Revere - have seen your postings before and they interesting and information. May have even quote you a few times. After a recent almost news black out on Avian and Ebola - it would seem the presses are beginning to role again and keeping an eye on the Jakarta Post - where in parts we have an 80% CFR (case fatality rate) is a must do. Whenever it starts to trickle into other countries red flags go up, but we seem to get used to a steady persistent stream of Avian deaths from Indonesia and Southeast Asia.

IMHO no way are these figures accurate in terms of number of cases. It has been documented that many more cases of Dengue Fever and pneumonia are often labeled the culprit when the proper tests are not run. We now have a 30 minute test in Vietnam to identify Avian.

Good luck on your site - you are coming up several tickers - so you are being read.

Medclinician

"Within five months, a family from Rawa Buaya subdistrict in West Jakarta lost two children to what was diagnosed as typhoid fever by doctors at the Sumber Waras Hospital.
AR, 22, died last Friday after suffering from high fever, headaches and respiratory problems. His 19-year-old sister died after suffering similar symptoms in April.
However, on Monday the Health Ministry confirmed that the cause of both deaths was avian influenza." (Kompas Indonesia).

So how come we hear about Abdul Rozak's sister dying from bird flu at the moment of his death, rather than at the moment of her death in April? As if they didn't now?

I have a friend named Fardah on the ground in Indon. He works for a communications branch of the government. He says that there are a lot of cases and that they really dont know what they are in some, but they do in others. Each island is made up of districts and each one has a doc in charge. Many of them are run like little fiefdoms and they are very hard to remove when they make a mistake. Add in that communications in some areas is less than what we had in the US at the turn of the century in the west and you have the info stream we have now.

Its a good point about Rozak and his sister. You wont ever likely get an answer. Andrew J. is down there I believe still and has been for years. He could elaborate for weeks I am sure.

Besides oil and a couple of other products, the Indons only have tourism to support their economy. The thing up in Banda Aceh absolutely devastated them. Add in a couple of quakes, a couple of volcano's and one big time incompetent government that has tried and succeeded in forcing its way onto the WHO board and you have the recipe for disaster. They wouldnt acknowledge that BF was out and running until had taken at least one large cluster, then they would say it was contained.

If it does break out in a large and ugly way it will likely bring their government down completely.

By M. Randolph Kruger (not verified) on 03 Oct 2007 #permalink

Just our luck, a great source of info has been removed. Enjoyed Andrews comments for several years about Indon.

By M. Randolph Kruger (not verified) on 03 Oct 2007 #permalink