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Paradigm Shift Intervention Monitoring
Cluster In Tanjung Priok North Jakarta Indonesia
Bird flu actually detected on her 5-year-old woman with the initials U.S. in Tanjung Priok, North Jakarta, Jakarta Province. This is confirmed by the Ministry of Health Directorate General of Disease Control and Environmental Health. New cases of H5N1 have also been confirmed by the Center for Basic Biomedical and Health Technology, Health Research Agency.
The above translation describes another fatal case (5F) in Tanjung Priok in North Jakarta who was the sister of a WHO confirmed case (23M who died January 7) who raised pigeons. The 9 day gap in dates of death raises concerns that the cluster was due to human to human transmission.
This Indonesian cluster follows a cluster in Bali, which involved a mother and her son and daughter. Those sequences which had multiple receptor binding domain changes (D187N, A188G, R193M) were released almost immediately, and release of sequences from this cluster would be useful.
These receptor binding domain chnages continues to increase concerns that the multiple chnages in circulation will recombine to produce combinations similar to those censored at Nature and Science which produced efficient transmission in a ferret model.