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Paradigm Shift Intervention Monitoring
H5N1 Cluster In North Jakarta
ASR, 5, from Tanjung Priok in North Jakarta, died on Monday after receiving treatment at the Persahabatan hospital in East Jakarta since Jan. 10, the Health Ministry announced on Thursday.
The above comments from the Indonesia Health Ministry confirm the H5N1 cluster in North Jakarta. The spead in the dates of death strongly suggest human to human transmission between the siblings and increases concerns that the receptor binding domain changes in the Bali cluster are generating increased transmission efficiencies. These concerns have been increased by the recent release of H5N1 sequences from fatal cases in Cambodia, which include HA S227N and PB2 E627K. These two changes are strong candidates for two of the five changes described in the censored papers at Nature and Science and raise concerns that the close proximity of these changes and the sharing of such changes between clade 1 isolates in southeast Asia and clade 2.1 isolates in Indonesia demonstrate the distinct possibility of additional recombination between these sub-clade.
Indonesia promptly released sequences from two of the three cluster members in Bali. Release of sequences from the cluster in North Jakarta would be useful
The clusters in Indonesia bracket the H5N1 clusters in Egypt, which highlight the need for the immediate publication of the receptor binding domain changes described in the censored papers at Nature and Science. The censorship of these important papers continue to be hazardous to the world’s health.