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Suspect Sumatra H5N1 Cluster Raises Pandemic Concerns

Recombinomics Commentary

May 10, 2006

Last casualties who died were Ana Br Ginting, the woman was 29 years old, the citizen Street Veteran, Kabanjahe, the capital of the Karo Regency. He died around struck 05.00 WIB, during in the maintenance in the central Public Hospital (RSUP) Adam the Owner, Street Bungalow Medan.

Two casualties beforehand that died was Roy Karo-Karo, 19 years. He
Died on May 9 2006, now his mother Praise Br Ginting died last May 4. Both of them were expected strong terjangkit the bird flu virus.

Now casualties that still was treated at this time, numbering five people. Four people that was treated in isolation space of RSUP Adam the Owner, respectively Jones Ginting (25), Bonny Karo-karo (18) and Renaita Tarigan (1.8 years), as well as Obviously Ulina Ginting (8).

While Rafael Ginting, 8 years, was treated in RS Elisabeth, Street Imam Breakingprep Bonjol Medan.

The above detail on the suspected H5N1 bird flu fatalities raises additional pandmeic concerns.  The mother died on May 4 followed the death of her son on May 9 and another family member on May 10.  The delay of 5-10 days between the index case and family members is the hallmark of person-to-person transmission of H5N1.  In Indonesia, as many as 2/3 of cases are linked to family clusters and the vast majority of the clusters have the 5-10 day gap.

However, in the past familial clusters were smaller, generally invoving 2 or 3 people.  This cluster has 8 family members who have died or are hospitalized with bird flu symptoms, signaling a more efficient transmission of H5N1.

H5N1 has been present in Indonesia since 2003, but the first reported human cases were reported last year.  If the current cluster is positive for H5N1, they will be the largest cluster in Indonesia and the largest confirmed cluster if all test positive.

In any event, the large number of family members, ranging in age from 40 to 1.5 and the differences in onset dates suggests this cluster is cause for concern.

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