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Sumatra H5N1 Cluster Linked to Fertilizer?

Recombinomics Commentary

May 11, 2006

the Family that was killed it was suspected resulting from bird flu in the Karo Regency, North Sumatra (North Sumatra) evidently liked to work the soil. They often bought manure from Binjai and Langkat, the area that his poultry was stated positive affected avian influenza (AI).

The above comments suggest that the suspected cluster of H5N1 bird flu cases is linked to contaminated fertilizer.  However, although fertilizer may have led to infection of the index case, Praise br Ginting (40F aka Fuji Finting, 40M), who died May 4, there was a significant gap in the dates of death in other family members.  Her son Roy Karokaro (19M) died on May 9 and the aunt, Anta br Ginting (29F) died on May 10.

At least 4 family members remain hospitalized.  Boni Karakar (15 or 18M) is a brother who is in the most critical condition and is on a respirator.  Cousin Reneita Boru Ginting (1.5F) is also in critical condition.  Both are at RSU Adam.  Cousin Obvious Ulina Ginting (8) may be another name for Rafael Ginting (8 or 10) who has been transferred to RS Elizabeth, along with uncle Jones Ginting (25 or 35M).

The spread in age and disease onset dates suggest the index case infected the other family members, rather than all 7 or 8 being infected by contaminated fertilizer.  If H5N1was efficiently transmitted by fertilizer, the number of cases in North Sumatra, Binai. or Langkat would be higher.

The second H5N1 cluster in Indonesia was also said to linked to fertilizer last fall in Jakarta.  However, like the cluster in Sumatra, there was a significant time gap between disease onset in the index case (aunt) and family member (nephew), both of whom were H5N1 positive.  The aunt died and the nephew recovered after hospitalization with a mild case of influenza.

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