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Efficient Transmission of H5N1 to Karo Cluster Members

Recombinomics Commentary

May 15, 2006

Praise br Ginting experienced was sick to last April 27 2006, with the sign of the continuous high fever to the temperature of his body reached 390 C was accompanied by coughs.

The midwife the Village, Spoilt br Karo that was assigned in this village to be accompanied by the Sub-district Head three bows Drs could we Sinulingga, to the reporter, on Tuesday afternoon (9/5) said that himself could treat casualties several days in Pustu (the auxiliary Community Health Centre), afterwards saw his condition that did not improve then was reconciled to RSU Kabanjahe. Spoilt added, casualties died to last May 3 2006.

Added Spoilt, second casualties Roy Karo-Karo that also the son of the uterus from Praise br Ginting after his mother died last May 3, also fell ill, afterwards immediately was reconciled to RSU Kabanjahe. Because of the illness that was suffered by him almost be the same as that was experienced by his mother, afterwards was reconciled to RS Adam the Owner, Medan. However, after several days were treated in Medan, finally Roy also died in RS Adam the Owner on May 9 2006.

The above translation of the initial symptoms in members of the H5N1 cluster from Karo points toward human-to-human transmission.  Most of the H5N1 bird flu clusters described to date have a 5-10 day gap in disease onset dates between the index case and other family members.  The dates above indicate that the index case developed symptoms on April 27, 2006 and her oldest son became ill around the time of her death.  That was followed by symptoms developing the other family members.  Six of the eight have now died and the remaining two are hospitalized at Adam Malik or Elizabeth hospitals in Medan in North Sumatra.  The dates of death for the other family members were May 10, 12, 13, 14.

The cluster is the largest reported to date in Indonesia. The efficient transfer of H5N1 from the mother to seven other family members is cause for concern.

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