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Nurse Hospitalized With H5N1 Bird Flu Symptoms in Bandung

Recombinomics Commentary

June 2, 2006

A 25-year old nurse identified by her initials as `Ci` is currently being treated at the Hasan Sadikin Hospital here for bird flu-like symptoms.

"We could not confirm whether she is positive of having been infected by avian influenza virus or not, although she had earlier have contacts with siblings, 18-year old Ad and 10-year old Ai, who died of bird flu virus recently," he said.

The ailing nurse has never had contact with poultry, but she had treated the sibling when being treated at Ujungberung Hospital, where Ci works as a nurse.

The above description of a nurse with H5N1 bird flu symptoms is cause for concern because of the link to two confirmed fatal H5n1 cases.  However, since the temperature of the nurse has begun to fall, the symptoms may be coincidental.  However, the milder symptoms may simply reflect a milder case.

The second confirmed case in Indonesia was fatal, yet her nephew had a mild case of H5N1 and quickly recovered.  Milder cases of H5N1 in Indonesia would be easily missed, because most testing for H5N1 is on patients who have been transferred to an infectious disease hospital, and if they recover at the primary care facility, they are not tested for H5N1.  Similarly, most H5N1 testing in Indonesia requires an association with dead or dying poultry, although the sequence of the H5N1 from patients in West Jakarta, including Bandung, do not match reported sequences of H5N1 from poultry.

H5N1 in a health care worker would be cause for concern. One nurse in Vietnam was H5N1 confirmed which was linked to an H5N1 confirmed patient, but a firm link has not been confirmed in Indonesia.

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