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H5N1 Bird Flu Confirmed in Tangerang Cluster
June 3, 2006
The nine-year-old boy died in the intensive care unit only an hour after being admitted, but was buried before the ministry could run blood tests.
The death of the two children could indicate the development of a new bird flu cluster, Health Minister Siti Fadilah Supari said Friday.
"The local test from the victim in Pamulang is bird flu positive. The symptoms of the virus are very similar to previous clusters we've had. The parents are also suffering from flu, and we are giving them a full dose of Tamiflu now," Siti said.
The family lived near a poultry slaughterhouse. after a week of caring for two siblings who were confirmed to have died of bird flu.
The above comments confirm H5N1 bird flu in the fatal cases in Pamulang, Tangerang and note that the parents have had flu symptoms and are taking Tamiflu. However, two younger siblings also have symptoms and have been hospitalized. If the additional four family members test positive for H5N1, they will represent the second largest cluster in Indonesia, following closely in time to the large cluster in north Sumatra which involved eight family members.
However, the H5N1 in the two clusters is likely to be distinct. The H5N1 in Sumatra has a wild type H5N1 cleavage site and is amantadine resistant. The human H5N1 in West Java, including Jakarta and surrounding regions, have almost exclusively had a novel cleavage site. The cases in West Java and surrounding are which have yielded human H5N1 with the novel cleavage site include Tanggamus in Lampung, Tangerang in Banten, Jakarta, and Bekasi, Bogar, Bandung, Indmaji, Depok, and Sumedang in West Java (see map), which account for the majority of the human cases in Indonesia.
The latest cluster in Tangerang may indicate that this version of H5N1 is causing both larger and more frequent clusters, which is cause for concern and highlights the need for immediate release of the sequences of these human isolates, which are currently password protected in a WHO private database.
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