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Third H5N1 Confirmed Case in Western Java This Week

Recombinomics Commentary

August 12, 2006

An Indonesian teenager has tested positive for bird flu according to local tests and is being treated in hospital, a senior health ministry official said on Saturday.

It was not clear if the 17-year-old youth from West Java had contact with sick fowl

The teenager's swab samples will only be sent to a World Health Organisation-accredited laboratory if the health ministry thinks the specimens need further testing.

According to the WHO, if two independent local laboratories return positive results from human samples, then the case is considered definitive.

The above comments describe the third confirmed H5N1 bird flu case in Indonesia this week.  The first case was from Bekasi and died on August 7.  The second case was from Tangerang and died August 8.  The above case is from the West Java regency of Garut.

H5N1 cases from these areas have been common in 2006 and all cases have a novel sequences not found in H5n1 from poultry from Indonesia.  Additional recent samples have been sent to Australia for testing, but matches with these samples are also unlikely.

The cases in the western portion of Java continue to mount, and H5N1 from these patients continue to evolve away from the H5N1 sequences in Indonesia.

More aggressive sequencing is required to determine the course of the human infections and to monitor the genetic changes, which will be necessary from effective vaccine targeting.

New H5N1 cases are also being reported in Thailand, Laos, Vietnam, and Cambodia.  The H5N1 in Indonesia have sequences in common with Clade 1 isolates from southeast Asia.  However, recent sequences from Hong Kong as well as earlier sequences from Laos and Malaysia indicate the Clade 2 Fujian strain of H5N1 has moved into Southeast Asia.  This strain has been found in all reported human H5N1 cases from China in 2005 and 2006.

Sequence data from all of these isolates would be useful.

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