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Suspected H5N1 Cases in Jakarta Indonesian Children

Recombinomics Commentary

September 19, 2005

News reports quoted Santoso Suroso, director of the Sulianti Saroso Infectious Disease Hospital, as saying that two children, aged 18 months and 3, were admitted to the hospital in North Jakarta late Sunday.

The number of children hospitalized with bird flu symptoms continues to grow.  There appear to be at least four children hospitalized, but the number of suspect cases may be as high as six.  At least two have tested positive for H5N1 and those samples have been sent to Hong Kong for confirmation.

One victim, 8 years of age, is a relative of Rini Dina (37F) who died and was H5N1 positive based on a PCR test.  It remains unclear if the 8 year old, who has since developed symptoms, is among those listed as patients in the Sulianti Saroso Infectious disease hospital.

Another victim, age 6 (initials MT), is also listed as positive in lab tests.  That patient was originally admitted to Siloam Gleanegles hospital in Tangerang and then transferred to the infectious disease hospital.

In addition to the two patients above, there are 2-3 additional patients at the hospital.  One is 3 years of age and another is 18 month.  Earlier reports had indicated there were three patients at the hospital, so the total appears to be 4-5 as of Sunday evening.

Another death, a 2 month old child who died of pneumonia and lived above a chicken slaughterhouse is under investigation.

The above cases are in addition to the 8 year old index case of the auditor's family cluster, and her 1 year old sister.

Thus, the number of confirmed or suspected children infected with H5N1 in the Jakarta area is between 7 and 9, which is in addition to the two adults who were PCR confirmed to be H5N1 infected.  The two unrelated adults were government office emplyees and were related to at least 3 of the children described above.

It is unclear why H5N1 cases have been concentrated among children, or why the two adults have been government office workers.  Many of the cases are known to be from the Tangerang region southwest of downtown Jakarta.  It remains unclear if any of these cases are linked to the H5N1 confirmed infections in the Rangunan Zoo or the pet birdcage across the street from two of the victims.  However 3 of the children have died as have two adults, which is the highest concentration of H5N1 fatalities recorded.  None of the children have been discharged and most have been recently admitted to the hospital, so the case fatality rate may be very high, since 5 have already died.

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