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H5N1 Suspected in Four Hospitalized Children in Jakarta

Recombinomics Commentary

September 19, 2005

Although there are many conflicting media reports, it seems that there are at least four children hospitalized who have tested positive for H5N1 and / or are suspect cases with symptoms.  If the conflicting descriptions conflict because more than one patient is being described, then the number of patients is higher.

The first case is a 6 or 7 year-old girl with the initials MT or MG.  She was first admitted to Siloam Gleneagles Hospital in Tangerang, and then transferred to Sulianto Saroso Infectious Diseases on September 14.  She is also from Tangerang.  She is H5N1 positive for antibody and her H5N1 negative PCR test is being re-tested.  She is still on a ventilator, but is stable.

The second case in the nephew of Rini Dina, the immigration worker who died on September 10 and was the second officially confirmed H5N1 case.  She lived in or near Tangerang.  The nephew is 8 or 9, has initials S or F and is also H5N1 positive.  He has been described as having no symptoms or the start of mild symptoms and his admission date to the infectious disease hospital has ranged from September 13 to not yet admitted to Sulianto Saroso.

The third case is a 3 year-old girl named Rosani Ningsih.  She was admitted to Sulianto Saroso on September 18 and is serious condition.

The fourth case is an 18 month-old patient also admitted to Sulianto Saroso on September 18, and also in serious condition.

In addition to the four cases described above, a 2 month old boy named Livo Russtini died on or about September 6 from pneumonia.  He had bird flu symptoms and lived above a chicken slaughterhouse, which may have been the slaughterhouse 100 meters from Rini Dina's house.

There are also the three fatalities in the family of the auditor (38M).  The auditor is the only confirmed cases in the family cluster.  The index case, his 8 year-old daughter, was twice positive for H5N1 antibodies.  The two samples were collected 3 days apart so the increase in titer did not rise 4 fold, so she was designated a probable H5N1 case.  Her 1 year-old sister died quickly and only one serum sample was collected.  The disease onset dates of June 24, June 29, and July 2 suggest the index case infected her 1 year-old sister and the father was infected by one of his daughters.  All three died within a few days of each other and all had bird flu symptoms.  They also lived in Tangerang and all were treated at Siloam Gleneagles Hospital.

In addition, two zoo workers have tested positive for H5N1, as have 19 exotic birds at the Ragunan Zoo in Jakarta.  Four additional birds returned inconclusive results.  Only four of 27 birds were H5N1 negative.


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