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Baby of H5N1 Ragunan Zoo Visitor Admitted in Jakarta

Recombinomics Commentary

September 29, 2005

In the meantime, from 10 patients who had results of birds flu of the negative of Department of Health Research And Development just eight patients that was permitted to come home. Two patients were still being observed by his clinical situation, namely the Woman Erwin Mugirahayu, and Dodi.

Up until today, came two new patients that is, Suki (1 year 2 months), the child the Woman Erwin the Well-being, that experienced the hot and breathless sign.

The above machine translation indicates that the baby of an admitted H5N1 patient was just admitted as his mother was about to be discharged.  The large spread between onset dates suggests more human-to-human transmission by a zoo visitor with mild symptoms.

The mother, Nyona Erwin Mugirahaya, had visited Ragunan Zoo on the Sunday before it closed.  She was initially admitted to RS Hermina and then transferred to RS Suliani Saroso on September 22.  Discharge was scheduled for today, but as noted above, the discharge was delayed.

On the evening of September 28, her 14 month old son, Muhammad Subhi Ariq, was admitted with fever and shortness of breath.

This transmission chain is cause for concern.  The family lives in Plumpang Rawabadsk in Northern Jakarta and the mother appears to have been infected at the zoo.  The symptoms in her son suggest he was infected by his mother or another family member, since the zoo has been closed since September 19.

Infection of two family members via casual contact is cause for concern.  The extended transmission chain suggests ongoing transmission of H5N1 bird flu in humans is on the rise.

In Demak, Central Java there is another extended transmission chain in a family.  Two children have already died and a third has bird flu symptoms.  Demak is near Semarang, where H5N1 has also been detected in the zoo there (see Indonesia map).  Semarang is now forming another cluster, providing additional evidence that the pandemic in Indonesia has now moved to phase 5 as clusters get larger and begin to form clusters of clusters (see Jakarta map).

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