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13th Fatal H5N1 Bird Flu Case Recorded in Jakarta

Recombinomics Commentary

October 3, 2005

Sudarmaji (68), the sufferer Suspect Birds flu had finally blown out the last breath in RSPI Sulianti Saroso. The owner of the poultry farm in Bogor died on Sunday October 2 struck 09.20 WIB.

The "big possibility because" Pneumonia Heavy (the acute lungs) that was suffered by him. But the treatment of his body same like the patient, the Information headword and Surveillance KLB of birds flu RSPI Sulianti Saroso birds Flu in his office, Street Sunter Baru, Jakarta, Monday (3/10/2005).

Sudarmaji was treated in RSPI since September 30. He was expected suffered Suspect Birds flu after experienced hot high and breathless during two days were endless.

The inhabitants of North III Bamboo, the Brother's Land, of Petamburan had the poultry farm in Bogor. He normally views his kept chicken a week very much. Apart from having livestock breeding, Sudarmaji also a heavy smoker.

The machine translation above describes the latest suspected bird flu fatality.  The death raises the number of suspected fatalities in Jakarta to 9 (see Jakarta map) and the number of suspected H5N1 bird flu fatalities in Indonesia to 13 (see Indonesia map).

These fatalities are difficult to confirm because there is no sample collection at the primary facility, and collection of nose and throat samples at the infectious disease hospital may be made after the virus has moved to the lungs.  Collection of  lung tissues at autopsy could resolve the cause of death, but there have few autopsy reports, which may be limited because of religious prohibitions.

The number of lab confirmed cases is slowly increasing and some of the cases recover and have milder symptoms.  It is not clear if age and smoking history contributed to the fatal outcome in the latest case, but host factors may play a role.  Although all three members of the initial familial clustered died, in the second cluster, the aunt died but her nephew had a relatively mild case and has been discharged and has returned to school.  Since both were PCR confirmed, and it is likely that the aunt infected her nephew, host factors or dosage may have produced the dramatically different outcome.

Similarly, the Ragunan zoo visitors have had relatively mild cases also, although a few have tested positive for H5N1 antibodies.

The steady stream of new patients referred to the infectious disease hospitals indicates that infections are widespread and ongoing.

A more aggressive sample collection protocol may identify additional lab confirmed cases, and more sequence data from pigs and poultry would help determine how the H5N1 is evolving in Indonesia and also which isolates do and do not have amantadine resistance markers in M2.


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