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Lab Confirmed H5N1 Bird Flu Case in Lampung

Recombinomics Commentary

October 3, 2005

One from three patients who it was suspected were affected by the virus of birds flu, namely Hendriyansah (21) the citizen from the Binjai Village, the Show Subdistrict, the Tanggamus Regency, was stated positive was affected by birds flu. He that was treated since last September 26, was still receiving the maintenance and was placed in space of the Hospital isolation of Abdul Moeloek (RSUAM) Banda Lampung.

This matter was said by the Head of the Medical RSUAM Service Field, Dr Arif Effendi Sp. Heads of households in Banda Lampung, Monday (3/10). At this time the health service and the director RSAM were still waiting for results to be written of the laboratory in Hong Kong.

Wise said although positive was affected by the virus of birds flu, but the Hendriansyah condition increasingly improved from before. Despite this, further Wise, Hendriansyah continued to be given medicine antivirus Oseltamivir and the intensive medical service.

The above machine translation describes another lab confirmed H5N1 infection in Indonesia.  The number of confirmed cases in Jakarta is 10 (see Jakarta map)  and the total number of lab confirmed cases for Indonesia is now up to 13 (see Indonesia map).  Six of the 13 have died.  Most of the others however, are expected to recover raising the possibility that many of the patients that test negative and are released are actually false negatives.

Generating false negatives, especially in milder cases that may have a lower viral load, is not difficult.  The number of false negatives can be enhanced by limited sample collection.  The patients described in media reports are usually transferred to infectious disease hospitals.  Since the primary care facilities do npt collect samples for testing, the clinical samples tested may be collected too late.

Since there are reports of casual transmission, detection of human to human transmission may be missed.  The number of missed cases may be enhanced by protocols for transfer to the infectious disease hospitals.  Lately, most patients have been linked to dying poultry.  Mild cases linked to human-to-human transmission would probably not be transferred or tested.

Thus, the extent of H5N1 infections in humans in Indonesia remains largely unknown.  The potential silent transmissions are cause for concern, because efficient transmission of a mild H5N1 would be generally missed by the testing procedures being used in Indonesia.


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