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Confirmed H5N1 Case in Bandung Indonesia
October 11, 2006
"A 67-year-old woman living in the Cisarua area of Bandung had contact with fowl," the official from the bird flu information centre said by telephone. The woman was admitted to the hospital on Oct. 7 and was still alive, the official added.
The woman tested positive to the H5N1 virus after a test at a health ministry laboratory and one conducted by NAMRU, the U.S. Naval Medical Research Unit based in Jakarta, the official added.
Hadi Yusuf, the director of the Hasan Sadikin hospital in Bandung, southeast of the capital Jakarta, said the woman was being treated with the anti-viral drug Tamiflu and antibiotics.
"Her condition is bad. For a second day, she has been on a respirator and her blood pressure is high."
Yusuf said the woman had come down with a fever two weeks after being in the vicinity of dead chickens.
The above description confirms H5N1 bird flu in an elderly patient (67F) from the Bandung area. There is also evidence for neurological involvement, which is unusual for cases in Indonesia. Similarly, the patient is markedly older than most cases in Indonesia. The sole survivor from the infection in Karo also had neurological complications, but those problems may have been due to a secondary bacterial infection.
It remains unclear if the infection in the older patient with neurological complications represents a new H5N1 strain in the Bandung area. A large number of patients in the area have been hospitalized with symptoms, but most tested negative for H5N1 and recovered after Tamiflu treatment.
Although poultry was dying in the vicinity, to date all reported patients from Bandung have been infected with H5N1 with a novel cleavage site and additional markers that did not match the H5N1 in poultry on Java. The only bird isolate on Java with the novel cleavage site was from a duck on Indramayu and matched a small subset of patients from 2005. All of the more recent isolates were readily distinguished from the H5N1 from the duck in Indramayu.
Recent reports from Indonesia have described H5N1 in cats. H5N1 from a kitten in the Indramayu is the only match for the vast majority of the human H5N1 isolates.