Avian influenza, human (145) - Indonesia

International Society for Infectious Diseases
<http://www.isid.org>

Source: Reuters Alertnet [edited]
< http://www.alertnet.org/thenews/newsdesk/L14723621.htm>

The World Health Organisation (WHO) on Thursday retrospectively
recognised a further 2 cases of bird flu in Indonesia, including one
where human-to-human transmission could not be ruled out between siblings.

The United Nations agency said that fresh results had shown that a
27-year-old from West Sumatra province, who cared for his 15-year-old
sister in hospital last May [2006], had also been infected with the
H5N1 virus despite initially testing negative.

"The 27-year-old male reported no contact with diseased or dead
poultry in the days prior to symptom onset as he spent most of his
time at the hospital," the WHO said in a statement. "The
investigation determined that he had exposure to his sister during
her hospital stay and that human-to-human transmission could not be
ruled out as the source of his infection," it said. Both brother and
sister recovered. The WHO also accepted that a 5-year-old boy, who
died last March [2006] in Jakarta, had died of bird flu after being
exposed to diseased poultry.

Indonesian health authorities announced the case on Wednesday, citing
fresh test results.

The retrospectively confirmed bird flu cases -- which follow 3 others
announced last Friday -- bring the total in Indonesia to 65,
including 49 fatalities, according to the WHO. The national death
toll is the world's highest from the disease which affects mainly
animals [birds] but which experts fear could mutate into a pandemic
strain capable of killing millions of people.

Although human-to-human transmission is not conclusive in this
instance, the circumstantial evidence is, nonetheless, of
concern. It will be interesting to find out if there is any evidence
of secondary transmission to others in contact with the male patient,
or to the health care workers or other family members in contact with
the girl. ProMED thanks A-Lan Banks, Marianne Hopp and Joseph Dudley
for sending similar reports.

A map of Indonesia can be accessed
at:
< http://www.lib.utexas.edu/maps/middle_east_and_asia/indonesia_pol_2002.jpg>