Additional H5N1 Clusters in Makassar Indonesia

Commentary

Additional H5N1 Clusters in Makassar Indonesia
Recombinomics Commentary 23:07
November 24, 2008

As of now, the city recorded that one resident has died of bird flu. The victim, Akirah, 14, resident of Jl. Maccini, Makassar, died in June 2006. The laboratory test of his blood and mucus specimens resulted in positive confirmation that he was infected by the H5N1 virus. The lab result was only disclosed three months after his death.

The above comments on the history of H5N1 cases in Makassar, Indonesia fail to note that the above case was part of a fatal cluster. The mother (56F) and brother (17M) of the confirmed case also died with bird flu symptoms, but they were not tested. These clusters begin to show the gross under-reporting due to a lack of testing, misdiagnosis, or false negatives. In 2006 there was also a large cluster in Makassar, as well as another cluster in 2005.

This long series of under-reported cases has now been impacted by flat denials of cases that have been lab confirmed, further depressing the number of confirmed cases.

However, the current cluster of 19 is among the largest, and reports of PCR lab confirmation of the first seven cases increases concerns that transmission of H5N1 to humans in Indonesia may be significantly more efficient than indicated by WHO situation updates, which document the WHO lack over oversight since H5N1 was confirmed in a human cluster in Indonesia in 2005.