Out of China, on 2/16/09....
National Chief Veterinary Officer in Kangzhen, the Ministry of Health deputy director of the office of emergency and Yang Dong-ming, director of the National Influenza Center on Human infection of highly pathogenic avian influenza prevention and control work-related questions to answer users questions. In response to questions raised by netizens on Kangzhen express highly pathogenic avian influenza incubation period of greater change.
The incubation period of avian influenza, generally recognized international or a week, but volatility is still relatively large. Some infections, like a few hours, more than a dozen hours or even days will be the incidence. Some can go a long ten days, or even 20 days before onset. The international community in order to facilitate the highly pathogenic avian influenza prevention and control, it provided a longer incubation period, because the back of the protective measures are based on the incubation period to decide...Therefore the provisions of the international community are 21 days, after 21 days if there is no outbreak, as evidenced by the elimination of the epidemic was lost. [http://tinyurl.com/bc9umo]
On February 18, 2009, we hear of this from Senior author Leonard Mermel, DO, ScM, medical director of the department of epidemiology and infection control at Rhode Island Hospital, along with Eleni Patrozou, MD:
Mermel says, “Our findings indicate that pre-symptomatic transmission of influenza has been inferred based on the presence of the virus in the upper respiratory tract rather than from the appropriate transmission experiments. This is troubling because our review of the literature does not support significant influenza transmission based on positive nasopharyngeal cultures in the absence of symptoms.”...Mermel adds, “Asymptomatic individuals may shed influenza virus, but studies have not conclusively determined if these individuals effectively transmit influenza to others. Our review of the literature suggests that the role of asymptomatic or pre-symptomatic influenza-infected individuals in disease transmission may have been overestimated in recent articles that have served as the basis for national and international pandemic planning.” [http://tinyurl.com/cgnnuq]
Now, for some musings on the current situation in Indonesia.
Bekasi is not doing very well.....we had a suspected cluster on 2/14, involving 3 families, all tested negative, currently we have Andriansyah, dod: 2/28, and because the victim was in numerous facilities, we have 33 people being observed...
Total 33 residents of Kampung Sukamantri...These people are known to have close (less than 1 meter distance) contact...“Monitoring will be done during 17 days or two times incubation period since Ardiansyah casualty. The purpose is to prevent transmission of avian influenza H5N1 virus from bird to human or human to human”, says Heru Hermawan, team member of Bird Flu Eradication Kabupaten Bekasi. [Birdflucorner.wordpress.com]
That worries me. We currently have Doctors, that treated a suspected case, being thrown on tamiflu, and continuing to practice.
March 2nd: The head of the Service of Medis Rumah Sakit Annisa Kabupaten Bekasi, Dr Rina, said two doctors and an official who were taken the sample of his blood was still going to work. They also did not suffer the sign was sick the high fever, the cough and breathless. [http://tinyurl.com/aaxo5h]
Depok, the recent case, Nurliga Mahmuda (5), dod: 2/28, is another concern. The family has been tested, and there is a command post set up. The Major recently spoke...
Nur Mahmadi Isma’il: “the indication of an illness occasionally had the characteristics of the resemblance so as to need the further research to ascertain him”...”the patient suspect bird flu that died indeed must was treated like bird flu casualties to prevent the spread.” [http://tinyurl.com/ct8mqy]Then, there is Bogor
Feb. 25th:
District Surveillance Officers (DSO) or the official surveilans the city.Feb. 20th:
Dwi Susanto: "Every time had the report" on the "death" of the "poultry that it was suspected was infected by AI, then we also at once carried out epidemiology investigation". [http://tinyurl.com/bnld2s]
From Kabid P3Kl Dinkes City of Bogor, Sri Pinantari:
"Furthermore, the control will be more strict time limit to three months"..."If there is H5N1-positive birds will be of 100-300 meters far as to investigate what people are experiencing symptoms of flu that is not normal"..."Now this is the distribution to the three levels, namely poultry to human transmission. Here we try to prevent the spread does not go to the next stage of transmission of the human to human"..."To prevent direct contact of poultry is a suspect bird flu, according to him, the officer will diperisai tool pelidung and self-medication tamiflu if needed. "In our Dinkes has 160 cadres that have been built and trained to assist our officers in the various villages"...[http://tinyurl.com/brxhpc]
Jakarta is ready though....
Head of Health Office of Jakarta, Ernawati Dien:
“... his side has spread thousands of Tamiflu-bird-flu drug overlooks village level health centers in the se-Jakarta...if there are suspect cases of bird flu, the procedure has a fixed (protap) standards for conducting investigations. "The investigation comes from the range and Dinkes Disnak. Insya Allah, we are ready" [http://tinyurl.com/dhbdeu]
Yet, their actions do tell me they are worried.....
East Java (Sutini, dod: 1/24, confirmed)
February 24th....A doctor and 4 paramedics of Dr Sutomo hospital Surabaya are quarantined....
...Surabaya were quarantined due to bird flu-like symptoms on early February. This is right after one Surabaya bird flu victim (St/18) was treated in that hospital. Further test revealed that the doctor and one of paramedic tested negative bird flu infection. Up to last Sunday (22/2), three other paramedics are still in critical condition. [http://birdflucorner.wordpress.com]
In Central Java, 60 birds die, and they give direct examinations to residents in two hamlets, to anticipate the possibility of cases in humans.
Wonogiri, Feb. 20th -
...This time, at least an 60-tails in the village poultry NGADIREJO District Eromoko since died suddenly on Tuesday (17 / 2) and up to yesterday.
"On the findings that we make a direct examination of all residents in the two hamlets, Nglengkong and Siyono," explains Head of Animal Health Animal Husbandry, Fisheries and Marine Wonogiri Ismaryati Budiningsih, yesterday. He explained, the examination is conducted to anticipate the possibility of cases in humans. According to him, all the residents in the area around the index case has been ordered to be examined... [broken link]
Also, in Rembang, we had a suspect that tested negative, AR (4). But they monitored three villages. They say the incubation period is 21 days, tight supervision will be applied to anticipate spread to man.
Feb. 24th:
Kesehatan Service of the Regency (ET AL) Rembang. Kepala DKK Sutejo...his side continued to monitor three villages...”Masa the incubation of the bird flu virus 21 days. Therefore, three villages still in the tight supervision to anticipate the spread of the virus to manusia,” he explained. [http://tinyurl.com/cwnmy8]
We have heard from the Indonesian authorities....but their voice does not reassure me. Here’s a few quotes...
Feb. 25th:
Up to the middle of January 2009, according to the Department's data of the Health, the spread of bird flu was still coming from the poultry to humankind. Not from humankind to humankind. The proof is, the specimen inspection of all case contact showed the negative. [http://tinyurl.com/d78jjw]
Another from the 25th of February:
Chairman of the Executive Committee of the National Bird Flu Control and Preparedness for pandemic influenza, said Bayu Krisnamurti, mutation virus bird flu (avian influenza) has not occurred in Indonesia.
"Hopefully will not happen, has happened is that the virus found in birds such as the outside cats, dogs and pigs in different regions, and that is already there since two years ago," he said on the sidelines simulated bird flu response in Yogyakarta on Wednesday, (25 / 2). [broken link]
On February 18th, there’s this:
Drh Mustafa Kasie Peternakan Kota Banda Aceh: Said he this virus was afterwards found also could spread to the other species like the pig, the cat, the dog, the tiger, and humankind. "This just the first time happened in this year, but last year (2008) had the official found 14 points, said Mustafa...At this time Mustafa words of a team hunted serga bird flu that was named Parsipatory Disease Surverlance Respon (PDSR)......
Virus bird flu that was contagious at this time was the sub-type H5N1 that had incubation time for 3-5 days...This virus could spread through air or contact through food, the drink, and the touch. [http://tinyurl.com/bwosmd]
In South Sulawesi, Makassar, we have Fadillah (7), adm: 2/28. They talk of dogs spreading the virus, because Fadillah’s family did not own poultry...
The victim does not have their own poultry...''events that are separated only Hasanuddin village. Likely to have a dog eating the dead birds have been destroyed. We estimate such as that, because the distance is very close, only one village diantarai's previous location,''...[http://tinyurl.com/dcaf2e]
Speaking of dogs....if you go to Bali, be careful....and don’t wait for a travel alert from any of the Gov’t officials...
Feb. 25th
Denpassar Animal Husbandry and Maritime Affairs Agency:
the agency was concerned with the fact that Denpasar was still officially under threat from both bird flu and rabies.
Dewa Made Ngurah: "Nobody wants this to happen. We have done all we can, but there are still outbreaks" [http://tinyurl.com/bptevk]
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