Indonesia Commentary: 7 Deaths as of May 1st. 1 confirmed source of infection.

Today I'll talk about the 7 deaths thus far in 2012 in Indonesia. I am not going to provide the links within this blog to the cases. They have all been reported here in H5N1 Pandemic Information News.

Out of the 7 deaths so far this year, 1 may have a source of infection.

That 1 case that has a definite source of infection would be the 17 year old out of Nussa Tenggara Barat Province that died on March 9th.

From the WHO Update:

Epidemiological investigation conducted by a team from the health office indicated that there were sudden poultry die-offs in his neighbourhood. http://www.who.int/csr/don/2012_03_26/en/index.html

The victim, Puguh Dwi Yanto (23) out of Jakarta, raised pigeons. Puguh Dwi Yanto's neice, also contracted bird flu, was confirmed, and died. Below, the reference to "US 5" refers to Adra Soraya Ramadani (5).

The WHO update speaks of this, but does not specifically say whether any of the pigeons were infected. I would think if they were infected, the WHO update would have said so.

An epidemiological investigation conducted by the Ministry of Health and local health officers indicated that he raised pigeons, and there was a sick pigeon he nursed that subsequently died.....http://www.who.int/csr/don/2012_01_11/en/index.html

The WHO update for the niece, also mentions the contact with pigeons, but fails to mention whether said pigeons were infected:

Epidemiological investigation indicated that she was a family contact of case 183, and frequently had direct contact with the same pigeons as that case, and the same household environment...http://www.who.int/csr/don/2012_01_19/en/index.html

From the Dir. General of Animal Husbandry and Animal Health Ministry of Agriculture [http://tinyurl.com/8a9s8rz]

Excerpt from link:

C. The development of AI in Poultry Situation in Jakarta
In connection with the case of the victims died due to AI's PD (23) and U.S. (5) in the Great Sunter - North Jakarta, so we report this with action steps to control Avian Influenza (AI) in poultry has been, is and will be as follows:
1. Based on the identification of risk factors for transmission of avian influenza that:

a. Local / residential neighborhood of AI patients are less hygienic, some residents of surrounding communities still maintain the yard al chicken fowl, wild duck and pigeon racing. PD victim has a history of contact with his racing pigeons.

b. The day before (Saturday) there is a tail of a dead chicken's neighbor the victim with a radius of about 50 meters. chicken carcass was immediately buried by the owner. So when Tim came not obtain samples from dead birds.

2. Surveillance tracking cases of AI in poultry in the vicinity of the victim that the results of laboratory examination of 53 specimens from poultry samples and 31 samples from environmental specimens negative results against H5N1 AI virus.

Another confirmed case, that does not have a source of infection is the 19 year old out of Banten Province. The onset for her was February 8th. She was dead on the 13th. 5 days later. No source of infection was found.

Epidemiological investigation is ongoing by the Ministries of Health and Agriculture.

http://www.who.int/csr/don/2012_02_21/en/index.html

In March, we have a confirmed case and death out of Bandung Bali. A 12 year old. Much like the case we reported on last week, 4/25/12, there was no signs of infected or dead poultry in the area.

The March confirmation, from WHO:

Epidemiological investigation into the source of infection indicated contact with poultry, though no poultry deaths within the household or neighborhood have been reported. The risk factors are still under investigation....http://www.who.int/csr/don/2012_03_01/en/index.html

Death from 4/25/12, Ni Nengah Puspasari (8):

Oh. Wait. We have a bit of a snag. It seems that this case was confirmed in a lab in Sanglah as positive. But...it was confirmed in the lab in Jakarta as negative. So this case will not be counted. It's just as well, because there was absolutely no history of any contact with poultry. This life was cut short, and Ni Nengah got sick on the 21st of April, and was dead on the 24th. 4 days later.

Also in March, we have a 24 year old, Female, from Bengkulu Province. She died 8 days after onset. The source has not been confirmed.

Epidemiological investigation conducted by a team of public health and animal health authorities indicated an exposure to a potentially contaminated environment where sudden deaths of poultry had recently occurred...http://www.who.int/csr/don/2012_03_12b/en/index.html

The 7th confirmed death this year also has no contact with sick/dying poultry, and they can not confirm infected poultry in the proximity of the victim.

From the Ministry of Health in Indonesia:

MAY 1, 2012

Epidemiological investigations have been carried into the homes of people and the environment by the local health office team, acquired risk factors, namely the possibility of contact with poultry (quail eggs) for the case of parents selling quail eggs. ...http://tinyurl.com/6lpth8s

7 Deaths as of May 1st. 1 confirmed source of infection.