Commentary
Suspect
H5N1 Cluster in Riau Indonesia
Recombinomics Commentary
12:54
April 2, 2009
the deceased parents at this time, Haryono (42) experience symptoms of heat illness with fever fell dizzy.
Tumirah (59) and Kadiran (67) who is deceased grandfather and grandmother also experienced symptoms of high fever and fell dizzy heat. Both also have had intensive treatment in hospitals Arifin Achmad.
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Rini Hermiyati of the Pekanbaru Health Office said she had assigned a team to observe the health condition of the victim's family members and at the same time make an inventory of neighbors who were in contact with the victim.
"No one has been found with symptoms of bird flu, but those having contact with the victims will be closely watched out for 21 days," Rini said.
The above translation and comments present two very different views of the relatives of the lab confirmed fatal H5N1 infection of a toddler (3M) in Riau (see updated map). The local media notes that the father and two grandparents have had symptoms and have been hospitalized, and the father remains hospitalized. In contrast, the Jakarta Post states that no one has been found with "symptoms of bird flu", suggesting a very narrow definition is being use to make the claim.
This cluster is very similar to other clusters in Indonesia which involve lab confirmed fatal cases. In several instances relatives of the confirmed case died earlier, but were never tested. In other cases, relatives developed symptoms but recovered after treatment with Tamiflu, and were said to be H5N1 negative. In other instances, the earlier contacts were said to have died of other diseases that are associated with bird flu symptoms, such as lung inflammation, thyphus, or dengue fever.
These clusters in Indonesia continue to cause concern. Reporting of confirmed cases by WHO has ceased, as has the flow of sequence data from poultry or patients, even though Indonesia has reported the highest number of fatalities and the case fatality rate remains at 80%.
The inability of WHO to exercise oversight remains a hazard to the world's health.
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