Suspect H5N1 Cluster in Garut Indonesia
Recombinomics Commentary
April 16, 2007
A five-member family were admitted to Slamet Hospital in Garut, West Java, on Saturday evening due to concerns they had contracted the bird flu virus.
Yogi Prayogi, spokesman for the hospital, said the family, ranging in age from 50 to six years old, were rushed to hospital suffering from respiratory problems and high fevers, symptoms associated with bird flu.
"Five of the family's chickens died suddenly and were buried in the front yard of their house. Not long after that, members of the family fell ill," Yogi said.
The condition of two of the family members was critical, both with temperatures above 39 degrees Celsius, he said.
The above comments describe an H5N1 suspected familial cluster in Garut, Indonesia. This region has previously reported one of the largest suspect clusters in Indonesia. Although only three members of the Garut cluster were confirmed, many family members and contacts died with bird flu symptoms and samples were not collected for testing. Others tested negative, although they were hospitalized and placed in intensive care. Sequences from the Garut cluster were similar to H5N1 sequences from Java, and included the novel cleavage site RESRRKKR. Although closely related sequences were not found in poultry isolates from late 2005, early 2006, more recent poultry isolates have had the novel cleavage site, indicating the common strain found in human cases in Indonesia was becoming more widespread.
The linkage of the above family to dead poultry, as well as the critical condition of two family members is cause for concern. In the prior outbreak, the practice of feeding dead chickens to dogs was described. H5N1 has been isolated from dogs and cats, raising concerns of additional evolution in mammalian hosts,
Although sequences from early 2007 were released by Indonesia, more recent sequence data has been lacking.
More information on the H5N1 status of the family, and associated sequences would be useful.
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