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Commentary

Another Fatal H5N1 Case Denied in Indonesia
Recombinomics Commentary 12:36
May 21, 2008

Results of the Laboratorium Health Hall inspection (BLK) Dinkes (Health Service, ed) West Java on the sample of blood and the suspect's liquid suspect bird flu, late Tini Suhartini (54) from the Babakan Asem Village, Desa Ranjeng, Kecamatan Cisitu, Kabupaten Sumedang, was stated positive H5 bird flu of Avian Influenza-AI).

"Results, the sample" of the "patient's blood was positive H5, but not specific H5N1."

Positive H5, he said.

H5 that personally, said Hilman, meaning that influenza.
"The influenza his kind sorts."
Beginning with H5N1, H5N2, et cetera up to H5N15.
Whereas bird flu or AI personally the entry in the category H5N1.
However, for the case of the patient was expected by AI that died that, despite only was stated positive H5, we took the maximal risk of considering the patient was affected by AI, he said.

The above translations describe another lab confirmed fatal H5N1 case in Indonesia, with comments discounting the diagnosis.  The only confirmed bird flu fatality reported to date that was not H5N1 was an H7N7 case in the Netherlands in 2003.  The likelihood that the Indonesian patient died from another H5 serotype is remote, and largely irrelevant, since the patient has already died, indicating any other H5 infection would have a case fatality rate of 100%.

The above comments sound remarkably similar to the denials in South Korea, where a soldier culling H5N1 infected birds also tested positive for H5.  He was positive on two or three independent tests leaving little doubt that he was H5N1 positive, but a failure to dedtect the N1 led to a “negative” report.  The H5N1 was recently said to be 99.7% identical to the H5N1 in Japan, which had a clade 2.3.2 HA and 2.3.4 related sequences in the other seven gene segments.  Moreover, the HA sequences in Japan had M230I, increasing the likelihood of human infections.

The above qualifications in Indonesia follow denials on three clusters linked to three H5N1 confirmed cases.  These denials continue to cause concerns.

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