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Commentary
 
Second Suspect H5N1 Bird Flu Cluster Member Dies in Bandung

Recombinomics Commentary

May 24, 2006

Teti died after being treated 19 hours in Space of the Poinciana Tree Isolation RSHS. The Hose five hours after the Teti death, Ade that also was treated in same space appeared the Power.

The above translation indicates the second sibling in Bandung in West Java has died.  Death was 5 hours after index case, indicating both died on the day that they arrived. Other media reports indicate a third sibling is being treated at home.

Indonesia has a high case fatality rate, due in part to late admission of patients.  Usually patients are kept at home or treated in primary facilities and only those admitted to infectious disease hospitals are tested.  Thus, surveillance remains poor and clusters remain high.  Family members are not trained in universal precautions and frequently become infected by the index case or additional family members.

The clusters of cases in north Sumatra, Bandung, Jakarta, and Surabuya are cause for concern.  The case fatality rate is high and the cluster in Sumatra has been transmitted through several generations of human-to-human transmission (H2H2H2H2).

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