Commentary
Indonesian Denials of H5N1 Cases In Sumatra Raise Concerns
Recombinomics Commentary 00:18
August 11, 2008
A senior health official says 13 villagers hospitalized with bird flu-like symptoms in western Indonesia have tested negative for the disease.
Nyoman Kandun said the test results came back negative on Saturday and the patients' conditions are improving.
He says dozens of chickens started dying last week from the H5N1 bird flu virus in Air Batu, a village on Sumatra Island, sending panicked residents rushing to a nearby hospital.
The above comments provide an update on the situation in northern Sumatra, but it is not convincing. H5N1 is endemic in poultry in Indonesia, and the fully extent is unclear because Indonesia has not filed an OIE report since 2006. Although their reporting requirement is every six months, since they declared H5N1 endemic, they have not met the six month requirement.
Similarly, they have not released any sequence data on human H5N1 isolates since early 2007, and have only sent samples from a handful of patients who have died in the past 18 months. Their recent announcement that they will limit reports on human cases, and the absence of WHO confirmation of the patients who were confirmed in July, continues to raise concerns due to lack of transparency.
These changes happened while clusters were obvious, even though Indonesia denied their existence. One of the clusters was specifically denied by Kandun, who stated that the brother of an H5N1 fatal case died of dengue fever.
This is of concern, because now media reports are stating that the patients who are being hospitalized with bird flu symptoms are being diagnosed with dengue fever. The association of H5N1 positive poultry, patients with bird flu symptoms, including fatal cases, and a diagnosis of dengue fever, are cause for concern.
Clarification of the situation by the WHO team on the ground in northern Sumatra would be useful.
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