Commentary
ProMED Halts Reports Of Suspect H5N1 Cases in Indonesia
Recombinomics Commentary 02:54
August 11, 2008
Until further notice, ProMED-mail will not report suspected human cases of avian influenza in Indonesia until they have been confirmed by the Indonesian Ministry of Health.
The above statement by ProMED is unfortunate. It is in response to Indonesia's failure to confirm H5N1 in the 13 hospitalized patients in North Sumatra. Indonesia's track record on confirming H5N1 patients has been poor. In addition to having the largest number of confirmed H5N1 cases and confirmed H5N1 deaths, it also has the highest case fatality rate, raising questions about its ability to detect non-fatal cases of H5N1.
'
Although Indonesia has failed to recently confirm H5N1 in patients in North Sumatra, H5N1 has been confirmed in poultry and three patients recently died with H5N1 symptoms. However, these patients were not tested for H5N1, which is still not uncommon in Indonesia.
The number of hospitalized patients continues to rise, and some are being diagnosed with dengue fever. However, Indonesia's record on diagnosing H5N1 patients as dengue fever cases has also raised concerns, especially when the dengue fever diagnosis is confirmed by the Minister of Health even when the sister of the dengue fever patient tested positive for H5N1.
The presence of a WHO team investigating the three fatal cases is unusual, especially since no H5N1 cases in humans has been reported.
ProMED's reliance on confirmation by the Indonesian Ministry of Health is unfortunate. The Ministry of Health has yet to issue a report the lab confirmed cases from July, and they have stated that they will report cases on a delayed basis.
ProMED's aiding and abetting of this diminished transparency in Indonesia, the country with the highest number of confirmed H5N1 cases in the world, should not stand.
Media Links
Recombinomics Presentations
Recombinomics Publications
Recombinomics Paper at Nature Precedings