H5N1 Confirmed in Bali Cluster
Recombinomics Commentary
August 13, 2007
Samples from an Indonesian woman who died on Sunday on the resort island of Bali have tested positive for bird flu after an initial test, officials said on Monday.
The woman, 29, from a village in the district of Jembrana in western Bali, was suffering from a high fever before dying of multiple organ failure, said Ken Wirasandi, a doctor at the Sanglah hospital in the Balinese capital Denpasar.
Suyono said there had been sick chickens around the woman's house and many had died suddenly in recent weeks.
He said initial investigations indicated last month the daughter had become sick after playing with chickens and died a week later.
The above comments indicate the initial H5N1 test on the deceased mother was positive. The positive lab result, coupled with the sick and dying chickens and a fatal infection in the patient’s daughter strongly suggest human to human transmission.
Moreover, media reports describe the hospitalization of a neighbor with bird flu symptoms, as well as symptoms in the father of the neighbor, who has been diagnosed with typhus. Several H5N1 confirmed patients in Indonesia were initially diagnosed with typhus.
These patients raise additional questions about H5N1 testing in Indonesia. Even though the daughter had bird flu symptoms and chickens were sick and dying, the dead child was not tested for H5N1. Similarly, the father of the neighbor was also probably not tested for H5N1. Although there have been no confirmed human cases on Bali, there have been many positives in poultry, including isolates from 2004 and 2005.
The clustering of patients in two neighboring families, coupled with dead chickens and lab confirmation of H5N1 is cause for concern.
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