Zoonotic Diseases

Diseases discussed here have a history of use as an agent for biological warfare, either in the U.S. or abroad. Its use may have been experimental or actual, and any detrimental consequences upon humans, animals or the environment may have been intentional or not, depending on the circumstances, the point in time, and the nature of the disease.

Monday, October 10, 2011

"Bird Flu" Kills 2 More in Indonesia

ProMED-mail promed@promed.isid.harvard.edu to promed-ahead-e.

show details 7:05 PM (17 minutes ago)



A ProMED-mail post

ProMED-mail is a program of the

International Society for Infectious Diseases


Date: Mon 10 Oct 2011

Source: Jakarta Globe [edited]

Bali officials are on alert again after 2 children at Denpasar's

Sanglah General Hospital were diagnosed with the H5N1 strain of avian

influenza. Five- and 10-year-old siblings, resident in Bangli

district, were admitted to the hospital on Friday night [7 Oct 2011]

with symptoms of avian influenza and placed in isolation. The

hospital's medical and nursing director, Anak Agung Ngurah Jaya

Kusuma, said on Sunday [9 Oct 2011] that the children had been in

direct contact with dead poultry around their house and were treated

at a local health clinic before being brought to Sanglah.

Officials are still waiting for results of further tests from Udayana

University and the Health Ministry.

Bali Animal Husbandry Agency head Putu Sumantra said a team had been

deployed to Bangli, but preliminary results showed no trace of H5N1

[presumably in poultry - Mod.CP]. He said that given the preliminary

test, he was not ready to conclude that the birds had died of avian

influenza. "Nevertheless, we remain vigilant. Some of the dead birds

have been sent for further lab tests; the area has been sterilized,

and we have taken samples from family members," he said.

A total of 2 people died of the virus in 2007 and 2008 [in Bali], but

the province has still not enacted a 2005 gubernatorial regulation

banning the import of poultry into the island from other areas.

Denpasar agricultural quarantine chief Saiful Muhtadin said many

attempts have been made to smuggle poultry into Bali, especially

through Padangbai and Gilimanuk harbors.

[Byline: Made Arya Kencana]


Communicated by:

Nati Elkin



Date: Mon 10 Oct 2011

Source: Avian Flu Diary [abridged & edited]

Roughly 48 hours ago [8 Oct 2011], FluTrackers posted an Indonesian

MetroTV report on 2 children (a 5-year-old boy and a 10-year-old boy)

hospitalized on Friday [7 Oct 2011] with severe respiratory symptoms

on the resort island of Bali. Given their reported contact with

chickens and the endemic nature of the H5N1 virus in Indonesia, bird

flu was immediately suspected. Over the next 2 days, the news hounds

on FluTrackers and Flu Wiki posted more than 24 translated reports on

these 2 children, and yesterday [9 Oct 2011], we learned that

preliminary testing indicated bird flu, and that both children were on


This morning [10 Oct 2011], we have had word that both children have

died and that H5N1 has been confirmed. While a number of news reports

are reporting these deaths, TEMPO Interaktif seems to have the most

details. The TEMPO Interactive reports that the 2 children from

Tembuku Village, Bangli, Bali allegedly died from bird flu early

Monday morning [10 Oct 2011]. The bodies of the brothers are still

stored at the General Hospital Center for Sanglah.

According to other reports, prophylactic Tamiflu is being provided to

family members and close contacts of these boys, and the community has

been told that Tamiflu will be provided to anyone who had contact with

sick or dead chickens.

All of this is highly reminiscent of the events of August 2007, when

an outbreak of H5N1 killed 2 women (and was suspected in the death of

one of the women's 5 year-old daughter) on the island of Bali. Bali,

with a population of just under 4 million, is a popular international

tourist destination, although its reputation has suffered in recent

years due to outbreaks of bird flu, dengue, and rabies.

A number of countries, including the US and Australia, have issued

travel health warnings for Bali and for the rest of Indonesia [with

respect to risk of rabies virus infection - Mod.CP]. Although news

reports of bird flu outbreaks and human cases in Indonesia have

declined over the past couple of years, the virus remains endemic in

that country and continues to mutate and spread.

Reporting and surveillance in Indonesia, as in much of the world,

leaves much to be desired, so while Indonesia reports 146 total deaths

from the H5N1 virus, the actual number is unknown. With these 2 new

deaths, a good deal of attention will be focused on Bali over the next

couple of days to see whether additional cases show up.

[Byline: Michael Coston]


Communicated by:

ProMED-mail Correspondent Mary Marshall

[ProMED-mail acknowledges receipt of another report with similar

information from Dr. Andri Jatikusumah, M.Sc., Direktur Eksekutif,

Center for Indonesian Veterinary Analytical Studies (CIVAS), Jl.RSAU.

No 4, Atang Sanjaya, Kemang Bogor.

Reports of human cases of avian influenza A/(H5N1) virus infection

from Indonesia have not always been confirmed by laboratory diagnosis

at a WHO-accredited institution. While the 2nd report announcing the

death of the 2 siblings states that the diagnosis of avian influenza

A/(H5N1) virus infection has been confirmed, the 1st report states

that it is not yet certain that the deaths of the domestic poultry in

the village where the children lived were the result of avian

influenza virus infection. Further information is awaited.

Denpasar in Bali, Indonesia can be located in the HeathMap/ProMED-mail

interactive map at: . - Mod.CP]

[see also:

Avian influenza, human (59): transmission in mammals 20110926.2921

Avian influenza, human (58): H5N1 clade, WHO 20110902.2682

Avian influenza, human (57): alert 20110829.2654

Avian influenza, human (56): Cambodia (KC) 20110819.2525

Avian influenza, human (55): data analysis 20110811.2439

Avian influenza, human (54): Egypt, WHO 20110810.2427

Avian influenza, human (53): Cambodia, Egypt 20110803.2338

Avian influenza, human (52): Cambodia (BM) 20110729.2279

Avian influenza, human (45): Indonesia (JK), WHO 20110603.1700]




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