Click to Translate to English Click to Translate to French  Click to Translate to Spanish  Click to Translate to German  Click to Translate to Italian  Click to Translate to Japanese  Click to Translate to Chinese Simplified  Click to Translate to Korean  Click to Translate to Arabic  Click to Translate to Russian  Click to Translate to Portuguese


Forum Home Forum Home > General Discussion > Latest News
  New Posts New Posts RSS Feed - Indonesia deadly strain
  FAQ FAQ  Forum Search   Events   Register Register  Login Login

Online Discussion: Tracking new emerging diseases and the next pandemic

Indonesia deadly strain

 Post Reply Post Reply Page  12>
Author
Message
Guests View Drop Down
Guest Group
Guest Group
Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Topic: Indonesia deadly strain
    Posted: August 12 2006 at 11:59pm
So far the mortality rate for Indonesia is:
 
56 cases and 44 dead
 
That is just horrendous and represents 78.5%
 
This the bug that has a big cluster and we must watch for clusters as they will get steadily longer and turn to Phase 4.
 
With the Indonesia clade, the possibilities are the stuff of nightmares.
 
So far this year 91 people ave the bug and 61 died - 67%
 
Compared to 1918, this bug makes that one look like a Sunday School picnic.
 
Any of your friends not prepping, you can tell them they are making an evolutionary decision - their genes will not be passed on to the next generation
Back to Top
Fiddlerdave3 View Drop Down
Valued Member
Valued Member


Joined: August 09 2006
Status: Offline
Points: 32
Post Options Post Options   Thanks (0) Thanks(0)   Quote Fiddlerdave3 Quote  Post ReplyReply Direct Link To This Post Posted: August 13 2006 at 2:01am
The problem with Indonesia stats is two possible areas of inaccuracy:
 
1. The bird viruses aren't matching the human viruses, so the practice of testing only cases around bird H5N1 outbreaks means they could be missing alot of cases.
 
2.  The distrust of government and modern healthcare there (imagine running and hiding out to escape intensive care!) means that the missed cases could a.) mean a lower death rate because the missed cases are surviving or b.) mean as high or higher death rate because the missed cases are dying but just being buried. 
 
I haven't picked up the Indonesian government is looking real hard - I have  a real feeling they'd like to ignore it, so missing cases by following WHO procedures is fine with them, paying attention to extra dead bodies is not something they care about.  Just keep the tourists coming!
Back to Top
Guests View Drop Down
Guest Group
Guest Group
Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: August 13 2006 at 6:18am
Indonesia confirms new human case of avian flu
Published: Sunday, 13 August, 2006, 11:47 AM Doha Time

JAKARTA: A teenager was confirmed yesterday as the latest bird flu case in Indonesia, the country worst hit by avian influenza with 44 human deaths recorded, health officials said.
The 17-year-old youth, who lives in an isolated area of West Java’s Garut district, has refused treatment at a hospital designated for bird flu cases, said Runizar Rusin, an official with the health ministry’s bird flu centre.
The teenager is Indonesia’s 59th confirmed case based on local tests, which are usually accurate, and his refusal typifies a lack of knowledge of the danger of the virus among Indonesians in rural areas, Rusin said.
“His test results, which I obtained today, show that he is positive with H5N1 (the deadly strain of the virus) but he is not hospitalised, as, being a villager living in an isolated area, he thought that he’s just suffering from ordinary flu after visiting a local health clinic,” Rusin said.
“But fortunately, the clinic took samples of his blood and saliva and sent them for testing and they came out positive.
“Now our team in the field are trying to take him to a hospital” in West Java’s main town of Bandung, he said.
The teenager had been in contact with dead chickens near his house before he became ill, he said.
Rusin said samples from the teenager were confirmed by the health ministry’s research and development laboratory and the US Naval Medical Research Unit laboratory in Jakarta.
Samples from his relatives and neighbours had also been taken for testing and a culling of poultry within a 1km radius of his house would be carried out soon, Rusin said.
His case comes after officials earlier this week confirmed the deaths of two teenagers from the virus, taking the number of human fatalities to 44 in Indonesia.
Meanwhile, Cambodia has suffered its second outbreak of bird flu this year in the same province where the H5N1 virus killed a boy in April, officials said yesterday.
The virus was confirmed in more than 1,300 ducks that died in Prey Veng province, 70km southeast of Phnom Penh, but there were no immediate reports of human infections, they said.
“Yes, bird flu is back,” senior Agriculture Ministry official Nou Muth said. “We have announced this outbreak to alert villagers not to handle dead poultry.”
Most of the more than 130 people killed by the virus, including six in Cambodia, have contracted the disease through close proximity to infected birds.
“Bird flu is still the hot issue for us. We are still worrying that villagers in the affected are might have been selling their chickens or ducks to others secretly,” Nou Muth said.
Several hundred domestic ducks, which can carry the H5N1 virus without necessarily showing symptoms, had been culled in within 3km radius of the outbreak, agriculture official Yim Vanthan said.
The world’s first first lab-confirmed human-to-human transmission of bird flu occurred in Indonesia three months ago in a cluster of seven deaths, sparking serious concern among scientists.
It raised the spectre of a dangerous viral mutation that may have permitted efficient transmission among people, bringing nearer a global human flu pandemic with the potential to killmns. But the slight mutation that took place was determined to be insignificant. – Agencies

http://www.gulf-times.com/site/topics/article.asp?cu_no=2&item_no=102246&version=1&template_id=45&parent_id=25
Back to Top
Guests View Drop Down
Guest Group
Guest Group
Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: August 13 2006 at 6:24am
What mystifies me is we continually get these cases in Indonesia with no cases in U.S. We live in a global communinty. Is it so unlikely that one person with this whatever it may be, would get on a plane and come here? Is there current testing being done for H5N1 in humans in the U.S. anywhere who exhibit symptoms and have the results of those tests ever been released?
Back to Top
Guests View Drop Down
Guest Group
Guest Group
Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: August 13 2006 at 6:52am
well my guess would be that they are a 3rd world country
 
and handel everything there poorly......
 
the virus isnt even active in this country yet....
 
and even if it dose we are a much more sanitary country...
 
 
Back to Top
Left Field View Drop Down
Advisor Group
Advisor Group


Joined: January 13 2006
Status: Offline
Points: 176
Post Options Post Options   Thanks (0) Thanks(0)   Quote Left Field Quote  Post ReplyReply Direct Link To This Post Posted: August 13 2006 at 7:26am
d even if it dose we are a much more sanitary country...
-------------------------------------------------------------------------------------
are u sure, go into any restaurant and they will have it posted "Employees must wash their hands before returning to work."  If we are so sanitary, why do so many people have to be told to wash their hands?  And how many non-employees do you see not washing their hands?  Yuck, I have to use a paper towel to open the door on my way out.
Back to Top
Guests View Drop Down
Guest Group
Guest Group
Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: August 13 2006 at 11:16am
well going from a country that its people sleep with there chickens
 
to our people bein told to wash there hand i think we are ok in that regard.
 
usin a paper towel to open doors huh"ever see the tv show Monk"
 
:P
Back to Top
Guests View Drop Down
Guest Group
Guest Group
Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: August 13 2006 at 1:13pm
If you are so poor that you live with your chickens, you might not be able  to afford a plane ticket to the US.
Beth
 
Originally posted by medclinician medclinician wrote:

What mystifies me is we continually get these cases in Indonesia with no cases in U.S. We live in a global communinty. Is it so unlikely that one person with this whatever it may be, would get on a plane and come here? Is there current testing being done for H5N1 in humans in the U.S. anywhere who exhibit symptoms and have the results of those tests ever been released?
Back to Top
Oisanatta View Drop Down
V.I.P. Member
V.I.P. Member


Joined: May 08 2006
Location: United States
Status: Offline
Points: 308
Post Options Post Options   Thanks (0) Thanks(0)   Quote Oisanatta Quote  Post ReplyReply Direct Link To This Post Posted: August 13 2006 at 1:39pm
Originally posted by ops144 ops144 wrote:

well my guess would be that they are a 3rd world country
 
and handel everything there poorly......
 
the virus isnt even active in this country yet....
 
and even if it dose we are a much more sanitary country...
 
 


having been on a couple of missionary trips to 3rd world courntries, no question that usa is "more sanitary", but is it really enough?  i am also faculty at a dental school, and I see colleagues come into the rest room and NOT wash their hands when they are done with whatever! scary!!

so i wouldn't bank on employees in restaurants washing their hands the way that hands should be washed.  the signs are great for a CYA....and because by law there must be a posting.  check out your city's local paper in the section where restaurant citations are buried....it'll freak you out and you'll bag your own lunch or skip that going out to the restaurant stuff.  not that we have to live in a bubble....just saying, though, that just because we live in the usa, we should not be complacent.
The only thing worse than a brutal lie is the brutal truth. (M Twain) I waited patiently for the LORD; He turned to me and heard my cry. He lifted me out of the pit; He set my feet on a rock. Psalm40
Back to Top
Fiddlerdave3 View Drop Down
Valued Member
Valued Member


Joined: August 09 2006
Status: Offline
Points: 32
Post Options Post Options   Thanks (0) Thanks(0)   Quote Fiddlerdave3 Quote  Post ReplyReply Direct Link To This Post Posted: August 13 2006 at 3:25pm
Didn't I read that H5N1 will live for 3 days on a hard surface like a doorknob? Who washes their hands everytime they touch their nose, eyes, or after a cough or sneeze? 
 
Once H5N1 is H2H efficiently, between airborne and surface transmission, I doubt we will have much protection.  Regular flu gets around pretty well each year.  H5N1 in humans seems to be losing its association H5N1 birds in the last year, so its transmitting in new ways.
 
And since we hav no sick birds here (maybe), we don't test people dying of pneumonia, etc for H5N1.  How would we know?
 
Note:
Interesting study on restroom hand washing in women:
"However, for many people, it is not a part of the routine restroom behavior. Hand washing has become something that is forgotten or taken for granted. In addition, it has become an act done out of social expectation instead of sanitary reasons. Past research shows that people wash their hands because they feel it is the socially excepted thing to do. When a person is not around to monitor the hand washing behavior, it no longer becomes necessary. Conversely, when another person is present in a public restroom, it may cause a degree of self-awareness and allow the person to feel that they should do the socially desired thing. Studies have shown that as many as 50 percent of Americans do not wash their hands.....Overall, only 40 percent of the women in the study washed their hands."
Later edit:  I emphasised women because I imagined men's rate of washing is probably lower, not higher, than women's.
Back to Top
Guests View Drop Down
Guest Group
Guest Group
Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: August 13 2006 at 3:45pm

MedClinician,

Glad to see you back on the boards. I enjoy reading yours posts. Argyll.

Back to Top
onlooker View Drop Down
Valued Member
Valued Member
Avatar

Joined: August 13 2006
Status: Offline
Points: 2
Post Options Post Options   Thanks (0) Thanks(0)   Quote onlooker Quote  Post ReplyReply Direct Link To This Post Posted: August 13 2006 at 4:12pm
Originally posted by Left Field Left Field wrote:

d even if it dose we are a much more sanitary country...
-------------------------------------------------------------------------------------
are u sure, go into any restaurant and they will have it posted "Employees must wash their hands before returning to work."  If we are so sanitary, why do so many people have to be told to wash their hands?  And how many non-employees do you see not washing their hands?  Yuck, I have to use a paper towel to open the door on my way out.



I hope you also use it to shut off water and that you crank dowen the towel before washing otherwise what's the use?
Back to Top
Guests View Drop Down
Guest Group
Guest Group
Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: August 14 2006 at 4:47am
    Originally posted by medclinician

What mystifies me is we continually get these cases in Indonesia with no cases in U.S. We live in a global communinty. Is it so unlikely that one person with this whatever it may be, would get on a plane and come here? Is there current testing being done for H5N1 in humans in the U.S. anywhere who exhibit symptoms and have the results of those tests ever been released?


Medclinician:

Its no mystyery. It's that efficient, sustained H2H2H does not yet exist with H5N1. There are more than 200 million peple in indonesia, and still only 39 cases this year. Even if the real number is 10 times that many, the incidence is still less than 0.0002%. H5N1 is still relatively hard to get. I agree that we may be closer than WHO admits, but even so, we are a mutation or 2 or 3 away from a real pandemic.

just trying to put things into perspective

gardener

    
Back to Top
Guests View Drop Down
Guest Group
Guest Group
Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: August 14 2006 at 5:24am
Originally posted by argyll argyll wrote:

MedClinician,

Glad to see you back on the boards. I enjoy reading yours posts. Argyll.



Thank you Argyll. I have tried to gather information from all over the world as well as share some of my personal experience after 40 years in the field of medicine. I do try to differentiate between comment and data.


Back to Top
Guests View Drop Down
Guest Group
Guest Group
Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: August 14 2006 at 6:17am
medclinician,

I think you are being alarmist. this post is going to sound a little harsh, because when you write with a tag of "medclinician" and your post sounds like the world is falling apart from the standpoint of infectious diseases in general, I feel that I must respond. 'cause it's not. yet.

First of all, and most importanty, we do test for flu. All the time. Basically everyone with respiratory failure without a clear etiology and anyone hospitalized with symptoms of flu gets a rapid test for flu. This includes children. If it's flu and the person has exposure to a group of animals known to becarrying the disease or has recently arrived from an area with endemic bird flu, we will subtype to determine H5N1.

Yes, once Avian flu is seen in birds in this country, we will see sporadic cases contracted from birds, probably associated with marginal and unsafe living conditions. Maybe we will see them this fall with the southern migration. However, this will be avian flu in humans, NOT pandemic flu. It will pose a minimally greater risk to the population than other zoonoses like hantavirus and plague.

This is a far cry from coming here to "find a warm comfy spot and spread." The conversion to pandemic virus could happen here, but given the sheer numbers of people who live close to poultry in the rest of the world, it is unlikely. If a pandemic comes, it will most likely arrive with a human travelling from an area where the virus has already started to spread. In that case, we will have warning.

Yes, sanitation is a general problem in the spread of disease, but it ever has been. Since the advent of soap and running weater, it is only getting better. The of illness in daycares is un fortunate, but a fact of life. After you work with children for several years, you become immune to most of it.

Gastroenteritis circulates twice a year in the early spring (rotavirus) and late summer (enterovirus). We are smack in the middle of enterovirus season (roughly July 15 to September 15th.) Your antibodies to these only last a few years, so the fact that your whole family got sick is unfortunate, but hardly concerning from a public health perspective.
Disease that need to be reported generally are. Lice and strep don't need to be reported.

hope your family are feeling better.

gardener
Back to Top
Jhetta View Drop Down
Senior Advisor Group
Senior Advisor Group
Avatar

Joined: March 28 2006
Status: Offline
Points: 1272
Post Options Post Options   Thanks (0) Thanks(0)   Quote Jhetta Quote  Post ReplyReply Direct Link To This Post Posted: August 14 2006 at 8:21am
Gardener,
 
Thanks for your post, grounded and accurate... I would add that limited numbers of people have inherited or acquired immune disorders that would facilitate infection's of many types.
 
They would be more vulnerable in the following environment and would most likely not develop immunity!
 
 
"Yes, sanitation is a general problem in the spread of disease, but it ever has been. Since the advent of soap and running weater, it is only getting better. The of illness in daycare's is un fortunate, but a fact of life. After you work with children for several years, you become immune to most of it. "
Back to Top
Guests View Drop Down
Guest Group
Guest Group
Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: August 14 2006 at 3:52pm
Originally posted by gardener gardener wrote:

medclinician,

First of all, and most importanty, we do test for flu. All the time. Basically everyone with respiratory failure without a clear etiology and anyone hospitalized with symptoms of flu gets a rapid test for flu. This includes children. If it's flu and the person has exposure to a group of animals known to becarrying the disease or has recently arrived from an area with endemic bird flu, we will subtype to determine H5N1.

Yes, once Avian flu is seen in birds in this country, we will see sporadic cases contracted from birds, probably associated with marginal and unsafe living conditions. Maybe we will see them this fall with the southern migration. However, this will be avian flu in humans, NOT pandemic flu. It will pose a minimally greater risk to the population than other zoonoses like hantavirus and plague.

hope your family are feeling better.

gardener


I agree with you, no doubt there are many good hospitals that do follow up on respiratory infections without a clear etiology, swab test, and if there is further reason to believe the patient has been exposed to Avian will continue to run to subtype to check for H5N1.

Having worked at such hospitals such as Stanford, which are leaders in disease research and very thorough, I would need to do more research to verify how many hospitals, if such data is available, are as vigilant in screening for H5N1.

In speaking to Dr. Kumar in the Cayman Islands, one perspective is that bird flu in humans is a misnomer. In Dr. Kumars words "at this point it becomes human flu." Whether there needs to be a mixer vessel (pigs) who are now a species that can carry H5N1 or can be directly transferred to humans a a submutate form (such as the hunter incident in Ohio) is a question which some research has already been done on.

Since there have been statements by government officials, the executive office, preparation for mobilization of the military and national guard, extemely precise preparation plans drafted in preparation of a coming Pandemic, it is likely there are reasonable amounts of data to support such action.

It should be understood that there is evidence that in types of human H5N1 rectal swabs are testing positive, strains have developed which can live at much lower temperatures in the upper respiratory tract, and the barrier of acid in the stomach has failed to keep infections from the lower intestinal tract. Also, it has been found in the blood of human patients.

No less than 30 research companies are actively working presently on developing vaccines and potential vaccines as well as antibody research and several vaccines which have already been tested and have proved effective in some cases.

In suggesting a stockpile of 400,000,000 doses of Tamiflu, and increased Relenza research, this indicates that  there is  a definite informed group of scientists who feel Avian will pose a significant health threat to America.

No doubt, there are multiple other strains of disease which many suggest should receive more attention and more funding. It has been pointed out that West Nile Virus is an active and present disease in the U.S. and needs to be addressed.

One must consider a separation from what might be considered alarmist, in the face of the growing infections of human H5N1  in Indonesia and Vietnam.

It is good to have such a dialogue and I hope it is interesting and informative to those who read these posts.

In closing I would restate there is a tremendous political and economical undercurrent in discussing the feasibility of a Pandemic.  I respect the opinion and experience of all who post.

There is certainly an indication of at least two camps, or prospectives here. I most honestly hope the model you have described of a very weak infection with minimum deaths and a much over hyped danger is the more accurate extrapolation of the future. No one, more than I, would be very grateful to be mistaken or worried about something which will never happen.

Perhaps in the media the spin is turning from the "not if, but when" to "probably never, but if so, of little account."

Defintely, one always would strive to be the voice of reason, the calming view which represents a reality which is less threatening, less ominous, less likely to cost a lot of money, and hope a Pandemic never occurs.

More research is called for here. I respect your right and view that Avian is not a serious threat to America and will not result in a world wide Pandemic. But in all sincerity and based on my research so far, I believe it will.

I appreciate your concern for our family. We are on the same team, all of us who are health professionals, and it is not my intent to unduly alarm people. Let's monitor the situation and continue to exchange data.

When the government is worried enough to spend a lot of money, resources, and personnel, then I worry as well. We probably have the most informed agencies and database in the world. So my thoughts still based on all I have read and researchered are still.. not if, but when.
Back to Top
Guests View Drop Down
Guest Group
Guest Group
Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: August 14 2006 at 6:14pm
medclinician - I don't think your posts have an alarmist undertone. I respect your opinion and I'm aware of the research you've done. There were many people during Katrina that thought 'it' couldn't happen and that the mayor's orders for evacuation were alarmist overkill. We all know that story.
Keep up your posts, and thanks for writing in such a way as to be understood by the layperson and armchair enthusiast. You're one of the people that have helped me understand the full scope or at least a more clear picture of H5N1.
A tip for your family's gastroenteritis: try a gluten free diet for a few weeks, my family also suffered from persistent gastro and this cleared everyone up within a few weeks.  Also a dose or two of probiotics can help overcome persistant bugs. I'm hoping for the best for you and yours.
Back to Top
joseph View Drop Down
V.I.P. Member
V.I.P. Member


Joined: February 21 2006
Location: United States
Status: Offline
Points: 82
Post Options Post Options   Thanks (0) Thanks(0)   Quote joseph Quote  Post ReplyReply Direct Link To This Post Posted: August 14 2006 at 6:19pm
Some good things mentioned yet we need to take into account the many people that are not coming in to be tested with mild cases. But that can be bad, the way I see it is there is twice the amount they are reporting.
Back to Top
Gimme View Drop Down
Valued Member
Valued Member
Avatar

Joined: March 19 2006
Location: United States
Status: Offline
Points: 428
Post Options Post Options   Thanks (0) Thanks(0)   Quote Gimme Quote  Post ReplyReply Direct Link To This Post Posted: August 14 2006 at 6:37pm
Originally posted by medclinician medclinician wrote:

What mystifies me is we continually get these cases in Indonesia with no cases in U.S. We live in a global communinty. Is it so unlikely that one person with this whatever it may be, would get on a plane and come here? Is there current testing being done for H5N1 in humans in the U.S. anywhere who exhibit symptoms and have the results of those tests ever been released?
 
 
I haven't heard of any thing yet.   Terrorist threats win the day as far as priorities & news events go in this messed up world it seems.
I just pray we aren't missing something here.......
 
 
 
 
 
Back to Top
 Post Reply Post Reply Page  12>
  Share Topic   

Forum Jump Forum Permissions View Drop Down