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Online Discussion: Tracking new emerging diseases and the next pandemic.

CLUSTER IN INDONESIA

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    Posted: May 12 2006 at 10:39pm
HEALTH

Indonesia probes possible bird flu

Four of eight cases investigated were fatal

SPECIAL REPORT
Indonesian and World Health Organization officials on Saturday were investigating eight suspected bird flu cases, four of them fatal.

All eight cases were from the same family. Four members of the family have died from what health officials suspect could be bird flu, said WHO spokeswoman Sari Setiogi.

Blood samples have been sent to a WHO lab in Hong Kong for analysis, Setiogi said.

The family lived in a village in the Tanah Karo district in north Sumatra.

Indonesia's death toll from the H5N1 bird flu strain stands at 25 -- the world's second-highest toll after Vietnam, according to reports from The Associated. Press.

Several fatalities were members of the same family or lived near each other.

Health officials closely study such groups of cases, know as "clusters," to see whether the virus, which currently is almost always transmitted from birds to humans, has mutated into one that can easily pass between humans -- a scenario that many fear could turn into a global human pandemic.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Sure2Survive Quote  Post ReplyReply Direct Link To This Post Posted: May 12 2006 at 10:52pm
It appears that we may have efficient human to human transmition going on in Indonesia.  I am also seeing on Google that any links to the Indonesian articles have been redirected to other stories.  We may be experiencing a temporary coverup as the Pandemic may have begun!
Sucess requires eye's wide open
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: May 13 2006 at 3:27am
yes it looks like a cover up to me too
 
the other thing is this vill is a long way out in the sticks and they are jumping on it and the people infected supposed to be 12 people
 
they are saying they caught it from manure and that sounds like crap to me
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Scotty Quote  Post ReplyReply Direct Link To This Post Posted: May 13 2006 at 4:22am
Kilt: Don't know if that was accidental or not but it certainly gave me a laugh to start the day with.

This looks like it needs watching but this is not the sort of H2H that would send me running for the hills. When we see dozens of small clusters spread throughout an entire region then I will worry. Even at that point my gut feeling is that we will still have three or four days before the real panic starts. IF it starts.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote oknut Quote  Post ReplyReply Direct Link To This Post Posted: May 13 2006 at 4:33am

Bird Flu deaths raise human transmission fears
13/05/2006 - 09:29:32

Indonesian and World Health Organisation officials today were investigating eight suspected human bird flu cases, four of them fatal, in a district on Sumatra island.

WHO spokeswoman Sari Setiogi in Indonesia said tests on villagers’ blood samples in northern Sumatra’s Tanah Karo district had yet to be completed.

A WHO team has “checked the village and at this stage we can say they are still suspect at the moment,” Setiogi said.

Nyoman Kandun, head of the Health Ministry’s office of communicable disease control, said the samples have been passed on to a WHO lab in Hong Kong for confirmation.

He said the possibility of human-to-human infection ”could not be ruled out.”

Kandun said all of the suspected victims were part of a large family, with most living near each other in the same village.

http://www.breakingnews.ie/2006/05/13/story258548.html

 


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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: May 13 2006 at 5:35am
    http://visz.rsoe.hu/alertmap/woalert.php?lang=eng

Please check out this site.
one day there was 3 bird flu flags
then the next 6 bird flu flags
today there is 8 bird flu flags

My fear is it is spreading faster.
What will happen next?
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: May 13 2006 at 6:07am
    why is it that who doen't have all the places listed as bird flu.

Poland
Ukraine
Russia
Somelia
The site i posted for emergency has these listed
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Commonground Quote  Post ReplyReply Direct Link To This Post Posted: May 13 2006 at 6:08am
Found this in my folder of printed papers:

Major Parts of the Federal Response Plan
Article Tools Sponsored By
Published: May 3, 2006

In a report released Monday, the White House outlined a plan to respond to a potential pandemic flu outbreak. The plan outlines the potential spread and the planned governmental response. Stages may be skipped. Durrently the country is in stage 0, but has reached stage 1 before.

STAGE 0: New domestic animal outbreak or animal-to-human infection abroad.
THE FEDERAL RESPONSE
Deploy diplomats, scientists and health experts to help contain outbreak.

STAGE 1: Unconfirmed or suspected human-to-human infection abroad.
THE FEDERAL RESPONSE
American facilities and resources would be provided to help identify the virus through genetic testing. Federal agencies would increase surveillance at the borders and prepare to impose travel restrictions.

STAGE 2: Confirmed human-to-human infection, an outbreak, abroad.
THE FEDERAL RESPONSE
A declaration of an Incident of National Significance would make the Homeland Security Department the lead agency to coordinate response. A test would be developed and distributed to check for infection. Travelers to the United States would be screened before department and upon entering the country. Travel restrictions would beconsidered for the affected area and for countries that do not have adequate screening programs.   Quarantine stations would be activated.

STAGE 3: Outbreaks in multiple locations abroad.
THE FEDERAL RESPONSE
Antiviral medications in the strategic stockpile would be distributed. Production of seasonal flu vaccine would be stopped and switched to the production of pandemic vaccine. Because it has to be grown in eggs, it will take six to eight months before the faccine is available.

More stages - but that's what I'm typing out right now.

Here is something too:

However, page 46 Pandemic triggers is EXTREMELY useful. 4 objective triggers for a pandemic:
1. 3 health care workers contracting pandemic flu at work
2. 5-10 Human to Human (H2H infection)
3. More than 1 generation of H2H
4. Human and avian genetic combination with changed transmission pattersn.

"The incubation period for H5N1 avian influenza may be longer than that for normal seasonal influenza, which is around 2 or 3 days. Current data for H5N1 infection indicate an incubation period ranging from 2 to 8 days and possibly as long as 17 days....WHO currently recommends than an incubation period of 7 days be used for field investigations and the monitoring of patient contacts".
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Post Options Post Options   Thanks (0) Thanks(0)   Quote bjregg Quote  Post ReplyReply Direct Link To This Post Posted: May 13 2006 at 6:27am
Commonground,
Thanks for all of the useful information you have posted.  It is greatly appreciated.  bj
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Post Options Post Options   Thanks (0) Thanks(0)   Quote bjregg Quote  Post ReplyReply Direct Link To This Post Posted: May 13 2006 at 6:35am
Birdlady,
I count 9 bird flu flags, one is behind another flag and barely shows.  bj
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: May 13 2006 at 6:40am
So the country is in stage 0, the world is in Stage 3.
Good marketing.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: May 13 2006 at 6:53am
    bj so what do you think of the rapid changes on this site. Do you think something big is going on? Maybe this is the start of the pandemic? I watch this site everyday and the changes are rapid.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: May 13 2006 at 7:27am

 
Dead    JAKARTA, May 13 (Xinhua) -- Five Indonesian people from a family related by blood were positively infected by avian influenza virus after tested by the country's laboratory, health ministry official said here Saturday.

    Director General of Disease Control of the ministry, I Nyoman Kandun said that the five from Indonesia's North Sumatra province had had contacts with fowls and pigs.

    He said that their blood samples had been sent to the World Health Organization's (WHO) affiliated laboratory in Hong Kong.

    They have been tested, the result were positive, Kandun told Xinhua.

    The five are 29 year-old woman, two men of 19 years old and 35,whom have died since at the end of last month, and two others men of 25 years old and 35 years old man, whom survive, according to the director.

    They are from one family tree, he said.

    The director said that tree others people from the family were suspected of having the virus, including a 40 year-old woman and a 10 year-old boy, both of them have died, and a 35 year-old man whom survive.

    According to Kandun the WHO has confirmed 26 out of 35 people contacted by the virus, have died.

    The highly pathogenic H5N1 strain is endemic in poultry in parts of Asia, which killed more than 90 people.

    The WHO has said that the virus may mutate in to a certain form that could infect human to human which turn the outbreak into pandemic that could kill millions of people because they would have no immunity. Enditem Cry

Editor: Yang Li
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Post Options Post Options   Thanks (0) Thanks(0)   Quote bjregg Quote  Post ReplyReply Direct Link To This Post Posted: May 13 2006 at 7:56am
Birdlady,
I hope not, but the recent information doesn't look promising.  Also, you have to take into consideration the likelyhood that a number of governments are not being aboveboard relative to their reporting of incidents.  Bottom line: this is not good.  bj
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Commonground Quote  Post ReplyReply Direct Link To This Post Posted: May 13 2006 at 8:08am
Thanks for the compliment bj. Trying to contribute my fair share in any way I can.
One thing I noticed with the above post from PonyGirl, is that these people are a bit older.
I was wondering about the Pandemic triggers that I posted above. Would it be a combination of 1-4 that would trigger a pandemic?
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Mahshadin Quote  Post ReplyReply Direct Link To This Post Posted: May 13 2006 at 8:20am
The first death in this news was on may 4th foloewed by 2 deaths on may 9th and 10th and 2 more on may 12th.
 
The virus has a 2 - 8 or maybe longer incubation period.
 
12 other people are hospitalized (Not confirmed)
 
Who states a 21 day window (Once efficient H2H starts) to getting a pandemic under control before it is out of their hands. 
 
This information suggests the 21 day window if you do the math is already or close to being done. Also h2h would be a likely scenario based on the dates of the deaths.
 
What is not mentioned and needs to be confirmed is the 12 people hospitalized and wether they are related to the 5 deaths, if so I think these cound be considered second generation.
 
Of course all this is assuming effecient h2h and a different pattern of infection.
 
Any thoughts??
"In a time of universal deceit, telling the truth is a revolutionary act."   G Orwell
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Commonground Quote  Post ReplyReply Direct Link To This Post Posted: May 13 2006 at 8:23am
We have to find out WHO the other 12 are. Live nearby? For all we know...they could be HCW's!!! We don't know squat.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote bjregg Quote  Post ReplyReply Direct Link To This Post Posted: May 13 2006 at 8:26am
Commonground,
I'm not sure, it could be interpreted as being one or more of the identified triggers.  Things just do not look too good.   As for the individuals noted in PonyGirl's post, I  guess classifying them as "a bit older" is relative.  I'm 55 and the individuals in their 20's and 30's seem young, albeit, not children.
Thanks again for all of your diligence and information.  bj
 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Commonground Quote  Post ReplyReply Direct Link To This Post Posted: May 13 2006 at 8:49am
bj, so far, a lot of the victims of bf have been children, or kids in their 20's. 5 of these people were 35 years old and up.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote janetn Quote  Post ReplyReply Direct Link To This Post Posted: May 13 2006 at 8:58am

Im getting two separate clusters here one has already been pegged as coming from fertiliser. This new one is still unknown.

Particurly disconserting is the mortality rate its well over 50%. It should be going the other way, for several reasons 1 earlier detection now 2 better tx knowledge 3 viruses generally weaken as mutate.

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