- "The taking of the sample of blood was carried out
because of two children Suwadi, Faisal Paradise (15) and the daughter Sulistyowati
(18 months), died without being known by his cause. Now one child Suwadi
other, Nur Aidy (8), was reported was sick."
- The above machine translation describes a family cluster
in Demak, Central Java. Three children in the Suwadi family have now died
or have symptoms. The index case, 15 year-old Faisal Paradise showed symptoms
on September 15 and died September 20. 18 month old, Sulistiwadi died
four days later. Now 8 year old, Nur Aidy is showing bird flu symptoms.
The family's chickens had recently died. The time gap between the deaths
of the two siblings and the disease onset of the third sibling suggests
- Nur Aidy has been transferred from Wedung Community Health
Center to RS Kariadi in Semarang. Another patient, 58 year-old Suprat,
was also transferred to RS Kariadi. He is a chicken vendor and began to
show bird flu symptoms about a week ago. The cluster of H5N1 bird flu
cases is shown on the Indonesia map.
- The clustering of cases is cause for concern. Three family
members with bird flu symptoms suggest human-to-human transmission of a
virulent H5N1. Moreover, the hospitalization of the chicken trader from
the same area causes additional concerns. This cluster is far from the
much larger cluster in Jakarta (see map). Yesterday, a child was just admitted
who's mother had been hospitalized after a visit to the Ragunan Zoo where
there was massive H5N1 infections in asymptomatic birds on exhibit. Now
the zoo in Semarang is also H5N1 positive raising the possibility of another
large cluster due to casual contact.
- These growing clusters, and clusters of clusters, signal
a pandemic phase 5, which is getting close to the final phase 6.
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- Patricia A. Doyle, PhD
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