- They were spread in 9 provinces that is the Special Capital
District of Jakarta (45 cases), Banten (13 cases), West Java (10 cases),
Central Java (3 cases), East Java (3 cases), South Sulawesi (4 cases),
North Sumatra (1 case), East Kalimantan (1 case) and Lampung (3 cases)
and 2 cases were not yet known by his province origin.
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- From this case whole, 11 people among them died (3 people
from 4 cases confirm, 2 people from 11 cases probable and 6 people from
69 cases suspek).
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- The number of suspected H5N1 bird flu cases has grown
to 89 as of Thursday. The breakdown of the 84 cases from Wednesday are
listed above. The cases are increasing daily and media coverage of the
specifics has diminished. Cases are increasingly being reported as composite
numbers.
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- The distribution shows that the cases are spread across
the country (see Indonesia map), although most are in the Jakarta area
(see Jakarta map). The number of cases reported a week ago was 42, so the
increase in cases has been rapid.
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- The number of cases in the suspect category is high because
many samples have not been confirmed by Hong Kong, but many mre test negative
because of sample collection. Since samples are not collected at the primary
hospital, the collections at the referral hospital test negative because
they are collected too late after the onset of symptoms and the H5N1 has
moved from the nose and throat to the lungs. Some of thes patients are
positive for antibody, but others are negative because the serum is collected
too early.
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- Thus, the total number of suspect cases is more accurate
than the lab tests, because of sample collection.
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- The number of cases is rapidly increasing. Most of the
more recent cases have links to dying poultry. However, many cases infected
by people would not be transferred, so they would not be tested. Thus
the number of suspect cases is a gross under-estimate of the true number
of cases. Many are not detected because they do not go to hospitals because
of costs.
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- The monitoring of H5N1 should be more aggressive. Multiple
samples can give a clearer picture of the true extent of the H5N1 in Indonesia.
The testing should include patients who have symptoms, even if there is
not a link to dying poultry. The large number of zoo visitors who had
symptoms or tested positive for H5N1. indicated transmission of H5N1 was
caused by casual contact. More aggressive monitoring and tracing of these
infections will determine how easily H5N1 is transmitting human to human.
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