- "The patient of various male gender died, on Sunday
(9/10/2005) struck 22.30 WIB. he just entered RSPI to struck 22.10 WIB.
Cahyadi was the reconciliation patient from RS Budhi Asih that has treated
for 3 days."
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- The machine translation above on the 12th bird flu fatality
in Jakarta and 16th fatality in Indonesia (see map) is cause for concern.
The reported suspected bird flu cases in Indonesia are largely drawn from
the infectious disease hospitals that transfer patients from primary care
facilities. The primary care facilities do not test for H5N1, so many
patients are H5N1 negative because by the time they are transferred, the
H5N1 has moved from the throat and nose to the lungs, and the nose/throat
swabs are then negative.
-
- Since many of the Indonesian cases are mild, these patients
are never admitted to the infectious disease hospitals. This was seen
when 115 Ragunan zoo visitors were denied admission because they had mild
bird flu symptoms.
-
- In the above case, holding the patient three days at
the primary facility led to his death 20 minutes after transfer.
-
- The testing procedures in Indonesia are poorly conceived
for identification of H5N1 patients.
- The procedures are very effective at generating false
negatives.
- Monitoring of H5N1 remains scandalously poor.
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