Bird Flu Center

A 67 year old woman from Indonesia that had been treated in a hospital for the last week, died as a result of an infection with a highly pathogenic strain of avian influenza virus. She is now the country’s 54th human victim, out of 71 confirmed infections. The virus was very aggressive in her case, as doctors report and the patient died on Sunday night. The virus strain identified in this case is the highly pathogenic H5N1 and hospital officials say that the disease had also affected the woman’s kidneys. Indonesia has now long been the world’s most affected country by bird flu, but authorities are still reluctant to use mass culling as a way of containing the disease.

A 67 year old woman living in Indonesia’s West Java province is the country’s latest bird flu victim. She was tested positive for the disease on Wednesday and has also been diagnosed with encephalitis. This could make her the first Indonesian victim to suffer brain inflammation as a result of the avian influenza virus. The woman is treated at Hasan Sadikin hospital in Bandung, where she has been placed in isolation. It is believed she contracted the disease from her chickens, which died just days before she was admitted to hospital.

A newspaper published in Azerbaijan’s capital, Baku, has printed an unconfirmed report about 2,000 bird having been found dead in a region in Iran, close to the Armenian border. According to the journal, samples were taken from the birds and sent to laboratories in Tehran and Italy, to analyze the possibility that the birds had been infected with the avian influenza virus. The birds are claimed to have been found in a water reservoir, however, no health official, neither, from Iran, nor Armenia, has confirmed the case. The border between the two countries is under careful supervision by soldiers who are on the lookout for any potential health hazard. Armenian authorities claim that, in any case, their country is well prepared to deal with a potential outbreak of the disease, as stocks of anti-viral drugs have been gathered.

Vietnam’s efforts of fighting avian influenza have shown visible results this year, as the Asian country has not detected any new cases of the disease since last December. A nationwide program to combat the disease has seen the majority of Vietnam’s cities and provinces vaccinate large populations of poultry. The Veterinary Department, working inside the Ministry of Agriculture, has requested the help of local authorities to reinforce necessary measures throughout the country, to ensure that the massive outbreaks recorded in 2005 will be not be seen this year.

A research project from a group of students at the Udayana University in Bali has discovered traces of the bird flu virus in several disease pigs, between the months of May and June 2006. Out of a number of 20 pigs studied, two were tested positive for the H5N1 virus. A closer look is taken into the case, but it is said the pigs could not be cured by a series of medical treatment. Subsequent study only found traces of the highly pathogenic virus in some tissues of the pigs. The research has not yet been made public as a scientific study, but the case has been sent to the Bali Breeding Service.

A 21 year old woman living in the Tulung Agung district of East Java has become Indonesia’s 69th case of human infection with the avian influenza H5N1 virus. The announcement was made on Thursday by the director of Animal Disease and Health Control, Nyoman Kandunsaid. The woman has presented flu like symptoms since September 19th and was hospitalized 6 days later. It is believed that her contacts with diseased fowls led to the infection. Furthermore, she is the sister of another confirmed case of bird flu, as an 11 year old boy from the same family fell ill and eventually died on September 18th. 52 out of the 68 cases recorded in Indonesia so far have been deadly, making this the world’s hardest hit country by the disease.

Only days after confirming the first avian flu outbreak after a 6 weeks quiet period, China has now declared that a new outbreak of H5N1 was detected in poultry from a northern region of the country. The Henan New Village, from the Ningxia region, was reported to see about 1,000 birds die within the last days, and further testing confirmed the presence of the highly pathogenic bird flu virus. Around 70,000 more birds were culled in an effort to contain the spread of the disease. The world’s most populous continent has so far recorded 21 cases of human infections with the virus, of whom 14 perished. However, some believe that the real number of human cases is far greater and that authorities have kept the silence on many of the cases.

Philippine’s Department of Agriculture, by its Bureau of Animal Industry, has issued warnings that the smuggling of poultry and poultry products could help spread the highly pathogenic avian influenza virus. The announcement was made after some reports stated that the smuggling of exotic birds and poultry products from Indonesia’s North Sulawesi and Kalimantan provinces was intensifying in the southern Philippines. Indonesia is having real difficulties in fighting the disease so agriculture officials in the South of the Philippines have asked for assistance from the Coast Guard, Customs Office and Port Authority to closely monitor the poultry products being introduced into the country. Unlike other Asian countries, the Philippines has recorded no bird flu case in the last 3 years.

China is reporting the first avian influenza outbreak in over six weeks, as poultry were found dead in a province from the far north of the country. 985 chickens died from the disease in a village in the city of Baotou, in Inner Mongolia. The agriculture ministry made the announcement, as almost 9,000 other domestic birds have been culled to prevent the virus from spreading. It is not yet known when did the first sign of the disease appeared, but the virus was confirmed as the highly pathogenic H5N1 on Friday. Quarantine was set up in the area and the outbreak is now under control, authorities say. So far, 21 people have contracted avian influenza, of which 14 died, as official reports say. The last recorded victim occurred in July in the western region of Xinjiang.

The sister of a boy that had previously died of bird flu earlier this month has now tested positive for the H5N1 virus. She is believed to have contracted the disease after coming into contact with sick and dead birds, as her brother. The 21 year old woman is now being treated at a hospital in the East Java province. Official laboratory testing have confirmed the initial diagnosis on the patient and the case is now worrying as it might signal a possible cluster in the woman’s family (a transmission of the virus from person to person). The woman is suffering from pneumonia as well and although her condition is stable at the moment, her state has not recorded a significant improvement, with the patient still being assisted by a respirator. Although so far human infections with the avian influenza virus were due mainly to direct contact with birds, cases such as this one raise fears that the virus has mutated to a form that can be passed on from person to person.

A 20 year old man living in Indonesia’s West Java province was hospitalized on Tuesday with typical bird flu symptoms and was later tested positive for the virus. It is the country’s 67 bird flu human case, with 51 deaths recorded so far, 40 of which occurred this year alone. The central laboratory in Jakarta confirmed the presence of the highly pathogenic H5N1 virus in samples taken from the man. More worrying is that the case might be one that signals the discovery of a cluster in the man’s family. His 23 year old brother died only days ago with similar flu symptoms, but he was not taken to hospital for testing prior to his death. Also, the two men’s sister, aged 15, was also hospitalized this week after developping high fever and cough. This indicates a possible common source of infection for all the family members, although the possibility exists that the virus had been passed on from one person to another. The man is being treated in an isolation room in the hospital, but his condition is still to improve.

Thailand has reported its third bird flu victim this year. A 59 year old farmer living in the country’s north-east died on the 10th of August, in a region near the Lao border. A senior health ministry official declared that it is believed he had been in contact with sick poultry just before falling ill. Laboratory tests on samples taken from the man were completed only last week, giving for a late discovery of the case. Thailand has recorded 17 bird flu deaths since 2004 and although its initial response to the disease was believed to be slow and inefficient, the country is now praised by international authorities as being one of the best prepared to combat the highly deadly virus.

An Indonesian boy aged 9 has succumbed the avian influenza virus, becoming the country’s 51st victim, an official of the health ministry confirmed on Sunday. The death was recorded on Friday in a hospital in the capital city Jakarta, as Runizar Ruesin, the head of the center, told a press agency. This comes only days after another bird flu victim was documented in the East Java province and will again provide reasons for concern for the international community regarding Indonesia’s capability of containing the disease.

An 11 year old boy that died on Monday has become Indonesia’s 50th avian influenza victim, as it was confirmed that he had been infected with the H5N1 virus. This number is the highest in the world, as the country has long surpassed Vietnam as the world’s worst affected state by the disease. The boy lived in the densely populated East Java province and had previously had contact with diseased poultry. Later on, he developed fever, cough and breathing difficulties, before eventually succumbing to the disease two days later. Results from two laboratories were required to officially confirm this case to the World Health Organization.

A three year old Iraqi boy living in Baghdad has been confirmed as having been infected with a mild form of bird flu last March. This is the first confirmed human case in the capital city and the country’s third avian influenza case overall. The case has been retrospectively confirmed by the Ministry of Health as having been caused by the H5N1 strain of the virus. It took several testing methods to confirm the initial diagnostic on the boy, as samples were originally deteriorated during shipment. Iraqi officials confirmed the discovery of the H5N1 highly pathogenic bird flu virus in poultry in Baghdad, but no human cases had been confirmed in the capital yet. A teenage girl and her uncle, living in the province in Sulaimaniya, northern Iraq, are the only confirmed human victims of the disease.

Indonesia’s laboratories are still inefficient when it comes to rapid assessment of a bird flu patient and making a diagnostic. While in Vietnam such a case requires one day of testing, in Indonesia the great majority of avian influenza patients are diagnosed after three days. This is the warning given just recently by Dr. Santoso Suroso, the director of the Sulianti Saroso Infectious Disease Hospital in Jakarta. This is of particular importance with a disease such as bird flu, where quick and effective treatment is needed to give the patient any chance of survival. There are only three national laboratories that can test samples for avian influenza and all three lie in the capital city, Jakarta. However, samples come in by the thousands and from all over the country. For that reason, Indonesian authorities have taken the measure of building eight other regional laboratories, to help in the detection effort.

The Vietnamese police has started an investigation into a scam which misused tens of thousands of dollars from government funds meant to prevent bird flu. The director of a Health Department from the Bac Lieu province in southern Vietnam is accused of having inflated the prices of bird flu protective equipment by 1 billion dong (around $60,000) and is ow under investigation. A local newspaper quoted a report by the provincial police to say that 5,100 masks were bought at a price of 50,000 dong, when their actual price was only 15,900 dong, while a protective suit was bought with 68,000 dong instead of 30,800 dong each. The scam took place in early 2004 when avian influenza outbreaks were detected all across the country. Vietnam had, at one point, the world’s highest bird flu death toll, but decisive measures to curb the disease have led to the country not reporting any new outbreaks among poultry this year and no human case of the disease since November 2005.

Samples taken from five South Koreans have revealed the had been infected with the H5N1 bird flu virus three years ago, but no further symptoms of a serious illness developed in any of them. Old samples were sent to the US Centers for Disease Control and Prevention, as part of a program testing 318 poultry industry workers that might have been exposed to the virus during an outbreak in late 2003 and early 2004. South Korea dealt with an avian influenza outbreak that infected around 400,000 poultry between the months of December 2003 and March 2004, without any human cases being reported at that time. Another 5 million poultry were culled in an effort to contain the disease.

Thailand has found no outbreaks of avian influenza on its territory for more than one month. Phichit and Nakhon Phanom provinces have been removed from the flu infected provinces as early as August 23rd. A seminar held on Thursday gave Dr. Jaral Trinvuthipon, an assistant to a Thai minister, the opportunity to make the announcement that the country is on the right way to eradicating the disease. International authorities attribute Thailand’s success in containing the virus to good detection of new outbreaks and a rapid reaction and measures of dealing with an outbreak. Thai authorities now hope that the disease will be completely eliminated by the year 2008.

Indonesia’s bird flu death toll rose to 49 yesterday, as the country declared a 5 year old boy that had died six months ago was a victim of the H5N1 virus. The case was included in the statistics as the United Nations Health agency has revised its definition for human cases of avian influenza, as Sari Setiogi, a World Health Organization spokeswoman in Jakarta, declared yesterday. The boy lived in Bekasi, in the province of West Java and tests and samples collected from him were analyzed by the US Centers for Disease Control and Prevention in Atlanta. The H5N1 infection was confirmed and so Indonesia is now easily leading the world’ worst affected countries by bird flu list. The child died on March 19th and in that period poultry deaths were also recorded in the area where he lived. Most of the bird flu human cases have been linked with previous contact of the victims with sick or dead birds. The fear is that a mutation of the virus could cause it to be passed on from person to person and cause a world epidemic.

A Vietnamese research team has studied 18 bird flu victims and compared them with 8 people infected with a strain of human flu virus. The team, working at the Hospital for Tropical Disease, in Ho Chi Minh City, have discovered interesting details about the way avian influenza is manifested and the way it attacks the human body. The H5N1 virus used a high virus load to cause a massive inflammatory response which eventually kills the victim. Also, tests revealed that the highly pathogenic virus puts higher loads of the virus into the victims’ throats, rather than their nose, which commonly happens in regular human flu victims. The virus’ ability to replicate is also much higher that the one of a common flu. The human body’s response to the virus, an intense inflammatory effect, combined with other effects of the virus, is what eventually causes the patient to die. Roughly 240 people have been infected with bird flu since the first outbreaks were reported in 2003 and about half of them have succumbed to the disease. Another finding of the study was that antiviral drug are to some degree in fighting the bird flu virus, with drugs such as Tamiflu reducing the virus load and preventing a harmful response by the human immune system.

A 14-year old girl living in Indonesia’s South Sulawesi province has been recorded as the country’s 48th avian influenza fatality. The girl died in June, but was only recently tested positive for bird flu. The country’s Health Minister, Siti Padila Supari, held a news conference in Jakarta to make the announcement. She also said the the girl had previously had contact with fowls, as many chickens were found around the girl’s home. It is most probably that this is the source of infection. Indonesia’s death toll of 48 is now the highest in the world, easily surpassing Vietnam’s, a country that has, however been free of human cases of avian influenza for months.

A woman living in the South Sulawesi province, that had passed away in June, has been confirmed to have been infected with avian influenza. Laboratory testing results were only made public yesterday, as health officials from the country are forced to admit yet another flu case, despite the recent nationwide campaign that aims both to educate the general public on the disease and implement prevention measures. The case took so long to discover as the patient was not intentionally tested for bird flu at the time. She only presented high fever and the case was later forwarded to central health authorities to confirm a suspicion of avian influenza. Dead chickens were also found in the area where the woman lived and culling of other birds in the area will soon be carried out.

A 14-year old girl from Indonesia who died some two months ago was found to had been infected with the bird flu virus. The discovery comes so late after the girl’s death because she was tested as part of a routine check on several patients that presented influenza symptoms. The girl lives in a province 1,400 km northeast of Indonesia’s capital city, Jakarta, a region where chickens were also found dead after apparently becoming infected with the bird flu virus. One ministry official declared that two independent laboratories have confirmed the case, which is the country’s 47th, a death toll that is the highest in the world. The country’s refusal to conduct mass culling of birds in infected areas has been highly criticized, as now most of Indonesia’s 33 provinces have bird flu outbreaks. However, a plan of great proportion is under way now, as 300 million poultry are set to be vaccinated against the disease by the month of December. A nationwide campaign that aims to educate the general public was also launched last week. Avian influenza so far remains mainly an animal disease, but further mutations of the virus could cause it to be easily transmitted among humans and therefore cause a pandemic.

Spread across the world’s largest archipelago, consisting of more than 18,000 islands in Southeast Asia, Indonesia could be taken into consideration for many different reasons. Placed in a region of historical importance, anciently traversed by an important trade route to China, it was a thriving place for Hinduism and Buddhism before coming under the influence of Islam. Nowadays, its population of 200 million people make it the post populous Muslim-majority nation anywhere in the world. However, this is not information you will come across if you search for this country in the news now. 2006 has brought Indonesia in the spotlight for the ravishing effect that bird flu has had in the region.

Although the virus was originally discovered in Hong Kong and China, different factors that are to be found in Asian countries, such as poor hygiene measures in populations living closely together and relying heavily on backyard poultry raising, have rapidly spread the disease across the entire continent. While last year Vietnam was the most heavily hit country, Indonesia and Thailand have proven unable to contain the disease in recent months. Indonesia in particular is now facing a severe crisis, raising concerns at an international level. While the main causes for the situation are relatively obvious, Indonesian authorities seem unable to cope with the massive epidemic among poultry, which eventually causes human victims as well.

The main reason the country is often helpless in its attempt to contain the virus is financial inability to sustain an anti bird flu effort. The 2005 tsunami tragedy has severely impaired a country already facing financial difficulties. With thousands of victims and people left with no shelter, as well as major infrastructures to rebuild, an epidemic of massive proportions is not what the government would have been glad to face. Avian influenza is spreading rapidly and one of the basic measures that are to be taken is a rapid and complete culling of the birds in the affected areas. However, this requires the government to reimburse the owners for the killed birds. In a country where most of the population depends heavily on raising domestic poultry, this adds up to quite a hefty amount. It seems what a peasant receives for every bird is now little more than one dollar. In these conditions many  choose not to allow the culling of the birds.

Another issue is sending the message across to the entire population. Avian flu prevention requires education of the population, especially in a country with a large percentage of rural population. However, the isolation of many provinces and lack of coordination between the government and local authorities often lead to inefficiency of flu prevention programs. Cultural differences among Indonesia’s population only add to the obstacles that officials are facing.

In May, a case of particular importance drew the world’s attention again. A entire family of eight from North Sumatra fell victim to the disease and raised concerns that the virus had been transmitted from person to person. This is the biggest concern that experts have about the virus. If the illness can be transmitted among humans, then a pandemic is one step away. However, the case was the only one to be reported so far and it is not yet clear what the circumstances were. In recent weeks, Indonesia’s death toll has risen rapidly to 46, the highest in the world. 29 out of the country’s 33 provinces have been confirmed to have bird flu outbreaks and these worrying figures have prompted the government to launch a massive campaign against the disease. The plan is to vaccinate around 300 million poultry, starting this month and continuing all the way to December. A nationwide bird flu education is also on the table, with the focus on rural farmers and their families.

Although the issue may at times seem out of control in Indonesia, a look to the example Vietnam has given is encouraging when it comes to fighting the disease. Although suffering heavily after massive outbreaks, strict prevention and surveillance measures, as well as quick action after the discovery of new infected areas, have kept the country clean of any new human cases this year. Indonesian authorities hope that the disease’s spread can be at least slowed down, as eradicating of the virus looks impossible. Time will tell if success is possible in this undertaking.

Indonesian authorities announced the start of a nationwide anti bird flu campaign on Friday, in an attempt to stop the spreading of the disease which has been confirmed in 29 out of the country’s 31 provinces. After two years since the first cases confirmed on Indonesian soil, the death toll has risen to 47 in the Asian country and now massive funding is going towards an effort which is planned to help the country go through the crisis. One health official declared the government is aware that the issue is not one that will go away soon. Women and children constitute the majority of bird flu victims so far.

Ai Siti Amanah, a 9 year old girl living in an Indonesian region heavily affected by bird flu, has died after falling victim to the virus. She was only admitted to hospital carrying symptoms of the disease a day before. Laboratory tests proved that she had bird flu and further samples have been sent to an US-affiliated laboratory for confirmation. The village of Clikelet, where the girl lived, accounted for another bird flu victim just recently, while another death was recorded but without tests being carried out on the boy before he was buried. Avian influenza’s worst form - the H5N1 strain - is ravaging poultry stocks across Asia since late 2003. Indonesia now hold the highest death toll, with the latest victim bringing the number of deaths to 45.

South Korea has temporarily banned poultry imports from the United States, waiting on further laboratory results for the two swans from the state of Michigan found to have a strain of bird flu virus. South Korean say they do not want to take any chances and that the ban will be lifted if the virus proves to be a low pathogenic form of avian influenza. Roughly 26,000 tons of poultry were imported by the country from the United States, in the first half of the year alone. The US authorities announced earlier this week that the initial tests carried out on samples taken from the swans have ruled out the possibility of the virus being a dangerous H5N1 version. A definitive result will be available in about two weeks.

Another bird flu suspicion surfaces in Indonesia, as a nine year old girl from Cikelet, in West Java’s Garut district, is suspected of carrying the bird flu virus. The area is the same where the country’s latest confirmed case died in hospital, just recently and bringing Indonesia’s victim count to 44. A doctor from Garut’s main hospital told the press that the girl, living in a village from Cikelet, was admitted to hospital with typical symptoms of pneumonia. Suspecting a bird flu case, doctors put her in an isolation unit and took samples to test. However her condition remained critical until her death yesterday.

A cousin of the latest recorded bird flu case in Indonesia died more than a week ago and it is now revealed that he presented flu symptoms. A 17 year old teenager from West Java’s Garut district is refusing hospital treatment and is the country’s 57th confirmed case. Health authorities claim this highlights a need for more medical equipment. Garut’s health office’s chief, Iman Firmanulah, has told reporters that the young man’s cousin Misbah died on August 6th after exhibiting flu-like symptoms. Both of them had come into contact with dead poultry but Misbah was buried before researchers had the chance to test him for bird flu. A positive diagnostic cannot be made now but his symptoms were very similar to those of bird flu patients. Members of the man’s family are now being tested for avian influenza.