by DemFromCT
The Indonesian cluster that's worrying flu bloggers and flu scientists hasn't quite burned itself out. With reports of scattered cases throughout Indonesia, but with a focus on N. Sumatra, the FAO and WHO have begun to talk a bit more openly about what's going on. Presumably, this is being done with the permission of the Indonesian government, since WHO is almost always constrained by local politics.
"We have seen these types of transmission before in Thailand and Vietnam and China where people living in close contact with an infected person have themselves become ill with bird flu without coming into contact with poultry," [WHO spokesman Maria] Cheng said.
"It is possible it is happening in Indonesia, we do not have any confirmation right now. But it is possible."
Health officials in Indonesia are still struggling to track down the source of a worrying family cluster of infections as tests showed that two more people have died of the disease.
One of the latest victims belonged to a Sumatran family, which lost several members earlier this month to bird flu, sparking fears of human-to-human transmission.
An Indonesian health official was unable to rule out human-to-human transmission.
I Nyoman Kandun, director for the Indonesian health ministry's communicable disease control centre, said an epidemiological investigation into a cluster of seven fatal cases in Sumatra, which health experts feared might be Indonesia's first case of human-to-human transmission of the deadly virus, was inconclusive.
"We cannot confirm that [human-to-human transmission] has occurred but we cannot rule it out," Kandun told reporters.
When the cluster, now eight individuals, begins in April and runs through mid-May, it's not from a single point source of infection. In fact, parallel to the statements from WHO and FAO, Mike Leavitt is sending tamiflu to an unspecified country in Asia. As explained here, the purpose of tamiflu would be to bolster containment of virus spread so as to head off a major epidemic.
The United States has sent a supply of Tamiflu to Asia to help the region prepare for a human outbreak of avian influenza, U.S. Health and Human Services Secretary Mike Leavitt said on Monday.
Leavitt did not say how much of the medicine -- recommended by the World Health Organisation (WHO) as a frontline treatment against a pandemic flu outbreak -- was sent, or where it would be stored.
"The United States government has just deployed treatment courses of Tamiflu to a secure location in Asia. The shipment is currently in transit and it will arrive later this week," he told journalists during the WHO's annual assembly in Geneva.
"I am not going to specify the amount or the location, but I want to make clear that we are beginning to deploy it," he said.
Can we put the picture together? The most logical explanation is that Indonesia is having some limited H2H spread of H5N1, something that's likely happened before in Vietnam, Turkey and Azerbaijan. The US Government is aware and is preparing stockliles of antivirals in case they are needed. Indonesia cannot deal with this by itself; it's had almost no success in culling poultry, and it's beginning to worry its neighbors. In the face of this, WHO denials of the possiblity of limited H2H have stopped (possibly in conjunction with the untimely death this week of the WHO's Director-General Lee Jong-Wook) and a subtle shift in the description of the H2H problem has occurred.
Indonesia will get close scrutiny this week, as will Romania (where large scale quarantines are taking place in the midst of H5N1 outbreaks amongst birds).
Stay tuned. Anyone who thinks H5N1 is no longer a problem because Vietnam and Thailand are under control is simply not paying attention.
Thanks DemFromCT for keeping us informed on this issue!
Posted by: Jon | May 22, 2006 at 21:46
There are many who may disagree with you, regarding the following entry in your Blog.
"Stay tuned. Anyone who thinks H5N1 is no longer a problem because Vietnam and Thailand are under control is simply not paying attention..."
On the other hand of course, you could well be right about the above!
In any case, we have today added the "WHO Gets More Honest About Indonesia" entry of your blog, to the "Best Bird Flu Blogs:..." section of our web site: www.birdflubreakingnews.com.
Thank you for this and we hope that we will have further contributions from you, providing a balance against the those who have an opposing view.
The Best Bird Flu Blogs team.
www.birdflubreakingnews.com
Posted by: Best Bird Flu Blogs team. | May 22, 2006 at 23:08