What the…?!?!
Published online: 28 July 2006; | doi:10.1038/news060724–12
Bird flu outbreaks in Indonesia going unstudied
“No sequence data” have been acquired from birds for nearly a year.
Declan Butler
Nature has learned that very few — if any — avian flu samples from Indonesian birds have been sent to official labs for sequencing over the past year.
The data blackout comes just as surveys of the country are revealing a startling number of previously unrecognized avian outbreaks.
“We have had no sequence data from poultry viruses for Indonesia for almost a year, since last August,” says Peter Roeder, a consultant for the UN Food and Agriculture Organization (FAO) in Indonesia. “It just happened; no one was sending any samples,” he says.
Experts say that without thorough genetic sequencing of bird viruses from the area it is difficult to tell whether the virus is mutating, or how the human cases correspond to birds in the area. There have been some human viruses found in Java that so far have no obvious avian counterparts: perhaps simply because matching strains in birds have not been sequenced, or perhaps not.
Good news?
Only now has a batch of such samples finally arrived at the World Organization for Animal Health (OIE) reference library in Geelong, Australia. “Good news: more than 100 animal isolates ready to go,” reads a report from an international expert consultation on combating H5N1 in Indonesia, held in Jakarta in late June. Some 91 of these samples have now arrived, says Roeder.
This activity may have been spurred by the limited human-to-human spread of H5N1 seen within a family in Kubu Sembelang in May this year. Scientists are keen to compare the human viruses with previous avian outbreaks in the area, but no such recent samples have been available.
Reporting of poultry results from Indonesia is “inadequate”, with “specimens going into a ‘black box’”, read the Jakarta meeting documents, adding that “this lack of information on avian H5N1 viruses requires urgent attention.”
“Over the next few months there will be quite intensive genetic analysis of the samples,” says Roeder. “This is something we really have to get on top of.”
Under surveillance
It has been difficult to organize sampling in Indonesia, Roeder says, with a decentralized system of responsibility for collecting viral material in a country spread over some 6,000 inhabited islands, with many backyard farms.
But that seems to be improving. There is an Indonesian government strategic plan, being assisted by the FAO, to create a large, coordinated surveillance and control programme around the country. A pilot scheme involving 12 teams has been running in the area around Jakarta since January this year.
The results of that pilot have proven startling. The Jakarta teams alone have discovered an average of 24 previously unknown infected locations a week between January and May. “The community surveillance system is starting to work,” says Roeder.
Thank you, Theresa42.
““The community surveillance system is starting to work,” says Roeder.”
We’ll have to wait and see whether that is actually the case.
The results of that pilot have proven startling. The Jakarta teams alone have discovered an average of 24 previously unknown infected locations a week between January and May.
Doing the math — 22 weeks times the average 24 infected locations = 528 infected locations around Jakarta between January and May
Given the number of human cases, those numbers sound about right.
Indonesia has never done any mass culling of poultry after detection of cases, only of infected chickens. Given that H5N1 infection carries 100% death rate in chickens, that means they only killed chickens that were already dead!
528 infected locations (not chickens) around only Jakarta in just 5 months…. Quite shocking. Although not as shocking as the fact that they’re not sending samples out for testing.
Didn’t the infected chickens have to be tested in an autorized lab other than Indonesias? This article is stating that the specimens were never sent outside of Indonesia.
Commonground – at 21:00
Chicken samples, not human samples.
Commonground,
I spent a long while trying to figure out the word ‘autorized’ thinking it must be a technical word, something to do with biological safety maybe. Took me more than a minute to realize it was a typo.
Help! I’m dyslexic!
LOL
Doesn’t this contain a bit of good news? Assuming that kind of widespread infection, with untold numbers of contact with not only chickens, but human to human contact and no outbreak?
The leap could be at any moment, I know. But seems like more evidence of a difficult leap. Is that a fair statement?
Patch – at 21:26 “Doesn’t this contain a bit of good news? Assuming that kind of widespread infection, with untold numbers of contact with not only chickens, but human to human contact and no outbreak?
The leap could be at any moment, I know. But seems like more evidence of a difficult leap. Is that a fair statement?”
That would be one way of thinking about it. On the other hand, given the high CFR in Indonesia, it would be prudent to assume that this could break out. ie low-ish risk, extremely high impact, IMO
Could there be unreported human cases (misdiagnosed as some thing else) due to the unknown presence of infected poultry and lack of alertness? There are lots of other diseases in Indonesia and some could have been called ‘death by natural causes’.
ANON-YYZ – at 21:38 “Could there be unreported human cases (misdiagnosed as some thing else) due to the unknown presence of infected poultry and lack of alertness? There are lots of other diseases in Indonesia and some could have been called ‘death by natural causes’.”
I’m sure there must be.
For example, there was a case last year where one person was diagnosed and then it turns out that 2 brothers had died the week before with similar symptoms but were never diagnosed. Now if it wasn’t for the third case, we would not have known of those other 2, who BTW were never counted in the WHO numbers.
That’s why Monotreme and I pretty early on caught on to the fact that CFR may be higher not lower than official figures because of all the missed dead cases. Symptomatic cases who survive are harder to miss as they are very sick for a prolonged period, and mild cases do not seem to be frequent from the limited seroprevalence data.
ANON-YYZ
Have you read the fictitious scenario that I wrote up for the WHO containment protocol thread? at 19:39
anon_22 – at 21:53
I read the scenario a few months back. That’s why I brought this question up when I saw all these unreported poultry infection sites.
My fear is there were other human cases which then infected poultry or mammals and ….
the kettle was boiling and we didn’t know.
ANON-YYZ. This but has been so widespread and in so many animal species since 2003, the pot is bound to be always on a slow simmer (we can’t see the steam)…
…but since the geographical explosion after Q. lake, it is definitely on the boil…
…Think of Africa which is actually poorer and more susceptible to viral evolution then Asia…now it has opened a two front war with weak oppositions.
Tom DVM – at 22:07
and we are the frog.
That’s OK…I really like frogs!!
My God, I hate that! I tried to figure out what anon-yyz was saying and then suddenly got it, with visuals in techni-color!
ARGH!!!
:0)
Tom, What about a possible third pot? Maybe they need to do some testing down in El Salvidor and I don’t mean blood tests. gina
Hi gina. Did I miss something…What’s going on in El Salvador?
Hi Tom,
At about the same time the 17m/Tiawan died of BF and D. fever, there was an outbreak of D. fever in San Salvador, El Salvador. This was on a thread a couple of days ago. I asked them a question about this, but I guess no one thought it was important. Sense I believe birds migrate, I also belive this virus is happening in the south. Who is to say the pot has to boil in the north? gina
Hurricane Alley RN – at 23:42
El Salvador is certainly a lot closer than Asia or Africa. Do we need Spanish speaking fluwikians to check out the local news, farmer’s magazines, vet’s publications etc?
Anon YYz:
Don’t bother Joe Neubarth has a gang following it with him. It’s all there with url on his thread at Avian flu talk at http://tinyurl.com/nybll.
TomDVM you might reminder he mentioned something coming for dinner via Columbia a month ago and we didn’t know what he meant? I googled him. He’s on it and it’s worrisome. BTW, he predicts your same timeline.
ANON- YYZ
I would love for someone to take a look at it since I don’t speak Spanish. My granson has been visiting, therefore I have not been able to investigate further. gina
Leo7 – at 00:03
How credible is Avian flu talk?
Didn’t Joe Neubarth ‘predicted’ that it’s going to be a Mild pandemic flu while refusing to supply evidence, that he was going to publish a book? And then I saw him posting something about being a historian and wanting to study flu samples thousands and millions of years ago under the arctic ice cap?
I can’t fit the pieces together. Something is not right about this story.
Leo7
It seems to be a popular timeline with some of us. gina
Anon YYZ:
His email is from a university and he did write a book about a group of people surviving a catastrophe. No, didn’t read it. I did read his threads to follow his POV, I think he’s hit on something. El Savador went to a yellow alert for dengue fever before we learned about the combo dengue/H5N1 infection in Thai. China exports heavily to South America. TomDVM is watching the pigs, and Neubarth is watching all animal die offs. It’s just another piece of interesting information to me. (Also, I’m in the south)
Was there anything BF related to the ostrich die offs in Africa?
anonymous – at 09:38
Ostriches South Africa. Quote - “An outbreak of a less virulent strain of avian Influenza in the Western Cape province of South Africa, has resulted in the culling of 8,000 ostriches… A further investigation has been performed in the surrounding areas and has shown that the H5N2 outbreak was under control and had not spread to other ostriches… The current outbreak of highly pathogenic avian influenza (HPAI) is a subtype H5N2, not H5N1.”
i need to go to malaysia in the coming weeks on a business mission and i have been reading about traces of the bird flu virus there as well. i am very much concerned about this and want to be wel prepared in any case. i have been looking for some sort of medication agaist the virus that i could carry with me on my trip. i came across Tamiflu on a drug delivery site and i am hesitating between the oral suspension or the tablets. which one is the best and most effctive out of these two? please help. i found them here:http://www.drugdelivery.ca/s3353-s-TAMIFLU.aspx
madhouse – at 03:01
There was a thread about DrugDelivery.CA
Just a red flag, please do your own verification.
08 June 2006 MadDog – at 01:15
I ordered several things fromthem in December (including T), and never got anything other than a large charge to my credit card. After months of emails and calls (the phone just rang and rang) I finally got an email from their customer service saying that they couldn’t fill the orders and that I’d get a “refund soon”. Never happened. When I contacted my credit card fraud division, they said they were pursuing “several” fraud orders against the company. It’s still not resolved. Later I saw on one of these threads that the copany had changed hands and were disavowing all prior orders. Anyone thinking of using them should read some of the reviews on the net. Buyer beware.
madhouse – at 03:01
Buying online Tamiflu is risky. Lots of fake Tamiflu out there.
If you have legitimate business trip, quite likely your doctor will write you a proper prescription, then you don’t need to buy from risky source.
madhouse - 03:01
Oral Suspension Tamiflu is for young kids below 2. Welcome to Malaysia. If u can’t purchase Tamiflu in yr country, u can purchase it in Kuala Lumpur at Guardian Pharmacy chainstores (http://www.guardian.com.my) or any other large chain pharmacies for ~RM165/box of 10 tablets. But u need to pre-order, call in advance to the branch nearest yr hotel or wherever u’re staying, so that they’ll order it directly from Roche & await a 1–2 wks delivery time. U don’t need doc’s prescription, but better if u have one.