Forum: Indonesia Outbreaks XIV

Continued from here

Indonesia Summary - Updated as of 10/06/06

Note: The 5 patients in Makassar have not yet been marked as negative. Please see my question on the prior thread.

NoFluingAround – at 02:49 Influentia2 – at 23:15 After I posted I realized I left out the fact that it was Dengue fever in Delhi that they were talking about becoming an epidemic. So, we have a major outbreak of Dengue in Delhi, a confirmed case of Dengue, that turns out to be Bird Flu a couple of months later in Indoesia ….Fishy.

Michelle in OK - Hopefully there will be more articles out today and tomorrow on the 5 that were diagnosed negative. Just hold out on them another day or two. I’ve recorded them on my list as tested negative and gone home, but we’ll watch. I agree Faisal and Ical are the same, they have the same last name. Might be a sibbling, right now we’ll keep them as one person. I am confused with Nurasiah. The only person I can connect it to is Nur Azis (11). I do not have a Nurasiah on my list.

Commonground: Yes, Nurasiah is Nur Azis (11). From one of the reports:

“Six patients suspect this was their respective, Dion R (7), Mustarisa (4), Nur Asiah (11), Apriliyani, Paturungi, and Salsabil. From six patients tesrebut, four among them, Dion, Mustarisa, Nurasiah, and Salsabil entered on the same day, on Monday (2/10).”

Two patients Still Suspect AI http://tinyurl.com/qefog

07 Oct 2006 MAKASSAR

Lima [five] from seven patients suspect Avian influenza (AI) or bird flu, that was treated in the room of Building ferns of Lontara I the Hospital (RS) Wahidin Sudirohusodo (WS) was stated by the bird flu negative. The afternoon yesterday, they came home back to their respective house. They were the Rahmayanto Lamp, Mustarisa, Muhammad Salsabil, Paturungi and Apriyani.

Whereas two other patients, Ical Mahendra and Nur Asia were still being treated in the room 2 vips B2 because still suspect AI.

“Five patients could have come home.”

Whereas two other still suspect AI, because results of the sample of his blood do not yet have results till today (yesterday), said the nurse in ferns space, Naderi, yesterday.

According to Naderi, the Lamp and Mustarisa evidently did not contract AI but suffered Dengue Fever Dengue Fever (DBD). Although could RS WS asked them to be treated, but parents’s side wanted his two children to take medicine the road.

Whereas Muh Salsabila was diagnosed suffered pneumonia, Apriyani and Paturungi experienced the nutrient not all that. “For that the nutrient was not all that given by the motivation in order to improve his nutrient and give his child milk,” said Naderi.

Two patients suspect AI that still was treated till at this time, namely Ical and Nur Asia his condition began to improve against the first day was treated. The temperature of the body of Nur Asia yesterday already 36.6 Celcius levels whereas Ical 37 Celcius levels. According to Naderi, Ical and Nur Asia still was stated suspect through to results of the sample of blood of Jakarta decisive whether the two children were positive or negative AI. “If indeed AI, in the day of the three conditions for the patient usually is serious. “Hot him was very high, 39 to 40 Celcius levels and very breathless. But, up until today, the fever of the two patients did not experience the rise, said Naderi.

From results of the inspection, Nur Asia had the story of the TB from his parents who just underwent medical treatment during the last six months. The condition for Nur Asia at this time still was rather feverish and few coughs.

Whereas Ical, did not yet have the special diagnosis. “Ical the fever, shivered.” Cramps and the cough. It did not yet have his illness diagnosis specially. We were waiting for results of the sample of blood in Jakarta, added Naderi.

5 children Suspect Negative Bird Flu

Makassar, the Stand — Lima the child of Space of the ferns Isolation of occupants’s patient had finally been permitted to come home by the doctor in RS Wahidin Sudirohusodo, Sbatu (7/10). They were stated by the bird flu negative. The nurse was on duty at Tia Saugi, said, this child was Muhammad Salsabil (1,6), Paturungi (7), Apriani (8), Dion Rahmayanto (6), and Mustarisa (4).

Now an other patient, Nur Asia (11), was not yet permitted to come home because of results pemeriksaaan the sample of the mouth liquid and the nose him was not yet received. “The five patients have come home this morning (yesterday), while Nur Asia was not yet given by permission came home because results were not yet available, but possibly same results, because of his condition gradually membaik,”kata Tia.” Will improve Tia also said, in accordance with the report on Doctor Ahmad, the patient in Space of the ferns Isolation again will be filled up by a patient suspect bird flu. Till Saturday early afternoon, the patient that was meant to not yet occupy maintenance space. “Indeed up until now (yesterday) still in the child’s part, the paediatrician that broke when he would here,” explained Tia during it was confirmed. http://tinyurl.com/fat54

From #13, raina – at 15:17
South Sulawesi, hospitalized in Makassar Wahidin Sudirohodo, “lived in Street Maccini” - Suspected Badan Apriani/Fani (8), hospitalized on Sept 30
-Other Information
In contact with sick poultry that died recently

I’m just home for a few minutes, but Akhira also lived on Maccini Street.

yes, lived on same street—it seems everyone is neighbors of everyone else. But Akhira died in June, almost 4 months ago. So what is going on? Just synchronicity? Just coincidence?

And then, of course, if you believe all the negatives released in unison yesterday, then nothing is going on.

Bandung, West Java: new case, “Ny MK” female, age 65-- date of onset 10–5−06. Also states Aziz, Wildan, Krisna, and SC/Holy Rahmawati still in hospital. dated 10–8−06 http://tinyurl.com/njgys

Bandung — MIOL: the Patient suspect bird flu in the Handsome Sadikin Hospital (RSHS) Bandung again improved to five people, namely Az (9), Wil (20), Kri (17), Suc (14 months) and finally NY MK 65 that just entered UGD RSHS around struck 15. 00 WIB. NY MK, the citizen of the Village of the Love Round, the Heulang Sand Village, Kec. Cisarua, the Bandung Regency, that could be beforehand treated in RS Saint Yusuf, but because of showing signs of his bird flu were reconciled to RSHS Bandung. According to the husband of the patient MK, Itang (72), in Bandung, on Saturday, his wife was treated in RS Saint Yusuf since Saturday early afternoon around struck 12. 00 WIB, but because his condition increasingly descended, in a hot manner the high body through to 40 levels celcius, finally was reconciled to RSHS Bandung. When coming in UGD RSHS MK’s physical condition has descended and in the situation did not make himself aware, afterwards after being observed, direct, MK at once entered space of the bird flu isolation that is Poinciana Tree Space struck 15. 30 WIB.

Itang said, his wife has felt was sick since Thursday 5/10 and just was brought to the hospital two days afterwards and was based on results x-rayed in RS Saint Yusuf menunjukan strong signs of his wife terjangkit bird flu. “His body was hot high but did not experience breathless,” he said. He said, two from his five kept chickens died suddenly last week, in fact the chicken was ready him will be used for the need of Lebaran and the rest of them will be sold to the market.

In the meantime, the doctor in UGD RSHS, Dr Diana said the condition for the patient when coming to have been serious, and because of pointing out signs tertular bird flu then immediately was reconciled to Poinciana Tree Space. The chairman of the team of the control of RSHS Bird Flu Dr Hadi Yusuf said although being based on the Itang acknowledgment was not breathless was experienced by his wife, but from the medical inspection was seen if MK experienced breathless. “We did not believe just like that, therefore we the cheque because indeed his reconciliation suspect bird flu,” he said to the reporter

The action memasukan to Poinciana Tree Space was done to anticipate MK’s possibility really terjangkit bird flu, because apart from his kept chicken there are those that died, there were also several neighbouring chickens that took part in dying suddenly.

In the beginning inspection of MK’s physical condition continued to descend with the temperature of the body achieved 40 levels celcius, blood pressure continued to descend through to 180, results x-rayed pointed out the existence of the infection in the lungs or pneumonia, his leucocytes descended until 1. 600, likewise with trombosit blood took part in descending. “Expected that because of the virus infection”, “but still could not be known by his virus kind, because of being waiting for results of the further inspection,” he said. Hadi also said, despite already last week the chicken belonging to the patient died, but this case must continue to be guarded against.

In the meantime, the four patients that still was treated in RSHS Bandung, namely Az (9), Wil (20), Kri (17), Suc (14 months) his condition has improved, in fact the patient Wil and Kri that were the older brother was siblings and was the citizen of the Village Andir the Lembang Subdistrict, the Bandung Regency on Monday (9/10) the day after tomorrow has been permitted to come home. Wil and Kri, could be returned because the Balitbangkes inspection showed results of bird flu of the negative.

Bandung, West Java: more on “MK” whose name is Mama Komariah. dated 10–7−06. http://tinyurl.com/z7cga

Metrotvnews.com, Bandung: the Handsome Sadikin Hospital (RSHS), Bandung, West Java again received the patient suspect bird flu. Casualties were named Mama Komariah, villagers the Love Round, Cisarua, the Bandung Regency. With the entry Mama, RSHS currently treats five patients suspect bird flu. Mama entered RSHS, on Saturday (7/10), in the afternoon and immediately was treated in isolation space. Beforehand, Mama could be treated in RS Saint Yusuf, Bandung. However because his condition continued to worsen, Mama finally was reconciled to RSHS. Doctor who examined him suspected Mama was infected by bird flu. This was marked in a hot manner high and breathless that was experienced Mama. However his assurance was still being waiting for results of the further inspection. Now the husband Mama, Itang said his wife complained the fever since Thursday (5/10). Further Itang said znumanyz weeks ago, his two property chickens and several chickens in his house environment died suddenly.

Bandung, West Java: more on Mama. dated 10–7−06. http://tinyurl.com/r9mhk

Bandung, (HOMEWORK). … Mama lunar (65) was run off with to Poinciana Tree Space of RSHS Bandung after beforehand suffered hot the fever, was accompanied breathless…. Itang said, the two chicken carcasses were at once thrown away because worried terjangkit bird flu. He received information concerning bird flu through the television broadcast….

Blood pressure began to descend 100 per 90. According to results x-rayed, on his lungs had a little pneumonia,”… This morning, his side took the sample of blood Mama to be tested in Balitbangkes Jakarta.

pugmom - at 15:35: “He said, two from his five kept chickens died suddenly last week, in fact the chicken was ready him will be used for the need of Lebaran and the rest of them will be sold to the market.”

“Lebaran” is the word Indonesians use for the feast at the end of Ramadan, when approx. 17 million Indonesians travel to the countryside to celebrate with their families. It will take place this year around Oct. 24–26. There is great incentive for farmers to sell their goods at this time as they fetch unusually high holiday prices.

Reconciliation from RSI, Currently is treated by RSUD Dr Iskak

 TULUNGAGUNG

- the bird flu Threat in Tulungagung apparently did not yet abate. Yesterday the night, Miftahul Mufidah, villagers Betak, the Kalidawir Subdistrict, was run off with to RSUD Dr Iskak Tulungagung. That he because of being stated suspect (it was supposed) bird flu. The previous day, the girl was 18 years old was treated in the Islam Hospital (RSI) Tulungagung. However because of his condition increasingly worsened and results of the diagnosis in RSI stated that results headed to the virus avian influenza (AI), then the daughter of the couple Karji-Supingah direct in referred to RSUD Dr Iskak. When being brought to RSUD, the condition for casualties in the weak situation. Apart from suffered breathless, he also experienced coughs and the fever. Increased again, phenemonian also worsened. “When being brought here, reconciliation from RSI indeed said 75 percent casualties suspect AI. Okay Then, was treated by us like the bird flu patient,” said RSUD public relations Dr Iskak Tulungagung Triwidyo Agus Basuki. The assumption of the existence of the bird flu was strengthened by the existence of many chickens died around casualties’s residence. The Miftahul Mufidah house indeed close to the poultry farm. The “chicken that died that property of the neighbour that be at a distance 500 metre from our house,” said Supingah, the mother of casualties. How results of the official’s inspection RSUD? Answered Oki -the nickname Triwidyo Agus Basuki, was not yet found by the indication of bird flu. The temperature of casualties’s body was not too high, revolving 36 levels celcius. Moreover results of the photograph of the chest of casualties also were not found by the existence of the disturbance to his lungs. We still could not confirm whether casualties suspect AI or not. But if seeing results of our official’s inspection, was not yet found by this indication. If AI usually the temperature of his body will be very high, minimal 38 or 39 celcius, pungkas Oki. (yog)

http://tinyurl.com/zxfuw

pugmom at 15:40: Is this the name of the region in Bandung: Cisarua?

Commonground: Yes, Cisarua is a subdistrict in the Bandung Regency, West Java

Influentia2 at 17:53… the article is dated October 8th. I am listing the initial hospital date at 10/06, with a transfer on 10/07. Perhaps better dates will surface in later articles.

Indonesia Summary - Updated as of 10/07/06

pugmom at 15:05… with all the negatives, perhaps nothing is going on.

I went back and searched a little on Akhira. If I’m not mistaken, she was the first patient confirmed positive by Indonesia for whom no samples were sent to the WHO. This was from an article you posted on the Outbreak VI thread at 14:28:

Indonesia’s 47th fatality from the virus was a woman called Akira from South Sulawesi province… “We did not send (the samples) to the WHO (World Health Organisation) because our positive results are usually positive results at the WHO,” she added.

Perhaps just coincidence (except I don’t believe in coincidence.)

Commentary

Mammalian H5N1 Evolution in Indonesia

Recombinomics Commentary October 7, 2006 - http://tinyurl.com/mmx3g

The recent announcements of H5N1 bird flu in cats in Indonesia, coupled with results from expanded sequencing of poultry strongly signal the existence of a separate mammalian H5N1 reservoir in Indonesia that is responsible for the vast majority of human cases.

This separate reservoir creates significant problems, because most of the attention has focused on infected poultry, and the mammalian reservoir has been significantly under investigated and under reported.

Therefore, a review of the evolution of this mammalian reservoir is useful. Although Indonesia did not acknowledge H5N1 infections until 2004, the first isolates were from birds in 2003. Sequence analysis of the 2003 and 2004 isolates indicated the H5N1 was Clade 2 and had a number of genetic markers that were specific for Indonesia.

The first human case was reported in July of 2005, and the sequence of the isolate, A/Indonesia/5/2005 had the Indonesia specific markers, but also had a number of unique polymorphisms, including one that created a novel HA cleavage site, RESRRKKR. However, the second human isolate, A/Indonesia/6/2005 had the more common HA cleavage site, RERRRKKR, and was similar to bird isolates. Subsequent human isolates in 2005 had the novel cleavage site, but several had an additional silent change, so although the cleavage site matched the first sequence at the protein level, there were a number of changes at the nucleotide level that divided the sequences with the novel cleavage site into two groups.

However, as the number of sequences increased in early 2006, it became increasingly clear that the human sequences were separating from the poultry sequences, all of which had the common bird cleavage site. The first match of the human sequences was from H5N1 from a throat swab of a cat in Indramayu near a residence were two siblings died from H5N1 infections. The sequence of the cat isolate not only matched the more recent human sequences, but was very close to the sequences of the isolates from the two siblings, A/Indonesia/283H/2006 and A/Indonesia/286H/2006, as well as other human isolates from Indramayu, A/Indonesia/292H/2006 and A/Indonesia/304H/2006. New isolates in 2006 collected from patients in East and West Java were sequenced and all were matches of more recent sequences such as the four human and one cat isolate from Indramayu.

In May of 2006 however, there was a new cluster in the Karo regency in north Sumatra. This outbreak was the largest to date and involve secondary and tertiary transmissions of H5N1. Consequently a meeting was call by WHO and consultants in Jakarta in June. Included in the presentation was a phylogenetic tree that summarized the H5N1 Indonesian isolates as of June 12, 2006.

The tree, which had the human sequences in green and the Karo cluster shaded in pink, clearly showed the match problem. All of the sequences with the novel cleavage site were on the lower portion of the tree and there were no poultry sequences on these two lower branches. Moreover, all of the recent human sequences from Java were on the lowest branch, which was even further from the poultry isolates. Thus, the human isolates were evolving away from the poultry isolates, suggesting the existence of a separate mammalian reservoir.

However, all of the human isolates were from July, 2005 or later, while most of the bird isolates were from earlier dates. Therefore 91 samples were schedule for shipment to Australia for virus isolation and sequencing. The samples were from infections between September, 2005 and March, 2006.

As sequences from these more recent and geographically dispersed isolates began to be published, it was becoming increasingly clear that the vast majority of the human infections on Java were not from domestic poultry. Each human sequence mapped to the lower portion of the tree and which was more distinct from the bird sequences.

The second set of new bird sequences included an isolate with the novel cleavage site. It was from a duck on Indramayu isolated in 2006. However, that isolate match the upper branch of the human sequences, which were composed of six isolates from three patients in 2005. Thus, although every human isolate in 2006 was matching the lower branch, the one duck sequence matched the upper branch.

The third set of poultry sequence had two matched with the lower branch. However, the two matches were from chickens in central Sumatra from 2005. Thus, none of the poultry isolates matched the lower human branch, while all human isolates, as well as the cat isolate, matched the lower human branch.

These data again supported a separate reservoir for the human sequences, and the only matches on Java were from the one cat, and all human isolates. The recent announcement indicates more H5N1 has been detected in cats, but the sequences of those isolates have not been released. Swine H5N1 sequences have been reported, but none match the human sequences.

The match failures pose a major problem because testing of humans is largely limited to patients how have been near dead or dying poultry. However, the poultry association has not been linked to the human infections, so an expanded testing of patients with symptoms is warranted. Similarly, more sequencing of H5N1 from other reservoirs is warranted by the match failures between mammalian and avian sequences.

RSHS Bandung received the New Patient the Assumption of birds flu

Caption next to Photo: 08/10/2006 13:16 of Mama Komariah was reconciled from RS Saint Yusuf Bandung because his condition showed the sign was similar to bird flu. The sample of blood and the spinal cord liquid Mama has been sent to Balitbangkes Jakarta to be checked.

Liputan6.com, Bandung: the Handsome Sadikin Hospital (RSHS) Bandung received the new patient the assumption of bird flu, Ahad (7/10) days.

Mama Komariah was reconciled from RS Saint Yusuf Bandung because his condition showed the sign was similar to bird flu. The woman 67 years experienced the high fever achieved 40 Celsius levels and the cough was accompanied breathless. Currently, the condition for Mama Komariah continued to be monitored by the medical team.

The citizen of the Village of the Love Round, the Cisarua Subdistrict, Bandung this was isolated in Poinciana Tree Space RSHS. In The Meantime the sample of blood and the spinal cord liquid Mama has been sent to the Body of Health Research And Development (Balitbangkes) Jakarta to be checked.

Mama was the 63rd patient who was treated in RSHS Bandung. From the number, eight positive people of bird flu. Totalling six including dying, one of them Zakaria Divine Guidance (20 years). Divine guidance was reconciled to RSHS, several hours after his older brother, Indra Jayakusumah died in RS Saint Yusuf [read: the Bird Flu Patient in Bandung died].

Was based on the Department’s note of the Health, totalling 52 people died in the case of the spreading of the virus avian influenza in the Motherland. From the spreading of the plague of bird flu in 30 provinces, nine positive provinces bird flu. Among them in West Java was gotten by 22 cases with 18 people died. http://tinyurl.com/kmyc8

‘’‘His mouth was installed Ventilator MK’s Condition continued Memburuk’‘’

RSHS, (GM).09/10/2006 - the last Condition for the patient suspect bird flu had the initials MK (65), the citizen Kp. The Love round, the Pasirhalang Village, Kec. Cisarua, Kab. Bandung it was reported continued to worsen.

According to the Head of Handsome Sadikin Space of the Hospital Poinciana Tree (RSHS) Bandung, Block represented the Chairman of the Handling of Bird Flu, Dr. Hadi Yusuf, Sp. P. D., K. P. T. I., on Sunday (8/10), casualties were forced to have to put on the ventilator (respiratory aids) through the mouth. “Casualties’s respiration continued to descend through to lowest was recorded by 38 times per the minute.” Therefore, casualties used the ventilator, said Block.

In the meantime, further Block, increasingly bad him the condition for casualties till at this time was triggered by bad him the condition for casualties when being brought to maintenance space RSHS. At First again after being done by observation by the team of the handling of bird flu, he continued, casualties also it was known contracted pneumonia (the acute lungs). “When putting on the ventilator then casualties were still being seen heavy when breathing.” <snip>

Therefore, to ascertain casualties positive or not terjangkit the virus avian influenza (AI), the sample of blood and apus casualties were immediately sent to the Body of Health Research And Development (Balitbangkes) RI in Jakarta. Rancananya, the sample of casualties’s blood was just sent, on Monday (9/10, today, red).

In the meantime, the Ron condition (11), the citizen Street. Cijagra RT 04/RW 10 Kec. Bojongsoang, Kab. Bandung that was reconciled to RSHS not long after MK, tended to improve.

As being reported beforehand, RSHS Bandung again received two patients suspect bird flu had the initials MK (65) and Ron (11). <snip>

http://www.klik-galamedia.com/

So “Ron “ is a new case? age 11. I guess we have no other details on this person, as date of onset, etc. Thanx for info Pixie.

I wonder why they did a spinal tap on the older patient, I don’t think we heard of them sending in spinal fluid before on any other patient, have we?

Worrywart—from the earlier articles, it said she had lost “awareness” which means she is lapsing into coma. Spinal taps are routine with comas of undetermined origin. I am so glad they did one, as maybe they can isolate H5N1 from her cerebralspinal fluid, if it is there. In my mind, this would be a critical determination.

more on pigs in Bali. dated 10–8−06. http://tinyurl.com/q8c89

Metrotvnews.com, Denpasar: Tim the researcher the Medical Faculty the Animal, the Udayana University, Bali found the case of the spread of the bird flu virus to the animal of the pig livestock in several cities in the Balinese Province. The case was found in part in the Tabanan Regency and the Gianyar Regency…..

community unrest in Deli Serdang, North Sumatra. dated 10–9−06. http://tinyurl.com/ocr5r

‘’‘The plague of Bird Flu caused the Community’s Unrest The Pakam the deepest part’‘’, (the Analysis) The regent Deli Serdang Drs H Amri Tambunan said, became an epidemic him the bird flu virus that it was identified as the cause of the death of several people, caused the unrest for the community.

This condition, certainly could be understood because bird flu was the dangerous virus that could threaten the health of the community, especially because not yet everyone that understood and knew more far the influence and the level of the spread that could happen to humankind, said the regent in the Forum for consultations of Bird Flu that was spread out of the Control Public of the Deli Serdang Regional Government with the Department of Kominfo-RI in balairung the complex the Pakam The Deepest Part of the regent’s office.

From the condition that happened, there was no other alternative to all the elements of the community must have the big interest in prevention efforts and the control of the possibility of expanding him the case of the bird flu, because be related to to the dignity of the life of the community many….

setting up new hospital for AI in Kediri, East Java. dated 10–7−06. http://tinyurl.com/mepbn

The sun - Kediri, the Government of the City Kediri East Java prepared the fund of Rp 600 million to develop the special installation the maintenance of the bird flu patient or the patient Avian Avian influenza (AI) in the territory of Karesidenan Kediri East Java. The allocation of this fund was prepared after the Government of the East Java province maintained the regional public hospital (RSUD) Gambiran the Kediri City as the hospital of reconciliation of the bird flu patient for the territory of Karesidenan Kediri that covered the City and the Kediri Regency, Blitar, the Tulungagung Regency, the Trenggalek Regency….

According to him, the allocation of the Rp fund 600 million for the installation treated especially AI was budgeted for in the change in the budget of year finance. Whereas his execution project will begin to take place to this coming 2007….

The installation will be developed in the complex of RSUD Gambiran the Kediri City that his location was separated with the main building. He explained, apart from causing hundreds of thousands of poultries in his village to die and to be destroyed, the spreading of the bird flu virus in Karesidenan Kediri also attacked nine citizens who were stated as suspect and two other people died, because positive was affected by bird flu. It was further that Bambang said, uptil now the handling suspect bird flu was from the Kediri Regency assessed slow.

Because to get the handling that more intensive the patient must be brought to RS reconciliation in RSUD Dr. Soetomo Surabaya and RS Syaiful Anwar Malang that was also significantly significant needed trip time that relatively old. He added, with the determining of RSUD Gambiran the Kediri City as RS the maintenance of this bird flu then was hoped for by the handling against suspect AI the Kediri Regency could be immediately carried out.

setting up new AI facilities (by end of December) in South Sulawesi. Dated 10–8−06. http://tinyurl.com/rsvy8

RS Salewangang got up Space of the Bird Flu Isolation Maros, the Stand — the regional Public Hospital (RSUD) Salewangang, the Maros Regency, was at this time carrying out renovation for the increase in space of the isolation of the bird flu sufferer. “Uptil now did not yet have isolation space for the bird flu sufferer.”

Therefore, now RSUD Salewangang builds him, the Maros headword of the Health Service, Minhajuddin Hanafi, on Saturday (7/10). Moreover, his plan will be developed also the special room for the sufferer the HIV/the AIDS and illegal drugs. This was based on the South Sulawesi instruction of the Health Service that Obliged all the hospital in the area to be equipped the room of the isolation for the bird flu sufferer, the HIV/the AIDS, and illegal drugs. The RSUD Salewangang managing director, Andi Firman Jaya, explained, the development swallowed the Rp budget 350 million. Whereas the fund that was allocated from the Budget of the Income of the regional Expenses (APBD) 2006 only Rp 250 million.

Dewan Perwakilan Breakingprep Rakyat Breakingprep Daerah Vice Chairman (DPRD) Maros, HM Hatta Rahman, added, will look for the solution for the increase in the development cost of three isolation spaces. “We immediately will look for the solution that was best for the development of this hospital.” Moreover, we gave the deadline to complete the development to the end of December 2006, he explained…

The RSUD Salewangang requirement EXPENSES, the Maros Regency during 2005 totalling Rp 5,426 billion and this figure increased in 2006 to Rp 11,557 billion. The existence of the increase dikritisi by Vice Chairman DPRD Maros, HM Hatta Rahman, so that RSUD Salewangang does not have the reason again to not increase his service. DPRD Maros, said Hatta, will continue to increase and increase the budget of the cost of the hospital expenses maximally from the year to the year…

Bottom portion of this article mentions earlier cases than Mama. Rest of the article is about Mama and does not add anything to what we already know, (at least I don’t think so).

<snip>

This morning, his side took the sample of blood Mama to be tested in Balitbangkes Jakarta. Although clinically was classed in the difficult condition, but according to the latest report, the team of the doctor not yet gaze at needed to install the ventilator. On that occasion, Dr. Hadi explained the condition for the patient suspect mature, that is Wil (17), Kris (20). The older brother was siblings from Kec. Lembang this his situation increasingly improved. Therefore, Wil dak Kris could have come home, on Monday tomorrow. Whereas suspect the child, Az (9) from Tasikmalaya, and Sc (14 months) from Jatinangor, Sumedang, also improved. However, the child’s two patients still could not be ascertained by his returning time. Was based on results of the Balitbangkes test, the four of them were stated by the negative terjangkit the bird flu virus.

http://www.pikiran-rakyat.com/cetak/2006/102006/08/0103.htm

More news about pigs and H5N1 in Bali.

Metrotvnews.com, Denpasar: Tim the researcher the Medical Faculty the Animal, the Udayana University, Bali found the case of the spread of the bird flu virus to the animal of the pig livestock in several cities in the Balinese Province. The case was found in part in the Tabanan Regency and the Gianyar Regency. Up to now, the bird flu virus spread to various territories in Indonesia. Last September, the Organisation of the Health of the World (WHO) mentioned Indonesia was the country with casualties died most resulting from bird flu. Last casualties that was expected terjangkit bird flu was Mama that currently is treated in the Handsome Sadikin Hospital, Bandung.

http://www.metrotvnews.com/

Pugmom-Thanks for explaining that to me, I did not know that was a regular procedure for coma. thought she may have had mengingitis or something like that.

Okieman at 22:08… I had not recorded SC (14 months) as negative before. The other three we had.

Indonesia Summary - Updated as of 10/08/06

Bandung, West Java: Mama not doing well, in spite of a team of 9 specialist doctors working on her. dated 10–9−06. http://tinyurl.com/fm9vz

Bandung — MIOL: the Condition for the health of Mama Komariah, 67, the patient suspect bird flu that was treated in Handsome Sadikin space of the isolation of the Hospital Poinciana Tree (RSHS) Bandung, at this time increasingly worsened….

To make the medical maintenance effective against Mama, that till Monday his condition increasingly worsened, the team of the control doctor of RSHS bird flu dropped nine doctors off. “We will not be reckless in handling the patient suspect bird flu like Mama.” So, we dropped nine doctors off. The number not yet including several special doctors, among them the lung doctor, said the chairman of the team of the control of Hadi Yusuf bird flu, on Monday.

Hadi said, originally blood pressure Mama could increase through to 40 levels celcius, and oxygen to his blood precisely descended. As medical anticipation efforts, the team of the doctor was forced to install the ventilator implement. “Before being installed the ventilator implement, the team of the doctor could try to make use of cover oxygen to the respirator.” However the condition Mama stayed unstable. And, to restore again the condition for his health, Till today the implement (the ventilator) this be forced still continue to we rose, said Hadi. Hadi mangakui since being sent from the Hospital Saint Yusuf Bandung on Saturday (7/10) last week, the condition Mama still continued to worsen, was increased by the existence of pneumonia to his lungs….

Pro-med comments on the infected pigs in Bali. dated 10–8−06. http://tinyurl.com/ftfu6

Bird Flu Virus Infects Pigs in Bali

The Team of Veterinary Faculty at Udayana University has found evidence that the avian influenza (AI) virus has infected pigs in Bali. Wider scale research is now in process. The AI finding on pigs was due to college students’ research, which diagnosed several ill pigs from May to June 2006. Out of 20 pigs, 2 were positively infected by H5N1 virus. “The pigs are in Gianyar and Tabanan,” said I Gusti Ngurah Mahardika, a professor at the faculty, on Fri 6 Oct 2006.

The virus grows in ill pigs, and the pigs cannot be cured by medical treatment. [At necropsy], there are red blotches on the spleen. By [immunohistochemistry], the red blotches were viruses on the pigs’ tissue.

However, the H5N1 virus was not found in the animals’ tissue. “Probably the virus only passed by, or is called an opportunistic virus,” said Mahardika.

The finding has not yet been publicized as a scientific study, but it has been conveyed to the Bali Breeding Service as a warning.

Virus contagion, according to Mahardika, is likely because with the pattern of chicken and duck breeding, the animals are free to enter pig stalls. In Bali, 900 000 pigs live side by side with other cattle.

http://tinyurl.com/kpgke (Excerpt)
The Indonesian government and China will increase the co-operation in the economic field and the trade that mutually menguntung-would. The shape of this co-operation has dita you tangani him nota kesepahaman (MoU) by Commerce Minister RI Come On Pangestu and Commerce Minister China, Bo Xilai, on Friday (6/10) in Nusa Dua Bali. MoU this covered the co-operation Website Economics and the China-Indonesia Trade, the Formation of the Promotion Committee of Investment Together, the Decline in the Cocoa tariff under the Decline Program in the tariff (EHP) in accordance with the ASEAN-China Agreement of the Trade Region (ACFTA), as well as MoU the Technical Co-operation the Control of Bird Flu.

09/10/2006 16:02 - Sosial Budaya/Headline News
http://tinyurl.com/k9tar
The regional public hospital (RSUD) Deli Serdang, North Sumatra, at this time still was treating a flattest patient bird flu.

The patient was named Darwin the son Sitepu, 16 years, this till Monday (9/10) still was weak. Already villagers’s two Wonosari days, the Market Seven, this Morawa Cape Subdistrict was still being treated intensively in VIP Space the Orchid Ii RSUD Deli Serdang. Every time two hours very much the temperature of his body was checked. Darwin was stated flattest bird flu because of the characteristics of the characteristics breakingprep early that was suffered by him resembled bird flu, as coughs and the temperature of the body achieved 38 levels celsius. According to the mother of the patient, the Boru Sembiring Opinion, his child experienced hot high after touching his five chickens that died suddenly. Beforehand, RSUD Deli Serdang also treated a patient who was expected terjangkit bird flu was named Elisa. However, after being treated, Elisa was stated by the negative and has been permitted to come home

I have a DL (9) Admitted on 10/l under N. Sumatra. Can anyone else tell me if they have an age for DL? Somewhere I picked up 9 years old. I’m wondering if this could be “Darwin” - who is 16 years old.

I found the verification that DL is 9. Pugmom at 16:56 - October 2nd, of this thread. So DL can’t be Darwin listed above.

Commonground… I have DL shown as a female. It is interesting to note that DL also started out in RSUD Deli Serdang, but was later transferred to RSUP H Adam the Medan Owner.

I don’t have an Elisa listed, but will not add as a time frame was not given and she was stated negative already.

Michelle, I never had Elisa listed either……she’s already home now anyway. But it makes you think, what other cases have we not heard about?

geez, I had just posted that article about community unrest in Deli Serdang, North Sumatra yesterday evening. (at 21:17). Now we have the real background for the article.

bump

Here’s my current summary:

-East Java province, hospitalized in Surabaya, Dr. Soetomo`s hospital, patients from Tulungagung -Confirmed

• Abram, (11), died Sept 19, index case
• Eni Wulandari (25), in hospital Sept 25, sister of Abram, has improved somewhat

- Suspected

• Tukinem (70), grandmother of Abram, symptoms reported on Sept 28, also has asthma, tested negative

 -Tested

• Sutris and Sriah (parents), Winda (relation?), Santi (older brother), parents tested negative
• 6 students from Abram’s school

-Other Information

• Index case suspected to have caught AI from chicken fertilizer
• Other family and HCW tested negative

-East Java province, Kediri, patients from Ngebrak -Suspected Dimas Amir Ahmad (2), fever and cough, improved after doctor, not sure if sample was taken, happened before Oct 9 -Other information

• area poultry tested positive for BF, ten area chickens died two days before symptoms

-West Java province, hospitalized in Bandung, RS Hasan Sadikin hospital, patients from Sukaratu

 -Confirmed

• Taufik Zakaria (20), died Sept 28, hospitalized Sept 25, second index case

 - Suspected

• Indraya Jayakusuma (25), died Sept 24, brother of Taufik, no samples taken, first index case
• Intan Mustika (15), sister of Indraya and Taufik, went to hospital Sept 25, father reported her to have not had contact with poultry unlike her brothers, negative (positive for seasonal flu) and discharged
• Santi (18), symptomatic on Sept 26, hospitalized on Sept 28, cousin of index cases, reported negative, gone home
• Gugun Gunawan (19), symptomatic on Sept 23, fever has begun to descend, neighbor of Indraya, reported to have slept over in Indraya’s room.

 -Tested

• Samples taken from 18 contacts, including 3 other family members (2 parents Ahmad Kosasih (55) and Nurjanah (43) and cousin Hani (21)), others are neighbors.

 -Other Information

• Brothers fed dead chickens to their dog(s), some chicken used was from Garut
• Birds around the home of family were found to be positive for H5N1. Other birds in the neighborhood have been culled.
• Brothers had traveled home from Garut just before becoming sick, burials in Garut
• Family dog plus 11 dogs in the area have been tested, family dog tests negative
• Healthy chickens in the area tested positive

-West Java province, hospitalized in Bandung, RS Hasan Sadikin hospital, patients from Sapan - Suspected

• (General) /Amah/Amas (41), hospitalized on Sept 28, dengue also suspected, previously had typhus, reported negative

-West Java province, hospitalized in Bandung, RS Hasan Sadikin hospital, patients from Kahuripan, previously at Lembang Hospital for 2 days -Suspected

• Wildan (20), hospitalized Sept 29, report negative Oct 5
• Krisna (17), hospitalized Sept 29, brother of WD, report negative Oct 5

-Other Information

• Father, Dadang Rohman (46), said 2 of 3 chickens died recently
• Uncle, Wahyuna (42) said doves of the family died recently
• Reports say poultry in the area tested negative

-West Java province, hospitalized in Bandung, RS Hasan Sadikin hospital, patients from Jatinangor -Suspected

• Suci Rahmawati (14 months), hospitalized Oct 2, symptomatic a week ago, previously at Berung Public Hospital and brought to Bandung after condition worsened, reported negative Oct 6
• Hir (12 months), hospitalized Oct 2, cousin of Suci, lives next door, not as sick as Suci

-Other Information

• Father of SC, Ikin (33) said a week before two chickens belonging to a neighbor 5 meters away died, children did not play with them

-West Java province, hospitalized in Bandung, RS Hasan Sadikin hospital, - Suspected

• (General) /Amah/Amas (41), hospitalized on Sept 28, dengue also suspected, previously had typhus, reported negative

-West Java province, hospitalized in Bandung, RS Hasan Sadikin hospital, patients from Heulang - Suspected

• Mamah Komariah (65), hospitalized on Oct 7, feverish since Oct 5, previously at RS Saint Yusuf, put on a ventilator Oct 8, spinal sample taken, coma

-Other Information

• area/family chickens died two weeks ago

-West Java province, hospitalized in Bandung, RS Hasan Sadikin hospital, patients from Bandung - Suspected

• Ron (11), hospitalized on Oct 8

-Other Information

• area poultry died recently

-West Java province, hospitalized in Tasikmalaya regional public hospital, patients from Cilumanjang - Suspected

• Ateng (50), symptomatic Sept 22, hospitalized Sept 28, sent home Oct 4
• Muslihan (12/13), son/daughter of Atang, symptomatic Sept 20, hospitalized Sept 28, sent home Oct 4
• Azis/Ajis (9/10), not sure of relation to other suspects, but apparently contact, hospitalized at Kawalu Community Health Centre on Sept 29, reported no contact with chickens, symptomatic on Sept 26, moved to Bangung on Oct 1, reported negative on Oct 3
• Mae (42), wife of Ateng, not hospitalized

 -Tested

Six family members and neighbors -Other Information

• Wife reported 20 family chickens had died suddenly, samples have been taken, preliminary result is reported as both negative and positive in different reports

Parents have evacuated children from the area

-Central Java province, hospitalized in Semarang Karyadi Hospital, patients from Gisikdrono Suspected

• Bimo Alamsyah (2.5), hospitalized Sept 28, improving (Oct 3), tested negative Oct 3, sent home

Other Information

• Chicken deaths recently, as well as 4 cats and 6 goats, one goat was consumed by people, including the patient, cyanide poisoning in goats offered up as explanation, chickens in area have tested negative

-Jakarta, hospitalized in Jakarta North Sulianti Saroso hospital, from Pondok Pinang -Confirmed

• Fajar (9), symptomatic Sept 13, hospitalized Sept 20, died Sept 22

-Suspected

• Mariyani (24), first report on Sept 29, hospitalized before that, showing improvement, said to be typhus – if she is the same as Y. (29), then tested negative Oct 5

-Other Information

• Department of Health lab official sick, doesn’t say with what?
• Five symptomatic people from the same area tested negative Muhamad Faisal (15), Abdulah (36), Azwar (15), Sumarni (39), and Sri Fortune (37)

-Jakarta, hospitalized in Jakarta North Sulianti Saroso hospital -Suspected

• Farida (15 months), hospitalized Oct 2, measles originally suspected, died Oct 5, negative for BF

-Other Information

• Chickens in the area have been sick

-North Sumatra province, hospitalized in Medan, Adam Malik Hospital, patients from Tulungagung - Suspected

• Marlina Bt Sitorus (11), died Sept 18, index case
• Bitner Sitorus (37), father of Marlina, hospitalized Sept 20
• Lena Br Tampubolon (32), mother of Marlina, hospitalized Sept 20
• Retno Sitorus (12), brother of Marlina, hospitalized Sept 20

 -Tested

• Juli (1.5) and Tika (5) (siblings) were also brought to the hospital, but were sent home to grandmothers house in Sumber Rejo Village

-Other Information

• Culling of chickens around family area planned
• Entire family to go home

-North Sumatra province, hospitalized in Medan, Adam Malik Hospital, patients from Pagar Jati -Suspected

• YT (7), hospitalized on Sept 29

-North Sumatra province, hospitalized in Medan, Adam Malik Hospital, patients from Serdang Bedagai -Suspected

• DL (9), hospitalized on Oct 1, symptomatic for several days

-Other Information

• poultry around the house died recently

-North Sumatra province, hospitalized in Tulungagung, RSUD Dr Iskak, patients from Betak -Suspected

• Miftahul Mufidah (18), hospitalized Oct 6, previously at Tulungagung Islam Hospital

-Other Information

• neighbors poultry, 500 meters from house, recently died

-North Sumatra province, hospitalized in Deli Serdang, RSUD Deli Serdang -Suspected

• Elisa hospitalized and tested negative before Oct 7

-North Sumatra province, hospitalized in Deli Serdang, RSUD Deli Serdang -Suspected

• Darwin (16), hospitalized Oct 7?

-Other Information

• touched 5 chickens that died suddenly

-South Sulawesi, hospitalized in Makassar Wahidin Sudirohodo, Street Flamboyan - Suspected

• Paturungi (7), hospitalized on Sept 26, tested negative Oct 7, said to have malnutrition, gone home

-Other Information

• In contact with sick poultry that died recently

-South Sulawesi, hospitalized in Makassar Wahidin Sudirohodo, “lived in Street Maccini” - Suspected

• Badan Apriani/Fani (8), hospitalized on Sept 30, symptomatic on Sept 28, tested negative Oct 7, said to have malnutrition, gone home
• Faisal/Ical Mahendra (7), neighbor of Apriani, hospitalized Oct 5, symptomatic Oct 3, also neighbor of “Salsabila that was treated more previously…think this is Muhammad Salsabil from below”

-Other Information

• In contact with sick poultry that died recently

-South Sulawesi, hospitalized in Makassar Wahidin Sudirohodo, “Street Perintis” - Suspected

• Nur Azis (11), hospitalized Oct 2, critical Oct 5, said to have TB
• Muhammad Salsabil (6) , hospitalized Oct 2, tested negative Oct 7, said to have pneumonia, gone home

-Other Information

• Family chickens died last week

-South Sulawesi, hospitalized in Makassar Wahidin Sudirohodo, “Street Perintis” - Suspected

• Mustariza (4), symptomatic Sept 27, hospitalized Oct 2, critical Oct 5, tested negative Oct 7, said to be dengue, gone home
• Dian/Dion Rahmayanto (7), symptomatic Sept 27 , hospitalized Oct 2, sibling of Mustariza, critical Oct 5, tested negative Oct 7, said to be dengue, gone home
• Nurwan(30), symptomatic Oct 3, neighbor of Mustariza and Dian
• Nurhidayati/Hidayati (21), brother of Nurwan

-Other Information

• Children played with dead chicken that died suddenly, especially Mustariza
• Family’s blood tested, Budi (8), Agus (18), Sabang (70), and Asseng (65).

-South Sulawesi, border Maros-Makassar, patient from Warumta - Suspected

• Hasifah (4)

-Other Information

• Recent chicken deaths
• 7 other people in the area tested

Raina: Thank you. That’s an excellent summary to bring to the attention of our families, friends, local town officials, and regional media who truly believe that nothing at all is happening in Indonesia “because if it were, the major media would be covering it.”

Raina 15:11

I am going to copy(STEAL:)this so I can make some notes. Good work again I don’t know how you do it. I did notice this: North Sumatra province hospitalized in Tulungagung RSUD Dr Iskak, patients from Betak -Suspected

Miftahul Mufidah (18), hospitalized Oct 6, previously at Tulungagung Islam Hospital -Other Information

neighbors poultry, 500 meters from house, recently died

I think Tulungagung is in East Java same as Abram and Eni but I might be wrong.

Thanx Raina—a great job! and we appreciate it!

Bandung, West Java: poor MaMa—not doing well at all. dated 10–9−06. http://tinyurl.com/jgkv9

Bandung — MIOL: the Condition for the patient suspect bird flu Mama Komariah, 65, that was treated in RS Handsome Sadikin (RSHS) Bandung, continued to worsen. Apart from already did not make himself aware, the citizen Kp. The Love round, the Heulang Sand Village, To. Cisarua, Kab. Bandung, this also experienced breathless difficult. “Apart from the sample of blood, we also took the sample of casualties’s spinal cord.”

We suspected, casualties did not only experience the infection on the chest, but also has attacked the brain, and that happened to the bird flu patient in several neighbouring countries, explained the Chairman Tim the Handling of RSHS Hadi Jusuf Bird Flu, on Monday….

Although already since Sunday (8/10), respiratory aids have been given to casualties, but his breathless condition has not still improved. The temperature of casualties’s body also still was tall, so as the tight supervision continued to be carried out by the team of the doctor. The “condition for stable casualties, but heavy…..” In the meantime, because the condition for his body continued to improve, four patients suspect bird flu that beforehand was treated in RSHS, has been permitted to come home, on Monday. The four patients who have been stated by the bird flu negative were Great, 9, from Kp. The Subang mountain, Kel. Cilamajang, Kec. Kawalu, the Tasikmalaya City, the older brother’s patient was siblings Wildan, 20, and Krisna, 17, the citizen Rt 04/05 the Andir Camp, the Kahuripan Warehouse Village, Kec. Lembang, Kab. Bandung as well as Holy Rahmawati, the child was 14 months old, the citizen Street.

BANDUNG

4 Pasien ”Suspect” AI

Four suspect bird flu that was treated in Poinciana Tree Space of RSHS Bandung has been returned to his house was their respective, on Monday (9/10). Was based on results of the sample test in Balitbangkes Jakarta, Wil (20), Kris (17), Az (9), and Sc (14 months), was stated by the bird flu negative.

Clinically, Wil and Kris were stated healthy. For almost seven days, they did not suffer hot high and did not have the complaint anything.

The two mature patients from Lembang, it was suspected only suffered the normal respiratory tract infection. Likewise Az and Sc, clinically his situation was good. Four people came home made use of the ambulance belonging to RSHS and was delivered to his house was their respective.

Therefore, according to the latest report, only a patient suspect that was treated in Poinciana Tree Space of RSHS Bandung, that is MK.

Attacked the brain?

The condition for the patient suspect bird flu, MK (65), was not yet said improved. The team of the doctor that handled took the sample of his spinal cord liquid to be checked in Balitbangkes Jakarta. “Kesadaran MK descended after hot two hari,” the Chairman’s words Tim the Handling of the Case of Bird Flu from the Handsome Sadikin Hospital (RSHS) Bandung, Dr. Hadi Jusuf, Sp.P. D. KPTI, on Monday (9/10).

According to Dr. Hadi, MK’s cerebral membrane liquid must be checked because frightened of having the possibility of the brain of the inflammation, meningitis. The indication was in that direction seen because when entering Poinciana Tree Space, MK did not make himself aware.

”Jika results of the upper laboratory inspection his cerebral membrane liquid showed positive terjangkit the virus H5N1, this was the first case in Indonesia. Beforehand, the virus H5N1 that was proven attacked the brain had happened in Thailand,” he said. According to Dr. Hadi, oxygen in MK’s blood still was low so as to have to be helped the ventilator. Although being not too heavy, still was gotten by pneumonia on the left and right lungs. Moreover, leucocytes and trombosit him was still low. Nevertheless, blood pressure and the temperature of his body have improved. “Suhu the body has been good, approximately 36 levels celsius,” he said.

http://tinyurl.com/ogm7q

raina at 15:11… the only suspected case I couldn’t locate on the spreadsheet was Hasifah (4) from Maros/Makassar. Can anyone help me identify whether this is a new patient or perhaps we have a different name or I just missed it. If there is an article someone can reference I’d appreciate it.

Okieman plans to do a map tonight, so I’ll forward an updated summary as well. If this is a new suspected case, I’d like to include it.

MAKASSAR

The patient Suspect AI Membaik

(09 Oct 2006) the Condition two patients suspect (was expected) Avian influenza (AI) or bird flu, on last Sunday began to improve. They; Ical Mahendra,7, and Nur Asia, 11 that was treated in the Room 3 spaces of Building ferns Lontara I the Hospital (RS) Wahidin Sudirohusodo (WS), still terbaring weak although the infusion hose has been released. “Their condition has rather improved.” Earlier (yesterday), his infusion has been released. But still was rather feverish, said Naderi, the nurse in ferns Space. Feverishly Ical, has begun to descend through to 36 Celcius levels.

The same condition was also shown Nur Asia, the citizen Moncongloe Maros.

From observation of the Dawn yesterday, two patients suspect this AI was falling asleep twisted was accompanied by their respective parents. Naderi said, the patient was not yet permitted to come home until the sample of their blood was from Jakarta known by results. “Until this, the status the two patients still suspect AI. because, the sample of their blood did not yet confirm whether they really were affected by bird flu or had the other illness,” said Naderi. He added, results of the sample of blood it was estimated arrived this Sunday.

For the time being, the diagnosis Nur Asia still the TB whereas Ical the normal fever.

Till yesterday, RS WS also treated 15 patients suspect AI since last January 2006. http://tinyurl.com/ee8z9

On Tuesday, October 10 2006 the Vaccination AI mass in 12 Kecamatan

TULUNGAGUNG- the Tulungagung Livestock Breeding Service spread out the vaccination avian influenza (AI) in a mass fashion. This vaccination was carried out to 12 subdistricts that it was suspected have been attacked by bird flu. The implementation of the vaccination was revealed by the Section Head Tulungagung Danduk Sudarham Livestock Breeding. According to him, the vaccination was carried out in connection with the alert status of one bird flu. So as with this vaccination was expected to be able to prevent casualties’s new emergence AI. “This vaccination has become the routine program.” Before being stated alert even one we have carried out the vaccination like this. Indeed after alert one we more intensified the vaccination and spraying, said Danduk during it was confirmed the Queen yesterday. Revealed by Danduk not all the villages were in 12 subdistricts vaccinated. But only villages that were regarded as serious happened the spreading of the AI virus that divaksin. The 12 subdistricts, including the’‘’ Tulungagung Subdistrict, the Karangrejo Subdistrict, the Ngantru Subdistrict, Kecamatan

Boyolangu, the Ngunut Subdistrict, the Rejotangan Subdistrict, the Pucanglaban Subdistrict, the Kalidawir Subdistrict, and the Bandung Subdistrict.’‘’ “This vaccination was carried out in the village that has been found had bird flu.” Moreover also villages that was regarded as potential big became the place of the spreading of the AI virus, he said. ‘’‘The handling of the AI virus in Tulungagung apparently might not be underestimated. Because of the number of casualties in this marble city most in East Java. From four positive AI cases died, two among them from Tulungagung. Moreover, the deadly virus has spread almost all over Tulungagung.’‘’ According to the data from the Livestock Breeding Service, the bird flu virus has spread in 12 subdistricts that were vaccinated this. The “positive chicken of AI was only found in several villages in the certain subdistrict then.” If that other took part in being vaccinated that would because of being regarded as just serious, argued Danduk. http://tinyurl.com/otrlq

Indonesia Summary - Updated as of 10/09/06

Michelle—I can’t find 4 y.o. Hasifah from Maros either. Not in my notes or sheets. Not in the FW search engine either.

New suspect H5N1 case map has been emailed to DemFromCT for posting at his convenience. Kudos to all the Fluwiki Searchers Of The News.

http://tinyurl.com/qunzu

Jakarta: spread him came back the case of bird flu pushed the Livestock Breeding Service to promise to tighten the supervision of the inter-province poultry traffic. However, this promise was not proven to be Official Special Capital District of Jakarta Livestock Breeding. Was based on the SCTV monitoring in the Pulogadung region, Jakarta East, on Tuesday (10/10), not one official of guarding Livestock Breeding of the Service in one of the poultry entrances to Jakarta. At dawn earlier, only had the workers who were unloading supplies of the piece chicken from Tasikmalaya, West Java. Without the supervision from the Livestock Breeding Service, the workers only checked the chicken in a kasat manner the eyes. They also admitted to be able to accept the consignment of two chicken trucks died. However, their direct supplies denied.

The lack of the official was in the field denied to the Livestock Breeding Service Jakarta Edy Setiarto as the form of negligence. He explained, the consignment chickens might not move before being checked by the official. “Must be checked by us,” stressed Edy. From the SCTV monitoring around 200 thousand until 500 thousand tails of the poultry every day entered Jakarta. Most piece chickens came from West Java, Central Java, and Lampung. Without the tight supervision, there was no guarantee that this poultry was free bird flu.

Pugmom & Michelle: I have Hasifah (4) here as suspected: http://tinyurl.com/rp9q8

The Makassar patient - 05 Oktober 2006 <snip> The patient was named Faturungi and Apriyani, yesterday already did not impose the infusion and could have played. It was hot that the Nurasia body has also descended, but the adolescent from Moncongloe, Maros was still continuing to vomit. “Till at this time did not yet have the change except hot his body that has descended,” said Bahtiar, the father Nurasia.

Whereas eight citizens who lived in the border of Maros-Makassar were taken the sample of his blood by the team of the Health of the South Sulawesi Province of the Service, on Wednesday, followed the death of the property chicken of a citizen the previous day in this environment. One person among them, Hasifah (4) showed the sign was infected by the virus H5NI, because hot his body achieved 37.5 Celcius levels. The eight villagers Warumta, the Marusu Subdistrict, of Maros were taken the sample of his blood because of contact happening to the chicken that died suddenly.

This article contains info on Mama (MK-65) that we have seen elsewhere, but also gives some full names of some of the patients that might be helpful:

In the meantime, four patients suspect bird flu that his condition improved and was stated by the bird flu negative, was permitted to come home, on Monday (9/10). They were the older brother was siblings from Lembang, Wildan Budiansyah (20) and Krisna Karya Nugraha (17), Azis Muslim (9) from Tasikmalaya, and Suci Rahmawati (14 months) from Jatinangor, Kab. Sumedang. http://tinyurl.com/fvpox

Kediri

http://tinyurl.com/n7d9b

16 chickens died Suddenly the Citizen of the Kediri Regency increasingly worried spread him the virus Avian influenza (AI) or bird flu in his territory. Kediri totalling 16 nonpedigreed chickens belonging to villagers Ngebrak, the Gampengrejo Subdistrict, of the Kediri Regency, that was found died suddenly, after being tested in the location (rapid test) evidently positive was affected by bird flu.

From 16 tails, 10 including being belonging to Mohamad Mujammil, 29, the citizen of the Grompol Village, the Ngebrak Village, the Gampengrejo Subdistrict, Kediri. Now six other property of the neighbour Mujammil.

Two days after the death ten chickens, the child Mujammil that still was 2 years old, that is Dimas Amir Ahmad, suddenly fell ill. These pre-schoolers experienced the fever, hot, and the cough. However, after being brought to the doctor, these pre-schoolers gradually recovered. “My child not until diambi the sample of his blood,” said NY Siti Amaroh, the wife Mujammil, on Sunday (8/10).

Yesterday morning through to the afternoon, the official from the Animal Service the Kediri Regency vaccinated and sprayed disinfectant against 5.000 property chickens 450 villagers Ngebrak. The Animal service aimed at all the chicken in 23 villages would divaksin.

UPDATE An assumption patient of bird flu was treated in the regional Public Hospital Dr Wahidin Sudirohusodo Makassar, South Sulawesi, till Tuesday (10/10). Ratnawati was treated in isolation space after three days suffered the clinical sign similar to bird flu like the high fever, mucus on the lungs, and often the cough. The citizen Tamangapa, Makassar, this also had the story of contact with the poultry that died because of bird flu. Apart from Ratna, since two days set, in isolation space also was treated by Faisal. To ascertain his illness, the sample of the area of the two patients will be sent to Jakarta. The week set, six patients who were expected by bird flu also were treated in RS Wahidin [read: the Patient the Assumption of Bird Flu in Makassar improved]. They were stated free bird flu after results of the blood test were known by the negative. (TNA/Tim Coverage 6 SCTV)October 10 Lupitan6

Update on Eni. http://tinyurl.com/kb6n3
Stated recovered, this Sunday the PATIENT TULUNGAGUNG DIPULANGKAN BIRD FLU -the News of the Health - the Information Service and Communication, 10–10–2006 14:02 WIB - After being treated for 14 days in space anastesi old RSU Dr Soetomo Surabaya, the bird flu patient from Tulungagung, Eni Wulandari (25) was stated recovered. Estimated, this Sunday Eni could be immediately returned. The chairman of the Forum for the RSU Press Dr Soetomo Surabaya, Dr Urip Murtedji SpB KL, was contacted in his office of Surabaya, on Tuesday (10/10) said, at this time the Eni condition began to improve and tended stable. When not having the obstacle, he could be immediately returned. “Meski he has been stated recovered, but might not yet meet the other person, including his family sendiri,” he said. He added, Eni might come home after undergoing three inspection times polymerase chain reaction (PCR) in the Department of the Health. “Eni underwent PCR twice PCR, that first was stated recovered, that second just was sent yesterday. That third will be sent two days mendatang,” he said. Nevertheless, to know the patient tertular bird flu from where, still was needed by time 3 months. That dikarenakan the sample of blood must in sent to WHO. the Process was returned by him Eni to Tulungagung, will be done by the handover of the patient from RSU Dr Soetomo Surabaya to RS Ishak Tulungagung and Dinkes Tulungagung. That was done so that the patient receives attention after coming home from Surabaya. Till at this time, was recorded had two positive patients bird flu that succeeded in being cured by the total. They Anang from Kediri and Eni from Tulungagung. Whereas 2 other patients only experienced suspect bird flu and succeeded in recovering. Eni Wulandari was the patient who was sent from RSUD Ishak Tulungagung on Monday (25/9) with the positive diagnosis bird flu. After getting the maintenance for 2 days, the patient was given the respirator or breath aids. Whereas on Thursday (28/9), the patient was stated positive bird flu by the Department of Health

More on Tulungagung’s mass vaccinations. dated 10–10–06. http://tinyurl.com/am6wk

TULUNGAGUNG — MIOL: the Spreading of the bird flu virus in Tulungagung, East Java (East Java) increasingly alarmed. Up to now 12 from 19 subdistricts in this area has been stated the area endemi bird flu…..

To anticipate the bad impact of the spreading of the virus that claimed two lives of this Tulungagung citizen, the local livestock breeding service incessantly carried out the mass vaccination in almost all the villages from 12 subdistricts…

He claimed concerned because currently Tulungagung occupies the majority of bird flu casualties in East Java that is 2 from 4 casualties was killed during this 2006…

To be known for the last three months two children in Tulungagung namely Tyo Setyawaning Praise, 8, villagers Sukoharjo, the Bandung Subdistrict and Abram,11, villagers Kaligentong, the Pucanglaban Subdistrict died karena Positive was attacked AI. the two children were killed before could be brought to the AI reconciliation hospital namely RS Dr Soetomo, Surabaya.

Now another namely Evi Wulandari,25, the deceased’s full sibling Abram is currently treated in RS Dr Soetomo because positive tertular AI.

Influentia2 at 05:36: from your post above:

“Apart from Ratna, since two days set, in isolation space also was treated by Faisal. To ascertain his illness, the sample of the area of the two patients will be sent to Jakarta”.

It sure reads as if there are 2 patients here. I originally read “treated by Faisal” as referring to a doctor, but I now think this is the name of a second patient. Do you think so??

Temanggung, Central Java: Agriculture office now open 24 hours to deal with BF. dated 10–10–06. http://tinyurl.com/lmljc

Metrotvnews.com, Temanggung: the Temanggung Service of Regency Agriculture, Central Java, opened the service command post 24 hours to deal with the spreading of the bird flu virus in Temanggung.

Moreover, the local Livestock Breeding Service also formed Tim Fast Perfume that was assigned to give the fast service for the citizen if being found by the existence of the indication of the spread of the bird flu virus. Was based on the local data of the Livestock Breeding Service, the number of poultries that died in two last weeks continued to increase, that is reaching 3000 poultries. The poultry kind that dies generally dove birds and the chicken…..

In the near future, the Livestock Breeding Service will isolate the movement in and out of the poultry in this territory. Six poultry markets in Temanggung his plan was closed for the time being. The closing was carried out because of being suspected these markets became spread means of the virus.

Does anyone monitoring the situation/ case numbers in Indonesia have evidence or an assessment of a) the period of hospitalisation of positive patients who are treated and recover from H5N1 infection b) the period of time at which virus is active in the body i.e how long it takes for a negative test to result?

Additionally, but unrelated to Indonesia it would be useful to know a) an indication of the period of incapacity from 1918 H1N1 infection b) an idea of how long it was that patients were ill in the 1957 and 1968 pandemics?

I am trying to check assumptions on which continuity and national resilience plans are based, and there does not seem to be published evidence based data on this - hence the question. Thanks

Many thanks

Flumonitor - at 07:46, sorry can’t help you out. I’m posting - not analyzing.

flumonitor ¨C at 07:46

You can get to the spreadsheet by going to the following website. The logon is ¡°wikimember¡± and password is ¡°wiki123¡å. I think Michelle has the time patients enter the hospital, whether they have been tested positive, and when they leave (for some of them).

ftp://www.singtomeohmuse.com/

In my post above, the logon should be wikimember and the password should be wiki123.

We will have to keep our eyes on these Villages:
I found this: Location is in North Sumatra.
District in East Coast Region:
Kabupaten Asahan, Kisaran
Several villages were in shavings attacked by the Virus H5N1 on Tuesday, 10–10–2006

Several areas in the shavings Regency, especially the Simodong Village and the Tador Sea Village, the Subdistrict Sei Like, evidently currently has been classed as the endemic region the virus H5N1. This was appropriate results of the laboratory test against several chicken livestock from two villages. “Kami did anticipation so that the plague attack of the illness not until infected manusia,” said the Section Head Agriculture and Livestock Breeding (Distanak) shavings Ir Oktoni Eryanto to Medan the Business, on Thursday (5/10). Said Oktoni, among anticipation of the development of the deadly virus was did bio security with disinfektan as well as the vaccination to the poultry that not yet terjangkit. Moreover did counselling to the citizen about the control method of the poultry that died and was suspected resulting from the attack of the bird flu virus. This case was known when the discovery thousands of tails of the poultry in several villages in the Subdistrict Sei Like. Was based on the official note that succeeded in being received by the Distanak side local, the number of animals that died suddenly in the period two weeks in this territory reached 6.608 tails.

Sorry - I didn’t include this at the top of the article:
Medan Bisnis – Kisaran

Forgot Link: http://tinyurl.com/ghyn6

Oikeman at 9.00: cannot access the site as page unavailable. I will try again later, or if you can could you email it to jp at vibrantlife dotcodotuk would be very grateful.

An update on the vomiting cases, which are now crowding hospital corridors: http://tinyurl.com/z37dm

BANDUNG

Some patients was forced to be treated in the Corridor of RSD Soreang Muntaber Serang Bandung.

After attacking Kab. Garut, Sukabumi, and Kab. Tasikmalaya, muntaber (vomited defecated) currently attacked the citizen in Kab. Bandung. Totalling 87 sufferers muntaber filled the regional Hospital (RSD) Soreang, on Tuesday (10/10). The limitations of the room capacity in RSD Soreang made dozens of patients be forced to be treated in the corridor with used veldbed. <snip>

The increase in the sufferer muntaber in RSD Soreang the first time being seen since Sunday morning (8/10). At that time as many as 32 sufferers were treated. The amount afterwards increased and his peak happened on Monday until reaching 87 people. From this number, 40% the sufferer was children and the baby. The sufferers came from 12 subdistricts in Kab. Bandung. Kec. Soreang was that most with 51 sufferers and spread in 10 villages. The other sufferers came from Kec. Katapang, Margahayu, Ciwidey, Pasirjambu, Margaasih, Pameungpeuk, Arjasari, the Row, the Cavity, Rancabali, as well as Cihampelas. Several sufferers were reconciliation from puskemas. There were no fatalities in the case muntaber this. The patient muntaber in RSD Soreang continued to arrive till the afternoon yesterday.

“This stomach nauseas continued not long after opened the fast.”After that vomited again and again through to four times in one hour. I myself did not know food or what drink that caused muntaber this, said Herman (20), the citizen of the Village Ciputih the Pamekaran Kec Village. Soreang Kab. Bandung that was met in the IGD RSD Soreang corridor. Herman claimed, uptil now he mengonsumsi the drink of the repeated contents without the make that always was bought by him with the cheap price.The feeling of the stomach-ache that was not checked and diarrhoea that continually made Herman be run off with to the hospital by his family. Similar fate was suffered by Dede Sobarna (46). The citizen of the Village Bojonglaja the Kutawaringin Kec Village. Soreang this was run off with to the hospital after diarrhoea continually not long after him opened the fast, on Monday late afternoon (9/10). Was different to Herman, Dede only experienced vomited very much, not old before being brought to the hospital…<snip>

Several samples of the waste (faeces) from the sufferer was taken by the Health Service to diperiksakan to the laboratory until being known definitely cause micro-organisms muntaber this. “Giving of the infusion liquid was meant to avoid dehydration that was suffered by the patient because of diarrhoea continually or faded.” Several patients who experienced minor dehydration were permitted to come home, said Nieke. On the basis of so, the hospital side gave priority to giving of the infusion than the appointment of the room. “It was important, the infusion liquid was previously given to the patient to rescue the spirit of the patient.” <snip>

The RSD Soreang side in fact estimated the number of sufferers muntaber will continue to improve [increase] if the condition for the weather still as it is now. Moreover, the change in the season from dry to the rain season usually also will trigger the spreading of the illness muntaber.

Problems with getting conclusive test results and a diagnosis for MK (65):

BANDUNG

The condition for the Patient MK Not Yet Membaik guarded against the Pig as the Vector of the Flu Virus of Burung

MK’s Condition (65), the patient suspect bird flu that was treated in Handsome Sadikin Space of the Hospital Poinciana Tree (RSHS) Bandung did not yet improve.

Balitbangkes Jakarta again asked for MK’s sample for his four times. However, the team of the doctor still could not say results of the test polumerase chain reaction (PCR) first. ”Mesti him the second and third test has had results, but how come even asked that fourth. So, apparently still was that must they pastikan,” the Chairman’s words Tim the Control of Bird Flu in RSHS Bandung, Dr. Hadi Jusuf, Sp.P. D. KPTI, on Tuesday (10/10).

The patient from Kp. The round loved the Village of bar Sand, Kec.Cisarua, Kab.Bandung was treated in Poinciana Tree Space since last Saturday. Dr. Hadi said, his condition till yesterday did not yet improve. Although oxygen has in his blood improved, MK was still making use of the ventilator as respiratory aids. ”Belum had the improvement, still was heavy. Has had the reaction very few, but did not yet realise benar,” he said.

Clinically, the team of the doctor suspected MK of suffering the inflammation of the cerebral membrane that was caused by the virus. The inspection the complete laboratory will prove the virus whether actual attacked MK.

next portion of article is on exterminations and vaccinations of poultry in West Java <snip>

Guard against babi [pigs]

Apart from through the poultry, bird flu could be it was suspected spread through the other livestock animal, for example the case findings of the spread of the virus through the pig. The route of the traffic of the pig animal from Central Java like from Sukoharjo, Karanganyar, Sragen, Wonosobo, and Semarang headed Jakarta usually passes by to the West Javanese territory. <snip>

Was based on the research in Thailand and China, bird flu that attacked the pig became increasingly ferocious. The structure of the gene the unique pig could adapt to the virus. Moreover, the pig also became the virus vector that bermutasi so as the gene changed and the virus became raging as well as dangerous.

Kadisnak West Java, Rachmat Setiadi has done rapid test (the random test) against the pig animal in check point the east route, that is Losari and the Series. ”Kami checked clinically and several tails of the pig were taken his blood to be done by the serology test. But, until this, was not yet found the sample of positive blood the bird flu virus.

Whoops - url for above article on MK (65) and pigs in Bandung from Pikiran-raluat” http://tinyurl.com/g7nop

Pixie at 14:02: “Was based on the research in Thailand and China, bird flu that attacked the pig became increasingly ferocious.” This one line is perhaps the most disturbing that I’ve read from any of these translations that have been posted so far (I don’t much care for the following line, either). I don’t know the accuracy of the translation, but I don’t seem to recall on any of the news threads that bird flu research on pigs from China and Thailand made it into any of the MSM. Key words for me in that line: Thailand, China, bird flu, research, pigs, and ferocious. I may have to revisit my initial analysis of the role of the pig in all of this. If anyone finds any of this “research” that they are referring to, will you please post it? Thanks. You all are doing a great job on this thread.

muntaber=sickness

De jure - at 14:28: I had the same concerns over whether to bold that section or not, as I also couldn’t tell if it was a translation problem or if they meant exactly what they said there. I do not remember any pig studies that showed the virus was more “ferocious,” although it could adopt more mammalilan polymorphisms in pigs, making it have more affinity to humans (ie. transmisibility vs. virulence here is confusee?).

Grace RN: I think that sually when they say “muntaber” in these articles they mean diahrea/vomiting stomach bug sickness in particular.

SOUTH SULAWESI

Anthrax outbreak spreads in Gowa cattle - October 11, 2006

Andi Hajramurni, The Jakarta Post, Makassar

An anthrax epidemic has been declared in Gowa, South Sulawesi, with cows in three villages infected with the deadly illness and fears that infected meat has been sold to the public, an official says. No people in the region have been reported sick with the disease…

Bategulung village secretary Abdul Hamid said three cows in the village had been confirmed infected with anthrax during the last week. Two possibly infected cows had been slaughtered before the disease was detected and their meat sold to the public, he said. Abdul Hamid said the administration had issued a circular informing people not to sell or slaughter cattle until the beasts had been inspected and cleared by the local health office.

‘’‘Villagers in three areas had alerted the authorities after their cattle died of suspicious symptoms, he said. Farmer Lawonri Daeng Tulung, who owned one of the infected beasts, said he was not initially aware his cow was sick. “I took the cow to pasture. An hour later, however, I was informed by my neighbors that my cow had died,” he said’‘’….

An organ sample was later taken from the cow for laboratory tests. Samples were also taken from 96 other cows in the location.

Maros Veterinary Agency head Roni Mudidgo confirmed anthrax bacteria had been found in an organ sample taken from one of the cattle….. http://tinyurl.com/ngsn5

Has anyone else heard of Anthrax outbreaks in Indo?

From this time last year:

http://tinyurl.com/kdtan - 18 Nov 2005 “Five People Treated For Anthrax In Indonesia: A worrying anthrax outbreak in Makassar, Indonesia, has infected at least five people working in a slaughterhouse, an official stated, reports Jakarta Post”….<snip>

From the U.S. Embassy on outbreaks in 2004: http://tinyurl.com/hn2f6

“Anthrax is endemic to this part of West Java - about 60 kilometers from Jakarta - due to poor animal husbandry practices as well as ineffective prevention and treatment.” <snip>

“An anthrax outbreak near Bogor, West Java has claimed six lives and hospitalized eight people since October 16……eight more were hospitalized after eating infected goat meat. The district health office said an initial health survey shows that the virus has affected as many as 65 people, the largest outbreak in years.” (2004)

What concerns me is not that this is H5N1, but that outbreaks of anthrax seem indicative of a low level of disease surveillance in livestock, particularly if these animals not only are infected but their meat gets to market. Is there even a slim hope of adequate surveillance for H5N1 in animals in Indonesia - these anthrax outbreaks were not H5N1 but can we assume they would have been handled similarly if they were?

http://www.channelnewsasia.com/stories/singaporelocalnews/view/234633/1/.html

Singapore has also been having an outbreak of gastro-intestinal illness.

Pugmom 7:14 I don’t know yet. You know how I hate to speculate:)

Pixie 13:51

From your post “After attacking Kab. Garut, Sukabumi, and Kab. Tasikmalaya, muntaber” So in your opinion this article means whatever they had in Garut has spread out? Has anyone looked for a map yet? If anyone knows of a good map link I will look. I never can find a good map link and my PC won’t support Google Earth it is too old.

Pixie at 23:42… Thanks for the article about Hasifah. I’ve added this child to the list (I believe at home, with symptoms.)

Pugmom at 7:14… I have Faisal as an alternate name for Ical Mahendra (7) who we already have on the list (forwarded last night but not sure it’s posted yet.)

flumonitor at 7:46… to get the site with the spreadsheet, I often have to hit refresh. However, I don’t think we’ve captured the type of data you seek. We often have symptom dates and hospitalized dates but don’t typically capture reported/released dates. For the most recent Indonesian case which is in the process of recovering, please see the article above posted by Commonground at 6:33. It gives a good history for Eni Wulandari who became ill 9/23, tested positive, and is expected to be release 10/15.

Influentia2 at 16:59… this map link is pretty good. I had to click the left arrow to locate Sukabumi. Link to MSN Encarta

Thanks again to all who have taken the time to translate articles.

Link repaired. - pogge

Influentia2 - at 16:59: There is a good Encarta map of West Java, but I do not know how to paste it here. If you go to the closest level of detail available for the Bandung to Tasikmalaya area, it does reveal some interesting detail. http://tinyurl.com/oznn7

Bandung is where the latest cases are hospitalized. The other cities are fairly dispursed. To the West of Bandung is Sukabumi. To the SE of Bandung is Garut. Tasikmalaya is still further to the SE.

The cities do not seem to share any waterways. However, the map reveals that they do share a railroad. The outbreak of mutabar seems to have begun in Garut and has now spread NW of Garut to Bandung as well as SW of Garut to Tasikmalaya. I have no theory as to what the mutabar is beyond what it appears to be, but it does seem to be spreading.

Commonground – at 15:58 Anthrax here is today’s anthrax info: An anthrax epidemic has been declared in Gowa, South Sulawesi, with cows in three villages infected with the deadly illness and fears that infected meat has been sold to the public, an official says. No people in the region have been reported sick with the disease. Bategulung village secretary Abdul Hamid said three cows in the village had been confirmed infected with anthrax during the last week. Two possibly infected cows had been slaughtered before the disease was detected and their meat sold to the public, he said. ..

http://tinyurl.com/ru93q

Pixie 17:31 I was just going to post about the railway. Now I will see how far this railway goes. I don’t have a clue what this either but I am curious.

Michelle 17:31 Thanks for the map link. I just love this. I have already checked East Java out. I have been looking for something that may show rivers also. You guys are great.

My apologies for the sidescroll.

Please post new comments here

So the railroad goes from Bandung north to the Java Sea. Northwest to Bekasi/Jakarta, south to Bogor. Bandung just about due west to Cianjur.

Inbetween Bandung and Tasikmalaya the railroad goes south Cikajang.

So theoretically if we follow our links we can follow this whatever it is until someone figures out what it is ?

Pugmom was telling me about a documentary she watched and in Jakarta people lived inbetween the railroad tracks, as they are too poor to pay any rent. I find this so fascinating to maybe track this like this. Thank you again for this link Michelle and the article Pixie.