From Flu Wiki 2

Forum: Indonesia Outbreak III

27 August 2006

Oremus – at 00:49

Old thread taking long to load.

Old thread: Indonesia Outbreak II

Dude – at 00:56

If you want to use the FTP site to upload/download a copy of the excel spreadsheet summary (then anyone can download the file or you can send it to others for input etc.) or need an email box to communicate with one another, just let me know on the thread and I will create a box for you with your handle. The initial password will be wiki123 and then you change it to keep it confidential. dudeatsingtomeohmuse.com Hope this helps in some way you can think of. Great work and thank you all! We currently have six projects in the works ahead of this: I am now talking with about setting up an SQL database with the parameters that matter. It will, when done, have an input page and anyone can add or correct data and do sorts, lists etc. This will take some time because we have to know what fields to create, setup relationships, write the code, and design the front end. But we have made a commitment to do this. Just give us time. I hope we catch a break in this slide off a cliff and have some time. I will keep you all posted. It is nice to have a family member who is a DBMS programmer! Another designs web sites! And we host them…grin. I just wish we did not have to work to pay the bills right now. I would love to tell them to put this to the top of the list. This is not going to replace what you do, but give us a way to make connections and analyze this data.

I wanted to repeat my post because the thread (II) was closed and it was the last post.

Grace RN – at 01:11

dude- re”I hope we catch a break in this slide off a cliff and have some time.”

Do you feel that this situ is early panflu? (Just asking)

Dude – at 01:48

You know you are talking to a closet psychic, right? Grace, I feel that we are not seeing all of the cases - here and in other countries. I also feel that we are getting a glimpse of the real activity that goes on in Indonesia all of the time only because of governmental positioning for funds. So, when I try to judge based on this information, I am not clear on the real trend of the picture. The blanket medication muddies the water too. OK, those are my fall back positions - can’t get away from once being a pol. To directly answer your question, I would say 80% yes. It could take another year to fully come to efficient H-H or that could happen at anytime, but I think this horse is out of the barn. This virus has become too ubiquitous in the environment for us to stop. There is not the political will, expertise, or boots on the ground to do the job. There is too much magic belief and lack of education worldwide, there are too many people on our planet and too many chickens. Nature abhors a monoculture and it is time for her to make a major adjustment.

ANON-YYZ – at 02:19

Grace RN – at 01:11

No one can really forecast when or even if there is going to be a pandemic. However, the signs are serious but not hopeless.

I feel this round of Wack-A-Mole is a transition phase for the virus to have a multitude of testing ground to find the keys to conquer more species (hosts). If H5N1 “gets lucky”, it could find the perfect combination for humans quickly. So for humanity, it is a race against the clock - do we find the ‘silver bullet’ first or does H5N1 finds the combination first?

Does the virus have a fall back plan to survive if it doesn’t find efficient H2H? The answer is unfortunately yes as it is endemic and there is only one direction it can go and it’s not backwards.

Do humans have a fall back plan if we don’t find the ‘silver bullet’? The answer is unfortunately not yet. We as a species have been making the wrong choices for a long time, hoping that we will win the race to find the ‘silver bullet’, without building a fall back position. We may still do, but hope is not a plan and our fall back position is clearly week.

My take of Indonesia is that H5N1 will continue to pop up more and more frequently and visciously. If this happens only progressively and without a sudden turn, the world may yet be convinced into taking some serious preparation action - our fall back position, and even if we don’t find the ‘silver bullet’, we will survive as a civilisation.

The pop-ups may soon exceed Indonesia’s capacity to cope with. In that regard, I actually feel that the latest cut in their budget is partly posturing, but also genuinely running out of money and crying out for help - bear in mind there already has been some serious impact on its economy which continues to get worse. I also feel that even the ruling class is desperate enough to try to do something about it, not necessarily for altruistic reasons but for self preservation.

It will be nerve wrecking. The final page is here, to be written by all of the people of the world.

Stay strong. There is nothing to fear but fear itself. We have gone this far, we will not go down without a fight, and if 1918 was any indication, we will outlast the virus.

Commonground – at 06:41

http://www.metrotvnews.com/berita.asp?id=22971

The CONDITION for the PATIENT BIRD FLU improved

Metrotvnews.com, Jakarta

The new patient the assumption of bird flu in the Infection Hospital (RSPI) Sulianti Saroso, the Security, was moved from ICU space to normal maintenance space. The patient was three years old was moved around struck 10. 00 WIB. the Security arrived in RSPI on Friday (25/8) and immediately was brought to ICU space was done by observation. From results of the first inspection the Security was stated by the bird flu negative. However still will be done by the further inspection to confirm. While the patient that could be stated positive bird flu and afterwards were stated by the negative, Nursiva, his condition increasingly improved. According to RSPI Doctor Sardikin Giriputro Deputy Director, from results of the inspection third blood, Nursiva was stated by the bird flu negative. However he was not yet permitted to come home because still had the disturbance to the lungs.

FrenchieGirlat 06:54

Thank you for all the efforts to produce a tracking means of the sick in Indonesia. When we get to the stage where you have found the best way to do it, could we have a look at the distribution of the ages of the victimes (dead or suspected)? It seems to me that the majority are very young children and babies, the other peak being young adults. Normal flu does that, but I thought H5N1 did not exhibit a preference for tender flesh, since no-one in the world has immunity. So, whenever, would anyone talented in stats please make a distribution graph to see if there’s any significant deviation? And venture explanations why that would be, that is if indeed my observation proves true? (And also maybe by sex/age?). Thank you.

FloridaGirlat 07:00

Dude, Do you also sell / register domain names and host the sites?

Influentia2 – at 08:06

http://tinyurl.com/msa4b

Banyuwangi East Java

Excerpt:

Dozens Of the chicken carcass was found was scattered about all along the irrigation channel in the Krajan Village, the Kedungrejo Village, the Muncar Subdistrict, Banyuwangi yesterday. This carcass there is one that is still floating on the surface of water, leant on the canal lip or was mixed with the waste in the door to the distribution of water. Moreover, because of being brought by the water flow of some nonpedigreed chicken carcasses entered the area of the citizen’s rice cultivation. It was startling, this chicken carcass had the physical characteristics was proper for the poultry that was attacked by bird flu belonging to Joko Purnomo in the Krajan Village, the Blambangan Village some time before. This chicken mouth had phlegm, his head was blue and his chest was swollen. The assumption was increasingly complete.

Excerpt:

Sampir, one of the farmers in the Kedungrejo Village acknowledged if almost each morning had the chicken carcass that be involved in dam.This scenery has happened since last week.Occasionally, bangakai this was lost and washed away was brought water.However, at the time of certain his smell stang and built up with the waste.

Excerpt:

In the meantime Subari one of the citizens Blambangan claimed to be himself quite deliberate threw this chicken carcass to the canal away. The reason is, apart from simple, himself did not know bagaiaman the method destroyed the chicken that was attacked by the illness. It was “just frank that I did not know my chicken was attacked by the illness what.”

Influentia2 – at 08:14

Michelle in Ok

I am reposting this from yesterday for you. Should this be in the chart on the other thread? We may want to watch this and it might get lost on a huge thread like this. I’m still trying to figure out how to get info to you.

The HAMMER, Kompas - totalling 215 students the Aisyiyah Kindergarten, Palu, on Friday (25/8), began to be checked by Tim Medical the Control Command Post of the Plague of Palu City Bird Flu. The inspection was carried out to confirm that 215 students TK Aisyiyah not terjangkit the bird flu virus (avian influenza) considering in the TK building was found by 22 positive chickens terjangkit the bird flu virus.

http://kompas.com/

Okieman – at 09:16

Michelle in OK,

There is a filter tool (different from the sort tool) that might be of considerable use in your Excel spreadsheet. You may already be aware of it, if not, give me a call and I will explain how to use it. I’ve found most people are not even aware of it or have tried to use it.

Just for everyones info, Michelle is Okieman’s sister

Commonground – at 09:26

Pugmom - I have found my google preferences. Thanks for your tips!

pugmom – at 09:36

CG—good deal! Also your formatting on the new thread sure was perfect!

Commonground – at 09:40

http://tinyurl.com/jftgs

Jakarta – the large-scale Campaign to menyosialisasikan the prevention of bird flu will be carried out by the government in the near future. ”Kampanye will be large-scale, like the polio campaign, by involving the TV station and the artist as the star of flu of the socialisation advertisement burung,” Vice Chairman’s words Komnas Bird Flu, Trisatya Naipospos, in featuring discussions prevented the Bird Flu Pandemic in Time Break Cafe, yesterday. Trisatya explained, this campaign had a purpose menyosialisasikan lived clean and the everyday habit in order to be avoided from bird flu. Apart from preventing the pandemic, this campaign had a purpose in order to the wrong perception not happen in responding to the illness that was caused by the virus avian the influenza. For example, the labelling by sticking the sticker on the house remained at the bird flu sufferer who was done by the Karo Regency community. ”Yang clear, the policy not from the government of the centre. Possibly, the local policy. Actually this matter might not happen. Therefore, was given by us the understanding through the socialisation ini,” more male that his days as the official of the Agriculture of the Service. He added, the community usually just cares about the bird flu illness if having the family or the person that remained close the house remained at him terjangkit bird flu. ”Masyarakat tended immediately panicked blamed the penderita,” he revealed. In fact, lived healthy and the clean environment to avoid bird flu was joint responsibility. Apart from taking UNICEF and USAID in this campaign, by the hand Komnas Bird Flu co-operated privately, in part McDonald’s and Kentucky Fried Chiken (KFC), that was the company waralaba the fried chicken. ”Swasta also must take part in the contribution in the prevention of the bird flu pandemic. (more at site)

Milo – at 09:41

Dude – at 01:48 . . . there are too many people on our planet and too many chickens. Nature abhors a monoculture and it is time for her to make a major adjustment.

IIRC, one alternate myth about the beginning of the Trojan War was that the goddess Gaia, the Earth, complained to Zeus that there were too many people and she was suffering under the weight. Zeus set things in motion that led to the massive war in order to thin out the population.

In about a week and a half I can take over one area in the case summaries, but in a few days I’m leaving on a week-long vacation and will be mostly w/o computer access.

Commonground – at 09:41

Mods, could you remove post at 09:40 and put it in the News Thread? Thanks.

pugmom – at 11:51

Influentia2, Grace, Orlpreppie, CG: check new thread, I added some late editions to Michelle’s timeline.

Commonground – at 12:00

Milo - at 09:41, I need someone to cover for me while I house hunt two states away. I will be gone from September 11th through 17th. Want to do it? North & South Sumatra.

Commonground – at 12:11

pugman - the two in W. Java in Garut tested positive?

I put a date at the top of my post, because if we “bump” it from time to time, we won’t have a date. It will just say “bum” and the time of the post.

Also, the suspected total and confirmed total (in your case) and a grand total makes it easy for the person checking in.

If you want to make something in “bold” all you do is put three individual single quotes in front and in back of the particular word you want bolded. If you want to make the plus sign bold, you would type bold

pugmom – at 12:17

Also, I want to say something. I have been so worried that I would make a mistake or post a redundancy, or in some way screw up the timeline—almost more than I am afraid of the Panflu coming. Then I thought, hey relax!--we are all having trouble with the data and I bet everyone else feels stupid for posting wrong things. We are all in the same boat. Someone on here said, it is better to post twice than not at all! So let’s just all do the best we can and hope Michelle’s patience with our flubs holds up. With that, I am off to do our research.

pugmom – at 12:23

Hi CG—yes, those 2 tested pos. See NJ Preppie at 20:21. Also I was surprised to see 2 Gilangs on the list now, but they are different ages. Thanx for telling me how to make things bold. Is color that easy?? How are you doing? I think I have updated all my notes and now I am ready to start fresh with research.

pugmom – at 12:26

So once we have all the corrections and late editions added in, are we now only going to post the new data for Aug 27, 28, 29 sometime on the 29th?? Ie—only post our results every 3rd day? How do you want to do it??

Commonground – at 12:39

Hi pugmom, funny thing about the color. I made a note, so I would remember how to change color. All my note says is: Now that tells me a lot!!! I’d have to go into the formatting place to re-read how to do colors. Ugh, growing old sucks. Your thread reminded me of what we were saying yesterday. If we have a change like you’ve been experiencing with Garut, maybe we should put alongside it the notation “from NJ Preppie at 20:21″. I’m assuming that would be in the Indonesia Outbreak thread. That way, if someone is reading our update, and says “gee, 2 positive in Garut” that notation will refer them to the article posted and where we got the information. I forgot all about that. Hope I remember to do it myself.

As far as posting, and how often, I think we should leave it up to the individual. If there is a lot going on, and new people coming in fast and furious, post once a day, or whenever you can. If not, let it go 3 days.

And for making mistakes - my main concern is making sure my patients are in the right District/Region. Man are there a lot that go with N & S Sumatra. But, we have to all give ourselves a break. This new plan of ours is going to work out better for everyone! And Michelle in OK will be able to take a break from her research also.

I think you should post something up to get more volunteers for the empty Regions. Put it in this thread, referring them to the Summary thread and ask for sign-ups. try the bold function 3 single quotes in front and in back.

Commonground – at 12:40

LOL!!! Well!!! Guess the blue works!!!

Also, Pugman, I guess from now on we only put the “new” data, not the whole thing all over again, right?

pugmom – at 12:45

news from (((Bayongbong, West Java 8–26–06)))http://tinyurl.com/mpxws

Metrotvnews.com, Garut: A patient suspect bird flu was again run off with to the doctor’s Hospital Slamet, Garut, of West Java, on Wednesday night (23/8). The patient this time came from the Bayongbong Subdistrict, Garut that his location around 85 kilometre from the Cikeulet Subdistrict, the first territory in Garut that flattest bird flu. Now till earlier today, already six citizens Cikeulet that was run off with to the Handsome Hospital of Sadikin Bandung as the patient suspect bird flu. The patient was named (((Ari))) earlier entered RS the doctor Slamet struck 22. 00 WIB. villagers (((Mulyasari were 14 years old))) was run off with to the hospital after suffered hot and coughs for several days. According to the Ari family, they worried Ari was attacked by bird flu because beforehand, one of their property chickens died suddenly. After being treated in the hospital, the sample of Ari blood was immediately taken to be sent to the Hall of the Health of the Department’s Research And Development in Jakarta. The sample of Ari blood will be checked to confirm was attacked by bird flu or not. The patient is currently treated in RS isolation space the doctor Slamet. When entering the hospital last night, the temperature of the Ari body achieved 38.5 Celcius levels. However, at this time, the temperature of the patient’s body began to descend and already approximately 36.3 Celcius levels. Blood pressure and the Ari pulse were reported normal. Only, respiration or the frequency of breathing still above normal, namely 26 times per the minute. Normal him was below 20 times. The cough that was suffered by Ari it was reported began to descend. With the Ari entry to RS the doctor Slamet, was significant already 11 citizens suspect bird flu that entered the hospital of bird flu reconciliation in Garut this. Ten patients beforehand came from Cikeulet, including two people who died. (DEN)

pugmom – at 12:53

CG—yeah, just new data. I will also put date at top—thanks for suggestion. I am not sure about citing all our sources, Michelle said if we add too much data, it will wrap-around in her scroll, or something. At some point, they will have to trust that we have been careful with our data keeping, or go read the thread themselves. But, I am very flexible and will go along with anything. Huh-Duh—it was 3 quotes not parentheses, huh! Will try again soon. Also will send out help needed ad pretty soon to attract more volunteers.

pugmom – at 12:58

note: on article at 12:45 concerning patient: I believe Ari is a nickname for Mulyasari, so we are talking about only one person here.

pugmom – at 13:04

info out of “”“Jakarta 8–27–06″”“ no names or info yet though http://tinyurl.com/s5226 Metrotvnews.com, Jakarta: the Security (3), one of the new patients suspect bird flu that was treated in the central Hospital of the Infection (RSPI) Sulianti Saroso, Jakarta, on Saturday morning (27/8), was moved from space of Intensive Care the Unit In the meantime, the patient suspect other bird flu, Nursiva, his condition increasingly improved. According to RSPI Doctor Sardikin Giri Putro Deputy Director, from results of the inspection third blood, Nursiva was stated by the bird flu negative. However, he was not yet permitted to come home because still experienced the disturbance of the lungs. ()

pugmom – at 13:07

CG—still can’t make bold. What am I doing wrong? I can’t find the single quote on my keyboard, only the standard double quotes.

Milo – at 13:27

Commonground – at 12:00. Yep, I can take N and S Sumatra from the 11th to 17th.

Best of luck to you finding a nice house. Must be stressful house-hunting right now. House-hunting is stressful anytime (especially long-distance), but the threat of panflu adds a whole new layer to it.

Sarah – at 13:37

pugmom… single quote should be lower case of the double quote.

anonymous – at 13:42

It’s an apostrophe. pugmom, the same key that you used above for the word “can’t”.

Commonground – at 14:00

Michelle in OK - I’ve got a case that you don’t have on your list. Referred to Theresa42 Posts at FluTrakers in the Sumatra thread:

Simalungun, North Sumatra

1. 22-Aug RL (35 F Pregnant) suspected

I’ll wait to hear from you, then I’ll put it in the Summary. Could you post a Summary in the Summary? LOL! Your wonderful list didn’t come out right unfortunately.

Milo - Thanks! Yes it is stressful house-hunting. Lots of homes on the web to look at. We are retiring December 31st. And the threat of panflu is adding to my misery. But, I’ll get through it.

Oremus – at 14:07

anonymous – at 13:42

Too funny. lol

pugmom – at 14:10

Jakarta 8–25–06 now have name (Sulianti Sarosos) and age (3yo) on that case from Jakarta http://tinyurl.com/s5226 Metrotvnews.com, Jakarta: the new Patient the assumption of bird flu in the Infection Hospital (RSPI) Sulianti Saroso, the Security, was moved from ICU space to normal maintenance space. The patient was three years old was moved around struck 10. 00 WIB. the Security arrived in RSPI on Friday (25/8) and immediately was brought to ICU space was done by observation. From results of the first inspection the Security was stated by the bird flu negative. However still will be done by the further inspection to confirm.

pugmom – at 14:15

thanx. Next time, by gosh, you are all going to see BOLD!

pugmom – at 14:36

Kendari, SE Sulawesi—update on Ambo’s family—8–27–06 http://tinyurl.com/s6who

27/08/2006 14:05 the family’s three members Ambo the Rustling, the citizen Street Punggolaka, Kendari, that was expected terjangkit his condition bird flu continued to improve. They were beforehand stated suspect bird flu by Dinkes Kendari.

Sarah – at 14:43

bravo!

Milo – at 14:43

pugmom at 14:36 was expected terjangkit his condition bird flu continued to improve. They were beforehand stated suspect bird flu

Does anyone know what “terjangkit” means?

pugmom – at 15:31

Palu, Sulawesi 4 suspected (no Names yet) 8–26–06 http://tinyurl.com/fbmbg

On Saturday, August 26 2006 already Hundreds Of chickens Mati four citizens was suspected Suspek Burung Flu The HAMMER- the Case of bird flu that was found in the Kamonji District, Palu West, made startled government apparatus. Yesterday (25/8) in the afternoon government apparatus that came from the Health Service, Distanhut, with the Muspida element, the Palu Sub-district Head West and all the village head in the Palu city, carried out the meeting, to prevent the possibility of the spread of the bird flu virus to humankind. The meeting that took place in the mayor’s office was led by the Secretary of the City Palu H Arifin H Lolo SH MH. In the meeting was expressed by 4 Palu inhabitants it was suspected suspek the Bird Flu virus. Respectively 2 citizens Street Hayam Wuruk and 2 citizens of the Ujuna District……

pugmom – at 15:32

Milo—don’t know what that means as Toggletext won’t translate it. Maybe we can ask Mamypoko.

Michelle in OK – at 15:33

Does anyone have a suggestion on the city for Nursiva (3)? Is Jakarta correct, or is that simply the location of the News report?

I’m going to take a quick run through the news thread to ensure I’ve picked up all changes, then I’ll be glad to post an update on the Summary thread.

pugmom – at 15:37

I think she came from Bekasi, but got sent to hospital in Jakarta. I guess that would put her on the chart as having acquired the infection in Bekasi, West Java.

Michelle in OK – at 15:38

Also, per Influentia2′s post on the 215 kindergarten students which were tested… Do we have a location? I’m not going to post them as suspects, as the article does not mention symptoms; however, I do think it is worth noting at the bottom, along with the date of Mass Tamiflu Distribution.

Commonground – at 15:40

Michelle in OK - at 15:38 - I just posted Simalungun, N. Sumatra - RL (35F - Pregnant) in the Summary Thread.

Michelle in OK – at 15:44

Thanks Commonground, I’ve picked that one up. Also, I just saw that the 215 students are in Palu, which is Central Sulawesi.

pugmom, we have a Nursifa (6F) from Bekasi already. Is this Nursiva (3) a different person? The article refers to Nursiva as a male, but that is often confused in translation. The dates hospitalized are different, so that makes me think there are 2 individuals.

Commonground – at 15:49

Everyone - here for cities in Indo:

http://en.wikipedia.org/wiki/Cities_of_Indonesia#Jakarta.2C_5_cities

Michelle in OK – at 16:14

Thanks for the link, Commonground. I’ve added it to my favorites.

If anyone notices errors I’ve made on the Summary or suggested changes they’d like to see, please post to this thread & I’ll try to incorporate. Thanks.

pugmom – at 16:31

Michelle—I am 90% positive that Nursiva lady is just one person.

pugmom – at 16:32

actually, she is a 6 yo child—sorry

pugmom – at 16:50

They are listed with different ages—I need to go back and research this. Your new timeline is wonderful! Thanx so much. It is so much easier to keep tabs on cases when it is written down on paper in front of you.

Michelle in OK – at 16:51

pugmom, One reason I left it as 2 individuals is because Nursifah (6F) tested positive originally. Nursiva (3M) tested negative. I’m going to look back and see where/when Nursifah (6F) was hospitalized.

Michelle in OK – at 17:17

Both Nursifah and Nursivah were admitted to Infection Hospital (RSPI) Sulianti Saroso. Nursifa was on Aug-18, while Nursivah is listed as Aug-25. I now think it likely that there are two individuals.

jplanner – at 17:26

Thank you all for your time and persistance on this. I am really greatful to be able to come here and see in a digestable format what is going on instead of spending a ton of time digging it out. So you know, I have spent that extra time in alerting people about the situation in Indonesia as it unfolds. You really are doing a service to us all.

pugmom – at 17:37

Thankyou jplanner—we appreciate your comments.

Medical Maven – at 17:42

Where are the Indonesia sequences from this latest flurry of outbreaks? They are supposed to be released, correct?

pugmom – at 17:43

WANTED: VOLUNTEERS

to help translate Indonesian news. We have broken it up into manageable sections and are asking for volunteers to pick a region and research the news/other outlets to help us maintain a timeline of infections and suspected cases. If interested, go to the thread “Indonesian Outbreak Case Summaries.” Note: we will try to update every 3 days, so if you sign up, you may collect info for 3 days, then submit.

pugmom – at 17:45

Medical Maven, in all my readings out of Indonesia I have not heard the word “sequence” used once.

pugmom – at 18:26

Jakarta-8–26–06 New name, Nur Syifa, in hospital

I originally thought the patient’s name was Sulianti Saroso, but now realize that is the name of the hospital. However, found this article which does give us this name. http://tinyurl.com/rhaot

RSPI Sulianti Saroso was Still treating two patients Suspect Burung Flu Theresia Oktavina - Jakarta, the Infection Hospital (RSPI) Sulianti Saroso at this time still was treating two patients suspect bird flu. Now since 2005 was recorded by RSPI treated 200 bird flu patients. Was like this it was said Deputy Director RSPI Sulianti Saroso Dr. Sardikin Giri Putro to the reporter in discussions in the region of Semanggi Jakarta, on Saturday (26/8) Sardikin said, one of the child’s patients who was named Nur Syifa was still continuing to undergo the maintenance and in the process of recuperation. The Nur Syifa condition, he said, began to improve and could treat in isolation space after …..

pugmom – at 18:40

Garut, West Java patient named Tresna Alfajar Day treated since 8–24–06 http://tinyurl.com/k4dmg

Liputan6.com, Kendari: After could be refused took medicine by the Kendari Public Hospital, South-East Sulawesi, the family’s three members Ambo the Rustling that was expected terjangkit his condition bird flu continued to improve. According to Ambo the Rustling, after his three children were refused RSU Kendari because of not wanting to give free facilities himself brought his child to a practice doctor who afterwards gave syrup medicine penurun hot and the cough. Was based on SCTV observation, on Saturday (26/8), Listawati, Nur the guidance, and Ahmad the Dawn currently carries out the activity of his routine. However the three children Ambo this Rustling was still being seen by few coughs and breathless [read: the Palu Municipal Government Appoint KLB Bird Flu]. The citizen Street Punggolaka Kendari this beforehand also was stated suspect bird flu by the Kendari Health Service. However after being stated improved the family’s house Ambo the Rustling that could be given the bird flu label to the wall of his house some time before, the official Dinkes had finally pulled out the label yesterday. The representative of the Kendari Mayor of Andi Muzakkir Mustafa that was asked for by SCTV confirmation through the telephone said all the hospital that was managed by the Government of the Kendari City will give away the sufferer suspect bird flu. This medical treatment was special for the Kendari inhabitants and the poor family. In the meantime, the condition for the Tresna Alfajar Day, the patient suspect bird flu that was treated in the doctor’s Hospital Slamet, Garut, of West Java, since Wednesday set it was reported his condition gradually improved. Tim was medical also moved this patient to normal maintenance space. The day it was confirmed only was attacked by the disturbance of normal breathing [read: the Condition for the Bird Flu Patient from Garut improved]. Nevertheless, in the environment of the Day residence in the Saroja Village, the Mulyasari Village, Bayombong, Garut, as far as this is concerned was reported did not have the action anything from the local side of the agricultural service. In fact in the Day house often was gotten the poultry. This like that was seen in the Lily house, the grandfather the Day, that was located at the edge of the Mulyasari Village highway. The lily was still maintaining four chickens that his pen was located by his house. Several neighbours around it also maintained the poultry. According to the Lily, his kept chicken had also died suddenly because of being sick.

Monotreme – at 18:43

Medical Maven – at 17:42

Where are the Indonesia sequences from this latest flurry of outbreaks? They are supposed to be released, correct?

Good question. I just checked LANL and it looks like the most recent isolate from Indonesia in that database is from 07/06/2006, although I haven’t checked every record. I hope to have more authoritative answers to these questions when my database is finished.

Go herefor a complete list of human sequences in the LANL database (plus a few cat sequences that somehow got coded as human ;-) )

Dennis in Colorado – at 18:53

Commonground – at 06:41 According to RSPI Doctor Sardikin Giriputro Deputy Director, from results of the inspection third blood, Nursiva was stated by the bird flu negative. However he was not yet permitted to come home because still had the disturbance to the lungs.


Is there any consensus among the Indo-trackers? Should we consider Nursiva to be non-H5N1?

pugmom – at 18:56

Bayongbong, Garut, West Java

Additional information on post at 18:40. Tresna Alfajar Day is the same person as Hari Tresna Alfajar is the same person as the Ari we have listed for Bayongbong, Garut, West Java. Confusing, yeah, I know. http://tinyurl.com/rcwr9

Commonground – at 19:04

Dennis in Colorado - at 18:53, sounds like after 3 blood tests, they are considering Nursiva non-H5N1. That’s good news!

pugmom – at 19:20

regarding patient Nur Syifa at 18:26: I now think this is not a new name, but is the Nursifah we have been seeing. Geeesh, I think I will quit posting!! (kidding)

Average Concerned Mom – at 19:30

I want to take a quick second to thank everyone for all your hard work deciphering all this and making the info orderly for us. 9I don’t have the ability right now to join in, but as soon as I can I will. Meanwhile, THANK YOU!)

I know the work isn’t easy, and it is much appreciated, I’m sure many people feel that way and just (like me) just didn’t want to clog up this thread with all our appreciation!

Michelle in OK – at 20:55

pugmom at 18:26 and 19:20… it IS very confusing, but the article at 18:26 clears up the question for us. There are two separate patients at that hospital. I think Nursifah (6F) tested postitive but Nursivah or Nur Syifa (3M) tested negative. I’m going to keep him on the list for now so we won’t be confused with later reports.

I’m slightly perplexed about the Palu article at 15:31. Are these 4 patients in addition to the 3 we were listing (hospital admission date is the same), or is there only one more with 4 in total? For now I’ve listed 1 more since no names were given.

Also, when you put headings here, that works great and is really all that I need. Posting separate summaries gets to be a little too much for me to check. Thanks.

Michelle in OK – at 20:59

And talking about mistakes… I accidentally listed Ari from Banyongbong twice on the summary. So when I add the additional Palu patient, our tally is still at 59.

Grace RN – at 21:01

FWIW-re: suspected/reported cases in West Java- all towns/districts have one thing so far in common-they all are along major roadways.

pugmom – at 21:25

Michelle, I am glad you figured out the Nursifa question and I am sure you are right. I put in the Palu article, even though there were no names yet, just to give a heads-up that there might be more infections going to be listed soon. So, if I understand you correctly, you like the bold headings and find those enough without us going to the summary sheet and reiterating them?? That would be great, then all we would have to do is do a quick final notation on the 3rd day regarding our area? (Or do you even need that????)

pugmom – at 21:30

dbg has now signed up for Sulawesi!! Thankyou for joining our group. Let us know if you have any questions.

pugmom – at 21:55

Kendari, SE Sulawesi 8–28–06 update on Ahmad Djafan—now in ICU http://tinyurl.com/jgbaj

Metrotvnews.com, Kendari: One Of of the citizen’s children of the Punggalaka District, the Mandonga Subdistrict, of the Kendari City, South-East Sulawesi, was treated in the South-East Sulawesi regional Public Hospital, because of showing the sign was similar to bird flu. The patient was named Ahmad Jafar be aged one half of the year. He was run off with to the Intensive Care Unit of RSUD South-East Sulawesi in the critical condition. The hospital side still could not confirm Ahmad Jafar was infected by bird flu. However, a doctor stated the patient experienced the sign similar to bird flu. Now two relatives Ahmad Jafar, Istiwati (17 years) and Nurhidayani (5 years) also experienced the same sign, but was not yet brought to the hospital. According to the family, before being sick, dozens of tails of the chicken were around the residence of Ahmad Jafar found died suddenly.

Michelle in OK – at 22:38

pugmom at 21:55, I am including 3 people from this article. 1 in ICU and 2 at home with symptoms.

pugmom, per your question at 21:25, the bold headings with names and locations are fantastic. I usually read the articles to make sure I have a clear understanding and then post the names to the Excel spreadsheet. To be honest, I don’t think I’d use the notations much because of the extra time it would take. If you will each search out articles in your area and keep notes so you can check my summaries for your area, that would be a great help. I’ll feel better knowing people have checked the summary by area to ensure all errors are caught.

I’ll periodically try to report tallies as people are added. About this time at night (after the kids are in bed) will be my best time during the week to post and respond to questions. The tally is now at 62.

Michelle in OK – at 22:41

Correction to what I just posted… the three people were already included at Aug-23 as Ambu Sao’s family. The tally is back down to 59. My apologies. But I will add updates as to their conditions.

DennisCat 22:57

Not sure if this is new or not (I will let the “indo wizzards” check it) : 35F N. Sumatra Dated Aug 24.

“Another suspected human case of bird flu was reported Wednesday in Simalungun regency near Medan, North Sumatra, despite the government’s assurances it is doing its utmost to bring the deadly virus under control.

A 35-year-old woman was admitted to Adam Malik Hospital after showing symptoms of bird flu. Simalungun is close to Karo regency where eight people in one family died after contracting H5N1 last May in the world’s largest cluster of cases.

If proven positive, the woman may have contracted from chickens in her neighborhood who died suddenly and tested positive for the disease. “

http://tinyurl.com/72z2h

DennisCat 23:47

from toggletext trans-

“Tosin and Her was two from six patients suspect bird flu from Kab. Garut that was reconciled to RSHS Bandung. Four other patients namely Santi (8), Isma (5), Kuraesin (32) and Osin has been stated by the bird flu negative and was returned.”

http://tinyurl.com/j4zyy

28 August 2006

anon_22 – at 00:07

Hi, I just want to add my thanks to everyone. I feel slightly guilty for not having participated as much as I would have wanted. I’m still supposedly on vacation although I haven’t strayed too far from my PC. I have recruited my husband (who is also supposed to be on vacation.. duh!) to read through the Cikelet to Indonesia threads :-) He is getting cross-eyed from double checking names and dates and he’s only gotten to thread no 3, I think, but he is amazed at your guys! So thanks everyone for keeping up the good work!

Now a question: is there any part of this whole series of cases that looks like h2h2h? I am specifically thinking of the initial cases Ai Siti, Dea, and Euis Lina. I am getting that Ai Siti developed symptoms Aug 1 and died Aug 15, Dea (?sibling to Ai Siti) died a few days before Euis Lina (?mother to Ai Siti), who died on Aug 17. There was one point where the husband (Dadan?) and other 2 kids were being tested because they had symptoms. Was that correct and do we know what happened to them?

The reason I’m asking is that if there is any indication that the virus in this location is finding it easier to go b2h, then we need to know very specifically whether there is any clear indication of h2h2h as well in the same virus, cos that combination would be far more significant than either one on its own.

An additional thought: A very cursory read is giving me the impression that those who died did so before or quite soon after getting to hospital. If that is true, and the vast majority of confirmed and suspected cases who are treated promptly do survive, it may be a good indicator of tamiflu efficacy for treatment. This is likely to be the first batch of patients in Indonesia to get tamiflu early enough (I hope) to have a chance of that making a difference. So let’s watch that information and see what happens.

Dude – at 01:22

FloridaGirl – at 07:00 yes.

ANON-YYZ – at 02:27

anon_22 – at 00:07

I want to add my thanks to all who work so hard to pull this off. It won’t surpise me that in time the fluwikie will be where the MSM comes to get the update.

If you look at the onset dates of family members spread over 3 weeks or longer, it’s hard to argue B2H as it would be more reasonable to guess that after the first case, the rest of the family would be much more careful with chicken contact, while at the same time, such a long incubation period is unreasonable. If you want to prove ‘beyond a reasonable doubt’, it cannot be done and Indonesia and WHO will simply say there is no evidence of H2H as it can be ‘explained’ by sick chickens in the village.

As far as easier B2H is concerned, I notice that human cases are reported only one day after chicken outbreak, unlike in the past. The number of cases is also an indicator. Again, Indonesia and the WHO will say there is no evidence B2H is any easier - Cikelet residents are just inept.

That argument doesn’t hold water because officials of Bayongbong, about 100 KM north of Cikelet, reported new cases a couple of days ago and claimed that it was transmission from Cikelet. There were also reports of chicken smuggling out of Cikelet. Since Bayongbong is a much richer area, better hygiene (on plains with rich rice fields while Cikelet in South Garut is hilly and no rice fields and poor), the argument of poor hygiene cannot be used. Another case was reported yesterday where the doctor said a 6 yo had no contact with chicken (I posted the story, don’t remember what time).

It’s harder and harder for the final report of the WHO to say no H2H or no easier B2H.

Sorry I’ve been very busy and can’t be of much more help.

enza – at 02:43

Question: would it be fair to assume then(based on what we are seeing in Indo) that we are fairly condfident there are no other intermediate hosts?

AnnieBat 03:09

enza

I think it is fair to assume that we cannot state exactly where the ‘host’ for any of the outbreaks is located. Over time, there has been considerable discussion concerning possible hosts, and also discussion about the sequence in humans not matching the sequence in birds in the same region. But until the sequences are released we will not know.

When the case(s) in Cikelet was first found, it was stated that the cousins had fed dead chickens to local dogs. There has been nothing about the dogs since - their state of health, any testing or anything. It could be just as easily surmised that the ongoing cases in that area came from contact with the dogs - the bottom line is we just don’t know.

enza – at 03:13

Thanks AnnieB

FrenchieGirlat 05:15

I am reposting here what I just posted on the news thread, for further comments and discussion: I am reposting here the posts yesterday by anonymous – at 21:30 aka DennisC because I think they arrived late in the day and might be missed today, but they are important.

NEWS

Eggs on your platter may have a history of bird flu Ahmedabad,

“this might make egg lovers think twice. For, a number of eggs now available in the market belong to the bird-flu scare period, being brought out now by wholesellers who quietly hid them in cold storages and from State Poultry Department officials fearing that they would be destroyed. Poultry traders confirmed that at least 30 per cent of the eggs currently available in the State were hidden away in huge cold storages in February at the height of the bird-flu scare. Instead of suffering losses, many wholesellers decided to stash their existing stock at that time in cold storages. Also, taking advantage of the almost zero-demand for poultry products, they bought crores of eggs from small poultry farmers at 10 or 15 paise per egg and stowed them away.\\\

The eggs that were kept in cold storages then are now coming out into the market. There are chances that among the eggs that you are eating today, 30 percent happens to be of the time when the State Government was destroying eggs in flu-affected Uchchal…”

http://tinyurl.com/hhwgp

see also the following (WHO pdf report) about eggs and the virus: “The Avian Invluenza virus can be found inside and on the surface of eggs…. Only proper cooking will be able to inactivate the virus present inside the eggs.”

http://tinyurl.com/etehy

(DennisC – at 21:31 - sorry that was me - My computer cleans out cookies on Sunday.\\\


Comment/Speculation - In those cases where no contact with poultry has been identified, we’ve often wondered about another mammal vector, which I’m pretty sure exists and must be a factor in some of the infections.

However, the above stories makes me think that contamination due to eggs might also be possible. If one remembers the reluctance of the hungry Indonesians to have their chickens culled, many might have thought that if they couldn’t save the beasts, they might be able to hide their eggs. Eggs at normal temperatures do last a long time, without rotting, with plenty of nice feed for the virus to reproduce. It might explain some of the cases, especially also if there were a number of eggs cooked (soft-boiled, poached, scambled, omelette, pastry, sauces, soups, egg nog, etc.) on different days. There also might be bigger operators that were able to cold-store eggs in order to make a profit, as described in the above article. Farmers are farmers the world over - waste not want not! Eggs in cold storage will last weeks, and though cold may slow (does it?) the reproduction rate of H5N1, will it kill it altogether? If access to a town is restricted and trucks checked for chickens, how likely is a truckload of eggs be stopped, owing to ignorance of this possible mode of contagion and spread?

Commonground – at 06:12

[articles gives us an age for Fatima - 78 yrs. old] http://tinyurl.com/qdcox

A Citizen DidugaTerjangkit Flu Burung Hundreds Of poultries died Mendadak

Tebing Tinggi, (the Analysis) One of the citizens of the Environment of I Street Dr. Hamka the District Bulian the Tebing Tinggi Subdistrict of the City Rambutan, Fatimah (78) the Citizen, was run off with to RS the Tebing Tinggi Public because of being expected terjangkit the bird flu virus, on Friday (25/8). Casualties’s family said, the condition for the Fatimah health descended dratis, beforehand casualties experienced the high and breathless fever. Moreover the livestock around his house died suddenly. “Fatimah as far as this is concerned was not yet ascertained terjangkit flu burung,” said Dr. Parlin Sitanggang the specialist of the lung pulmonary disease RS the Tebing Tinggi Public. To avoid the spreading of the virus, the Tebing Tinggi Service of City Agriculture carried out the test against the chicken belonging to the community, afterwards did spraying in and around the poultry pen belonging to the community in the Bulian District. This action was carried out by the official of Tebing Tinggi City Agriculture of the Service after being monitored since Wednesday (23/8) hundreds of poultry animals especially the nonpedigreed chicken belonging to the community in the Environment i the District Bulian the Tebing Tinggi Subdistrict of the City Rambutan many that died. Saw the incident the community felt concerned and intent to anticipate him in the field. The animal that died that partly there are those that was planted by the community, but another part exiled him to Sei Kelembah that flowed into Sei Padang. The section head Tebing Tinggi City Agriculture, Drh. It was superior that Nirwan S when dikonfrimasi the reporter in the field justified the existence of the livestock belonging to the community fositif terjangkit bird flu in the District Bulian the Tebing Tinggi Subdistrict of the City Rambutan. “Kita was difficult to do the test against the chicken belonging to the community, because this animal has gone out the pen or was on trees. Results of our test today have one nonpedigreed chicken belonging to the community fositif terjangkit flu burung,” I was Superior Nirwanto S when doing the direct test test in the field. From 30 chickens that died, he said, four tails were burnt, two was buried and the rest was thrown away to the river.

Commonground – at 06:55

Just to clarify: When we state a case is “tested positive”, this is according to the labs in Indonesia. This is NOT a WHO confirmation. Correct???

Michelle in OK – at 07:56

Commonground at 6:55 - to the best of my remembrance, we have not received WHO confirmation on any of these cases.

Dennis C at 22:57 - I belive this woman to be the same as RL (35 F) pregnant and on Tamiflu. The city is the same, the hospital is the same and the date of admission is only 1 day off.

FrenchieGirlat 08:12

These are excerpts of a post by Theresa42 on FT:

[[ http://analisadaily.com/2-8.htm RSU Pematang Siantar Director kept the Bird Flu Patient secret ]], August 28, 2006 -The director of the public hospital (RSU) the Pematang Siantar city Dr Ria N Talambanua Mkes, apparently kept the patient secret “suspect” medicating bird flu to the hospital yesterday. […] However, the answer via the SMS apparently told the Analysis [Analisa newspaper] to interview the Section Head (Kadis) the health of the Simalungun Regional Government, because of the patient came from the Simalungun Regional Government. […] There is good him the RSU side was open [instead of secret, my note] when having the case like “suspect” bird flu because of all the social strata equally equally responsible towards the eradication of the virus that throw into turmoil that.


If I understand right, this one is professionnally a member of the regional government. Well, WHO and the like are not going to be able to say that this Indonesian patient is “inept, ignorant”, I doubt he’ll kill, feather or cook his own chickens. And it goes to show too that the masses do not seem to appreciate preferential treatment… BF will hit TPTB there or here. Perhaps we should make sure that when we have a news article on this case written in decent English, and hopefully more details on how he caught it (if proved positive), we should forward it to TPTB in our industrialized world. BF will not scour just the dungeons of society! During my last trip to Africa late last year, I met [a very educated someone] advising TPTB national stratosphere… who said he kept chickens in his backyards. Maybe this Indonesian patient did not have the opportunity to fly to Singapore, Amsterdam, or elsewhere for treatment, but boy am I sure that the one I met, if he fell sick, would be in the first plane to France for treatment, business class and all fancy stuff, coughing all over a Champagne flute while trying to get the favours of the air stewardess with watery eyes!

Michelle in OK – at 08:17

Anon 22 at 00:07 - As you discussed, the patients around Euis Lina are the ones most of concern to me. I show she was at Dr. Slamet Hospital in Garut on Aug-17, tested positive, and died. And yes, her husband, Dadan, and 2 children are said to have developed symptoms on Aug-21. 7 days later, we have no reports of positive or negative on her family.

If Euis Lina caught the virus from another person, that could be H2H2H. It is likely that her family was put on Tamiflu the very day they developed symptoms (if not earlier in the Aug-18 Mass Distribution of Tamiflu).

Commonground – at 08:24

Frenchiegirl - at 08:12:

Quoted from the same article: “His article, when it was confirmed about the patient “suspect” the bird flu kepimpinan RSU Dr Ria N. Talambanua M. Cash, through short massage service (the SMS), on Friday afternoon (25/8) confirmed had the patient “suspect” bird flu entered took medicine to the hospital.”

I’ve got my eyes on this and this passage makes me think they are talking about Fatima (78 yrs.) who entered the hospital on 8/26. I also have another notation of a quote from an article “A villager Seribu Dolok, the Silimakuta Subdistrict was expected BF”. I am keeping my eyes on this as well.

seacoast – at 09:33

Frenchiegirl - at 5:15

I think your ideas about the Indonesians hiding their eggs may be right on the money. If I were in their situation with a family to feed, I would be hiding my eggs. They prbably know just how long you can keep them before they rot and decided to start stockpiling, just like we did here in the U.S. in February. The perfect incubator.

Edna Mode – at 09:41

Am I correct in my perception that test results are not being released in nearly as timely a manner as they have in the past in Indonesia? If not, is it because of the increased number of tests being done (thereby causing backlog at the lab level)? Or do we suspect it is because the results are being withheld?

pugmom – at 09:52

Running out of supplies: 8–28–06 http://tinyurl.com/fwcqm

Metrotvnews.com, Palu West: the control Command Post of the plague of bird flu in the Palu Subdistrict West, Central Sulawesi, at this time has run out of supplies and the disinfectant liquid of bird flu medicine. The disinfectant liquid that beforehand totalling 15 litre was finished on Monday afternoon (28/8) earlier resulting from the number of the citizen’s requests for spraying. The number of citizens that asked spraying to make the official of the control of bird flu be overwhelmed…..

pugmom – at 10:02

Now banning reporters that take pictures of BF suspects and making the team of doctors that treat the patient to leave the premises. Pretty severe measures if they really think these cases are a negative. http://tinyurl.com/g3v8h Bandung 8–28–06

Metrotvnews.com, Bandung: two patients suspect bird flu was from Cikeulet, Garut, stated by the negative. The chairman Tim the Handling of Handsome Sadikin Hadi Yusuf Hospital Bird Flu confirmed the patient was named Tosin (61) and Herman (21) not terjangkit the bird flu virus. This assurance was received was based on results of the test the laboratory of the Body of Health Research And Development in Jakarta that was done by three times. Although being stated the negative, Tosin and Herman were still being treated in Space of the Poinciana Tree Isolation. The handling procedure was still being put into effect as the status suspect, including the ban on the reporter took the picture. The team of the decisive doctor, in the near future both of them will immediately leave the hospital. Beforehand, four patients suspect from Cikeulet, Garut, in the Handsome Sadikin Hospital also was stated by the negative and has come home. The four of them were Osin, Kuraesin, Risma and Santi. ()

Snowhound1 – at 10:04

Edna Mode…I have been wondering the exact same thing. After reading an article recently which dealt with Umar, the young man who was tested postive and is now recovering…there is this quote from the article. The “hundreds” is in reference to birds dying.

‘On hearing the answer “hundreds”, I strongly suspected it was bird flu, particularly since we’d had a similar case from a neighbouring village the day before,’ he said. Two days later Umar tested positive for bird flu and was in an isolation room in the nearest hospital, 55 miles away in Garut.

notice it says TWO days They seem to be sitting on a lot of information, I’m just not sure if it is good news or bad news that they are withholding.

link to article

ANON-YYZ – at 10:14

FrenchieGirl – at 08:12

Could the professional working for the government a Health Care Professionasl? Nothing indicated this person had prior contact with chickens.

FrenchieGirlat 10:21

ANON-YYZ – at 10:14 - I did wonder. We’ll have to wait to know unfortunately. Maybe he ate a contaminated omelette prepared by his servants???

mamypoko – at 11:07

Milo at 14:43 … terjangkit means infected.

Commonground at 06:12 … Fatimah is a female (common malay girl’s name).

ui – at 11:13

A dumb question from me:

Could (blood sucking) mosquitoes play a part in the transmission of H5N1 virus between humans or Pig/Dog2Human?

mamypoko – at 11:13

A dumb question from me:

Could (blood sucking) mosquitoes play a part in the transmission of H5N1 virus between humans or Pig/Dog2Human?

Okidokie – at 11:13

Many thanks to all the hard work. I was on vacation the whole last week. Recombinomics stated a cluster of 20. Does anyone have a summary of the cluster(s) sizes over the past 10 days as to how many and how large?

Commonground – at 11:21

Okidokie - at 11:13, I think Niman is referring to the situation in Cikelet, W. Jave. Please go the the Indonesia Outbreak Case Summaries thread.

Milo – at 11:27

Okidokie — There is a new Indonesia Outbreak Summary thread to try to keep all of this straight.

Commonground – at 11:30

mamypoko - at 11:07 Thank you so much. I need all the help I can get!!!

seacoast – at 11:31

mamypoko - 11:13

My guess would be no because HIV was not supposed to be spread by mosquitoes, BUT to mess things up, Triple EEE viris is spread by mosquitoes and other stuff too. so this response is probably a waste of time….

anon_22 – at 11:35

Michelle in OK – at 08:17 “Anon 22 at 00:07 - As you discussed, the patients around Euis Lina are the ones most of concern to me. I show she was at Dr. Slamet Hospital in Garut on Aug-17, tested positive, and died. And yes, her husband, Dadan, and 2 children are said to have developed symptoms on Aug-21. 7 days later, we have no reports of positive or negative on her family.

If Euis Lina caught the virus from another person, that could be H2H2H. It is likely that her family was put on Tamiflu the very day they developed symptoms (if not earlier in the Aug-18 Mass Distribution of Tamiflu).

But wasn’t Ai Siti Euis Lina’s daughter? And Dea, who died before her with unknown onset date? Euis Lina could have caught it from these 2 kids, and then later passed it to her husband and the other 2 kids. That would make it H2H2H.

Can anyone verify how sure we are that:

  1. Ai Siti and Dea were Euis Lina’s kids
  2. Whether there are any indications (including guesses, but please label them) of onset dates for Dea.

Thanks folks.

seacoast – at 11:39

Anon_22

Did you see Frenchiegirl’s post on stored eggs?

anon_22 – at 11:55

seacoast, I did, thank you.

I think stored eggs would be a problem technically. But in the case of remote villages in Indonesia, I doubt that they have the ability to do this to a significant degree. Most of these families are likely to be subsistence farmers living from hand to mouth. They may be able to store a few, but not to a degree that would cause widespread outbreaks. Sick chickens running around causing environmental contamination, handling of chickens and their waste, would be the biggest factors.

There was a study from Thailand last year that put as one of the top three risk factors for b2h as absence of indoor tap. Which tells you the degree that basic hygiene play a part.

FrenchieGirlat 12:11

anon_22 — at 11.55 - I don’t doubt your reply. How about this: if you have 20 chickens in your backyard and 25 eggs (soiled) in your kitchen. Your chicken are sick and culled. You might sell a few, bring some money, buy veg, do an egg soup with the veg the next day. The day after, without having washed your hands (or body), sweep the chicken coop, then make dinner with egg omelette and rice. You have a dozen eggs left, you sell, the day after another 6 of them, you get a slice of pork…, you little child is hungry, you have not much and you give him a milky-egg with cinammon to soothe the child. If you neighbour didn’t have eggs and is poorer than you, you might give him some too. If he’s richer you might sell them.

Else, you do like in the article, you’re a small operator, you have one truck, 500 chickens, you smell the wind, you buy egg cartons, you drive the truck to a bigger town 80 miles on the road, you put your eggs in cold storage. You come back. After 3 weeks, in your residing village, there’s hardly any chickens in your neighbourhood, you go fetch some egss and sell them with a profit…

So technically, why is this unlikely? What would the viral load be on and in the egg after keeping at normal temperature, after keeping in cold storage, after 3 days, a week, three weeks?

FrenchieGirlat 12:17

In addition, why do people like the CDC, WHO and the like who make leaflets on food safety in case of panflu recommend that eggs be thoroughly cooked?

DennisCat 12:23

here is some egg and cooking info from the FAO: 1. Conventional cooking (temperatures at or above 70°C in all parts of a food item) will inactivate the H5N1 virus. Properly cooked poultry meat is therefore safe to consume.

2. The H5N1 virus, if present in poultry meat, is not killed by refrigeration or freezing.

3. Home slaughtering and preparation of sick or dead poultry for food is hazardous: this practice must be stopped.

4. Eggs can contain H5N1 virus both on the outside (shell) and the inside (whites and yolk). Eggs from areas with H5N1 outbreaks in poultry should not be consumed raw or partially cooked (runny yolk); uncooked eggs should not be used in foods that will not be cooked, baked or heat-treated in other ways.

5. There is no epidemiological evidence to indicate that people have been infected with the H5N1 virus following consumption of properly cooked poultry or eggs.

6. The greatest risk of exposure to the virus is through the handling and slaughter of live infected poultry. Good hygiene practices are essential during slaughter and post- slaughter handling to prevent exposure via raw poultry meat or cross contamination from poultry to other foods, food preparation surfaces or equipment

http://tinyurl.com/g62pq

As I understand it, you want to cook the materials at >−165F for 10 minutes or so.

FrenchieGirlat 12:32

DennisC – at 12:23 - Thank you. Any running yolk would therefore be “contagious”… as in soft-boiled, poached, runny omelette, egg nog… not to mention handling the (soiled) eggs with (soiled) hands in (soiled) dishes. Same for cold storage eggs since H5N1 is not destroyed by cold. Then, what about the viral load in eggs, does it increase over time? After all, they do test for H5N1 high path characteristics in eggs (yeah, “germinated eggs” but still. Hmmm, nice yummy yolk for H5N1

Grace RN – at 12:38

pugmom at 1002

re:”The team of the decisive doctor, in the near future both of them will immediately”

Which team of doctors are they referring to-WHO? local docs? and why make them leave immediately?

pugmom – at 12:57

not sure Grace—my reading of it seems to mean the “local” team, and I could only assume they were asking them to self-quarantine, after this possible exposure. Yet, I know, I have to be careful not to read too much into these articles, esp with the difficult translations. I think the “team” was a group consisting of 2 doctors.

Michelle in OK – at 13:25

My statement at 7:56 was incorrect, according to a previos summary by mammypoko. The WHO gave positive confirmation on two early patients - Ai and Euis Lina.

Anon 22, I may have bungled this up, but I don’t show Ai as a documented blood relative to any of the other patients.

Only posted to show relationships in Cikelet - not comprehensive list

If I have incorrect information on anyone, please let me know.

Michelle in OK – at 13:31

On Ai, I should have said “neighbor” of Ismawati & Santi, not cousin

Michelle in OK – at 13:36

Also, I’m goint to remove Ai as a neighbor of Umar… a summary by Milo indicates that this was early reports, but that Umar is from Rancasalak Village while Ai was from Jojok Village.

Michelle in OK – at 13:48

Also potentially important if trying to determine series of events: Santi was not hospitalized until 8/16 and tested negative at that point. Parents said she had been coughing for around 20 days… that’s why I said symptoms at 7/27. If someone thinks I should change the dates, just let me know.

Leo7 – at 14:08

Anon 22 at 11:55:

Ever hear of Mohammed bah Abba? Fridge without electricity. Eggs and vegetables can indeed be stored safely for weeks on the cheap. See article from UK http://tinyurl.com/p22pl

anon_22 – at 14:20

FrenchieGirl, (also to Leo7),

I didn’t say unlikely as in impossible. I am just saying that my guess is it is not likely to be a major factor in the current outbreaks cos we know that there are lots of sick chickens running around. ie there are plenty of exposures such that whether or not they stored eggs probably won’t make a lot of difference. Plus I’m not sure that they have a lot of refrigeration capability.

It is of course possible. And your guess is as good as mine.

anon_22 – at 14:25

Michelle,

Thank you. So you reckon that the family included Dea (died Aug 16? or was her death reported on Aug 16?) , Euis Lina (confirmed, died Aug 17), Dakan the husband, and the other 2 kids?

Which means that the onset date of Dea and/or Euis Lina might give us a clue as to whether this is h2h2h. And of course the husband and other kids are as yet unconfirmed, and we don’t know whether they are now ok. Plus we haven’t excluded the possibility of continuing exposure to sick poultry etc.

Would that be an accurate description of our current understanding?

Grace RN – at 14:53

Have we confirmed that WHO is even in these areas of outbreak?

Commonground – at 16:51

Michelle in OK - they just confirmed over at CE that the following were sent home (they had missed it in articles):

Ismawati (5), Santi (8) [your Santi 6f?], Kuraesin (32) and Osin.

Prepping Gal – at 17:01

I’ve decided that when our Fluwikians can no longer keep track of the individuals, their ages, their relationship and their village I will know we really have gone h2h2h2

pugmom – at 17:05

Saribudolok, South Sumatra: new name (K boru Saragih from article dated 8–26–06. I am posting this article, even though it is 2 days old to illustrate that some of these cases are not getting reported to the MSM in Indonesia. This name did not appear in all the usual outlets, as Metro. This name was off the radar screen. However, I think it says alot in that it may confirm what we have suspicions about, ie. there are more people coming down sick than are reported.

http://tinyurl.com/jezdb

It was related that the Patient Suspect Bird Flu, the Simalungun Citizen was asked to stay Calm was written by editorial staff on Saturday, on August 26 2006 Simalungun (SIB) Kasi the Eradication of the Service Illness of Kessos Simalungun Dr Antonius S Ancient M

 Mepid

, on Wednesday (23/8) appealed to the community in order to stay calm, might not be concerned tertular related bird flu was treated by him a Saribudolok citizen in RS H Adam the Medan Owner. It was necessary, the community continued to follow various spread precautions of the virus from the poultry to humankind…. That was sent in the explanation of the handling of the continuation of the development of the case in Saribudolok the Silimakuta Subdistrict, one of the local inhabitants K boru Saragih was expected terindikasi was attacked suspect bird flu was reconciled to RS H Adam the Medan Owner. Was based on the clinical sign, experienced the fever with the temperature of the body on 38 levels, the inexperienced nose, the cough as well as the acknowledgment of the patient once direct contact with the poultry that died suddenly, then the medical team decided to send the patient immediately was treated in RS H Adam the Medan Owner. Concerning positive or negative results of being ill suspect bird flu was through results of the official’s inspection…. Always saw the condition for the environment around it and immediately reported to the official of the related service when having the death of the sudden poultry or the related matter other, he said. He added, the preceptive attitude and the community’s vigilance towards the spread of the virus berpatogenitas high that will grow when the community had knowledge and the understanding about this illness danger. COPYRIGHT © 2006 ANTARA

Commonground – at 17:18

Thanks Pugmom - I got it written down!

AnnieBat 17:23

pugmon at 10:02 and others following:

The “two to leave immediately” I think refers to the 2 patients when they are finished their treatment - not the doctors to leave.

ANON-YYZ – at 17:23

pugmom – at 17:05

Saribudolok, Simalungun

is in North Sumatra.

Map:

http://tinyurl.com/q3ds5

Commonground – at 17:35

I’m having trouble with this web site. Does anyone know where to click to get the Metro pages or the pages that would have flu burung.

http://www.sumeks.co.id/index.php

pugmom – at 17:36

thanks Anon! and AnnieB—I think you are right!

Commonground – at 17:41

Thanks ANON - it wasn’t listed on any of my information. Maybe I’ve bitten off more than I can chew?

pugmom – at 17:54

Hi CG: here are a few of my favorites.

http://tinyurl.com/pbzto (site I just found—very good— article came from there)

http://tinyurl.com/pxkr3 (metro) http://tinyurl.com/mbl4h http://tinyurl.com/n38zn (Liputan)

If these don’t keep you busy enough, let me know.

ANON-YYZ – at 17:58

Commonground – at 17:41

It’s only a minor detail, and we will always miss some.

Thanks for doing a wonderful job.

pugmom – at 18:01

CG—on that first link (I think you had trouble with it), it takes awhile to load. Then click on home page, then go to box in left hand corner, type in flu burung, and out will come this really excellent site I found today---nothing but flu burung—I could spend all day just on this site. Let me know if this doesn’t help.

Commonground – at 18:14

Thanks pugmom, That first site you recommended is GREAT!!! I use Metro & Liputan. It was this site: http://www.sumeks.co.id/index.php that I didn’t know where to go after I logged on.

Thanks ANON - YYZ - Maybe you can take the “other” slot which is keeping us all straight!!! LOL!

Influentia2 – at 18:14

UPDATE THE LASTING GODDESS AND TK SUKOWIYONO NEGATIVE

http://tinyurl.com/kzsoh

EXCERPT:

On Tuesday, 29 Agt 2006 ‘negatives, the Lasting Goddess’Pulang TULUNGAGUNG- the Goddess’s Lasting Family, 6, the child that was expected terjangkit the virus avian influenza (AI) yesterday could smile.That after results of the temporary inspection stated the daughter of the couple Sugianto (alm) and Marsiyah the bird flu negative.Moreover, villagers ‘Sukowiyono’, the Karangrejo Subdistrict, ‘that was permitted to come home’.’Beforehand, the TK child could be treated in the room of the RSUD isolation’ of orchid space Dr Iskak Tulungagung since last Thursday because of being suspected of being infected H5N1 (the AI virus).RSUD public relations Dr Iskak Tulungagung Tri Widyo Agus Basuki, said the Lasting Goddess has come home since last Sunday.

EXCERPT:

The student ‘TK Sukowiyono’ was brought to the hospital last Thursday.When being brought to the hospital because of being suspected of being affected by bird flu.Apart from because the high fever and coughs, around the location of his residence often died suddenly because of bird flu.

pugmom – at 18:32

Influentia2: Where did we have TK Sukowiyono on our list?

Influentia2 – at 18:36

Commonground 18:14

Try these words in your searches also:

Ayam means chicken ekor means tails

These words are showing up in the headlines more often than flu burung lately.

Sometimes the human cases will be mentioned at the end of the article, such as was the case with Ponorogo and Megatan culling stories last week.

Hope these words help. Searching and translating is time consuming and difficult to learn, you are doing a great job.

Thank you

pugmom – at 18:39

CG—I surfed around on that Sumatera site for awhile and never could pull up anything that had Flu Burung on it. Maybe it is a society paper, or a business paper, I just don’t know. Maybe Flu Burung is a taboo word.

pugmom – at 18:47

Simulungun, North Sumatra—name for “RL” and update on her condition:

http://tinyurl.com/qhxs4

In the meantime, Rasmita Boru Lingga, the patient suspect bird flu that was treated in RS Adam the Owner, Medan, North Sumatra, was still undergoing the intensive maintenance. Up to now, the condition for villagers Saribu Dolok, the Silimakuta Subdistrict, of the Simalungun Regency, North Sumatra, was still being not yet stable. According to Deputy Director RS Adam the Owner, M. Nur Rasyid Lubis, his side did not yet accept results of the sample inspection of blood that was sent to Balitbang Department of Health in Jakarta, on August 22 set. In fact, results of the research into the sample of blood could be used to know the Rasmita condition….

ondition.’‘’ 8–29–06

ANON-YYZ – at 18:48

Influentia2 – at 18:14

pugmom – at 18:32

TK = Taman kanak-kanak = kindergarten

The student ‘TK Sukowiyono’ means the Sukowiyono kindergarten student Lasting Goddess.

:-)

Influentia2 – at 19:11

ANON-YYZ 18:48

Thank you for pointing this out.

What translator are you using?

There are still some slots open to search, maybe you could help us out in that respect too. You have a much better translator it seems, so why waste it?

pugmom – at 19:52

She might be too busy keeping us straight on our Geography! Also, Influentia2, Mamypoko told us that Terjankit means infected. We’ll all be speaking Indonesian before you know it. BTW Anon, sometimes I see Simalungun in North Sumatra, sometimes in South Sumatra. Is it a region that covers both, or a town?, or both? It is also the name of the language they speak there.

Influentia2 – at 19:56

http://tinyurl.com/jccfh

After the plague of bird flu (Avian influenza/AI) struck Cikelet Kab.Garut, this time the concern about this virus also struck Cisolok, Kab.Sukabumi.The concern emerged, after approximately 100 chickens not the race (the nonpedigreed chicken) property of villagers Cicadas and Sirnaresmi, died suddenly.To prove the cause of the death of these chickens, is Official local Livestock Breeding has brought the sample of the chicken carcass to the laboratory.For the time being, the death of these chickens was stated as suspect bird flu.The head of the Animal of the Health Sub- Service in the Kab Livestock Breeding Service.Sukabumi, drh.Winda, on Monday (28/8) in Sukabumi, justified the existence of the chicken livestock belonging to the citizen in the Sirnaresmi Village that died suddenly with the sign similar to bird flu.Explained by Winda, the Sukabumi Service of Regency Livestock Breeding has sent the team to this village and carried out the socialisation about signs of the bird flu illness.

EXCERPT:

At first, when having a villager ‘Cicadas that was named Dede, died suddenly with was preceded by hot high, breathless, and coughs.’Winda still could not ascertain the cause of the death of chickens belonging to the citizen.However, was based on the report on the team that was involved to the location, on Friday (25/8), the death of chickens belonging to these Sirnaresmi villagers, was not far was different to the death of the chicken resulting from bird flu.Therefore, the Kab Livestock Breeding Service.Sukabumi for the time being said as suspect bird flu and after the existence of results of the laboratory, his side will inform the cause of this death, so as to not cause the unrest in the community.

Influentia2 – at 20:03

Cisolok West Java

Influentia2 – at 20:10

Also I need some help on a map of Krajan Village, the Kedungrejo Village, the Muncar Subdistrict, Banyuwangi.

I cannot use the google earth download on this old PC.

If someone could post a link showing the river or rivers in this area I would like to see it.

I have looked and can’t find a map with a river or name of the river on it. Any other villages along any river would help me out too.

Thanks

dbg – at 20:14

Palu, Central Sulawesi, August 28 2006 — The Bird Flu Command Post, received the Medicating Citizen (http://tinyurl.com/r44nh)

The bird flu Virus that attacked hundreds of tails of the chicken in the Palu territory West startled and disturbed the citizen. The Bird Flu command post that was placed in Street Datu Pamusu, the place of the discovery of the case, began to be visited by the citizen to memeriksakan the health. Andi Rahmawati the medical official of the Kamonji Community Health Centre that was placed especially in this command post said the citizen who came memeriksakan himself between 4–8 people since the command post was opened, Friday last week.

[snip]

Sohir, the citizen of the district Just admitted to panicking when learning many chickens died because of the bird flu virus. Moreover his two children that since several last days not all that. Both of them then below took medicine to the Bird Flu Command Post. It was “just frank that Sir I was very frightened like that learned bird flu attacked hundreds of tails of the chicken, I did not want the virus that was caused by him would berimbas to my family.” Therefore I came to this command post to confirm whether being sick my child did not have the influence from bird flu. Because since the last few days my child was more unhealthy, said Sohir plain. Sohir admitted to not yet knowing many matters of the danger and prevention methods of the bird flu virus. As far as this is concerned the picture about bird flu only was known through the TV broadcast or radio. Was not yet so clear. Sohir hoped had a kind of counselling or giving of the directory that could give the explanation more gave again details.

[snip]

According to walked on Susi SPi, the staff Distanhut, the Bird Flu Command Post opened the opportunity that as widely as possible to all the citizen in Palu West to willingly report the poultry that was known died suddenly. This matter was needed so that the official that the stand by during 1×24 the direct hour to the location. That was regretted because of having the citizen that still persisting maintained the poultry that was owned by him on the basis of anything not happening. Be forced the official only carried out spraying of the pen and this poultry. “In this case we could not force the citizen to hand over his poultry to be destroyed.” Be forced we only carried out spraying then. However we continued to hope the citizen continued to hand over the poultry that was owned by him willingly.

I don’t think these kids should be added yet, but we might be hearing more from the Command Post in coming days.

pugmom – at 20:23

Cikelet, West Java: new name: (either “Direct” or “Walk On”--age 60 8–28–06

http://tinyurl.com/zkkb6

It was other that Suspect AI entered RSU Dr. Slamet The report on the Reporter Kompas Adithya Ramadhan Garut, Kompas - on Monday (28/8) struck 19. 30, a male patient suspect bird flu had a name Direct (60), the citizen of the Cipicung Village, the Cikelet Village, the Cikelet Subdistrict, the Garut Regency entered RSU isolation space Dr. Slamet Garut. The patient was reconciled by the Cikelet Community Health Centre with the hot sign high, coughs, and breathless. Moreover, according to the wife of casualties, Walk On, his husband had the story of contact with the poultry even his 10 property chickens znumanyz days ago died suddenly. The head of RSU public relations Dr Slamet Garut, the Yogi Prayogi, said, at this time the patient could be handled in RSU so as to not yet have the plan to be reconciled to RSHS Bandung.

ANON-YYZ – at 20:31

Influentia2 – at 19:11

I was reading the context of the post and took a wild guess. So I used toggletext to translate from English to Indonesian and found the Indonesian word for kindergarten.

I am very busy at work so not able to commit time. When I have a few minutes, I’ll hop in and help where I can.

Thanks for asking.

Okieman – at 21:48

News

Also posted on news thread.

Toggletext translation:

Liputan6.com, Garut: the Handling of the bird flu illness must as immediately as possible because could increase fast and deadly not less than a week. However, evidently not all the doctors could at once know the sign of bird flu. Health Minister Siti Fadilah Supari regretted this condition. “It should be that his doctor must know [the sign of bird flu],” said Siti in Jakarta, on Monday (28/8). Siti also appealed to the official of livestock breeding and the health of the service during immediately to inform the area that was found had the poultry died suddenly to the doctors in a radius of one kilometre. The community that suffered the sign of flu after having the poultry died suddenly in his territory it was suggested immediately memeriksakan himself. This could help the doctor during immediately to diagnose the bird flu patient. In the Ai Siti Fatimah case, the doctor could not at once know the sign of bird flu. The Garut citizen, West Java, this was reconciled to the hospital from the community health centre in the critical condition. Nyanyanya was not helped. In the meantime, the Handsome Hospital side of Sadikin Bandung, West Java, ascertained two patients from Garut the bird flu negative. Tosin, 61 years, and Herman, 21 years, the Citizen of the Cikelet Subdistrict, Garut, that uptil now will be treated in space of the Poinciana Tree isolation, in a moment was permitted to come home. The condition the two patients increasingly good after undergoing the maintenance for a week. Although being ascertained was not attacked by the virus H5N1, Tosin and Herman were still occupying isolation space with the appropriate maintenance of the standard of the handling of the bird flu patient [read: the Condition for the Bird Flu Patient from Garut improved]. (TNA/Tim Coverage 6 SCTV)

http://www.liputan6.com/view/3,128208,1,0,1156815318.html

Michelle in OK – at 22:10

Wow, you all have been really busy. I’m sorry you had anything to report though, except for the patients who improved and were released.

Influentia2 @ 19:56… I picked up the new patient named Cisolok, but was confused by the rest of the article. Is Cicadas, named Dede, a casualty, or was it the chickens that died suddenly?

After refining the list for the above comments and only picking up Cisolok from the article at 19:56, the tally is at 61. I’ve reformatted so I can easily report the full range of information captured on each individual, if anyone has an interest. Including the names of hospitals might help you all more easily locate where new patients are. If the list is too cumbersome after trying it, we can scale back down as needed.

pugmom – at 22:10

Kendari, SE Sulawesi: possibility of 4 cases: 8–28–06 http://www.mediaindo.co.id/

Sulawesi Kendari opened the Command Post of Bird Flu Vigilance the writer: Halim Agil

Kendari — MIOL: the Government of the Kendari City, South-East Sulawesi opened the Command Post of Bird Flu Vigilance in six subdistricts……. The command post was formed to know faster the case of bird flu in the community. In the Kendari City was found by two cases suspect bird flu.In the Baruga Subdistrict totalling 2 bird flu patients. Whereas the poultry that died suddenly totalling 713 tails ayam…….

So, we may be hearing of new names soon.

ANON-YYZ – at 22:15

pugmom – at 22:10

Command post means treatment center. It may also mean Tamiflu blanket as in Cikelet. The decision to open the 2 command posts is not a good sign.

pugmom – at 22:23

Michelle—I think Cisolok is the name of the town. I think “Dede” might be the name of the patient from the town of Cisolok. Also the post at 21:48 mentions a patient from Garut named “Ai Siti Fatimah.” Now I don’t believe this is the same Fatima we booked in this morning as from Tebing Tinggi, North Sumatra. Yet, the name is vaguely familiar. Is it a new case or not??

dbg – at 22:31

Another good (but long) editorial (http://tinyurl.com/mrycd) from 8/26/06 by Burhanudin Sundu, The special staff and the regular writer to the magazine of Poultry Indonesia. Some snippets:

When the first wave of bird flu fall on on the end of 2003, we as playing games by producing the bird flu vaccine from China that was pointed out low the level of his capability.

There were several matters that became the reason why biosekurity often ineffective. Firstly, most of our poultry breeding efforts were still being traditional with the free “Scavenging” system where the chicken could roam about with the radius that quite far from sipemilik, in fact crossed the other territory of the village territory. In this system, almost was not possible biosekurity could be applied.

Our two quarantine systems did not go should. The sending system of the livestock from a territory to the other territory often without the system tight quarantine.

Three, the marketing system of the living chicken in the traditional market gave the opportunity terinfeksi him other chickens even humankind by this illness. Three matters above made eradication efforts of the bird flu illness become ineffective.

The problem that was shown by this illness only was not to the technical territory, but also social, economics and politics took the form of the policy and the regulation.

The width of our territory, the transport difficulty penetrated the rural territory, the inhabitants’s congestion of urban areas, the weakness of the system biosekurity and at least the staff was trained that was had by us, must be made the calculation material for steps in preparations.

AnnieBat 23:41

Michelle in OK - thanks so much for your update to the Summary Cases thread. As I suspected, it is grim reading when you see it laid out like that.

mamypoko – at 23:53

To Michelle in OK at 22:10, hope this helps.

The 1st half of Influentia2 @ 19:56 |Bird Flu Plagues Cisolok article says:

29 August 2006

mamypoko – at 00:02

Pugmom @ 20:23 1 more AI suspect enters Slamet Hospital article says:

Closed and Continued - Bronco Bill – at 00:13

Closed for length and contnued here

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