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Tuesday, September 27, 2005

Indonesian Bird Flu (H5N1) Update 2

It's possible that the other shoe has dropped in Indonesia. Many of the hospitalized cases in Jakarta are associated with a particular zoo, which has now been closed. The question which has been puzzling many is what was different about the infected birds at that zoo? Given the extremely close proximity in which humans and birds live in Indonesia, exposure to infected birds at the zoo seemed unlikely to be an additional risk factor.

Then consider this. In July, a man and his two daughter died of H5N1. One daughter was the first flagged case, followed later by the other two. He was a government official. Rina Dai (worked at the airport) became ill and died, followed by her nephew becoming ill later. Now we have a girl who has tested positive for H5N1 and was hospitalized on the 21st. Her two brothers are now ill.

There were cases in Vietnam in which human to human transmission was by far the most likely explanation for infection, but I believe that the clusters shown in these Indonesian cases with one case and then a delayed onset in other people put that beyond a doubt. This doesn't mean that H5N1 is now efficiently transmitting from human to human. But If it is transmitting at all, given the situation in Indonesia, it will naturally evolve for more efficient transmission.

I would also like to remind everyone that people have died without expressing H5N1 in their saliva. The infections seems either to be gastrointestinal or to be harbored deep in lung tissue, so swab tests for H5N1 are unlikely to be reliable. See autopsy report. Both WHO and Australia are sending stocks of Tamiflu to Indonesia, so I guess they have their own suspicions. The Indonesian cases are popping up over a wide area and on different islands, so it is not as if this thing can be contained. There are tons of infected birds, and since all testing has confirmed that wild birds also harbor the disease it is unlikely that culling can stem the animal/human vector.

Hey woman:) I came across this article and while it isn't meaty it might have info you are interested in on this topic:

If I had your email addy I could send such things directly- but I don't see it anywhere here.
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