A World Health Organization (WHO) reference laboratory
confirmed today that a 9-year-old Indonesian girl from the remote
Garut district in West Java province who died on Aug 15 had H5N1
avian influenza virus.
The girl's symptoms developed on Aug 1 and she
was hospitalized the day before she died. Recent chicken deaths
were reported in her household. She becomes Indonesia's 58th case
and its 45th fatality. Indonesia has the world's highest number
of avian flu fatalities, and the girl's case is the country's third
case in 2 weeks.
Investigators are assessing recent bird-flu related
events in three hamlets in the girl's village, which is about 93
miles southeast of Jakarta. The 17-year-old boy who was Indonesia's
57th case (confirmed by the WHO on Aug 14) is from the same village
but lives in a different hamlet. The WHO said the boy is recovering.
When the boy became ill, his 20-year-old cousin
developed severe respiratory symptoms but died on Aug 5 before he
could be hospitalized or tested for the H5N1 avian influenza virus.
“Based on epidemiological and clinical findings, however,
infection with the H5N1 virus is strongly suspected,” the
WHO said in its report.
The boy and his cousin developed symptoms on Jul
26, and investigators assume they acquired their infection from
the same environmental source. The WHO pointed out that the currently
recognized incubation period for H5N1 infection of 2 to 8 days makes
human-to-human transmission between the two highly improbable.
Teams that include authorities from the local health
department, the Indonesia Ministry of Health, and the WHO are in
the three hamlets investigating these cases. Animal health experts
are also on the scene. Recent unexplained poultry deaths have occurred
in the village, and exposure to sick chickens was documented in
all three cases.
Local publicity surrounding the recent avian influenza
events, along with the presence of the investigative teams, have
prompted additional patients to be screened for presence of the
H5N1 virus. The WHO said rumors of additional late July and early
August deaths from respiratory disease in the hamlets are being
investigated.
Initial media reports noted that the hamlets were
difficult to reach by road or phone, but the WHO said good field
communications have been established with the Ministry of Health.
An Associated Press (AP) report today said that
a total of seven confirmed or suspected bird flu deaths have occurred
in the village. Health officials told the AP they were awaiting
lab results for a girl who was hospitalized yesterday in West Java's
capital Bandung, where she received the antiviral drug oseltamivir.
Besides the 20-year-old man mentioned in the WHO report, the AP
said three others from the same area died before testing for the
H5N1 virus could be performed.
