Wednesday, May 24, 2006





The World Health Organisation's regional spokesman for Indonesia gave a chilling interview to From Voice Of America in which he called the bird flu outbreak that killed seven members of the same family "the mother of all clusters".

When members of the same family, or neighbours in a small village, become infected with the bird flu virus, the WHO refers to these outbreaks as "clusters", and while the most recent Indonesian 'clusters' are significant, Vietnam, Singapore and Thailand also also suffered 'clusters' during human bird flu infections and deaths in 2004 and 2005.

But the WHO spokesman, Peter Cordingly, admitted the Indonesian family toll of seven deaths out of eight known infections was the largest 'cluster' yet seen in one location.

Cordingly liked the phrase "mother of all clusters" enough to use it three times in the one interview, and emphasised the significance of the Indonesian outbreaks.

He also refused to rule out the possibility of human-to-human transmission of the virus, as scientists couldn't find a link to avian influenza infected birds in the latest deaths.

From Voice Of America News :

"For the first time now we have people dying from this virus but we can find no source of infection outside their own family," he explained.

"No dead chickens, no dying chickens, basically no animal source at all around them. So we're in a zone we've not been in before which is a large cluster and we don't understand it."

There is good news, however. Tests on samples taken from the infected show the virus is not mutating.

" shows no sign of the ability to transmit more easily between chickens and humans and no sign of any ability to transmit more effectively from human to human," he said.

A mutation of the H5N1 virus, where the virus meets a human influenza virus and then 'blends' to form a far more infectious new strain, is regarded by scientists around the world as the trigger for a pandemic.

Reuters is reporting that health experts are desperately trying to track down anyone who might have come into contact with any of the seven members of the Indonesian family now confirmed to have died from the H5N1 virus.

When they find such persons, they are immediately put onto the anti-viral medication Tamiflu, regarded as the most effective way of stopping the virus from spreading through the body, though it is not a vaccine that will guard against initial infection.

WHO sent in something of an emergency response team to the North Sumatran village earlier this week where the family members became infected and died. The US dispatched a shipment of Tamiflu to Indonesia to up their stockpile.

The WHO team is now watching the surrounding villages for outbreaks of the virus.

While there was no known contact with infected birds or animals for the family members, it has now been established that they had slaughtered and cooked chickens and a pig for a feast held on April 29.

Apparently the WHO team is having trouble getting the North Sumatran locals to allow testing on their chickens and pig stocks. Should the virus be found in any animal, the standard procedure thus far has been to install a quarantine that can stretch for miles, and all birds, or pigs, within the high-quarantine zone are slaughtered.

Poor villagers, with limited food supplies, would naturally not want to have such animals killed and the carcasses torched.

Compensation may come from the Indonesian government, but during outbreaks earlier in the year, many farmers who lost their entire stock of chickens complained that local corruption stopped them from recieving any compensation at all.


Reuters also reports : This large cluster meanwhile has re-ignited interest in a theory expounded by a growing number of scientists that genetics might predispose certain people to being infected by H5N1, which remains essentially a disease of birds.

Some people who survived H5N1 have been found to have more of a type of receptor cells along their respiratory tracts that avian flu viruses like to bind to -- which in theory would explain why some humans might be more susceptible to H5N1.

Such a genetic trait would also explain why cluster cases have invariably involved blood relations, and never husbands and wives.

"It appears that familial susceptibility amongst certain races, certain cultures and certain groups of people appear to be having a play in the pathogenesis and behaviour of this virus when it jumps from one species, like poultry, to humans."



From The Jakarta Post : One of two new suspected bird flu patients from the same family in Bandung, West Java, died Tuesday, leading to speculation that a new cluster has surfaced.

The two, a 10-year-old girl and an 18-year-old man, were admitted to Hasan Sadikin Hospital in Bandung on Monday evening, but the girl's condition worsened and she died at 2:50 p.m on Tuesday.

The siblings, residents of Cileunyi in Bandung regency, exhibited symptoms associated with bird flu and had known contact with dead chickens.

"They had high fevers and lower respiratory infections, which made it hard for them to breathe."

Indonesian health authorities have now identified five 'clusters' around the country.

UPDATE : reports that WHO will not raise their alert status from Level Three as there is no proof that the H5N1 virus is being transmitted easily from person to person in Indonesia, following the 'cluster' of at least seven deaths in the same family.

"All confirmed cases in the cluster can be directly linked to close and prolonged exposure to a patient during a phase of severe illness," said a WHO statement. "Although human-to-human transmission cannot be ruled out, the search for a possible alternative source of exposure is continuing."

The last of the family to die was a father who had cared for his dying ten year old son. WHO believes this close contact allowed the H5N1 virus to pass from the son to the father.

Three other family members who died had spent the night of April 29 sharing a small room with a woman who was the first in the family to die. She was reported to have been coughing frequently throughout the night, which may have passed the H5N1 virus to the next three victims.

Now doesn't that all sound like the bird flu virus has spread fairly easily throughout the family, based on their proximity to those already sick with H5N1 infection?

WHO may be playing it safe, fearing that raising the Alert Level from Three to Four (on a scale of One to Six) may trigger panic, not only locally, but on the global stockmarkets, though you would hope these kind of concerns wouldn't figure into their decisions, when early alerts will be the key to stopping the spread of pandemic bird flu.

Just the mere the possibility that human-to-human transmissions in Indonesia had taken place hit the markets hard, as you can read in the stories below.

Bird Flu Transmission Fears Hit UK Stockmarkets

Asian Markets Take A Tumble, Indonesian Rupiah Drops 10%

European Share Market Resumes Fall On Bird Flu Fears

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