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The
Ministry of Health in Indonesia reported that a
38-year-old father who died on 12 July was the country’s first
laboratory-confirmed H5N1 positive human case of avian influenza. His two daughters also died of severe
pneumonia illness compatible with H5N1 infection, but laboratory confirmation
is not yet available. Limited samples
were available from the 8-year-old daughter who died on 14 July, and the
1-year-old daughter who died on 9 July.
The 8-year-old became ill with fever, diarrhoea,
then cough, on 24 June. She was brought to SiloamGleneaglesHospital, Tangerang, on 28 June, where she died with respiratory
distress 20 days after onset. The
1-year-old became ill on 29 June with fever, diarrhoea, then cough, finally
respiratory distress, and died 10 days after onset. The father became ill on
2 July with fever, mild cold, then cough and was taken to the same
hospital on 7 July where he died 10 days after onset. Samples from the
38-year-old tested positive for avian influenza H5N1 virus by the WHO H5 reference
laboratories at the Department of Microbiology, University of Hong Kong, and
the Centers for Disease Control and Prevention, Atlanta USA. Samples from the two children are
undergoing testing.
The remaining four residents of the house (two
members of the family and two household workers) remain healthy and show no
symptoms to date. The Ministry of Health is closely following over 300
contacts, including health-care workers, family members, school and office
colleagues and neighbours. None of these contacts have shown any symptoms to
date.
An investigation is currently underway with team
members from Indonesia's Ministry of
Health, Ministry of Agriculture, United States Naval Medical Research Unit 2,
and WHO to identify potential sources of the infection. Serum samples have been collected from
contacts of the cases, starting from the family and neighbours, health-care
workers, while any possible poultry contact is being investigated (e.g.
market sellers, retail food outlets, pet
birds). Environmental and veterinary
sampling is being carried out by the Ministry of Agriculture.
Health education to hospital and
other health-care workers have been continuing since January 2004, when avian
influenza was first reported in Indonesia.
The Ministry of Health, working with WHO has carried out seminars and
workshops to strengthen surveillance of influenza-like illness, outbreak
investigation, and appropriate isolation and barrier nursing. Stockpiling of personal protective
equipment to protect health and veterinary workers, and procurement of antivirals for treatment and prophylaxis, as appropriate,
is continuing. Information has been
provided to assist the community with general health precautions, including
frequent hand-washing, avoiding contact with sick animals, and safe and
hygienic handling and cooking of poultry.
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