# 6420
The Indonesian Ministry of Health has posted a fairly detailed account of their 190th H5N1 infection, that of an 8 year-old girl from Falkirk District, West Java who died on July 3rd.
The girl (initials K.K.) initially developed a fever on June 18th – five days after reported contact with poultry at a live market near her home – and while on holiday in Singapore with her family was diagnosed as having strep throat.
She was seen at a local hospital upon her return from Singapore, but appears to have been discharged. Two days later, with her conditioning worsening, she was admitted to a different hospital and then transferred to another facility, where the diagnosis of H5N1 was finally made on June 29th.
I’ve a machine translation from the announcement that appears on the Indonesian Ministry of Health website.
July 5, 2012 | 8:07 am
Ministry of Health, "Directorate General of Disease Control and Environmental Health" announced one new case of H5N1 have been confirmed by the Center for Basic Biomedical and Health Technology, Balitbangkes.
Case on behalf of the families (female, 8 years) who Falkirk District, West Java. On June 18, 2012 the case began to experience fever, June 19, the case went on holiday to Singapore and the next day for treatment didokter private practice, was diagnosed with strep throat.
On June 24, returned to Jakarta. June 25, the case went to the hospital. Falkirk District B with a complaint over a week heat, vomiting, cough, no appetite and was diagnosed with febrile and impairment of consciousness and no radiographic results Duplex bronchopneumonia.
June 26, forced to go home, then went to the hospital. S West Jakarta, the situation gets worse case then mounted ventilator and ICU admission, on June 28, referred to the RSP with the diagnosis of suspected bird flu, on June 29, the results of the sample by the Research and Development (BTDK) Positive H5N1.Kondisi case worsened and finally died world on July 3, 2012 at 22:45 pm.
Epidemiological investigations have been done to the house of the case, the environment, markets and hospitals where the case was referred to hospital were treated before referral FB (RSP). Acquired risk factors, namely the possibility of contact with poultry as before (date June 12) the case goes to market with his father and brother, bought 5 chickens living in which case the vote and cut the chicken in the poultry abattoir (TPU), the case also hold the chicken been deducted. Every day the case to the school through a new market Falkirk existing poultry seller.
With the increase of these cases, the cumulative number of bird flu in Indonesia since 2005 until this news was broadcast on 190 cases with 158 deaths.
Director General of Disease Control and Environmental Health Prof. dr. Tjandra Yoga Aditama as the focal point of the International Health Regulations (IHR) has been informed about the case to the WHO.
Today’s report is the first one we’ve seen out of Indonesia since early May. The apparent CFR (Case Fatality Ratio), based on known cases in Indonesia, remains a sobering 83% (158 fatalities out of 190 cases).
The fact that this girl traveled to Singapore while actively infected will no doubt raise new concerns in the region over the ability of this virus to quietly cross borders.
While no additional transmission of the virus from this victim has been reported, this is the type of scenario that prompted Singapore to stockpile bird flu vaccine in 2010 (see Singapore Buys 1 Million H5N1 Shots).
Although we continue to see isolated human infections around the world, and the virus continues to evolve (see H5N1: An Increasingly Complex Family Tree), for now H5N1 is primarily a threat to poultry.
The concern, of course, is that over time that could change.
And so the world remains at Pre-pandemic Phase III on the H5N1 virus, and we continue to watch for signs that the virus is adapting better to humans.
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