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20 September 2005 |
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Bird Flu closes Jakarta Zoo, H5N1 human case(s) confirmed |
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The Jakarta Post reported September 19th and 20th that the Ragunan Zoo in south Jakarta has been closed down for 21 days beginning Monday, September 19th, after multiple bird species were found to be infected with bird flu. The Minister of Agriculture was cited as reporting that the infected species included eagles, herons, peacocks, mynahs, pigmy chickens, and wild ducks. This striking discovery likely means that H5N1 is more widespread in the avian population inside and outside Jakarta than previously known, and thus the risk for more human infections may be higher than appreciated. |
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Two persons who work in the Jakarta zoo have been hospitalized. One of these individuals is described as an employee and another as a vendor, and both are reported to have an influenza-like illness that warrants being evaluated for H5N1 influenza infection. All 500 of the zoo employees are to be offered testing for H5N1 avian influenza virus. So far no official report has been made public as to whether the type of avian influenza virus in the zoo has been proven to be the H5N1 virus. |
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Other zoos in Indonesia are being evaluated for the presence of avian influenza. 19 of 27 samples from the Ragunan zoo in Jakarta have been reported positive for avian influenza. The source of the infection within the zoo is not certain at this time. H5N1 virus infection of poultry, pigs, and humans has previously been reported in Indonesia earlier in 2005. |
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The WHO confirmed on 16 September the death of another person in Indonesia due to lab-proven H5N1 virus infection. This 37 year-old woman was reported by the Jakarta Post today to be a resident of Petukangan Utara, south Jakarta. She apparently lived near a chicken slaughterhouse in a south Jakarta suburb, according to today’s paper, while the WHO reported that she also had opportunities for exposures to ducks. |
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In July, 2005 a government worker died of H5N1 infection, close to the time of the death of his two daughters, ages 8 and 1, of a similar respiratory disease. This family lived in Tangerang, Banten province, in a western suburb of Jakarta. The epidemiological link to a known H5N1 virus exposure was never established for this family. |
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Currently there are at least six (6) persons in hospital in Jakarta being evaluated for H5N1 infection. At least two are young persons, ages 7 and 9 years. Their samples are being tested for H5N1 virus in the renowned virology referral lab in Hong Kong. One child lives in Tangeran and the other child is a “close relative”, according to the Jakarta Post, of the 37 year old woman who died two weeks ago and was confirmed by the WHO September 16th. |
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On Monday, September 19th the Indonesia declared the avian influenza outbreak an “extraordinary situation”. The Health Minister, Siti Fadila Supari, was reported in an AP article today (written by Niniek Karmini) as declaring that 44 state-owned hospitals had been assigned to treat avian flu patients, including with free medications. Person with influenza-like illness suggesting H5N1 infection “could be forcibly admitted to hospitals”. |
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Neighboring Malayasia is reported to have gone on heightened bird flu alert, checking poultry farms near the border with Indonesia. The WHO Director-General, Mr. Lee Jong-wook was quoted in an Agence France-Presse article September 20th while addressing the WHO’s regional committee for the western Pacific, to say that “It’s obvious a pandemic will occur, all the conditions are in place. The problem now is time”. |
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Models published last month in Science and Nature on how to control a nascent influenza pandemic, in part by rapid deployment of an antiviral stockpile by the WHO in partnership with the affected country have been base don a rural, rather than urban, area being the initial site of the pandemic. Any delay or mitigation of a nascent pandemic by such WHO-lead interventions would be significantly, and perhaps overwhelmingly, much more difficult if the pandemic began in a major metropolis such as Bangkok (as stated explicitly in one of the models), Jakarta, or other international travel hubs in Asia, Europe, or the Americas. |
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Daniel R. Lucey MD, MPH |
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Director for Biologic Counterterrorism and Emerging Diseases (CBC-ED) |
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ER One Institutes, Washington Hospital Center |
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Adjunct Professor of Microbiology and Immunology |
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Georgetown University School of Medicine |
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Washington, DC |
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email: Daniel.R.Lucey@Medstar.net |
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Website for this “newsletter” posting: www.BePast.org |
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