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Sixth Member of Indonesian Family Dies from Bird Flu

Chickens are brought to market in Jakarta, Indonesia, May 23, 2006. (©AP/WWP)

By Charlene Porter
Washington File Staff Writer

Washington -- Six members of an Indonesian family have now died from the highly pathogenic form of avian influenza, H5N1, that has killed 124 people in nine countries, the World Health Organization (WHO) confirmed May 23.

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

The H5N1 strain has appeared in animals in more than 50 countries since it first began spreading in Southeast Asia in late 2003. Human cases have appeared in 10 countries, with a total of more than 220 infections.

Humans have little immunity to this strain of influenza, so health officials warn that H5N1 could set off a global human pandemic if it were to mutate to become contagious among people.

A handful of earlier human cases have suggested the disease could pass from one person to another, but only with the close personal contact that comes with caring for an ailing relative.

Transmission through such contact is not considered "efficient transmission," as when a cough or sneeze can infect a roomful of people.

Investigation of illness in this family in the Kubu Sembelang village in the Karo District of North Sumatra indicates that three of the sick relatives spent a night in a small room with the female family member who is considered the initial case.

She was displaying symptoms of illness that night, and coughing frequently, according to the inquiry by WHO and the Indonesian Ministry of Health.

The investigation now turns to family contacts and the larger community in search of other possible exposures.

Most of the Kubu Sembelang family members died in the first two weeks of May, and no other cases have appeared in the broader area, providing “no further evidence that efficient human-to-human transmission has occurred,” WHO reports.

The H5N1 strain would have to undergo a genetic mutation to become a microbe efficiently transmitted among humans. The WHO update says that full genetic sequencing of viruses from the Sumatra cluster found no evidence of significant mutations.

U.S. ASSISTANCE

Epidemiologists from the U.S. Centers for Disease Control and Prevention are in Sumatra helping WHO and Indonesian health officials as part of a broad U.S. plan to provide assistance in world regions where the virus is considered most widespread.

U.S. Secretary of Health and Human Services Michael Leavitt announced May 22 that the United States is sending a shipment of the antiviral medication Tamilflu^® to Asia to be available in case of a widespread disease outbreak. (See related article).

The United States has earmarked $334 million to an international campaign to control avian influenza and prevent the emergence of human pandemic influenza, and Indonesia is one of the vulnerable nations receiving assistance in that campaign. (See fact sheet).

For ongoing coverage, see Bird Flu (Avian Influenza).