"Bird Flu Not spread among humans in Indo UN says"

How's this for a headline?....  and it's from our State Dept.

31 May 2006

Bird Flu Not Spreading Among Humans in Indonesia, U.N. Says

Disease confined to one family; other cases appear elsewhere in country

By Charlene Porter
Washington File Staff Writer

Washington -- International health investigators are finding no evidence that efficient transmission of the highly pathogenic avian influenza virus has emerged from a family cluster of cases in Indonesia, the World Health Organization (WHO) reports May 31.

Seven members of the same family in a village in Karo district, North Sumatra, were exposed to the disease and six died in late April and early May. (See related article.)

Disease experts from WHO and the U.S. Centers for Disease Control and Prevention joined Indonesian health officials in examining the case to determine how these various people were exposed and what those findings may reveal about potential mutation of the H5N1 virus.

This influenza strain, which has caused the deaths of more than 200,000 birds, is thought to have the potential to set off a human influenza pandemic if the virus develops the capability to pass efficiently from human to human.

In trying to find out whether that happened in North Sumatra, health experts put 54 close contacts of the infected family under quarantine. They are being monitored for disease, and receiving an anti-viral drug that has shown some effectiveness in combating H5N1.

“Despite multiple opportunities for the virus to spread to other family members, health care workers or into the general community, it has not, on present evidence, done so,” according to the WHO statement.

WHAT TYPE OF TRANSMISSION

As the Karo, Sumatra, case has unfolded over the past two weeks, health authorities have been careful to draw the distinction between limited human-to-human transmission of the disease and efficient human-to-human transmission. Limited human-to-human transmission can occur in the close contact shared by family members. Efficient and sustained transmission between people occurs when a virus can be passed through more casual contact, such as a cough or a sneeze on a bus or in an office.

The H5N1 virus has caused 127 deaths in 224 cases since it was detected in humans in late 2003. In all but a handful of cases, humans have become infected through direct contact with ailing birds, their feces or blood.

In just a few cases, authorities found a family infection passed from one person to the next, but only in close personal settings. One case involved a mother caring for a sick child.

The number of people involved in the Karo district outbreak made it distinctive from any previous cluster case. Investigators had to learn whether that much illness in one family marked an evolution of the virus. Analysis now has indicated that the virus itself has not undergone the genetic mutation that might mark its development of a capability for efficient and sustained human transmission.

THE CHAIN OF INFECTION

Investigators of the North Sumatra outbreak have identified the initial case in the family cluster to be a 37-year-old woman who kept backyard chickens and allowed them into her home at night. Some of those birds reportedly died shortly before the woman became ill.

This woman was developing serious symptoms in late April when family members came to visit. Nine relatives spent the night in one room, as victim Number 1 was “severely ill, prostrate and coughing heavily,” according to the WHO statement. Within days, other family members developed symptoms, and by May 15, seven cases had appeared with six fatalities.

FURTHER ISOLATED CASES IN INDONESIA

WHO reported confirmations of six other cases of H5N1 in humans in Indonesia May 29, but none of the cases is associated with the Karo district family cluster. In fact, they are widely dispersed geographically.

Two youngsters in West Java became ill on the same day, and died on the same day one week later. The brother and sister, ages 18 and 10, had been exposed to sick and dying chickens around their home.

Another fatality traced to H5N1 exposure in contact with birds occurred in West Jakarta. In East Java, a young man now is recovering after confirmation of H5N1, apparently due to exposure to dead birds. Further cases of recovery from H5N1 occurred in South Jakarta and West Sumatra.

Indonesia has detected 48 cases of H5N1, 31 of those appearing since January, and ending in 36 fatalities.

For ongoing coverage see Bird Flu (Avian Influenza).

The WHO’s update on the Indonesia cases is available on its Web site.

(The Washington File is a product of the Bureau of International Information Programs, U.S. Department of State. Web site: http://usinfo.state.gov)

http://www.birdflubreakingnews.com/templates/birdflu/window.php?url=http%3A%2F%2Fusinfo.state.gov%2Fxarchives%2Fdisplay.html%3Fp%3Dwashfile-english%26y%3D2006%26m%3DMay%26x%3D20060531145204cmretrop7.044619e-02%26t%3Dlivefeeds%2Fwf-latest.html

Thanks for putting the Web Site up there - I simply can't believe that the headlines were not intentionally written that way, and I think I'll just let them know that someone has noticed.  We still haven't heard a thing on how they're matching up these strains (i.e. birds, pigs, etc.) - now THAT would be interesting reading.