# 8775
The H5N1 virus, which long reigned as the emerging pathogen thought `most likely to succeed’, has been largely supplanted by H7N9 and MERS in the headlines over the past 16 months - but still circulates in poultry and wild birds in Asia and the Middle East - and still manages to jump to humans on occasion.
Exactly why reports of human infection with the H5N1 virus is less common these past couple of years is unknown, but this welcome period of relative quiescence is no guarantee that the virus won’t flare back up again, sometime in the future.
While there were media reports late last week indicating a new fatal H5N1 case in Indonesia, today the MOH has published a detailed account.
The patient, a 33 year-old male, progressed from a `cold-like’ illness to pneumonia to ARDS (Acute Respiratory Distress Syndrome) and then to death, over a two week period. During that time he was seen at two clinics (June 1st & 2nd) and admitted to a private hospital (June 4th) and then transferred to an FB (Flu Burung) Referral hospital on June 13th where he died on the 14th.
While no apparent exposure risks were detected at the victim’s home, investigators point out the patient might have been exposed at a live bird market he visited in East Jakarta, when he purchased live chickens on May 27th.
Although the number of new cases reported in Indonesia has plummeted over the past couple of years, sadly, the same cannot be said for the mortality rate from this virus. Today’s case marks Indonesia’s 165th fatality out of 197 known cases, making for a dismal survival rate of just over 16%.
Ministry of Health, through the Directorate General of Disease Control and Environmental Health announced a new case of bird flu have been confirmed by the Center for Biomedical and Health Technologies Daar, Balitbangkes. Case on behalf of RA (male, 33 years old) District residents Cakung, East Jakarta, DKI Jakarta, an employee.
On June 1, 2014, symptoms of colds and flu in the case and went to a private clinic. Next day, on June 2, 2014, the case went to a private hospital clinic with the diagnosis of urinary tract infection (UTI). And because there is no change and complained of nausea, vomiting and swollen eyes, on June 3, 2014 the case back to the private hospital for treatment with the diagnosis of Acute Respiratory Infections (ARI) and Dyspepsia. Conditions of the case does not go changing, so on June 4, 2014 cases of inpatient admission in private hospitals the same.
On June 5, 2014, complained of shortness of cases and consulted with a pulmonary specialist to diagnose bronchitis and coronary artery disease (CAD). Next day, on June 6, 2014, the case was getting packed and transferred to the ICU with the images contained thoracic infiltrates. Then there is deterioration with diagnosed pneumonia with acute respiratory distress syndrome (ARDS). On June 13, 2014, the case was referred to the FB Referral Hospital, and died on June 14, 2014 early morning at 01.00 hrs.
Epidemiological investigations have been conducted into the homes of people and the environment by Integrated Team MoH RI, Jakarta Health Department, East Jakarta Health Agency, Health Center Pulogebang, Cakung Health Center, Center for Veterinary Research (Bbalitvet), Marine and Agriculture Binas DKI Jakarta Sub-dept East Jakarta Livestock and Fisheries, Animal and Fish Health centers DKI, acquired risk factors, namely the possibility of environmental contacts in one market in East Jakarta, where the case of direct purchase live chickens slaughtered in the market on May 27, 2014.
Case the home environment is clean, no poultry in the complex. The house is adjacent to the township case tenement, but there is no population that raise chickens, there are only 2 who keep birds in cages suspended from the home page.
With the increase of such cases, since it was first discovered in 2005 till this news was published, the cumulative number of bird flu cases in Indonesia is 197 cases with 165 deaths.
Executing tasks Director General of Disease Control and Environmental Health Ministry of Health, Prof.. Dr. dr. Agus Purwadianto, SH, M.Si, Sp.F (K) as the focal point of the International Health Regulations (IHR) has informed the case to the WHO.
