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So far this outbreak followed the classic outlines:

– unexplained deaths from “fever/breathlessness” (no follow-up)
– birds die in locality
– severe illness in a couple of people – they are hospitalized (late) in poor condition
– people make the connection between the illness/bird deaths
– discovery of more people with similar but lower-level symptoms – they go for treatment
– everyone is Tamiflued
– 48 hours go by
– if the most critical patients’ immune systems have been overwhelmed by the virus, they may test positive but they probably won’t survive
– Tamiflu does its job and the virus circulating in the symptomatic individuals is reduced to undetectable levels
– the suspect cases test “negative” (in the same way that a person with Strep Throat would test “negative,” after 48 hours on antibiotics)

It’s the Indonesians themselves, the authorities, who will be in complete confusion if and when this process (which they have absolute confidence in) fails.  Watch for that.  Knock on wood that the Tamiflu keeps on working, but watch for that.


This was sent to me via e-mail from a newshound , unpathedhaunts. Thanks for a great summary!

Summary: Air Batu (Rough Draft)


 –Aug. 6, Mariana, nurse from  Kisaran hospital, Asahan District, reported three deaths and thirteen hospitalized. Patients exhibited symptoms similar to bird flu.

–Two patients sent to Adam Malik Hospital, Medan. Muhammad Sani Mufli, eight months old ;Fadilah Hanum , 7 year old girl

–Their village is Air Batu, Kabupaten Asahan, North Sumatra.  According to Adam Malik spokesman Sinar Ginting, the two are in “critical condition, with a high fever, serious respiratory problems and a cough.”  http://www.thejakartapost.com/news/2…)-sumatra.html

–They are given tamiflu and have improved

–Their father, Selamat Riyadi described sudden poultry death in his village one week prior.  His infant shortly after began to develop symptoms—respiratory problems and fever. Ginting  said that the birds that died suddenly in their village had been tested and were found positive H5N1. 

Blood, throat, and nose samples sent to Jakarta for analysis. Results should be back in one week. 

–Selamat Riyadi took his infant boy for prior treatment to a local clinic as he didn’t realize the seriousness of his condition, maintaining that he doesn’t keep poultry and that the nearest poultry to his house is 150 meters away.

Note:  Would like to know more about where he took the child as well as precisely how long the child was sick.

–Children were evacuated from the village after the discovery of the infant Muhammad’s illness.   Poultry were destroyed.

–From Jan. to Aug. 2008 Adam Maik Hospital had four suspect bird flu patients. 

–Reports (as well as Muhammad’s father)  suggest that three residents of the village had already died ( before Aug. 1 acc. to one report; “two weeks prior” acc. to another ) of flu-like symptoms and were buried.  Misman (45 ? reports differ); Igo ( 4 years old); Riski (6). Mother reported to be in Kisaran Public Hospital.   One news report said that when the medics came to the village, some people went to stand by the tree(s) where the people (who had died weeks previously)  were buried.

 –Eleven patients were sent to RSU Kisaran.  Blood samples have been sent to Jakarta.  They are identified as:

Darsiyem, D32, (One report says Igo was his son)


Ujang, US 38,

Sudira, Sdr 39,

Indah Purnama Sari,6,

Rindi, RM 8,

Dwi Yanti, DY 5,

Rama Agus Setiana, D 2,

dan Retno Ayu Pratiwi, RAP, 5

(NOTE: Ages for the above vary in reports; at least one person not accounted for in above listing.)

Erna Tresnaningsih, Indonesian Health Ministry Director Of Animan-borne Disease Control said that the dead chickens didn’t have symptoms that looked like bird flu.  EARN YOUR MONEY, ERNA!

–Aug. 8 , Sinar Ginting, spokesperson at Adam Malik Hospital, confirmed that the blood from both children had the virus.

–Poultry in the area is positive so they begin slaughtering birds. (But they can only go so far?)

–WHO arrives in affected village.  Some patients kept from leaving hospital despite improvement.

–Indonesian Health Ministry says villagers have recovered and have tested negative for avian flu               ( . . .after tamiflu)

 –Report out suggesting that an additional 74 may be infected.

Addendum to Summary.


The following agencies and officials are involved with or are closely monitoring the events in Air Batu: “We have carried out the intensive handling against the patient in RS H Adam Malik Medan and RSUD H Abdul Manan Simatupang Kisaran by dropping dozens of medical teams from three agencies to carry out observation and the medical handling of the patients,” Chandra said in the Bird Flu Patient Isolation Space at RSUHAM Medan, on Thursday (7/8).
Dr. Chandra Syafe’i, Head of North Sumatra Health Team
   North Sumatra Medical Staff
   RSU Jahi Adam Malik Medan
   USU School of Medicine
   Plantation Co., PTPN IV, Air Batu, Dr. Muhammad Hafiz
Asahan Regency Health Service/North Sumatra Health  Service Head, Dr. Armansyah
Asahan Regional Livestock Service, Head of Community Health Sector and Veterinary
   Services, Amir Husein
Asahan Subagency Head for the Handling and Eradication of Disease, Dr. Yunan Pane
Asahan Regional Livestock Service, Chief Officer Oktoni Eryanto
Centre of Health Research and Development (Puslitbangkes)
Kasi Observation and Domestic Animal Disease Observation, Harimansyah
Kebumen Regency Livestock and Fishery Health Agency, Head Suhartilah
Kisiran RSU HAMS Director, Dr. Bambung Wahydi
North Sumatra Livestock Veterinary Agency, Nurdin Lubis
North Sumatran Province Subagency Health Dept., Pemberatasan of Illness and and
   Environmental Sanitation, Dr. Surya Dharma
North Sumatran PDIP Politicians (no names given)
RI Health Department/Zoological Guidance and Evaluation, Tato Suharto
RSUP  H Abdul Manan, Simatupang
RSUP H Adam Malik Regional Public Hospital, Medan
   Team Leader Dr. Luhur Soeroso
   Public Relations Spokesperson Sinar Ginting
Shavings Regency Health Head, Armansyah
Shavings Regency Livestock Breeding Service, Drh Bakhtiar
U.S. Consulate-General, Medan
World Health Organization, I. Nyoman Kandun, Director General of Communicable