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August 17, 2005

Update on the Indonesian bird flu fatalitiesAvian Flu - What we need to know

Dr. Amin Soebandrio from the Ministry of Research and Technology Republic of Indonesia comments at ProMedMail on the source of the bird flu virus that killed a father and his two daughters in Jakarta over a month ago:

It could be true that the "escaped" bird(s) across the street were the source of the avian influenza A (H5N1) virus that infected 3 members of a family in Tanggerang, Jakarta, based on the finding of a trace of avian influenza virus in the dried bird droppings. However, this does not explain why only those 3 were affected, while the other family members showed negative results for both serologic and PCR tests. Also, none of the neighboring families showed a positive result.

There is also a question as to whether those 3 victims were exposed to the source at the same time or whether one of them was the index case and transmitted the virus to the other close family members sharing the same genetic susceptibility to the virus. As we know, the 2nd case showed symptoms 10-11 days after the 1st, the 3rd case a few days later: an unusual incubation period for avian influenza if they were exposed at the same time. My hypothesis is that they were grossly exposed to a (so far unknown) source, possibly repeatedly. Alternatively, one victim could have become a new infection source for the others who have similar genetic susceptibility. Could an intentional targeted spreading of the virus
possibly play a role in this case?

The ProMedMail commentators go on to say that

Dr. Soebandrio has made the interesting comment that differences in genetic susceptibility may have played a role in the Jakarta incident. This is an issue that deserves further study, particularly with respect to an apparent greater vulnerability of Vietnamese people to avian influenza virus infection.

This is an interesting hypothesis, and there may well be something to it in the case of the three Indonesian deaths. In general, I think the "greater vulnerability" observed in Vietnam seems likely to have more to do with how poultry is raised, cooked and consumed than with differences in genetic susceptibility.

Posted by dymaxion at August 17, 2005 01:02 PM

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