Human-to-human AI transmission possible in latest case
The World Health Organisation has reported that
human-to-human transmission of the avian influenza virus may have taken place in
the most recently confirmed case in Indonesia.
A 27-year-old man, who had mild symptoms and recovered from the avian
infection, reported no contact with diseased or dead poultry, but
had extended contact with his 15-year-old sister, who was confirmed as having
The girl developed symptoms on 17 May 2006 and was subsequently confirmed
to be H5N1 infected. Her brother spent six days caring for her during her
hospital stay. The brother developed mild symptoms of cough and abdominal
discomfort, with no fever, on 28 May 2006.
Despite his mild and atypical symptoms, the brother was tested as part of
the Ministry of Health's protocol for contact tracing and the management of any
contacts with symptoms. He was given a five-day course of oseltamivir beginning
on 1 June and was placed in voluntary isolation pending recovery.
Initial tests of samples collected from the 27-year-old male were negative
for H5N1 infection. In August, however, follow-up testing of paired-serum
samples found a fourfold rise in neutralisation antibody titer for H5N1, a test
result which meets the WHO
criteria for laboratory confirmation.
The 27-year-old male reported no contact with diseased or dead poultry in
the days prior to symptom onset as he spent most of his time at the hospital.
The investigation determined that he had exposure to his sister during her
hospital stay, and that human-to-human transmission could not be ruled out as
the source of his infection.
The retrospectively confirmed cases bring the
total in Indonesia to 65. Of these cases, 49 have been
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