Meanwhile, In Indonesia . . .

Meanwhile, In Indonesia . . .

# 807

If I wanted to, I could post at least a half dozen entries each day on outbreaks in Indonesia. The local media is filled with stories of bird deaths, culling operations, and warnings to beware of `flu burung'.

We also get, almost daily, reports of people being hospitalized for suspected bird flu. Unfortunately, we rarely get any follow up reporting. According to media reports, however, there are 20 people currently being treated for H5N1 infections in Indonesia. It is impossible to tell from the accounts if they have tested positive, or are merely suspected of infection.

The newshounds on the Flu forums are attempting to follow these, and other reported cases, from media reports. It is tedious, often mind-numbing work.

First, nearly all of the stories are printed in Bahasa, the language of Indonesia. Our tireless volunteer newshounds scan dozens of media outlets for Indonesian phrases like 'flu burung', or 'Mutasi' (mutation), or 'Pilik' (common cold) in order to segregate bird flu related articles from the rest. They then run these selected articles through translation software to convert them to English.

Given the limitations of translation software, sometimes the results are still indecipherable, and often comical. Last year, one headline read "Bird Flu Discovered By the Dog", which was a report on a dog that died, apparently of H5N1.

Once an article is translated, it is then posted, and the details are extracted and placed in spreadsheets. Often details, such as patient names, initials, or locations are left out of these articles, or simply wrong. It makes keeping track very difficult.

Yet amazingly, when Indonesia announced last week that 15 people had tested positive for H5N1, and 13 had died, since they stopped reporting to the WHO in January, those numbers were almost exactly what the newshounds had tracked. An astounding feat, by any measure.

There are many cases that simply fall into the `unknown' category. Hospitalized, or treated for H5N1, but never officially diagnosed one way or another. Some of these patients die, and we still get no official word on them.

The chart below is the current case count, as tracked by the newshounds on Flu Wiki, and compiled by Michelle in OK, for 2007. All 533 patients were mentioned in local news reports as having been suspected of `flu burung'. Only 22 have been officially diagnosed.

As you can see, we have 17 deaths, unexplained, and only 166 that were publicly reported to have tested negative. There have been 328 with symptoms, for which we have had no follow up reports.

Most of these `unknowns' are likely not H5N1. And no one is suggesting otherwise. Indonesia suffers from Dengue, Chikungunya, and a variety of other tropical diseases which can mimic flu burung. The vast majority of these unknowns probably are the result of these other pathogens.

If the reports of 20 hospitalized patients with H5N1 are true, however, it would indicate that at least some of these `unknowns' are bird flu cases. And there may be others that have been misdiagnosed. It is impossible to know for sure.

I present them mostly to give the reader some idea of the sheer number of cases that our dedicated newshounds have tracked since January of this year. We owe all of them, from all of the flu forums, a debt of gratitude.

If a sudden uptick in cases should occur, we will likely learn about it from them, and in the meantime, they have established a baseline to compare it to.

So while an isolated outbreak of H7N2 in Wales has caught the attention of the English press, we need to remember that the pot continues to simmer in places like Indonesia and Egypt, and most of it flies below the media's radar.