Three Indonesian clusters of H5N1 virus infection in 2005.
BACKGROUND
Since 2003, the widespread ongoing epizootic of avian influenza A (H5N1) among poultry and birds has resulted in human H5N1 cases in 10 countries. The first case of H5N1 virus infection in Indonesia was identified in July 2005.


METHODS
We investigated three clusters of Indonesian cases with at least two ill persons hospitalized with laboratory evidence of H5N1 virus infection from June through October 2005. Epidemiologic, clinical, and virologic data on these patients were collected and analyzed.


RESULTS
Severe disease occurred among all three clusters, including deaths in two clusters. Mild illness in children was documented in two clusters. The median age of the eight patients was 8.5 years (range, 1 to 38). Four patients required mechanical ventilation, and four of the eight patients (50%) died. In each cluster, patients with H5N1 virus infection were members of the same family, and most lived in the same home. In two clusters, the source of H5N1 virus infection in the index patient was not determined. Virus isolates were available for one patient in each of two clusters, and molecular sequence analyses determined that the isolates were clade 2 H5N1 viruses of avian origin.


CONCLUSIONS
In 2005 in Indonesia, clusters of human infection with clade 2 H5N1 viruses included mild, severe, and fatal cases among family members.
Kandun
I Nyoman
IN
Directorate General of Disease Control and Environmental Health, Ministry of Health, Jakarta, Indonesia.
Wibisono
Hariadi
H
Sedyaningsih
Endang R
ER
Yusharmen
Hadisoedarsuno
Widarso
W
Purba
Wilfried
W
Santoso
Hari
H
Septiawati
Chita
C
Tresnaningsih
Erna
E
Heriyanto
Bambang
B
Yuwono
Djoko
D
Harun
Syahrial
S
Soeroso
Santoso
S
Giriputra
Sardikin
S
Blair
Patrick J
PJ
Jeremijenko
Andrew
A
Kosasih
Herman
H
Putnam
Shannon D
SD
Samaan
Gina
G
Silitonga
Marlinggom
M
Chan
K H
KH
Poon
Leo L M
LL
Lim
Wilina
W
Klimov
Alexander
A
Lindstrom
Stephen
S
Guan
Yi
Y
Donis
Ruben
R
Katz
Jacqueline
J
Cox
Nancy
N
Peiris
Malik
M
Uyeki
Timothy M
TM
D000328:Adult; D000818:Animals; D000998:Antiviral Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D007223:Infant; D053124:Influenza A Virus, H5N1 Subtype / Q000235:genetics / Q000302:isolation & purification*; D007251:Influenza, Human / Q000453:epidemiology* / Q000628:therapy; D008297:Male; D053139:Oseltamivir / Q000627:therapeutic use; D012121:Respiration, Artificial
D000998:Antiviral Agents; D053139:Oseltamivir