AVIAN INFLUENZA (68): INDONESIA (JAVA) DUCK, H5N1 2.3.2.1 CLADE

ChannelNewsAsia, Agence France-Press (AFP) report [edited]

http://www.channelnewsasia.com/stories/afp_asiapacific/view/1242219/1/.htm





Indonesia has identified the bird flu [avian A/(H5N1)] virus that killed hundreds of thousands of ducks in recent weeks as a more virulent type which is new to the country, according to a letter seen Tuesday [11 Dec 2012].



"We found a highly pathogenic avian influenza sub-type H5N1 (virus) with clade 2.3..." the agriculture ministry's veterinary chief Syukur Iwantoro said in the letter obtained by AFP.



"This clade is a new clade found for the 1st time in Indonesia, that is very different to the avian influenza found before, which is clade 2.1." A clade is a group of organisms, usually species, with a common ancestor.



A poultry breeders' association had reported the death of more than 300 000 ducks in several provinces on Java Island since November [2012] to the ministry.



The veterinary office found the H5N1 virus involved was a different clade to that usually found in Indonesia, said Iwantoro's letter to local government offices and the World Health Organisation (WHO).



Iwantoro called for further research into whether there had been a genetic shift in the virus previously found in the country, or whether the new strain originated overseas.



"There is a suspicion that the virus has spread from other countries, possibly from Viet Nam or Thailand," Emil Agustiono, secretary of the national commission of zoonosis control that oversees bird flu, told AFP.



Health officials have told local governments to stop and check motorbikes and pick-up trucks commonly used to transport poultry, to try to reduce the spread of the virus.



The health ministry has told local offices to be vigilant for more massive poultry deaths, or for deaths of people in the vicinity, its head of communicable disease Tjandra Yoga Aditama told AFP.



Bird flu typically spreads from birds to humans through direct contact, but experts fear it could mutate into a form that is easily transmissible between humans.



Indonesia has suffered the world's worst human fatalities from bird flu with 159 deaths since 2003 out of 359 worldwide, according to the WHO.



--

Communicated by:

ProMED-mail






******

[2]

Date: Mon 10 Dec 2012

Source: FluTrackers [summ., edited]

http://www.flutrackers.com/forum/showthread.php?t=196156





Hundreds of thousands of ducks have died in several regions from a bird flu strain recently discovered in Indonesia.



Director of Animal Health, Ministry of Agriculture, told Radio Australia that the Ministry has detected the presence of a new type derived from bird flu since last September [2012].



The Ministry of Agriculture said the bird flu virus is a newly discovered variant of the H5N1 strain.



It was said that the new clade 2.3.2. could have mutated from the previous strains. New types of bird flu in Indonesia are expected because of the bird flu virus mutation; this is under detailed research.



Another possibility is that the new clade has been introduced from outside by migratory birds such as wild ducks and/or by poultry imports from abroad.



For the prevention of the spread, the Ministry has instructed destruction of affected birds and advised Local Government to instruct farmers to refrain from keeping ducks with other bird species.



"We will also coordinate with the Ministry of Health about the findings, in relation to the significance of the new type of AI [avian influenza] concerning public health," said Pujiatmoko.



So far there have been no reports of a new type strain of bird flu in humans in Indonesia.



This type of bird flu virus has previously been found in India, Viet Nam and China.



Meanwhile, the Indonesian Entrepreneurs Association of Local Poultry has reported more than 300 thousand ducks died last week [week of 3 Dec 2012].



Deaths of ducks have recently been discovered in 4 provinces of the island of Java, West Java, Central Java, East Java, and Yogyakarta.



Researchers of avian influenza from Airlangga University, Surabaya are engaged in the research related to these new findings, especially the role of ducks as reservoirs.



[Byline: Laban Laisila, Iffah Nur Arifah]



[The original report is from Radio Australia (in Indonesian, machine translated)

http://www.radioaustralia.net.au/indonesian/2012-12-10/jenis-baru-virus-flu-burung-ditemukan-di-indonesia/1058696]



--

Communicated by:

Gert van der Hoek

Senior Moderator

FluTrackers

http://flutrackers.com

[As of 9 Dec 2012, a total of 191 human cases of H5N1 have been reported by Indonesia since the start of the local epizootic there in 2005, of which 159 patients have, reportedly, died. During 2012, 8 cases have been reported, all of whom died. Indonesia ranks first globally, followed by Egypt (168 cases including 60 deaths) and Viet Nam (123 cases including 61 deaths).



Worldwide, 608 human cases have been reported since the start of the panzootic (initially, in 2003, in China and Viet Nam), of which 359 have reportedly died.



For the evolution of the Asian H5 hemagglutinin, see WHO's conceptual diagram of ongoing H5N1 evolution athttp://www.who.int/influenza/gisrs_laboratory/201101_h5n1evoconceptualdiagram.pdf. Also, see commentary by Mod.CP in ProMED-mail archive no 20111024.3168.



HPAI H5N1 was declared by Indonesia as an endemic disease on 21 Sep 2011; since then, no follow-up reports were required and have not been submitted. A change in the pathogenicity/epidemiology of the causative agent may require its immediate notification to the OIE. - Mod.AS

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/21SD.]

Merapi chickens died mysteriously

Dozens of residents slopes of Merapi chickens died mysteriously

Dozens of chickens owned by residents around the slopes of Merapi, in Srumbung district, Magelang regency, Central Java, died suddenly in the last five days.

Chickens in three farms owned by three residents that Heru Prasetyo (40), Mbah Hardjo Saripin and Mbok Trimo. The number of chickens that died suddenly it reaches 50 to 60 head.

"Starting Sunday (8/12) through Thursday (13/12). Initially I was not worried but why in the past five days of the death of chicken in strange condition. At the head of the cock and anal blue looks very clear," said Heru Prasetyo (40) to merdeka.com, Thursday (13/12)...

HUH ,Wonder what killed em.. 

Sespa announces award of examinations of hospital employees Curuçá

According to tests, servers experienced an infection chemistry. 
Secretary of Health ensures that there is no possibility of transmission.

The State Department of Public Health (Sespa) announced on Thursday (13) the results of tests performed in the municipal hospital officials Curuçá in northeast Pará.According to the official report, they had a chemical poisoning.

According to the examinations made by Sespa, the possibility of infection was discarded either by virus, fungus or bacterium. Thirty-two patients underwent blood tests, stool and urine in last November. The result of the tests, made by Instituto Evandro Chagas and the Central Laboratory of the Federal University of Pará (UFPA), indicated the presence of ammonium thiocyanate in the body of patients, which, according to Sespa, indicates a condition of intoxication chemistry.

"The hospital staff of Curuçá had contact with a chemical, which was has expired and he was content with leaking the bottle. Furthermore, [the officials] were in a room administrative inadequate, with administrative roles where staff used these papers to routine use of labor, "explains the infecciologista Sespa, Helena Drive.

The state secretary of health, Helio Franco, also ensures that there is no possibility of transmitting intoxication.

•  Since the end of November, the county hospital servers and relatives of employees showed symptoms such as body aches, eye irritation, bleeding, and tiredness. The Sespa recognized the severity of the patient's symptoms and said that everyone will receive treatment.

"There is an antidote, where we will begin the administration of these drugs, so that they become available for use by patients, but there is no need for all patients taking the medication.They will be evaluated by a rigorous criterion for the good of all of them, "says the infecciologista Helena.

Also according to the Sespa, the hospital reopened Curuçá on Thursday (13), but a team of the secretariat remains in the county to do a reassessment of the physical structure of the building.All 32 employees who had already contracted the intoxication high.

Understand the case
On 26 November, a report by Liberal TV showed that two servers Hospital Curuçá were already hospitalized and another 10 have had symptoms such as body aches, eye irritation and malaise. They complained that they felt ill after contact with a chemical used in x-ray machines.The Health Department of the State dismissed the suspicion of contamination by radioactive material.

There are reports that the material used for x-rays would have spilled in a room, there was a cleaning with a damp cloth and even that would have been used in other wards of the hospital."This product is very important, it contains thiosulphate and thiocyanate ammonia etchant, toxic.He may have caused this respiratory and hemorrhagic, "explains infectious Helena Brígido.

Three days later, five nursing techniques Hospital Curuçá to Bethlehem were taking blood samples. Investigations pointed to the possibility of contamination by viruses, among them the H1N1. The test results have not yet been disclosed.

On Friday (30), the picture of some patients worsened. Two patients were transferred to Bethlehem One felt a lot of pain and was another stunted fingers and said he could not feel his legs. On Sunday, a relative of one of these patients reported that he received the medical information of the two had already made improvements. http://g1.globo.com/pa/para/noticia/2012/12/sespa-divulga-laudo-de-exames-de-funcionarios-de-hospital-de-curuca.html

Brazil- victims of poisoning by ammonium thiocyanate

Exams  dismiss  infection  by  viruses,  bacteria  or  fungi  in  patients  Curuçá

The Health Secretary, Helio Franco, said tests in patients Curuçá ruled out infection by viruses, bacteria or fungus

Writing the News Agency of Pará Updated 13/12/2012 at 14:25

The Secretary of State for Public Health, Helio Franco, reported on Thursday, 13, at a news conference that the servers and patients of the Hospital Municipal Curuçá were victims of poisoning by ammonium thiocyanate, a chemical component of the fixer radiography, which damaged packaging allowed the liquid leaked and spread by the hospital environment. Helio explained that inadequate cleaning of the environment, using bleach and alcohol caused the substance to become volatile and be inhaled by people in the hospital.

With test results in hand, Helio Franco said is totally ruled out infection by viruses, bacteria or fungus. Tests on samples of blood and urine of patients were performed by the Central Laboratory of the State (Lacen), Instituto Evandro Chagas (IEC) and another lab outside the state. "It is not virus, not fungus, not bacteria," emphasized Helio Franco. "This is an episode restricted to hospital and there is no risk of transmission from one person to another," he said.

According Helio Franco, normal is that the human organism load up 4mg/litro ammonium thiocyanate. Among smokers, the rate doubles up.However, people are not affected in Curuçá smokers and some had high rates of substance, varying according to the time of exposure to the chemical.

It was also informed by the clerk that the patient's death Jhenyffer Roberta Abreu dos Passos, held at the Santa Casa de Misericordia of Pará, has no relation to the case of Curuçá, although she spent there.According to report of the Center for Scientific Skills Renato Chaves, she died of generalized infection, which began with a urinary tract infection, which is common in pregnant women, but can affect the kidneys if not treated appropriately. An examination of the IEC also pointed out that it was dengue.

About the victims of intoxication, Helio Franco said they will continue to be monitored and receiving all the support Sespa. "It is important that they are monitored their kidney function, liver and respiratory diseases," he said. The infectious disease doctor and epidemiologist Helen Brigido, the Sespa, explained that the human body thiocyanate ammonia turns into cyanide, and removes iron from hemoglobin, impairing their function oxygenation of the body, which explains the symptoms like shortness of breath , vaginal bleeding and Digestive and tingling in hands and feet.

The antidote of thiocyanate is an injectable drug called Hidroxocobalina."The drug binds to cyanide, which prevents it from attaching and remove iron from hemoglobin and is eliminated in the urine," said Helena. The drug is only used in part of the 32 patients affected by intoxication, especially in those with higher levels of thiocyanate. Those with low rates are eliminating the substance in the urine.

Initially, as the doctor, patients will be treated with the drug for ten days and will be reassessed on whether or not to continue treatment, since it can also produce side effects. Helena said, finally, that these people should remain under the control and monitoring interdicted by time, to reduce the risk of pulmonary and neurologic sequelae.

The secretary Helio Franco said the Municipal Hospital Curuçá was sanitized by a specialized company and will be reopened from this Thursday, with support from Sespa, who provided some equipment, medicines and supplies to improve the service. He said the hospital needs to be reclassified, because its structure is out of the current technical standards of the Health Surveillance Agency (ANVISA).

The Health Secretary took the opportunity to advise people to avoid making cleaning environments, including home, using different chemicals, it is not known which can result in a mixture of these substances. He suggests that they be used only soap and water and that the environments are kept fresh. "It's always good to let the wind and sun come in, because in dry environment, the bacteria die," he said.

Franco warned, though, about the care that health professionals should take with chemicals and the proper disposal of these products as well as medicines and hospital supplies. It is therefore important that all hospitals have committees Infection Control. "If the case had been Curuçá immediately reported to the Health Surveillance, the consequences would have been lower," he noted.  http://www.agenciapara.com.br/noticia.asp?id_ver=113876

Bird Flu Spreading

Bird Flu Spreading Loss Rp1, 28 trillion

Friday, December 14, 2012  http://m.mediaindonesia.com/index.php/read/2012/12/14/369935/293/14/Flu_Burung_Tebar_Kerugian_Rp128_Triliun

Beware of New Type of Bird Flu Virus

JAKARTA - The Ministry of Health (MoH) asked that the public be aware of the death of poultry in large numbers, as well as mutations in the H5N1 bird flu virus into a new kind called clade 2.3.2. DirekturJenderalPengendalian Disease and Environmental Health (P2PL) MOH Tjandra Yoga Aditama said, a mutation in the virus Influenza can occur, as has occurred in several negara.Namun, the case now is the H5N1 bird flu virus mutated into a new form or type clade clade2.3.2. 

"Regarding the news of the death of ducks and mutation of the bird flu virus in poultry. Mutations in influenza virus could have happened, "Tjandra said in Jakarta yesterday. According to him, other than in Indonesia, the H5N1 bird flu virus mutation into clade 2.3.2 belakanganinijugadilaporkanterjadi attacking poultry in Vietnam, Cambodia, Nepal, India, Bangladesh, Bhutan, Japan, Korea, and Hong Kong. So far, said Tjandra, in Indonesia itself has not been found in the case of transmission of the H5N1 bird flu virus is a new kind on manusia.Namun, it has asked to remain vigilant.

 "So far none of the infected humans in Indonesia," he said. Tjandra explained, cases of transmission of the bird flu virus is a new kind of human ever found in China, Hong Kong, and Bangladesh. As a precaution related to the spread of the H5N1 bird flu virus types 2.3.2, he claimed to have conducted a number of steps, one of which makes a circular letter addressed to all local health departments to be aware of the death of poultry in bulk, prevent, and supervise the possibility of human contact with the death of the birds. Deputy Minister of Health (Wamenkes) Mukti Ali Ghufron said, so far there has been no new reports of the discovery of bird flu cases in manusia.Kendati Thus, it remains prepared to anticipate the handling procedures of bird flu in humans, including setting up rapid response teams, and hospitals for people with bird flu. He urged the public to avoid direct contact suspected of being infected with bird flu.

 "We asked to avoid direct contact," he said. director of Animal Health Ministry of Agriculture (Ministry of Agriculture) Pujiatmoko said it was still investigating the likelihood of the spread of avian influenza through migratory birds from outside domestic or imported through itik.Namun, Ministry of Agriculture has banned the import of ducks from a country that has not been free of bird flu since 2005 ago, such as Malaysia, China, Hong Kong, Japan, Korea, Vietnam, Laos, and Thailand.

 "During this import from the duck area free of bird flu, "he said. As you know, hundreds of thousands of ducks in central Java duck died from the H5N1 bird flu virus types 2.3.2. In the last month, the H5N1 bird flu virus is a new kind of attack is said to have around 350,000 head itik.Kasus death on thousands of ducks occurred in West Java, Central Java, East Java, and Yogyakarta. In addition to including the largest category of deaths in ducks, bird flu attack time is considered more virulent than the attacks that happened before. 
plant Bird Flu Vaccine Amid the resurgence of the bird flu virus, Commission IX are different opinions regarding the production of bird flu vaccines. Committee member of the Golkar Party faction Poempida Hidayatulloh said plant construction projects bird flu vaccine should not be charged to PT Bio Farma (Persero). According to him, if the project is not intended for business or profit-oriented projects should bird flu vaccine plant restored to the Ministry of Health (MoH). 

One way could be to form a new company that deliberately created specifically to meet the needs of the community. "Let me set up a new company, for example, specifically to meet social needs, if the vaccine plant is not for business," he said. Committee Member of the PKS faction M Mantri Court affirmed, based on the information submitted by the Director of PT Bio Farma, the cost of engine maintenance plant needs approximately 50 billion per year. While on the other hand, vaccine manufacturers had no prospect bisnis.Karena recognized that, strictly it can not accept the continuation of the project if the investment cost is quite large but actually lose money.  andi setiawan 

Demand £500m back for Tamiflu, urge MPs

Ministers should demand that the pharmaceutical firm Roche returns £500 million to the NHS if it is found to have sat on trials data showing the flu drug Tamiflu to be ineffective, say MPs.

 Stephen Adams, Medical Correspondent

4:15PM GMT 13 Dec 2012

The Swiss drugs giant has been accused of withholding key data on effectiveness of Tamiflu, which the NHS stockpiled in vast quantities in 2009 to protect against the swine flu threat.

Roche claims the drug reduces the risk of developing flu-related complications including bronchitis and pneumonia.

Because vaccines cannot be made quickly enough to protect against emerging strains like swine flu - which experts initially feared was deadly - the NHS purchased millions of doses of Tamiflu.

However, over the last year scientists have begun to challenge Roche’s claims. They have regularly asked it to publish all its clinical trials into the drug - it has carried out at least 123 - but at the moment some claim 60 per cent remain unpublished.

Scientists fear Roche has cherry-picked the most favourable trials to publish - and effectively hidden the rest.

Now a group of MPs has written to Margaret Hodge, chairman of the Public Accounts Committee, urging her to press ministers to take action if Roche continues to refuse to publish full results.

Dr Sarah Wollaston, a Conservative MP and member of the Health Select Committee, wrote the letter.

It argues: “Without this information, UK regulators and doctors cannot properly assess the clinical benefit (if any) of Tamiflu.

“It could be that the previous government spent 0.5 per cent of the entire 2009 NHS budget on a drug which the manufacturers were aware was no better than a placebo.

"Without all the clinical trial data, we cannot draw firm conclusions, but it surely cannot be right for a pharmaceutical company to receive £500 million of taxpayers’ money if it withholds information about its own products.”

The letter continues: “In the event that your committee finds Roche has deliberately concealed evidence which shows Tamiflu to be simply a placebo with side effects, you might wish to consider a recommendation that the Government seeks repayment of the £500 million cost.”

The letter is signed by five other MPs, from the three main parties.

Speaking to The Daily Telegraph, Dr Wollaston said: “I’d like to see these Roche executives hauled up in front of the Public Accounts Committee and asked, ‘Where’s the data?’ “

Amazon, Starbucks and Google had been made to explain their tax avoidance schemes in front of the PAC, she said, so she could see no reason why Roche should not be subjected to similar scrutiny.

Dr Wollaston, a qualified GP, said Tamiflu was just one example of firms apparently concealing clinical trials data.

Mrs Hodge has yet to discuss the matter with other members of the Public Accounts Committee.

Roche denies it is concealing data. A spokesman said: "We stand behind the robustness and integrity of our data".

"Tamiflu is effective in reducing the severity and duration of symptoms in those infected with the flu and decreasing the risk of getting the flu," she went on, noting that these claims were supported by researchers including the Harvard School of Public Health.

She added: "Almost 80 per cent of Roche’s Tamiflu clinical data has been published as primary publications or made available to the scientific community on the web as complete Core Reports.

Of the remaining data, most come from studies that have recently been completed. Roche is working to make them publicly available."

She said: "Roche would cooperate with any requests from the Public Accounts Committee."  http://www.telegraph.co.uk/health/healthnews/9742581/Demand-500m-back-for-Tamiflu-urge-MPs.html

Bird flu outbreak, ranchers panic

..Double dosing makes the flavor of the meat especially sweet!

Thursday, December 13, 2012 - 15:01 pm

Illustration (special)

Sindonews.com - Some farmers in Malang, East Java was panicked with bird flu outbreaks in several areas.Even to anticipate the spread of the H5N1 virus to the farm, they give multiple doses of livestock poultry.Besides that, they are now beginning to routinely cleaning poultry cages. as in the chicken coop belonging Kelvin, Mendalawanwangi Village, District Wagir, Malang.Since a month ago he had given multiple vaccines to approximately 20 thousand chicken flocks. According to Kelvin, giving this vaccine to improve the immune chickens, which are not easily infected with bird flu virus.In addition, these measures will also reduce the mortality rate for chickens during the transition season to rainy season. "We have anticipated the spread of the virus by doubling the usual dose given," said Kelvin at his home, Thursday (13/12/2012). addition, every breeder cage cleaning routine use of formaldehyde as well as add chaff to keep the humidity stable. In a single harvest, the mortality rate is still normal breeder chickens which is approximately four to five percent of the total livestock.Whilst to date, the Office of farms Malang regency, East Java, not anticipate. Though bird flu outbreak has been observed in the city of Surabaya, Nganjuk, Kediri and Tulungagung.  

http://daerah.sindonews.com/read/2012/12/13/23/697214/flu-burung-mewabah-peternak-panik

Traffic Poultry Start Tightened

Big Small Normal

Officers burn a bird cage and its contents are contracted Bird Flu Epicenter poverty simulation held at Pandemic Influenza or Bird Flu Supplies Bataliyon Angkatan-3/Darat.Jakarta, Tuesday

TEMPO.CO , Malang  -In some areas, traffic pet fowl tightened. Government of Malang wary bird flu virus (H5N1) suspected new genes, which broke out in several areas in East Java.Moreover, the need for poultry meat of chicken and ducks is quite high. The need for chicken meat supplied from a number of areas such as East Java regency of Malang, Pasuruan and Blitar.

Simulation SMB II held at Palembang airport, yesterday

Simulation SMB II held at Palembang airport, yesterday

New Kind of Bird Flu Already Widespread in Central Java-Yogyakarta

TEMPO.CO , Bantul  -Head of the Center for Veterinary Wates Yogyakarta, Fadjar Sumping Tjatur Sense, said the spread of Avian Influenza virus Clade (gene type) 2.3.2 H5N1, which affects ducks, has penetrated 13 districts / municipalities in Central Java Province and two districts in Yogyakarta.

Fadjar not name the 13 districts / municipalities in Central Java affected suspected virus outbreak mutated H5N1 2.3.1. "In previous years, the virus that targeted thousands of chickens in Indonesia. In DIY regional reports emerged of Bantul and Kulonprogo, "he told Tempo on Wednesday, December 11, 2012. 

Fadjar said the report was the result of the latest information on the spread of the bird flu virus of unknown provenance. Other recent information, he said, came from Wonosobo.

The report says the number of chickens, which were around the cage 2.3.2 ducks infected with H5N1, died suddenly. "But we're not sure it's due to Avian Influenza or not, the sample was studied in the laboratory," he said, Thursday, December 12. 

He said his lab team also not sure the source of this new generation of avian influenza. He said, the lab who oversaw the East Java, Central Java and Yogyakarta, it received reports of the death of the first duck in September 2012 Wonosobo ago.

However, it can not be an indicator to sum up the region as early contracted the virus. "It could be because there are other areas have been infected but not send the report to us," he said. 

Fadjar explained that there are three possible sources of the spread of the virus which is now also widespread in Asian countries such as China, Vietnam and Bangladesh.

He said the virus could be spread by migratory wild birds, movement of poultry imported both legally and illegally to Indonesia or genetic mutations that occur in 2.3.1 H5N1 virus (old) in some local areas of Indonesia. "The pattern of spread faster than before because now extends beyond Java and attacked tens of thousands of ducks," said Fadjar.

http://www.tempo.co/read/news/2012/12/13/173448071

Health Warning As Norovirus 'Hits 750,000' in the UK

More than 750,000 people are thought to have been struck down by an outbreak of norovirus in the UK - an increase of 72%. The Health Protection Agency (HPA) says there are likely to be a further 288 unreported sufferers for every one of the 2,630 confirmed cases of norovirus so far this season. A spokesman for the HPA said the figures meant 757,440 people could be affected by the stomach bug, which causes vomiting and diarrhoea. "Laboratory co...

Read more  http://web.orange.co.uk/article/news/health_warning_as_norovirus_hits_750_000

Bird Flu Reappears in East Java, the Task Force is maximized

| Thursday, December 13, 2012

Import Ducks Not Be Closed

JAKARTA - The government will not ban imports of ducks (day old duck / DOD) and duck hatching eggs, as long as it only imports from Britain, Germany, and Malaysia, which is free from avian influenza (bird flu), although currently in the country was an outbreak of bird flu that attacked ducks (duck) in the country...  

http://www.solopos.com/2012/12/13/flu-burung-impor-itik-tidak-akan-ditutup-357634

Lampung Not Find Bird Flu Patient

..yet

Thursday, December 13, 2012, 21:01 pm

 AIRPORT - A number of government and private hospitals in the region of Lampung not received and found the patient suspect bird flu caused by avian influenza, until Thursday (13/12). Lampung Health Office, monitoring the progress of the spread of avian flu in various parts of Lampung in a single 24 hours. 'If patients suspect or suspects bird flu, a one-time 24 hours must be reported to the (official) province, as not to be late.
Until now there has been no reports of the various hospitals and clinics in the area, "said Chief Medical Officer of Public Relations Lampung, dr Asih Hendrastuti to / / AP / / in Sydney, Thursday (13/12).He said all government and private hospitals is in Lampung has not received reports of the discovery of the patient the patient suspect bird flu. That is, he said, the avian influenza virus has not spread to Lampung, as has happened in Java. "Hopefully not," he hoped. Based on the observation at the Regional General Hospital (Hospital) Abdul Moeloek Bandar Lampung, isolation of patients suspect bird flu still looks empty. Only hospitals that have Moeloek Abdul isolation room bird flu patients in Lampung with international standards. There appears there is activity in the isolation room. Asih said that if a patient suspect bird flu, it is definitely in reference to hospitals Abdul Moeloek, because handling bird flu patients is different from other diseases that patients can be treated in a regular room.  http://www.republika.co.id/berita/nasional/umum/12/12/13/mez2xz-lampung-belum-temukan-pasien-flu-burung