Research on the front lines...

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Person-to-person bird flu confirmed

 

Mark Forbes Herald Correspondent in Jakarta and agencies

August 31, 2007

 

BIRD flu has spread between humans on several occasions, a new study of deaths in Indonesia last year has found.

 

When seven members of a Sumatran village family died last May, the spread of H5N1 avian influenza virus from person to person was suspected but could not be confirmed.

 

A study of the outbreak by the Fred Hutchinson Cancer Research Centre in Seattle, Washington, has for the first time proved the virus spread between a "cluster" of people, researchers said.

 

The World Health Organisation has warned that if the bird flu virus mutated to easily spread between humans it could spark a global pandemic, killing millions. Indonesia, with 84 bird flu deaths, the highest toll in the world, has tried to play down fears of the spread.

 

The head of research for the Indonesian Health Ministry, Triono Soendono, refused to discuss the study's findings as it was "just one" piece of research. He claimed experts had concluded the case was not human-to-human transmission.

 

But the WHO assistant director for communicable diseases, David Heymann, said it was likely the Sumatran virus was spread by human-to-human contact. "We believe there has likely been transmission through intimate or close contact," Dr Heymann said.

 

The virus had remained "fairly stable" and there was "no evidence of anything spreading from that [family] cluster to others in the community".

 

The study's senior author, Ira Longini, said computer analysis established human-to-human transmission in the Sumatra cluster. "The world really may have dodged a bullet with that one, and the next time we might not be so lucky," Dr Longini said.

 

Dr Heymann said the WHO was aware of at least two other cases where human-to-human transmission of the avian influenza virus was suspected.

 

There was strong evidence in the case of a Thai mother and daughter who lived apart, he said. The daughter appeared to have contracted the virus after visiting her mother in hospital.

 

The Fred Hutchinson researchers also examined a second family cluster outbreak in Turkey last year, but did not have the evidence to confirm or refute human-to-human transmission.

 

In the Sumatran case, seven family members contracted the H5N1 strain of bird flu, one of the biggest clusters in the world. Six died and another female relative died before being tested.

 

http://www.smh.com.au/news/world/persontop...067276777.html#

 

 

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Ngurah Mahardika: Breaking the bird flu taboo

Prodita Sabarini, The Jakarta Post, Denpasar

 

August 31, 2007

 

It is very rare in Bali to hear someone talk frankly about the threat of bird flu on the island.

 

Earlier this year, while officials were in denial and avoided publicly speaking about the possible outbreak of bird flu in Bali -- fearing too much publicity could put the island's tourism industry at risk -- virologist from Denpasar-based Udayana University Ngurah Mahardika was the lone voice brave enough to be blunt about it.

 

After conducting extensive research, funded by the Agriculture Ministry from 2005 to 2006, he forewarned the island-province of possible human deaths, after discovering human viruses of the H5N1 strain present in Bali. In his research he came across the daunting discovery that the virus in Bali had crossed over to mammals, such as pigs, dogs and cats.

 

He became somewhat unpopular on the island, which at the time had just begun to recover from the aftermath of the terrorist bombings of 2002 and 2005.

 

Bali's government officials and politicians not only dismissed Mahardika's findings, but also criticized the validity of his research.

 

Despite his skeptics' doubts, and claims that his lab did not comply with bio-security standards, Mahardika was confident with his findings.

 

Some six months after issuing his warning, a bird flu outbreak in poultry spread across the island -- from Bali's southern Jembrana regency, to west Klungkung regency and the capital city, Denpasar.

 

Bali's first human victim of the bird flu virus died on Aug. 12, with a second death on Aug. 21, increasing the nation's death toll to 83 out of 105 cases -- the highest fatality rate from H5N1 in humans in the world.

 

"There was political apathy," he said. "This is the social cost of our ignorance".

 

When I first heard about the scientist, I imagined him to be old, bespectacled and gray-haired, with a calm grandfatherly demeanor. When I met him in his modest house last week in Denpasar, however, he made me realize I had been rather shallow in stereotyping scientists.

 

Mahardika is young and vibrant. At 44 years of age, he does not have a single gray hair in his neat black hair. He had a relaxed manner, which was reflected in his wardrobe of T-shirt and shorts. His eyes lit up when he talked about his work.

 

He recently attended a symposium on tropical diseases at Udayana University, where he presented his research to his colleagues. He was articulate and concise in his seminar -- with a hint of dark humor -- and gave an update on the bird flu situation in Bali.

 

Completing his higher education at Udayana University's School of Veterinary Medicine, Mahardika was always amazed with the unseen -- in particular, viruses. He said he hated classes but loved working after hours in the laboratory.

 

"My friends were usually bored after one lab experiment, but I could do ten and still be interested.

 

"There are two things that amaze me -- viruses and aircraft," he said.

 

He applied for scholarships to study virology in Australia, Germany and Japan. "I received an Australian and German scholarship ... but I chose (to go to) Germany simply because it was the furthest away from Bali ... I can visit Australia later in my life."

 

In 1991, he studied at Gissen University, where he finished his master's degree and PhD.

 

As a Hindu, he associates his study of molecular biology with his spirituality. "I am amazed at how god can create everything from only the four bricks found in DNA: Adenine, Cytosine, Guanine and Thymine," he said.

 

He said as a Balinese-Hindu, he believes there is "Atma" (an essential divinity) within all humans. "In my study of molecular biology, I have often asked myself if god put Atma in DNA."

 

After finishing his studies abroad, he returned to Udayana University. He even worked in a non-governmental organization (NGO) for a while, but his academic calling brought him back to the Udayana campus in 2004.

 

He became aware of the avian influenza virus in 2003 -- when the virus was first detected in Bali and had taken Indonesia's first H5N1 victim in Tangerang, Banten.

 

"I started to follow the development of the virus and had the chance to do extensive research in 2005," he said.

 

The island of Bali -- an area of only 5,000 square kilometers and inhabited by 3.2 million humans, who live alongside approximately 12 million fowl and 900,000 pigs -- is a potential breeding ground for the virus.

 

"It might seem an exhausted thing to say, but public participation is the only way we can fight this virus," he said.

With NGO experience under his belt, Mahardika set up a model program for bird flu awareness.

 

"My students and I held an educational campaign in Sedang village, in Denpasar. For a period of three months, we conducted campaigns aimed at educating elementary school children and villagers on the bird flu virus. It worked. When there was a bird flu outbreak in the village, they managed to contain it to only nine households," he said.

 

"There should be an ongoing campaign to combat this virus. Poultry should not be allowed to roam freely in neighborhood areas anymore. All chickens should be fenced in and separated from pigs. The public markets (where they are sold) should be reorganized ... live fowl should no longer be sold there."

 

Mahardika said the possibility of a pandemic was no longer a question of if, but when.

 

"Now is the only time humans have the chance to prevent a pandemic," he said.

 

"We didn't have a chance with AIDS because it spread quietly and unseen, but bird flu is different -- we have the chance to contain it. "It is in our hands -- we can either do something about it or remain in denial."

 

http://www.thejakartapost.com/detailfeatur....W05&irec=4