Background Since 2003, the widespread ongoing epizootic of avianinfluenza A (H5N1) among poultry and birds has resulted in humanH5N1 cases in 10 countries. The first case of H5N1 virus infectionin Indonesia was identified in July 2005.
Methods We investigated three clusters of Indonesian cases withat least two ill persons hospitalized with laboratory evidenceof H5N1 virus infection from June through October 2005. Epidemiologic,clinical, and virologic data on these patients were collectedand analyzed.
Results Severe disease occurred among all three clusters, includingdeaths in two clusters. Mild illness in children was documentedin two clusters. The median age of the eight patients was 8.5years (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 samefamily, and most lived in the same home. In two clusters, thesource of H5N1 virus infection in the index patient was notdetermined. Virus isolates were available for one patient ineach of two clusters, and molecular sequence analyses determinedthat the isolates were clade 2 H5N1 viruses of avian origin.
Conclusions In 2005 in Indonesia, clusters of human infectionwith clade 2 H5N1 viruses included mild, severe, and fatal casesamong family members.
Source Information
From the Directorate General of Disease Control and Environmental Health (I.N.K., H.W., Y., W.H., W.P., H.S., C.S.) and the National Institute of Health Research and Development (E.R.S., E.T., B.H., D.Y., S.H.), Ministry of Health, Jakarta; the Infectious Disease Hospital Rumah Sakit Penyakit Infeksi Sulianti Saroso, North Jakarta (S.S., S.G.); the U.S. Naval Medical Research Unit 2, Jakarta (P.J.B., A.J., H.K., S.D.P.); and the World Health Organization, Jakarta (G.S., M.S.) all in Indonesia; the University of Hong Kong (K.H.C., L.L.M.P., Y.G., M.P.) and the Department of Health (W.L.) both in Hong Kong; and the Centers for Disease Control and Prevention, Atlanta (A.K., S.L., R.D., J.K., N.C., T.M.U.).
Address reprint requests to Dr. Uyeki at the Influenza Division, Mail Stop A-32, Centers for Disease Control and Prevention, Atlanta, GA 30333, or at tuyeki{at}cdc.gov.
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