The Ministry of Health in Indonesia has reported a possible case of human-to-human transmission of avian influenza.
The information came from a World Health organization report that confirmed two additional cases of human infection with the H5N1 avian influenza virus, bringing the total of Indonesian cases reported in 2006 to 31.
The first case occurred in a five-year-old male. He developed symptoms on 4 March 2006, was admitted to hospital on March 6, and died on March 19. A field investigation at the time found that the boy was exposed to diseased poultry in the vicinity of his home, where some birds tested positive for the H5 virus.
The second case is a 27-year-old male. This person was identified during the tracing of contacts of the man's 15-year-old sister who developed symptoms on May 17 and was subsequently confirmed to be H5N1 infected. Her brother spent six days caring for her during her hospital stay. The brother developed mild symptoms of cough and abdominal discomfort, with no fever, on May 28; his symptoms remained mild and he recovered within a few days.
Despite his mild and atypical symptoms, the brother was tested for H5N1 avian flu virus. In August, tests confirmed that he had been infected.
The 27-year-old male reported no contact with diseased or dead poultry in the days prior to symptom onset as he spent most of his time at the hospital. The investigation determined that he had exposure to his sister during her hospital stay, and that human-to-human transmission could not be ruled out as the source of his infection.
The confirmed cases bring the total in Indonesia to 65. Of these cases, 49 have been fatal.