Three Indonesian clusters of H5N1 virus infection in 2005

I. Nyoman Kandun, Hariadi Wibisono, Endang R. Sedyaningsih, Yusharmen, Widarso Hadisoedarsuno, Wilfried Purba, Hari Santoso, Chita Septiawati, Erna Tresnaningsih, Bambang Heriyanto, Djoko Yuwono, Syahrial Harun, Santoso Soeroso, Sardikin Giriputra, Patrick J. Blair, Andrew Jeremijenko, Herman Kosasih, Shannon D. Putnam, Gina Samaan, Marlinggom SilitongaK. H. Chan, Leo L.M. Poon, Wilina Lim, Alexander Klimov, Stephen Lindstrom, Yi Guan, Ruben Donis, Jacqueline Katz, Nancy Cox, Malik Peiris, Timothy M. Uyeki

Research output: Contribution to journalArticlepeer-review

299 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)2186-2194
Number of pages9
JournalNew England Journal of Medicine
Issue number21
Publication statusPublished - 23 Nov 2006


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