Aug 21, 2006 (CIDRAP News) – A third human case of H5N1 avian influenza has been confirmed in a remote part of Indonesia where a number of suspected cases are being investigated, but most of the cases probably resulted from exposure to sick poultry, the World Health Organization (WHO) said today.The confirmed case was in a 35-year-old woman from the subdistrict of Cikelet in West Java province who died shortly after she was hospitalized Aug 17, the WHO said. She is the 46thIndonesian to die of the illness, out of 59 confirmed cases, by the WHO’s count. An Aug 20 Agence France-Presse (AFP) report identified the woman as Euis Lina.Multiple cases in close proximity raise the possibility of human-to-human transmission. The disease was confirmed in two other people from Cikelet in the past week: a 9-year-old girl who died Aug 15 and a 17-year-old boy who is still alive.Three other people in the area died previously of suspected avian flu but were buried without being tested, according to Agence France-Presse (AFP). One of them was the daughter of Euis Lina, said Indonesian Health Minister Siti Fadilah Supari, as quoted by AFP.Sixteen other people in the area have been tested for the virus, AFP reported today. Their initial results were negative, but the tests are being repeated, an Indonesian official told AFP.WHO and Indonesian experts have been investigating in the Cikelet area since Aug 17, according to AFP. The WHO said investigators think the human cases are related to poultry outbreaks that began in late June.Cikelet encompasses about 20 isolated hamlets of around 200 to 400 people each, situated in a basin surrounded by steep mountains and accessed only by rocky, winding paths, the WHO said. People in the area have little access to healthcare and often die of endemic diseases such as malaria.No mass poultry deaths are known to have occurred in the area before late June, when some chickens were bought from an outside market and added to local flocks, the WHO said. Large numbers of chickens began dying shortly afterward in an outbreak that continued through July and the first week of August.’High-risk behaviors’ cited”As the population had no experience with this disease, high-risk behaviors commonly occurred during the disposal of carcasses or the preparation of sick or dead birds for consumption,” the agency said. “These exposures are, at present, thought to be the source of infection for most confirmed or suspected cases.”Some people in the area died of respiratory illnesses in late July and early August, but no samples were taken and medical records are generally poor, the WHO said, adding, “Though some of these undiagnosed deaths occurred in family members of confirmed cases, the investigation has found no evidence of human-to-human transmission and no evidence that the virus is spreading more easily from birds to humans.”The Cikelet situation comes about 3 months after seven confirmed avian flu cases and one probable case occurred in an extended family in the Indonesian province of North Sumatra. That cluster brought the first laboratory-confirmed instance of human-to-human transmission and the first three-person chain of cases. However, the WHO concluded that the disease did not spread outside the family.Indonesian officials today played down the likelihood of a case cluster with person-to-person transmission in Cikelet, according to the AFP report.I Nyoman Kandun told AFP that the cases couldn’t be classified as a cluster at this point because the patients lived too far apart to have come into contact.The 17-year-old boy who survived the illness had contact with a cousin who was one of the three people who died of possible avian flu without being tested. The WHO said previously that person-to-person transmission was highly unlikely in that instance because both patients were exposed to sick chickens and both got sick the same day, whereas there would have been a delay if one had been infected by the other.Another suspected case-patient from the Cikelet area, a 4-year-old girl, was removed from a hospital today by family members against the advice of doctors, the Jakarta Post reported. After she showed some improvement, the family decided to treat her at home, though her test results were still awaited, said a spokesman for Dr. Slamet General Hospital in Garut regency.The story described the girl as one of 11 people from Cikelet with suspected or confirmed avian flu.The latest confirmed case raises the WHO’s global avian flu toll to 240 cases with 141 deaths. That includes 95 cases so far this year, equal to the total for all of 2005. Sixty-four people have died of the illness so far this year, compared with 41 for all of last year.FAO lists Balkans as high-risk areaIn other developments, the United Nations Food and Agriculture Organization (FAO) said today that the spread of avian flu among poultry has slowed in most countries, but warned that the southern Balkan countries and the Caucasus are a “high-risk region” for more outbreaks.”The region is not only a prime resting ground for migratory bird species, but poultry production is mostly characterized by rural and household husbandry with little in terms of biosecurity and strong regulatory inspection. In Romania it is still too early to say if the situation has stabilized,” said Juan Lubroth, head of the FAO’s Emergency Prevention System for Transboundary Animal Diseases, in a news release.The agency said H5N1 has been confirmed in 55 countries, up from 45 in April. But the virus’s spread among poultry has been slowed by efforts to improve surveillance, strengthen veterinary services, and, in some cases, vaccinate poultry, officials said.”More than 220 million birds have died from the virus or been killed in culling activities aimed at stopping the spread of the disease,” the FAO said.To fight avian flu, the agency said it has received US $67.5 million so far and has signed agreements with donors for another $29 million. An additional $25 million has been promised. The FAO has disbursed $32.5 million since donor countries at a conference in Beijing last January pledged $1.9 billion for the campaign to stop the virus.See also:Aug 21 WHO statementhttp://www.who.int/csr/don/2006_08_21/en/index.htmlAug 21 FAO news releasehttp://www.fao.org/newsroom/en/news/2006/1000378/index.html
Ulster flanker Henry slots in for his 10th cap in place of the injured Sean O’Brien in Ireland’s starting line-up for head coach Joe Schmidt’s first Six Nations clash on Sunday. Leinster battering ram O’Brien is unlikely to play again this season after undergoing shoulder surgery. Press Association And Munster’s determined blindside dynamo O’Mahony has backed replacement Henry to cause Scotland serious headaches over the ball this weekend. “Chris is an out-and-out openside; he’s dogged, he’s at the coal face as we like to call it, at that first breakdown he’s causing havoc,” said O’Mahony. “He’s a class footballer, so I don’t think there’s any worries of what he’ll bring to it. “He’ll wreck your head if you let him, and he’ll take that as a huge compliment I’m sure.” Talismanic lock Paul O’Connell assumed Ireland captaincy duties in the autumn Test series under new boss Schmidt. O’Mahony has total faith in his Munster team-mate’s stewardship, but challenged his Ireland colleagues to assume more personal responsibility than in the past. “These weeks guys really have to worry about getting themselves right,” said the 19-cap 24-year-old. “We’re looking to get to the stage where we have 10, 12, 15 leaders on the pitch. “If we’re going to be competing for Grand Slams or Six Nations we’ve got to have everyone leading the charge, and everyone’s got to see themselves as a leader in their own right.” Ireland forwards coach John Plumtree admitted Scotland boss Scott Johnson sprung several surprises with his pack selection. Plumtree said Ireland will not alter their approach to accommodate unexpected selections like lock Tim Swinson. But he did concede he has warned his pack to expect the entire back-five of Scotland’s pack to aim to play like loose forwards. “They’ve got some quite good depth there,” said Plumtree. “Their pack was slightly different from what I thought it would be. “But we don’t really have to change too much, because we know they will be coming hard at us with the ball, and trying to make it a real battle at the tackle. “They’ve got a dynamic back-row and two gritty guys in the second row there too, so we’ll have our work cut out. “Tim Swinson is a big carrier, and a pretty physical tackler, so he can cause problems if allowed. “And then they have Richie Gray to come off the bench and he will add an extra element in the last 20 I’m sure.” Former Wellington Lions and Natal Sharks coach Plumtree admitted fans’ fervour in the Six Nations build-up had caught him slightly unawares. Buoyed by that extra backing though, he vowed Ireland are determined to match that zeal when Sunday’s kick-off finally arrives. “It’s been a long time since our last performance, so it’s just great to get back into it,” he said. “It seems as though supporters hype it up more than Southern Hemisphere Test matches and Super 15 rugby. “I’m sure the intensity of the occasion will match that: we’ll definitely be ready.” Chris Henry will mess with Scotland’s minds at the breakdown in Ireland’s RBS 6 Nations opener, according to his back-row colleague Peter O’Mahony.
“That non-guarantee is overwhelming a little bit,” Sacre said. “But the Lakers knew what they wanted. They’re happy with me and I’m happy being with this organization.”It’s still a challenge considering Sacre has sat on the bench for 15 games because of D’Antoni’s preference to have a stretch forward. Sacre posted only two points on four shot attempts in five minutes against Toronto.“He has to go with the mindset to bring us energy and run the floor,” D’Antoni said. “He’s done that and done it well. But there’s a lot of people that have that role so we go back and forth at times to his detriment.”The Lakers also like Sacre’s team-first mindset, which he partly credits toward Nash.“He’s one of the hardest working guys even though he’s older than most people,” Sacre said of Nash, who turns 40 in February. “He’s always in the gym working his game, trying to improve and get better himself. I try to mimic my game after that.”Heavy roleJodie Meeks has remained in high spirits all season, and why shouldn’t he? He’s played for at least 40 minutes for the past eight games, because of long-term injuries to the Lakers’ backcourt.“It’s fun. I’m not complaining,” said Meeks, who posted 11 points in the Lakers’ win over Toronto. “I’ve been on the other side of that with not playing at all.”Meeks has managed such a role partly after reducing his sugar intake and lowering his body fat percentage from nine to six percent. He has also averaged a career-high 14.6 points on 44.6 percent shooting, with D’Antoni attributing it to improved outside shooting, drives to the basket and defense.“Sometimes last year I didn’t see the game as well,” Meeks said. “I wasn’t playing many minutes understandably since I was behind Kobe [Bryant] and he was healthy. This year, I’m getting more of a feel of things I can do.” The Lakers are, too.“He got us right through customs easily,” Lakers coach Mike D’Antoni joked.The Lakers like Sacre beyond travel conveniences. After being tabbed Mr Irrelevant as the 60th pick in the 2012 NBA Draft, Sacre has assumed a more relevant role with the Lakers, averaging 4.6 points and 3.4 rebounds through 14.2 minutes both as a reserve (18 games) and starter (eight).“I look at it as a blessing in disguise,” Sacre said of his draft standing. “It kept me hungry and kept me on my toes in getting better.”The Lakers sensed enough in Sacre’s improvement this offseason on his post moves, pick-and-roll execution and defense to sign him to a three-year extension worth $2.6 million, with the first two seasons guaranteed. TORONTO — A swarm of Canadian journalists hovered around his locker, latching onto every word he spoke.Steve Nash making a return to a country where he’s served as a living inspiration for all Canadian basketball players and the national team’s current general manager?Nope. Nash is training in Vancouver to heal the nerve issues in his back. Instead, Lakers backup center Robert Sacre took over ambassador duties.“I don’t think of it as that,” Sacre said before the Lakers’ 112-106 win Sunday over the Toronto Raptors at Air Canada Centre. “But I’m very proud to say that I represent Canada.” Newsroom GuidelinesNews TipsContact UsReport an Error