New Vietnamese cases and Indonesian update

Reports from Vietnam today say two deaths occurred at the Institute of Tropical Diseases in Hanoi last week, one a confirmed H5N1 fatality, the other inconclusive (but likely H5N1, in our view). The report from Xinhua says 18 people are currently under treatment at the Institute, one with ventilatory assistance, although SABC (South Africa) says only three of the 18 in the "isolation ward" are confirmed bird flu cases, 13 are suspected and two are thought to have non-avian influenza.

Vietnamese sources continue to say there is "no evidence" of human-to-human transmission, although the mode of acquiring the infection either has not been determined in these cases or is not stated. The "absence of evidence is evidence of absence" line of reasoning seems to be the order of the day.

Meanwhile, WHO has sent a team to Indonesia to help the government there investigate the recent family cluster of acute pneumonia that killed a father and young daughter and sickened another daughter.

The Ministry of Health's Director General of Communicable Disease Control Nyoman Kandun stated on Wednesday that the two died of an unspecified bacterial infection, not the H5N1 bird flu virus as reported earlier by Metro TV.

WHO epidemiologist Gina Samaan revealed that tests were still being conducted on the pair, but she "doubted" it was bird flu as the two had not been in contact with poultry before they died, Associated Press reported on Wednesday.

Iwan Siswara Rifei, 37, an employee of the Supreme Audit Agency (BPK) died at Siloam Gleneagles Hospital in Karawaci, Tangerang, on Tuesday evening.

His eldest daughter, Thalita Nurul Azizah, 10, died earlier on Saturday at the Harapan Kita Hospital, West Jakarta, from similar respiratory problems.

Younger daughter Sabrina Nurul Azizah, 8, is suffering from the same symptoms and is being treated in the intensive care unit of the Siloam Gleneagles Hospital.

Younger daughter Sabrina Nurul Azizah, 8, is suffering from the same symptoms and is being treated in the intensive care unit of the Siloam Gleneagles Hospital.

"The symptoms are indeed similar to SARS. But while SARS can kill its victims within several days, the members of this family have been suffering from the disease for a month," she said.

Siloam Gleneagles Hospital's medical director, Anastina, said that based on laboratory tests, "they were suffering from pneumonia".

Naniek said that the case is now in the hands of the health ministry.

This seems only to say that the Indonesian government is stating, without much evidence, that these cases are not from diseases that would have a serious impact on tourism and commerce.

Please forgive me for asking for better evidence than wishful thinking.