Girl's bird flu death shows importance of early diagnosis

Girl's bird flu death shows importance of early diagnosis

Zakki Hakim, Associated Press/Jakarta

Sixteen-year-old Siti Maulida died of bird flu in a local
hospital as an ambulance pulled up to take her to a government-
designated medical center that treats cases of the virus.

Had she survived the journey, she would have been given
antiviral drugs on arrival that could have saved her life,
according to a doctor from the center.

"If on the first day she came here, it could have been a
different story," said Dr. Ilham Patu from Sulianti Saroso
Infectious Diseases Hospital. "Hospitals must transfer their
patients quicker."

Siti's death -- the seventh from bird flu reported in
Indonesia since July -- shows the importance of early diagnosis.
It has also exposed the weaknesses and lack of coordination in
Indonesia's cash-strapped health service.

The H5N1 bird flu strain has ravaged poultry stocks across
Asia since 2003, and killed at least 67 people. Most human
victims are believed to have contracted the disease from sick
birds.

However, experts fear the virus will mutate into a form that
is easily transmitted between people, possibly sparking a global
pandemic that could kill millions.

Siti's father Baharuddin, 50, said his daughter had first
complained of stomachache and fever on Nov. 4.

When she showed no signs of improvement after two days, he
took her to the local hospital.

Doctors there initially thought she had dengue fever and put
her on an IV drip. Two days later, they changed their diagnosis
to suspected bird flu. She died later the same day, said
Baharuddin.

"She managed to chant the Islamic confession of faith one last
time, and said she wanted to sleep," said Baharuddin Friday on
the terrace of his one-story home down in a crowded district of
the capital, accessible only by foot. "She never woke up."

Sulianti Saroso is one of 44 hospitals around the country
chosen by the government to receive bird flu patients. Treatment
is free, and all have stocks of Tamiflu, the anti-viral drug
believed to be effective against bird flu if given early enough,
Patu said.

Diagnosing and treating bird flu is difficult. The virus'
symptoms mirror those of many common illnesses, and it can kill
within four days, even with treatment, said Patu on Saturday,
urging people with flu-like symptoms and a history of contact
with dead or sick poultry to come to one of the designated
hospitals.

"If we were told she had bird flu earlier, we would have had
more time and taken her to the government bird flu hospital for
immediate and better treatment," said Baharuddin. "I didn't have
the slightest idea to take her to (that) hospital."

Indonesia was criticized for moving too slowly when bird flu
first appeared in poultry stocks two years ago, but has promised
in recent days to step up the fight.

The government this week even ordered the military to get
involved, with thousands of troops being deployed to join
students and volunteers in going door-to-door in search of sick
birds.

However, Jakarta animal health agency head Adnan Ahmad said
officials had not slaughtered any birds close to Siti's home,
saying they opted instead to "isolate" the infected animals.

Slaughtering poultry in bird flu-infected areas is considered
by many experts as the best way to contain the virus' spread, but
Indonesia says it cannot afford to compensate farmers for mass
culls.

Baharuddin, who runs a small boarding house close to his home,
said the government should step up the fight against the virus.
"The government should not hesitate, because it will save lives,"
he said.