An additional case occurred in a 39-year-old man from West Jakarta. He developed symptoms on 9 May, was hospitalized on 16 May, and died on 19 May. The investigation determined that the man cleaned pigeon faeces from blocked roof gutters at his home shortly before symptom onset. No further potential source of exposure was identified.
The above WHO update leaves source of H5N1 bird flu in human infections in the Jakarta area unclear. Most of the reported cases in Indonesia are from Jakarta area or nearby locations in West Java (see map). The sequence from all but one of the human isolates has a novel cleavage site, which has not been reported for bird isolates in the area. Although there have been a large number of poultry isolates from various regions in Indonesia, there are no public sequences from wild birds, such as pigeons.
More detailed surveillance of H5N1 in the area would be useful. Thus far the only non-human isolate from the area with the novel cleavage site is from a cat. H5N1 from poultry and wild birds in the area should be isolated and sequenced along with mammalian sources such as swine.
These and prior H5N1 sequences, including human sequences should be released immediately. Source : Recombinomics