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To understand sparrow‘s ability in spreading H5N1 avian influenza virus, especially compared to backyard chicken, we performed an experimental infection study. Nine sparrows and backyard chickens were inoculated with H5N1 viruses isolated from sparrow and chicken. We observed the incubation period, clinical signs, and time of death after the exposure. We also carried out pathological anatomy and examined any histopathologyical changes. The results indicate that sparrows are more resistant to the H5N1 virus infection than chicken. The striking organ changes of sparrows died because of the virus infection were lungs and brains haemorrhage. Lung damage seemed to be the main cause of the chicken's death. Neuronal necrosis and gliosis seemed to cause the torticollis of sparrow. The H5N1 virus isolated from sparrow that was more virulent against sparrow than the virus isolated from chicken indicate the occurrence of sparrow's adaptation with the sparrow virus. Based on the longer incubation period and later time of death of sparrows after the virus infection than of chickens, and their ability to fly, we concluded that ability of sparrow to spread H5N1 virus was higher than that of backyard chicken.

The human influenza A virus (H3N2) has been the predominant influenza strain since 1992, and one property of this virus is non-agglutination of chicken erythrocytes [Ch(-) virus]. The Ch(-) virus in our study was able to acquire chicken hemagglutination [Ch(+)] by trypsin passage but not by chymotrypsin passage. Moreover, the trypsin-passaged Ch(+) viruses reacquired the Ch(-) property after a further chymotrypsin passage. In particular, genetic analysis showed no evidence of mutations in the hemagglutinin (HA) gene during either trypsin or chymotrypsin passages: the only differences found were in the HA cleavage sites between the trypsin-passaged virus and the chymotrypsin-passaged virus as determined by the N-terminal amino acid sequence. These results suggested that protease-dependent differences at the viral HA cleavage site, rather than genetic mutations, are likely to have a significant effect on the viral ability to produce chicken hemagglutination.

A case of Langerhans’ cell histiocytosisthat previously diagnosed as tuberculous osteomyelitis,focusing on difficulty in diagnosis.

Background Indonesian guidelines for childhood asthma recom-mend giving ipratropium bromide when there are no improvementafter 2 times salbutamol nebulization. The efficacy and safety ofearly nebulization of ipratropium bromide combined with salbutamolas first line in moderate asthma exacerbation in children are stillunknown.Objective To compare efficacy and safety between nebulizedsalbutamol-ipratropium bromide and salbutamol alone in childrenwith moderate asthma exacerbation.Methods Fifty-two children (2-6 years) with acute asthma (clinicalscore 5-10) were enrolled into a randomized single blind controlledtrial comparing 2 groups of 2.5 mg nebulized salbutamol (group 1)and 2.5 mg salbutamol combined with 0.5 mg ipratropium bromide(group 2). Nebulization was given until clinical score decreased 0.05). Therewere no toxic effects attributable to ipratropium bromide, and theside effects were not different between these two groups.Conclusion The combination of nebulized ipratropium bromideand salbutamol in a child with acute moderate asthma exacerba-tion was associated with higher reduction of clinical score and higheroxygen saturation, and may reduce hospitalization

The tuberculin skin test (TST) as a diagnostic tool for tuberculosis (TB) infection is used in many countries, including Indonesia, but lacks specificity. Interferon-gamma is a highly specific assay because it is not influenced by previous BCG vaccination or non-tuberculous mycobacteria (NTM) infections. We aimed to study the effect of BCG vaccination and NTM infection on the results of the interferon-gamma specific assay and TST among children with a TB contact. We carried out a cross-sectional study of children at an outpatient clinic in Surabaya, Indonesia. We studied 37 children aged 1-15 years having a household contact with an acid-fast bacilli positive adult index case. BCG vaccination was determined by the presence of a BCG scar. A PPD RT23 2 tuberculin test was used for the TST. ESAT-6, CFP-10, and TB 7.7(p4) antigens were used for the interferon-gamma assay by ELISA. Gastric aspirates were cultured in Lowenstein-Jensen media. A comparison of the two diagnostic tools among children aged 1-5 years without a BCG scar, revealed high agreement, while children with a BCG scar it revealed disagreement. Among children aged5 years with or without a BCG scar the comparisons revealed disagreement. Among children aged5-10 years, a comparison of the two diagnostic tools among NTM positive and negative children, there was a disagreement in results. Among children aged 1-5 years, the TST was influenced by a BCG scar. Infection with NTM had no influence on the results of the TST among children aged5-10 years, while in children aged 1-5 years and10 years the results could not be determined in this study.