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"First identified in humans in Hong Kong, influenza A/H5N1, known commonly as avian influenza, has caused human disease in 15 countries around the world. Although the current number of confirmed patients is tiny compared to seasonal and the recently emerged H1N1 swine influenza, H5N1 remains a candidate for the next highly pathogenic influenza pandemic. Currently, H5N1 has very limited ability to spread from person-to-person but this may change because of mutation or reassortment with other influenza viruses leading to an influenza pandemic with high mortality. If this occurs travellers are likely to be affected and travel medicine doctors will need to consider avian influenza in returning febrile travel-lers. The early clinical features may be dismissed easily as the flu resulting in delayed treat-ment. Treatment options are limited. Oral oseltamivir alone has been the most commonly used drug but mortality remains substantial, up to 80% in Indonesia. Intravenous peramivir has been filed for registration and IV zanamivir is being developed. This review will focus on the epide-miological and clinical features of influenza A/H5N1 avian influenza and will highlight aspects relevant to travel medicine doctors."

"Avian influenza atau Flu Burung adalah penyakit menular pada binatang yang kemudian menulari manusia pula. Penularan pada manusia menimbulkan masalah kesehatan penting sejak tahun 2004, apalagi dengan adanya ancaman pandemi. Sampai I Maret 2006 pasien penyakit ini pada sudah dilaporkan di 7 negara, yaitu Cambodia, Indonesia, Thailand, Viel Nam, China, Irak dan Tnrki. Jumlah total kasus adalah 174 orang, 94 diantaranya meninggal dunia (54.02%). Sampai 1 Maret 2006 Indonesia mempunyai 27 pasien, 20 meninggal (74.07%). Pasien A! Indonesia sebagian besar adalah pria (62.5%) dan semuanya datang dengan kehtlum demam. Pandemi influenza terjadi bila muncul virus sub tipe baru yang sebelumnya tidak menyerang manusia. Karena itu, avian H5N} punya potensi unluk menimbulkan pandemik karena mungkin menulari antar manusia. Dampak pandemik dapat berupa tingginya angka kesakitan serta pekerja absen dari tugasnya, yang semuanya akan memberi dampak sosio ekonomi yang besar. Tentang kematian, pengalaman masa lalu temyata bervariasi, tergantung dari 4 faktor, yaitu jumlah orang yang terinfeksi, vindensi virus, keadaan kesehatan pasien dan efektfitas upaya pencegahan yang ada. Prediksi akurat tentang angka kematian sulit dibuat. (Med J Indones 2006; 15:125-8)

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Avian influenza, or "bird flu", is a contagious disease of animals which crossed the species barrier to infect humans and gave a quite impact on public health in the world since 2004, especially due to the threat of pandemic situation. Until 1" March 2006, laboratory-confirmed human cases have been reported in seven countries: Cambodia, Indonesia, Thailand, Viel Nam, China, Iraq and Turkey with a tola! of 174 cases and 94 dead (54.02%). Indonesia has 27 cases, 20 were dead (74.07%). AI cases in Indonesia are more in male (62.5%) and all have a symptom of fever. An influenza pandemic is a rare but recurrent event. An influenza pandemic happens when a new subtype emerges that has not previously circulated in humans. For this reason, avian H5NI is a strain with pandemic potential, since it might ultimately adapt into a strain that is contagious among humatts. Impact of the pandemic could include high rates of illness and worker absenteeism are expected, and these will contribute to social and economic disruption. Historically, the number of deaths during a pandemic has varied greatly. Death rates are largely determined by four factors: the number of people who become infected, the virulence of the virus, the underlying characteristics ami vulnerability of affected populations, and the effectiveness of preventive measures. Accurate predictions of mortality cannot be made before the pandemic virus emerges and begins to spread. (MedJ Indones 2006; 15:125-8)"

"ABSTRAKLatar belakang: Kunjungan wisatawan yang semakin meningkat memberikan pengaruh pada resiko penyebaran penyakit oleh wisatawan. Pelayanan kesehatan bagi wisatawan merupakan hal yang diperlukan ketika seseorang ingin berwisata. Hal tersebut tentunya diperlukan suatu kesiapan bagi rumah sakit yang ada di Bali untuk menanganinya, salah satunya menyesuaikan standar pelayanan kesehatan untuk wisatawan mancanegara, yakni berstandar Travel Medicine.Tujuan penelitian: Menganalisis Kesiapan Rumah Sakit di Bali Dalam Penerapan Layanan Travel Medicine.Metode: Penelitian ini menggunakan metode kualitatif. Validasi menggunakan triangulasi sumber dan metode (wawancara mendalam, observasi dan telaah dokumen).Hasil: Belum terpenuhinya beberapa faktor input dalam penerapan layanan Travel Medicine. Selain itu, faktor process belum berjalan dikarenakan belum terpenuhinya beberapa faktor input dan penerapan model pelayanan yang berbeda dengan layanan Travel Medicine.Kesimpulan: Dari segi kualifikasi, ketiga rumah sakit yang menjadi objek penelitian; RSUP Sanglah, BROS dan BaliMed belum siap menerapkan layanan Travel Medicine.

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ABSTRACTBackground: Increasing tourist visits impact on the risk of disease spread. Thus, health care for tourists is important. This certainly requires a readiness for hospitals in Bali to handle it, one of which is to adjust the standard of health services for foreign tourists, namely the standard of Travel Medicine.Research Objectives: Analyzing Hospital Readiness in the Implementation of Travel Medicine Services in Bali.Method: This study uses qualitative methods. Validation uses source and method triangulation (in-depth interviews, observation and document review).Results: Several input factors had not been fulfilled in implementing travel medicine services. In addition, the process factor had not been implemented due to the lack of fulfillment of several input factors and the implementation of service models which were different from travel medicine services.Conclusion: In terms of qualifications, Sanglah Hospital, BROS and BaliMed were not ready to implement Travel Medicine services."