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Indonesian Government Expects Rise in Number of Suspected Bird Flu Infections

Posted on: Tuesday, 13 September 2005, 06:00 CDT

Text of article by Hera Diani and Suherdjoko entitled: "Government warns of more suspected bird flu infections", published in English by Indonesian newspaper The Jakarta Post website on 13 September

Minister of Health Siti Fadilah Supari said on Monday (12 September) that avian influenza had most likely caused the death of a woman over the weekend. A surveillance team was also sent to the neighbourhood of the 37-year-old dead woman, identified only as RD, to do blood tests on people who had contact with her before she died.

A sample of her blood has been sent to the WHO [World Health Organization] - sanctioned laboratory in Hong Kong to verify if the resident of Petukangan Utara subdistrict in South Jakarta was killed by the H5N1 strain of the virus. Siti said that clinical symptoms indicated that the woman was Indonesia's fourth human fatality from avian influenza, after the death of Tangerang resident Iwan Siswara and his two daughters in July.

"She most likely had bird flu, although several lab tests conducted here gave conflicting results. So we are still waiting for results from lab tests in Hong Kong," Siti told a media conference at her office. The results are expected within six days.

Siti said the woman was admitted to Bintaro International Hospital in Tangerang, Banten, on 6 September for severe pneumonia after suffering from flu for several days and leukopenia, a drastic decline in white blood cells to under 6,000 cells per cu.cm. The symptoms are common with bird flu infection. The woman lived near a chicken slaughterhouse in a crowded neighbourhood, but was not in frequent contact with chickens.

Siti said she expected an increase in the number of suspected human infections in the country due to the rising alert level. She called on people not to panic because while the source of the virus in either case had not been found, there was no case of human-to- human transmission of the virus.

Meanwhile, the dead woman's family urged the government to explain the cause of her death. Her husband, Agus Mardeo, said he was baffled by the media coverage saying that his wife had died of bird flu, as the Bintaro International Hospital indicated that pneumonia was the cause of death.

"I'm confused. I'd like to report the media to the Indonesian Broadcasting Commission. And I want the government to explain to me the cause of my wife's death," said Agus, who looked weary and upset. Agus' wife was buried at Cantung Cemetery in Semarang on Sunday (11 September) afternoon.

Despite a WHO recommendation to cull all poultry within a three- kilometre radius of an outbreak, the government conducted only a minor cull in Tangerang, following the death of Iwan and his two children. Only 31 pigs and 40 ducks were slaughtered after the Tangerang outbreak. The government has also closed the investigation into the source of the virus that killed Iwan and his daughters, which was thought to be the droppings of an infected chicken.

However, outbreaks have continued to occur among some 1.6bn chickens in the country, and around 45m ducks. It has affected 22 out of 33 provinces since 2003, killing over 9.5m birds.

"Reports continue to come in, but it's almost impossible to do a mass culling. It would take trillions of rupiah," Ministry of Agriculture's Director of Animal Health Tri Satya Putri Naipospos said at Monday's (12 September) press conference. However, Tri said the ministry continued to improve bio-security, selective culling, vaccination and regulating the poultry trade.

Steven Bjorge, technical officer of communicable diseases at the WHO office in Jakarta, said culling would be complicated in Indonesia as 70 per cent to 80 per cent of the chickens in the country were backyard chickens. "We have to expect there will be more cases because the virus clearly has been endemic in the bird population," he said.

Bjorge said that WHO has no criticism of the Indonesian side as this was a complicated and unprecedented matter. "As for my confidence in the Indonesian response from the health side, I know that people are working very hard. Every lead is being followed."

Source: BBC Monitoring Asia Pacific

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