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Indonesian Experts Warn Risk of Human-to-Human Bird Flu Transmission Rising

Posted on: Friday, 17 February 2006, 09:00 CST

Text of report in English by Abdul Khalik, carried by Indonesian newspaper The Jakarta Post website on 17 February

Amid the increasing incidence of bird flu cluster cases, health experts warned Thursday (16 February) of the growing likelihood of human-to-human transmission.

"We can't guess when the spread of the virus among humans will occur because it will need a thorough examination of the source of the virus from each patient in a cluster," the spokesman and head of the bird flu surveillance unit at North Jakarta's Sulianti Saroso Hospital, Ilham Patu, told The Jakarta Post.

"But the fact that we have more and more cases of bird flu clusters shows that we are very close to having one."

Cluster cases are defined as several members of a household or neighbourhood falling sick at the same time.

Health Minister Siti Fadillah Supari said Wednesday (15 February) the country had the highest number of bird flu cluster fatalities in the world, with six reported so far. Indonesia also has the world's highest mortality rate, with 18 fatalities of the 26 people who have tested positive for the H5N1 virus since July last year.

Both Siti and Agriculture Minister Anton Apriyantono, speaking after a meeting with President Susilo Bambang Yudhoyono about handling of the problem, said the virus appeared to be more virulent, with Siti saying there was the growing probability of human-to-human transmission.

Health experts say the cluster cases provide conducive conditions for the mutation of the virus to human-to-human transmission. There have been nightmare scenarios of the shutdown of affected cities, causing a huge economic impact, from a global pandemic.

The director of control of animal-borne diseases at the health ministry, Hariadi Wibisono, said his office was closely studying developments, and he predicted more cluster cases in the coming days.

The World Health Organization said it had not found any evidence of changing characteristics of the virus' transmission here.

"We still have Indonesia at level three. Although it means the bird flu virus still comes from animal (hosts), we don't rule out the imminent possibility that limited viral transmission between humans could occur," WHO public relations officer Sari P. Setiogi told the Post.

Pulmonologist Tjandra Yoga Aditama acknowledged the cluster cases indicated there was a great possibility for limited human-to-human transmission.

"Patients of cluster cases could have got the virus either from the same infected birds or chickens, or from one another. Further laboratory checks can determine where the virus came from," he said.

"If a similar source is confirmed, then there is no mutation or human-to-human transmission, but if the virus is a different type then there is viral mutation and the possibility that they got it from one another," he added.

Two patients showing bird flu symptoms died at Sulianti Saroso Hospital on Thursday. A 15-year-housemaid from Manggarai, South Jakarta, and a 27-year-old male resident of Bogor, West Java, died only after a day in the hospital.

If the Hong Kong laboratory confirms they died of the disease, their deaths would bring to nine the fatalities here this year.

With the infection of most patients linked to their rearing of poultry or living in close proximity to chickens or ducks, Jakarta Governor Sutiyoso said city employees would conduct door-to-door checks for poultry kept at residences, provide Tamiflu to residents with infected birds and monitor the supply of live poultry into the capital.

Source: BBC Monitoring Asia Pacific

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