Indonesia Update

Indonesia's Bird Flu Deaths Fuel Concern Over Control (Update4)

May 15 (Bloomberg) -- At least five Indonesians from North Sumatra province are suspected to have died in recent weeks from bird flu, a World Health Organization official said, fueling concern over the country's ability to halt the virus in poultry.

An Indonesian laboratory found five relatives were fatally infected with the H5N1 avian influenza virus, Sari Setiogi, a WHO spokeswoman in Jakarta, said yesterday. A Hong Kong laboratory will conduct confirmatory tests, she said. A sixth person who also died will be tested.

``Any time we see clustered cases, it raises questions, the greatest of which is whether the virus has evolved'' and is becoming easily transmitted from person to person, said William Aldis, coordinator of health policy and research for the WHO in Southeast Asia, in an interview in Jakarta today.

World health officials are concerned H5N1, which has infected more than 200 people in the past three years, may mutate into a form that spreads easily among humans, touching off a pandemic similar to the one in 1918 that killed as many as 50 million people. A cluster of H5N1 infections may signal the virus is becoming more contagious to people.

Representatives from the WHO, the United Nations' Food and Agriculture Organization and Asia-Pacific governments are meeting this week in Indonesia's capital, Jakarta, to discuss food security, poverty and preparing for disasters, such as a flu pandemic.

In the U.S., health officials agreed to pay as much as $32.3 million over five years to King of Prussia-Pennsylvania- based Tunnell Consulting for personnel and expertise to help build stockpiles of drugs and vaccines.

The H5N1 virus has killed at least 115 of 208 people known to have been infected since late 2003, the Geneva-based WHO said on May 12.

Economic Cost

In Asia, more than 200 million domestic fowl have died or been culled to contain the spread of H5N1, costing countries between $10 billion and $15 billion, Laurence Gleeson, Bangkok- based regional manager of the FAO's Emergency Centre for Transboundary Animal Diseases, told the conference today.

In Romania, as many as 1 million fowl may have to be culled to control the country's first outbreak on a poultry farm, Radio Romania Actualitati reported today. Health inspectors found chickens infected with an H5 avian flu virus at a farm near Codlea in the central Romanian county of Brasov.

Chicken meat and live poultry from the farm may have been sold in at least four other counties in the country, the radio station said, citing Romanian Agriculture Minister Gheorghe Flutur.

This year, 39 people are confirmed to have died from H5N1, almost as many as the 41 fatalities reported in the whole of 2005. More than a third of this year's fatal cases have come from Indonesia.

Outbreaks Widespread

Indonesia, the world's fourth-most-populous nation, has had outbreaks of H5N1 in poultry in 26 of its 33 provinces. Avian flu in poultry poses a greater risk to humans in Indonesia, where people and birds live side by side in rural and urban areas. Thirty million households in Indonesian villages keep more than 200 million chickens in backyards, according to the FAO.

Since July, 33 Indonesians are confirmed by the WHO to have been infected. Of those, 25 have died. If confirmed, the five North Sumatra cases will bring to one a week the average number of new H5N1 cases being reported in Indonesia since September.

Family Members

The suspected cases comprise two men, two women and an 8- year-old girl who lived closely with each other and had common ancestors, Agence France-Presse reported yesterday, citing I Nyoman Kandun, director general of disease control with the Indonesian Health Ministry.

The five had been in contact with sick poultry and pigs before they died within days of each other over the past three weeks, AFP reported. Three other people from the group also tested positive, the report said.

A WHO epidemiologist has been sent to the province to investigate the cases.

``This needs to be investigated rapidly so we can determine if there was any human-to-human transmission, or if anything else may have happened to suggest the virus is behaving differently,'' said Maria Cheng, a WHO spokeswoman in Geneva.

Almost all human H5N1 cases have been linked to close contact with sick or dead birds, such as children playing with them or adults butchering them or taking off the feathers, according to the WHO. Cooking meat and eggs properly kills the virus.

Monitoring

Avian flu controls in Indonesia, which successfully eradicated foot-and-mouth disease in cattle in the 1970s, have suffered because the government doesn't have enough people to monitor the spread of the virus in poultry. A law that came into effect in 2001 gave power to provinces and regencies with little supervision from the national government in Jakarta.

``They have particular institutional issues with coordination,'' FAO's Gleeson told reporters at the conference. ``The country is doing what it can with its resources. You could throw a huge amount of money at influenza control in this country and if certain other things are not in place, it's a waste of money.''

Gleeson said there needs to be more cooperation from Indonesia's general public.

``People have to understand that if they've got bird flu in their chickens the first thing they don't do is take it down to the market and sell it, which is one of the very common practices,'' he said.

To contact the reporter on this story:
Jason Gale in Singapore at j.gale@bloomberg.net

Last Updated: May 15, 2006 14:12 EDT