INDONESIA: Steps taken to confront bird flu but danger remains

[This is the first reference I have seen that the Bali patient has been hospitalized. It could be an error]

JAKARTA, 12 February 2009 (IRIN) - Indonesia is making progress in its fight against avian influenza but the danger posed by the H5N1 virus to humans remains high, specialists said.

Last month, the Indonesian Health Ministry announced that two more people had died of the disease, bringing the death toll to 115, the highest in the world.

Investigations indicated that both victims visited wet markets before contracting the disease.

On 8 February, a 20-year-old man on the resort island of Bali was hospitalised for suspected bird flu after dozens of chickens in his village tested positive for the virus. Tests were being carried out to determine whether he had contracted bird flu.

However, Bayu Krisnamurthi, executive director of Indonesia's National Committee for Bird Flu Control and Pandemic Preparedness, said there was no evidence the virus had mutated into a form that could make it easier for humans to be infected.

"Bird flu has now become like other infectious diseases spread by animals. The virus is around us, but there's no clinical evidence that it is any more dangerous than before," Krisnamurthi told IRIN.

Progress

James McGrane, team leader of the UN Food and Agriculture Organization's Influenza Control Programme in Indonesia, said the government had made substantial progress in bringing avian influenza under control, but more needed to be done.

Photo: Brennon Jones/IRIN

A specially-trained nurse at the East Java Provincial Hospital, Indonesia needs to work harder to tackle the disease, particularly on Java, where most of the deaths have occurred

"The disease appears to have been contained, with data appearing to indicate that both overall incidence and geographic spread are decreasing, although the disease remains entrenched in some areas," McGrane told IRIN.

"These advances have been made despite the unprecedented challenges presented to avian influenza control given Indonesia's massive and diverse poultry population," he said.

But McGrane said Indonesia needed to work harder to tackle the disease, particularly on Java, where most of the deaths have occurred.

Twelve of Indonesia's 33 provinces have recorded human cases of bird flu while only two provinces have had no avian flu in poultry, the national bird flu committee said.

Chairul Anwar Nidom, a virologist with the Tropical Disease Centre at Airlangga University in Surabaya, said a common policy on bird flu was lacking among government agencies, making controlling the disease more difficult.

"By and large the government has done a good job and people are aware of the danger of bird flu," Nidom said.

But Nidom criticised the government's policy of vaccinating poultry rather than culling, believing that it masks the virus, and ultimately contributes to its mutation.

"There's still no common agreement on this issue among government agencies. The agriculture and farming sector sees the need for vaccinations to save the economy. We are at a crossroads, having to choose between saving poultry and protecting human beings," said Nidom.

Nidom, who first revealed the outbreak of bird flu in Indonesia, said the threat of a pandemic remained high given the unpredictable nature of the H5N1 virus.

"Frankly, we still don't know exactly the virus's pattern of infection and its predispositions. As long as it remains so, it will remain a threat to humans," he said.

Photo: Brennon Jones/IRIN

Bird sellers at a market in East Java say they are unconcerned about the risk of avian flu or a pandemic

Krisnamurthi said despite the progress, there was no room for complacency and the government continued its campaign to warn the public about the danger of bird flu.

Last month, the Indonesian National Committee for Bird Flu Control and Pandemic Preparedness, supported by the UN Children's Fund (UNICEF), launched workshops on pandemic preparedness in 10 cities across the country, he said.

Since last year Indonesia has adopted a policy of only publicly reporting human infections from time to time rather than as they occur.

In addition, the country has been locked in a dispute with the World Health Organization over sharing virus samples for the past two years. Health Minister Siti Fadilah Supari has insisted Indonesia will not share virus samples unless it receives assurances it will be given any vaccine made from the viruses.

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