INDONESIA - AUGUST 11 AVIAN INFLUENZA (AI) UPDATE

UNCLAS SECTION 01 OF 03 JAKARTA 010140

SIPDIS

SIPDIS
SENSITIVE

DEPT FOR EAP/MLS, EAP/IET, A/MED AND S/ES-O
DEPT FOR G/AIAG/JLANGE AND RFENDRICK
DEPT FOR OES/FO, OES/EID, OES/PCI, OES/STC AND OES/IHA
DEPT PASS TO USDA/FAS/DLP/HWETZEL AND FAS/ICD/LAIDIG
DEPT ALSO PASS TO USDA/FAS/FAA/DYOUNG AND USDA/APHIS
DEPT ALSO PASS TO USAID/ANE/CLEMENTS AND GH/CARROLL
DEPT ALSO PASS TO HHS/WSTEIGER/ABHAT/MSTLOUIS AND HHS/NIH
PARIS FOR FAS/AG MINISTER COUNSELOR
CANBERRA FOR APHIS/DHANNAPEL
ROME FOR FAO
NSC FOR JMELINE
BANGKOK FOR RMO, CDC, USAID/RDM/A
USPACOM ALSO PASS TO J07

E.O. 12958: N/A
TAGS: TBIO AMED CASC EAGR AMGT PGOV ID KFLU
SUBJECT: INDONESIA - AUGUST 11 AVIAN INFLUENZA (AI) UPDATE

REF: A) Jakarta 09914 and previous

JAKARTA 00010140 001.2 OF 003



1. (SBU) Summary. On August 9, Coordinating Minister for
People's Welfare Aburizal Bakrie stated, according to the media,
that Jakarta had yet to receive promised foreign aid to fight
bird flu. Bakrie's statement was puzzling and frustrating to
donors. The May 2006 Donor Coordination Meeting, hosted by the
National Committee on Avian Influenza Management and Pandemic
Alert (KOMNAS),identified over $30 million in donor assistance
to Indonesia, with an additional $22 million in commitments of
support. Post continues to explore implications of the surprise
August 3 announcement by the Minister of Health Siti Fadilah
Supari about testing all AI samples using local laboratories.
Dr. Triono Soendoro, the Director of the National Institutes of
Health Research and Development (NIHRD),provided permission to
ship samples to the U.S. Centers for Disease Control (CDC) on
August 10. Patients from the Medan H1N1 cluster recovered and
several went home before being formally discharged on August 7.
The Eijkman Institute continues to perform additional analyses on
one sample from this cluster. NAMRU-2 and the MOH held a USAID-
funded conference in Bali to train 40 instructors to teach
provincial officials how to respond to newly emerging human cases
of H5N1. According to the media, Government of Indonesia (GOI)
officials acknowledged on August 7 that avian influenza has
spread to poultry in Papua. NIHRD and NAMRU-2 identified two new
fatal cases of H5N1. Both victims (a 16-year-old male and a 17-
year-old female) were from the greater Jakarta area. Confirmed
human cases of avian influenza in Indonesia are now at 58, with
46 confirmed deaths, a 79 percent fatality rate. End Summary.

Bakrie Statement Puzzling
--------------


2. (SBU) At a meeting with senior GOI Agriculture and Health
officials on August 2, Coordinating Minister for the People's
Welfare Aburizal Bakrie stated Jakarta had yet to receive
promised foreign aid to fight bird flu. The statement was both
puzzling and frustrating to donors. The May 2006 Donor
Coordination Meeting, hosted by KOMNAS, identified over $30
million in donor assistance to Indonesia, with an additional $22
million in commitments of support. This assistance encompasses
each of the goals identified in the National Strategy for Avian
Influenza Control and Preparedness for Human Pandemic Influenza
2006-2008. The USG provides the greatest assistance with $14.65
million obligated plus an additional $4 million projected.
Additional foreign donor contributions include: Japan ($5.5
million plus in-kind goods and services),Australia ($11.6
million),Canada ($3.5 million) and the World Bank ($280,000
obligated and finalizing a $10 million grant package.) KOMNAS
plans to host a two-day donor coordination meeting in Jakarta
August 23-24, 2006.

GOI to Use Domestic
Laboratories, Including NAMRU-2
--------------


3. (SBU) Post continues to research the implications of the
August 3 surprise announcement about the GOI's intentions to test
all AI cases using local laboratories. Post is concerned that

JAKARTA 00010140 002.2 OF 003


under this new procedure, the NAMRU-2 practice of sending samples
to CDC might be jeopardized. On August 10, Dr. Triono Soendoro
gave NAMRU-2 permission to ship samples from the two new cases
(16 year-old male and 17 year-old female) to the U.S. CDC for
testing. The MOH also encouraged the release of sequence
information on Indonesian-derived viruses from the World Health
Organization (WHO)-Reference Laboratories at CDC and the
University of Hong Kong. In response, the CDC entered all data
into GeneBank on August 4.

Medan New Cluster
--------------


4. (SBU) Samples from seven patients from the second suspected
Medan Cluster (Kabanjahe district, Karo regency, North Sumatra)
demonstrate that all were infected with an H1N1 Influenza virus.
The patients recovered and left the hospital prior to formal
discharge. Some have joined in a lawsuit against the MOH and the
President of Indonesia complaining of the stigma associated with
suspected avian influenza. Tests from a ten-year-old female from
the cluster are ongoing at the Eijkman Insitute. (Note: AI
outbreaks in animals serve as a sentinel for possible human
cases. Identification of people with influenza-like illnesses in
connection with animal outbreaks is a goal of the USAID-funded
animal surveillance and response program. It is necessary to
identify human suspects early enough in their infection to
receive proper health care, as well as to identify clusters. As
the animal surveillance and response program expands, we expect
it will identify larger numbers of human suspects.)

NAMRU-2 Training Seminar
--------------


5. (SBU) NAMRU-2 and the MOH organized a five-day, USAID-funded
conference in Bali to teach teams of trainers how to instruct
provincial and district outbreak responders about Avian
Influenza. Forty participants attended. Dr. Erna Tresnaningsih,
the Deputy Director of the National Institutes of Health Research
and Development, opened the conference. Both the WHO and USAID
were represented.

AI Infected Poultry in Papua
--------------


6. (U) According to local media, the Indonesian Ministry of
Agriculture acknowledged on August 7 that the AI virus has spread
to Papua. Based on laboratory analysis from the Bogor Veterinary
Research Center conducted on July 19, three of 37 birds tested
positive for H5N1. On July 11, a farmer from a Sempan village in
Timika reported to the provincial animal husbandry office that
his chickens were sick. Inspectors found birds with H5N1
symptoms at his farm and also at the local traditional market.
The regency culled 414 chickens from the area.

Human AI Case Profile
--------------


7. (SBU) NAMRU-2 has confirmed two new fatal cases in the greater
Jakarta area since last reftel, a 16-year-old male from Bekasi

JAKARTA 00010140 003.2 OF 003


and a 17-year-old female from Tangerang. NAMRU-2 data indicates
the following AI-related case profile as of August 11:

-- Number of laboratory confirmed (positive PCR and/or serology)
human AI cases: 58, of which 46 have been fatal (case fatality
rate of 79 percent).

-- Number of probable AI cases (awaiting WHO Laboratory
confirmation): 4, with 2 deaths (fatality rate of 50 percent).

-- Number of cases awaiting sequencing at the U.S. CDC: 2.

-- Number of possible untested AI cases under investigation (last
30 days): approximately 10.

Note: NAMRU-2 data corresponds with Ministry of Health data but
may vary at times with AI case figures presented on the official
World Health Organization (WHO) website, which usually lags NAMRU-
2 data by one week. The WHO website, last updated on August 9,
notes 56 human AI cases in Indonesia with 44 deaths. WHO figures
can be accessed at www.who.int/csr/disease/avian_influenza.

PASCOE