INDONESIA - SEPTEMBER 11 AVIAN INFLUENZA (AI) UPDATE

UNCLAS SECTION 01 OF 02 JAKARTA 011212 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 - SEPTEMBER 11 AVIAN INFLUENZA (AI) UPDATE REF: A) Jakarta 10923 and previous JAKARTA 00011212 001.2 OF 002 ¶1. (SBU) Summary. The Singaporean Embassy in Jakarta has proposed to hold a joint planning meeting for the Tangerang trilateral project on September 13. The Government of Singapore (GOS) plans to station permanent technical staff to head up project. The Ministry of Health (MOH) is evaluating the mass Tamiflu prophylaxis provided to Garut local residents during a mid-August AI outbreak. USDA plans a series of workshops on bird wet markets in Tangerang on September 18, 19, and 29. NAMRU-2 confirms two human cases (one fatal) of AI since Reftel A. As of September 8, data from NAMRU-2 and the Ministry of Health (MOH) show 65 human AI cases in Indonesia with 49 fatalities. End Summary. Tangerang Trilateral Project Update -------------- ¶2. (SBU) We met Singaporean Deputy Chief of Mission Lim Hong Huai Lim on September 7 to discuss implementation of the Tangerang Trilateral Project. Recognizing that GOI officials were not likely to take the initiative on the project without some prodding, Lim told us he has called for a joint planning meeting for September 13. He added that the Singapore Ministry of Health would assign a permanent technical staff member to implement the Tangerang project, and that additional technical staff would likely travel from Singapore for short assignments to assist on individual activities. Lim provided a GANT chart listing project implementation over a three-year span and requested USG comments. We agreed to support Singapore's request that the GOI designate a Tangerang project lead, name individuals to staff the working groups, and commit to a timetable of activities at the September 13 meeting. We also provided Lim with a summary of current and planned USG contributions in Tangerang. 
 MOH and WHO Collaborate on Evaluation of Tamiflu Prophylaxis -------------- -------------- ¶3. (U) The MOH, with WHO support, is evaluating the mass Tamiflu prophylaxis provided to Garut local residents in mid-August. Local health authorities working with the MOH distributed 2,900 prophylactic courses of tamiflu to villagers at the time of the outbreak. Researchers will survey households for coverage, compliance and adverse effects as well as analyze the decision making process for the actions taken in Garut. USDA Sponsors Wet Market Bird Seminar -------------- ¶4. (U) USDA will sponsor a series of workshops covering biosecurity and disease surveillance in wet markets in Tangerang municipality on September 18, 19, and 29. Seminar organizers will run a plenary session for an audience of sixty participants, targeting government and industry officials. There will also be multiple smaller workshops for poultry producers, slaughterhouse operators, and government workers. Speakers from national and international human and animal health organizations will discuss factors that influence the presence of H5N1 and HPAI at the market level. JAKARTA 00011212 002 OF 002 NAMRU-2 Human AI Case Profile -------------- ¶5. (SBU) NAMRU-2 has confirmed two new cases since we transmitted Ref A. The first, a 26 year-old male from Padang, Sumatra, is the brother of a 14 year-old female confirmed to have been infected with an H5N1 virus in May. The 14 year-old female became ill after taking care of the bodies of two other family members who developed signs of H5N1 infection following area poultry deaths and passed away prior to sampling. NAMRU-2 and MOH officials took samples from the 26-year-old male during the resulting investigation. NAMRU-2 and US Centers for Disease Control confirmed H5N1 exposure via a four-fold rise in antibody titers against the H5N1 virus. While never hospitalized, the victim experienced a mild febrile illness. Both he and his sister recovered. NAMRU-2 and NIHRD also confirmed a second case, a 14-year-old female from Makassar, Sulawesi, as H5N1 positive on September 4. Local officials obtained samples on 24 June and sent them to the NIHRD laboratory for testing weeks later. According to contacts, the NIHRD delayed testing the sample due to possible backlog. NIHRD shared the sample with NAMRU-2 and performed tests on September 4. Both laboratories confirmed the presence of H5N1. ¶6. (SBU) NAMRU-2 data indicates the following AI-related case profile as of September 8: -- Number of laboratory confirmed (positive PCR and/or serology) human AI cases: 65, of which 49 have been fatal (case fatality rate of 75 percent). -- Number of probable AI cases 2, with 1 death (fatality rate of 50 percent). -- Number of cases awaiting sequencing at the U.S. CDC: 1. -- Number of possible untested AI cases under investigation (last 30 days): approximately 28. Note: NAMRU-2 data corresponds with MOH 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 23, notes 60 human AI cases in Indonesia with 46 deaths. WHO figures can be accessed at www.who.int/csr/disease/avian_influenza. PASCOE