INDONESIA - SEPTEMBER 11 AVIAN INFLUENZA (AI) UPDATE

UNCLAS SECTION 01 OF 02 JAKARTA 011212

SIPDIS

SIPDIS
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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

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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