INDONESIA: MAY 31 AVIAN INFLUENZA UPDATE

UNCLAS SECTION 01 OF 02 JAKARTA 006812

SIPDIS

SIPDIS
SENSITIVE

DEPT FOR EAP/IET, A/MED AND S/ES-O
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/BILL STEIGER AND AMAR BHAT
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: MAY 31 AVIAN INFLUENZA UPDATE

REF: A) Jakarta 6495 and previous

JAKARTA 00006812 001.2 OF 002



1. (SBU) Summary: Three additional cases of H5N1 infection
have occurred in two locations in Indonesia since May 22
(ref). Two of these have resulted in fatalities, including
a 10-year old girl and her 18-year old brother, both whom
died 21 May in Bandung, West Java. NAMRU-2 and the Ministry
of Health (MOH) have also determined H5N1 exposure in a 12-
year girl hospitalized in Padang, West Sumatra who
reportedly cared for the bodies of two family members that
recently died with symptoms consistent with H5N1 infection.
Centers for Disease Control and Prevention (CDC) influenza
specialist Dr. Tim Uyeki returned to Jakarta from Medan May
27 and continues to work with the MOH in the investigation
of the North Sumatran family cluster and other recent human
AI cases. As of May 31, post reports 54 human AI cases as
confirmed or probable, with 40 resulting in fatalities (74
percent). End Summary.

North Sumatran Cluster Update
--------------


2. (SBU) CDC influenza specialist Dr. Tim Uyeki returned
from Medan May 27, but will continue to help Dr. Tom Grein
from the World Health Organization (WHO) in Geneva and the
Ministry of Health (MOH) with the ongoing investigation of
the family cluster and other human AI cases that have since
emerged. There is no evidence of additional cases outside
of the large family cluster. MOH officials will continue to
monitor close contacts of the victims. It appears that
surviving family members and villagers of Kubu Simbelang in
the Karo District have been more cooperative with the WHO
team, but less so with MOH officials. District health
workers continue to follow about 30 villagers who had
contact with the family and many of these are receiving
oseltamivir.


3. (SBU) Dr. Uyeki said he supports the WHO's plan to
conduct a serological survey at a later date, after careful
planning. A serological survey could provide important
additional information, including information about possible
sub-clinical AI infections.


4. (U) Ministry of Agriculture (MOA) officials said the MOA
sent serum samples obtained from pigs in the Karo District
of Medan to VLA Weybridge, United Kingdom, on May 25 for
further testing. In addition, Consulate Medan presented
North Sumatra Ministry of Health officials in
Kabanjahe with USAID Jakarta-produced posters and other
material that they will use to spread awareness of how to
diminish the risk of catching or spreading avian flu.

Additional Cases in Java
--------------


5. (SBU) Three additional cases of H5N1 infection have
occurred in other locations in Indonesia since reftel report
May 22, 2006. Two have them have been fatal. Details
follow:


JAKARTA 00006812 002 OF 002


--- NAMRU-2 and NIHRD have determined H5N1 infection in a 12-
year girl who cared for the bodies of two other family
members who recently died of probable AI infection. The
patient remains hospitalized in Padang with AI symptoms
Confirmation by the US CDC and UHK results are pending.

--- Both the U.S. CDC and the UHK have confirmed H5N1
infection in a 39-year old male who died May 21 at the
Infectious Disease Hospital in Jakarta. (reftel).

--- A 10-year girl and her 18-year old brother were
reportedly admitted May 22 with AI symptoms to the state-run
Hasan Sidikin Hospital in Bandung and died a day later. Dr.
Nyoman Kandun, Director General of Communicable Disease
Control and Environmental Health (CDC-EH or P2M) told the
local press that the victims were probably infected by sick
poultry. He added that dead chickens were discovered a few
days before the pair fell ill. Provincial Animal Health
officials reportedly culled up to 500 poultry within a half
a mile of the siblings' home after having found four H5N1
infected chickens in the area. NIHRD and NAMRU-2 found
samples from both patients to be positive for H5N1. The WHO
lab in Hong Kong confirmed infection in the case of the 10-
year old female, while results on the 18 year-old are
equivocal.

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


6. (U) In the past week, the number of confirmed H5N1 cases
in humans in Indonesia rose from 44 to 47, with 36 deaths
(77 percent).


7. (SBU) NAMRU-2 data indicates the following AI-related
case profile as of May 31:

-- Number of laboratory confirmed (positive PCR and/or
serology) human AI cases: 47, of which 36 have been fatal
(fatality rate of 77 percent).

-- Number of probable AI cases: 7, with 4 deaths (fatality
rate of 57 percent).

-- Number of cases awaiting verification by the U.S. CDC: 3.

-- Number of possible AI cases under investigation:
approximately 24.

-- Number of excluded AI cases: 302.

PASCOE