Identifier
Created
Classification
Origin
06JAKARTA9914
2006-08-07 08:48:00
UNCLASSIFIED//FOR OFFICIAL USE ONLY
Embassy Jakarta
Cable title:  

INDONESIA - AUGUST 4 AVIAN INFLUENZA (AI) UPDATE

Tags:  TBIO AMED CASC EAGR AMGT PGOV ID KFLU 
pdf how-to read a cable
VZCZCXRO2271
PP RUEHCHI RUEHDT RUEHHM
DE RUEHJA #9914/01 2190848
ZNR UUUUU ZZH
P 070848Z AUG 06
FM AMEMBASSY JAKARTA
TO RUEHC/SECSTATE WASHDC PRIORITY 8386
RUEHPH/CDC ATLANTA GA PRIORITY
INFO RUEAUSA/DEPT OF HHS WASHINGTON DC PRIORITY
RUEHZS/ASSOCIATION OF SOUTHEAST ASIAN NATIONS
RUEHRC/USDA FAS WASHDC
RHEHNSC/NSC WASHDC
RHMFIUU/BUMED WASHINGTON DC
RHEFDIA/DIA WASHINGTON DC
RUEKJCS/SECDEF WASHDC
RHHMUNA/CDR USPACOM HONOLULU HI
RUEKJCS/CJCS WASHDC
RUEHBY/AMEMBASSY CANBERRA 9800
RUEHFR/AMEMBASSY PARIS 0924
RUEHRO/AMEMBASSY ROME 1908
RUEHIN/AIT TAIPEI 1836
RUEHHK/AMCONSUL HONG KONG 2171
RUEHBJ/AMEMBASSY BEIJING 3558
RUEHHM/AMCONSUL HO CHI MINH CITY 0105
RUEHGZ/AMCONSUL GUANGZHOU 0257
UNCLAS SECTION 01 OF 03 JAKARTA 009914 

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 4 AVIAN INFLUENZA (AI) UPDATE

REF: A) Jakarta 09515 and previous

JAKARTA 00009914 001.2 OF 003


UNCLAS SECTION 01 OF 03 JAKARTA 009914

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 4 AVIAN INFLUENZA (AI) UPDATE

REF: A) Jakarta 09515 and previous

JAKARTA 00009914 001.2 OF 003



1. (SBU) Summary. On August 3, the Minister of Health Siti
Fadilah Supari announced that, effective immediately, the
GOI would no longer send samples to the WHO-Influenza
Reference laboratory in Hong Kong. Supari considers
domestic laboratories, including U.S. NAMRU-2, sufficiently
qualified to analyze samples. The Ministry of Health (MOH)
reported on August 3 that preliminary tests from an MOH
laboratory were negative on seven individuals suspected of
infection with avian influenza. However, U.S. NAMRU-2
tested samples from these same cases and found that one
tested positive for H5N1 infection. On August 2, the GOI
announced that Avian Influenza (AI) has infected poultry in
29 of the 33 provinces in Indonesia, including Bali. On
July 7, USAID started a new community-based program to
combat AI via improved surveillance through volunteers that
will reach villages in the most populated areas of
Indonesia. Teams are expected to be fully mobilized within
three months. As of August 4, data from the NAMRU-2 and the
Ministry of Health (MOH) show a single new probable H5N1
case in humans since reftel A. Confirmed human cases of
avian influenza in Indonesia remain at 56, with 44 confirmed
deaths, a 79 percent fatality rate. End Summary.

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


2. (SBU) The Minister of Health Siti Fadilah Supari

announced at an August 3 press conference that the GOI would
stop sending samples to a World Health Organization (WHO)-
sanctioned laboratory in Hong Kong, effective immediately.
Supari considers that local laboratories, including the U.S.
Naval Medical Research Unit-2 (NAMRU-2),laboratory are
sufficiently qualified. She also referred to the Eijkman
Institute, a semi-autonomous institute that falls under the
Ministry of Research and Technology. NAMRU-2 will continue
to send samples to the U.S. Centers for Disease Control
(CDC).

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


3. (SBU) Samples from seven ill residents of the Kabanjahe
district, of the Karo regency, North Sumatra, the same site
as the eight-member AI cluster in May, were tested for H5N1
by both Ministry of Health and NAMRU-2 laboratories. (GOI
routinely splits and shares samples of suspected AI cases
with both laboratories.) The MOH reported on August 3 that
preliminary laboratory tests completed were negative.
However, NAMRU-2 data indicates that one of the cases tested
positive for H5N1. NAMRU-2 will send this sample to CDC for
confirmation. Four of the seven individuals, all children
remain hospitalized in Medan.

AI Infected Poultry Discovered in Bali and Other Provinces
-------------- --------------


JAKARTA 00009914 002.2 OF 003



4. (U) The Indonesian Ministry of Agriculture acknowledged
that the AI virus has spread to 203 districts/cities in 29
of the 33 provinces in Indonesia. The GOI reported AI
infected poultry in Bali on August 1. Bali officials
believe the source of transmission was poultry smuggled onto
the island. "The H5N1 strain of avian flu began sickening
chickens on Bali about three weeks ago," said Memet
Zulkarnain, an official at the Ministry of Agriculture's
avian flu center. Although the Bali provincial government
has banned poultry imports, smuggling remains a problem due
to the higher costs of purchasing poultry in Bali versus
other areas. For example, a duck purchased for ceremonial
purposes in Bali would cost ten times the price (about USD
5.10) of a duck acquired in Java (51 cents). The provincial
government conducted a culling of 273 ducks and native
chickens. The government is also spraying disinfectant
around infected areas, slaughtering and burning the dead
poultry. The GOI has also reported outbreaks among poultry
in Kupang (East Sumba) and East Nusa Tenggara. So far, no
cases have been found in West Nusa Tenggara.


5. (U) The recent poultry outbreaks in Bali and North
Sumatra were identified through USAID's animal surveillance
program with the United Nations Food and Agriculture
Organization (FAO). The FAO teams began searching for AI in
poultry and found it in Bali in late June and in Karo, North
Sumatra in mid-July. We have suspected that AI poultry
outbreaks have been occurring on a regular basis in much of
Indonesia and additional resources are helping to find them.
When FAO identifies outbreaks, GOI response teams move in to
contain with culling and other measures.

USAID Assistance
--------------


6. (U) As of July 21, 2006, USAID/Indonesia has fully
obligated all Avian Influenza (AI) resources, including
$11.5 million announced by Secretary Rice in March. The
total amount USAID/Indonesia has committed to fighting AI in
Indonesia is $14.65 million. USAID's comprehensive program
for AI supports the Government of Indonesia National
Strategy for Avian Influenza Control and Preparedness for
Human Pandemic Influenza 2006-2008. The program includes
integrated public-and-private-sector AI surveillance and
response for both animals and humans. Other implementing
partners include the U.N. Food and Agriculture Organization
for animal sector surveillance and control; NAMRU-2 for
human surveillance and support of vaccine development; WHO
for human surveillance; and Winrock International for
internet and mobile-phone-based rapid reporting and
response.

New USAID Community-Based Program
--------------


7. (U) USAID has established a new Community-Based Avian
Influenza Control (CBAIC) program through a contract with
Development Alternatives Inc. (DAI). CBAIC will support a
number of USAID initiatives, including assistance to

JAKARTA 00009914 003.2 OF 003


Indonesia's National Committee for AI Control and Influenza
Pandemic Preparedness to facilitate coordination among all
levels and sectors of the GOI. The program will build upon
existing community-based volunteer organizations whose
members are already working in villages throughout the
country. The program will educate volunteers on AI
preparedness, surveillance, prevention and containment, and
on behavior change communications. The CBAIC start-up team
has been working in Indonesia since July 21.

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


8. (SBU) NAMRU-2 reports a single new probable case since
last reftel. NAMRU-2 data indicates the following AI-
related case profile as of August 4:

-- Number of laboratory confirmed (positive PCR and/or
serology) human AI cases: 56, of which 44 have been fatal
(case fatality rate of 79 percent).

-- Number of probable AI cases (awaiting WHO Laboratory
confirmation): 5, with 2 deaths (fatality rate of 40
percent).

-- Number of cases awaiting verification by the US CDC: 1.

-- Number of possible AI untested cases under investigation
(last 30 days): approximately 11.

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 July 26, notes 54 human AI cases in
Indonesia with 42 deaths. WHO figures can be accessed at
www.who.int/csr/disease/avian_influenza.

PASCOE