AVIAN INFLUENZA - BALI OUTBREAKS

UNCLAS SECTION 01 OF 02 JAKARTA 002333 SIPDIS SENSITIVE SIPDIS DEPT FOR EAP/MTS, G/AIAG AND OES USAID FOR ANE/CLEMENTS AND GH/CARROLL DEPT ALSO PASS TO HHS/WSTEIGER/MSTLOUIS AND HHS/NIH GENEVA FOR WHO/HOHMAN E.O. 12958: N/A TAGS: TBIO AMED CASC EAGR AMGT PGOV ID SUBJECT: AVIAN INFLUENZA - BALI OUTBREAKS REF: A) Jakarta 2257 ¶1. (SBU) Summary. The confirmation of two human AI infections and a group of suspected cases have drawn international attention to Bali. The Indonesian National Institute of Health Research and Development (NIHRD) determined H5N1 in two women from Bali and agreed to send the samples to the World Health Organization (WHO) Collaborating Center at the U.S. Centers for Disease Control (CDC) for research purposes only to ensure the virus had not mutated. NIHRD has determined the other suspected cases to be negative. The Government of Indonesia (GOI) has deployed epidemiological teams to the villages of both victims to analyze possible transmission sources while authorities cull chickens. Bayu Krisnamurthi, Chief Executive of the Indonesia National Committee for Avian Influenza Control and Pandemic Influenza Preparedness (KOMNAS) has assured us that the GOI and Bali authorities are aggressively handling the outbreaks. He advised that local authorities are keeping the Bali tourism industry apprised of all developments. End Summary. -------------- -------------- Human Cases: Two Confirmed Deaths, One Suspected Death -------------- -------------- ¶2. (SBU) NIHRD has confirmed H5N1 in two recent deaths in Bali. The first victim, a 29-year-old woman, died on August 12 in the Jembrana district. The woman's five-year-old daughter had died of an upper respiratory infection on August 4, but the family cremated the child before authorities could take a clinical sample. On August 15, NIHRD authorized the transfer of a virus sample from the 29-year-old victim to the CDC for risk assessment purposes, to verify the virus had not mutated. U.S. Naval Medical Research Unit Number Two (NAMRU-2) shipped the samples on August 16. CDC authorities have confirmed H5N1 and are characterizing the isolated virus from the sample. ¶3. (SBU) NIHRD confirmed H5NI in a second death at Bali's Sanglah Hospital in the Tabanan District on August 22. The victim, who died on August 21, was a 28-year-old poultry distributor. NIHRD authorized shipment of the sample, which NAMRU-2 sent to the CDC on August 23. ¶4. (U) The Indonesian and international media have reported other suspected AI cases in Bali since August 22, including the infection of a 58-year-old male who came into contact with dead poultry at a waste disposal site where he worked. However, NIHRD tests conclude that these cases are negative for H5N1. -------------- -------------- Animal Outbreaks: Culling and Intensive Monitoring -------------- -------------- ¶5. (SBU) Indonesian and U.N. Food and Agriculture Organization (FAO) authorities first detected avian influenza in poultry in Bali in ¶2003. Episodic outbreaks have continued in the Jembrana district and other districts since that time. According to KOMNAS authorities, AI in the poultry population is endemic to 140 Bali villages. ¶6. (SBU) Immediately following the reports of the H5N1 cases in Bali, Participatory Disease Surveillance and Response (PDS/PDR) teams deployed to both Jembrana and Tabanan districts and culled over 6,000 chickens. The teams are also conducting ring vaccination around the infection area. Epidemiological teams and Balinese authorities are intensifying socialization activities among all villages so that residents will recognize and report poultry outbreaks. A WHO doctor accompanied the GOI epidemiological field investigation team. -------------- Restaurants Remove Chickens from the Menu -------------- ¶7. (U) In response to the recent deaths, a number of Balinese restaurants and hotels have dropped chicken from their menus. According to press reports, restaurants are taking this step as a precautionary measure. The Head of the Bali Chapter of the JAKARTA 00002333 002 OF 002 Indonesian Farmers Union reported that consumption remains average, adding that farmers have taken some bio-security precautions, for example, by spraying their chicken coops with disinfectant every two days. ¶8. (U) Bayu Krisnamurthi, the Chief Executive of KOMNAS, has advised tourists to remain informed and be aware of precautionary practices. Local authorities are keeping the tourist industry in Bali, including hotels, restaurants and tour companies apprised of developments. Hume