INDONESIA - JANUARY 30 AVIAN INFLUENZA (AI) UPDATE

UNCLAS JAKARTA 000264 SIPDIS SENSITIVE SIPDIS DEPT FOR EAP/MLS, EAP/IET, MED/DASHO/EMR AND MED DEPT FOR G/AIAG AND OES DEPT PASS TO USDA/FAS/DLP/HWETZEL AND FAS/ROSENBLUM DEPT ALSO PASS TO USDA/FAS/FAA/DEVER AND USDA/APHIS/ANNELLI DEPT ALSO PASS TO USDA/FAS/OTCB/ROSENBLUM AND USDA/AHHIS AUSTGEN 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 BANGKOK FOR APHIS/CARDENAS, RMO, CDC, USAID/RDM/A CANBERRA FOR APHIS/EDWARDS ROME FOR FAO NSC FOR JMELINE E.O. 12958: N/A TAGS: TBIO AMED CASC EAGR AMGT PGOV ID SUBJECT: INDONESIA - JANUARY 30 AVIAN INFLUENZA (AI) UPDATE REF: A) Jakarta 00166 B) Jakarta 00107 ¶1. (SBU) Summary. The Mission is working to reverse a January 11 directive from the National Institute of Health and Research Development (NIHRD) instructing NAMRU-2 to no longer ship AI specimens to CDC until NAMRU-2 signs a Materials Transfer Agreement (MTA). At a January 26 ceremony, the Ambassador presented the GOI with 100,000 USAID-provided kits of Personal Protective Equipment and 1,000 decontamination kits for use in preventing the spread of bird flu. USAID organized a 2-day workshop to harmonize mass media and behavior change communications messages on January 24-25. On January 24, local press reports carried a claim by an Indonesian scientist that he had found the AI virus in flies. Teams of health workers have slaughtered poultry in advance of Jakarta's February 1 ban on residential poultry. The Mission's Naval Medical Research Unit (NAMRU-2) has confirmed two additional human AI cases since Ref A, both of whom have died. End Summary. NAMRU-2 Instructed To Stop Sample Shipments to CDC -------------- -------------- -------------- ¶2. (SBU) On January 11, the National Institute of Health and Research Development verbally instructed NAMRU-2 to no longer ship AI specimens to the WHO Influenza Reference Center at the CDC until NAMRU-2 signs a Materials Transfer Agreement (MTA). The decision came just a day after the GOI introduced text mandating an MTA during negotiations on a new NAMRU-2 Memorandum of Understanding. The Mission is working hard to reverse this decision. The Ambassador has raised the issue with Presidential Advisor Dino Djalal, Coordinating Minister for People's Welfare Aburizal Bakrie, and National Committee for AI Control and Pandemic Preparedness (KOMNAS) Executive Director Bayu Krisnamurthi. Djalal in turn told us he phoned Minister of Health Siti Fadilah Supari, who claimed the issue is a misunderstanding and promised to rectify it. However, on January 31 NAMRU-2 received a copy of a December 20 notice signed by Supari prohibiting the shipment of specimens out of Indonesia by any organization without the Ministry of Health's permission. The DCM is scheduled to meet NIHRD Director Triono Soendoro on January 31 to further discuss the issue. Pascoe Presents Personal Protective Equipment -------------- -------------- -------------- ¶3. (U) On January 26, the Ambassador presented Coordinating Minister Bakrie with 100,000 kits of Personal Protective Equipment (PPEs) and 1,000 decontamination kits to be used in preventing the spread of bird flu here in Indonesia. The USAID-funded donation represents the first installment of a transfer of 200,000 sets of PPE and 2,000 decontamination kits in 2007. The PPEs and decontamination equipment include protective suits, respirators, goggles and gloves, and will enable Indonesia's AI Control programs to expand their efforts to increase avian influenza-related surveillance and detection. The Ambassador also acknowledged the donation of almost 100K of equipment from USAID/NAMRU-2 for the AI laboratory at NIHRD. USAID Sponsors AI Communications Harmonization Workshop -------------- -------------- -------------- ¶4. (U) USAID's Community-Based AI Control (CBAIC) program organized and sponsored a communications harmonization workshop on 24-25 January 2007 in Jakarta. Over 70 representatives from 25 Indonesian and international donor organizations attended the KOMNAS-hosted event. The workshop resulted in agreement on communication strategies and messages in five key areas, including 1) bird to bird transmission; 2) bird to human transmission; 3) strategic positioning and branding; 4) pandemic simulation; and 5) institutional mechanisms for collaboration and coordination. As a next step, a representative team formed from the workshop participants will finalize a communications guide book based on the results of the workshop. Within the last 12 months, various GOI and donor agencies have launched eight separate communication initiatives without full coordination, raising the potential for conflicting or confusing messages. Indonesian Scientist Claims AI Found in Flies -------------- -------------- -------------- ¶5. (U) The Jakarta Post published an article on January 24 claiming that Veterinary Pathologist Wasito of Gadja Madah University has found avian influenza virus present in flies. Details of the research remain unknown. If confirmed, the findings would suggest that flies may carry the virus in previously infected areas. "We do not yet dare to say whether the avian influenza we found in the flies is low pathogenic or highly pathogenic. We can only say that in flies, we also found the bird flu virus in organs," Wasito said. Wasito did not say whether he planned to submit his research for publication. Health Teams Begin Jakarta Poultry Culling -------------- -------------- -------------- ¶6. (U) Throughout the week of January 21, teams of health works have slaughtered thousands of birds in Jakarta ahead of a February 1 ban on backyard poultry. Until the end of January, the program to eliminate birds is essentially voluntary: residents may eat or kill their birds and will receive 12,500 rupiahs (about $1.40) compensation for each bird, if officials find no virus in the area. Residents are not compensated if officials find evidence of infection nearby. Effective February 1, authorities plan to confiscate without compensation all birds found on domestic premises without certification. NAMRU-2 Identifies Additional Cases -------------- -------------- ¶7. (SBU) NAMRU-2 reports two additional cases of human H5N1 infection since Ref A, both of whom died. The cases include a 32-year-old female from Garut and a six-year-old female from Magelang. The 32-year-old female was admitted to the Dr. Slamet Hospital in Garut on January 16 and died January 20. The six-year-old was admitted to the Sardjito Hospital in Yogyakarta on January 19 after 11 days of illness and died the same day. She had initially been treated for typhoid fever at Morangan Hospital, near Magelang. The NIHRD has not permitted NAMRU-2 to ship specimens from the two to the U.S. CDC. ¶8. (SBU) NAMRU-2 data indicates the following AI-related case profile as of January 26: -- Number of laboratory confirmed (positive PCR and/or serology) human AI cases: 81, of which 63 have been fatal (case fatality rate of 78 percent). -- Number of probable AI cases: 4, of which 2 are fatal (case fatality rate of 50%). -- Number of cases awaiting analysis at the U.S. CDC: 0. -- Number of possible untested AI cases under investigation (last 30 days): 25. Note: NAMRU-2 data corresponds with Ministry of Health (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 January 22, notes 80 human AI cases in Indonesia with 62 deaths. For WHO figures, log onto their website at www.who.int/csr/disease/avian_influenza. PASCOE