INDONESIA - MARCH 6 AVIAN INFLUENZA UPDATE

UNCLAS SECTION 01 OF 02 JAKARTA 000398

SIPDIS
UNCLASSIFIED

DEPT FOR EAP/MTS, G/AIAG, L/DL, EAP/EX, AND OES/IHA
USAID FOR ANE/CLEMENTS AND GH/CARROLL
DEPT ALSO PASS TO HHS/WSTEIGER/MSTLOUIS AND HHS/NIH
DEPT ALSO PASS TO DOJ for OFL
GENEVA FOR WHO/HOHMAN
USDA/FAS/OSTA BRANT, ROSENBLUM
USDA/APHIS ANNELLI

E.O. 12958: N/A
TAGS: TBIO EAGR AMGT PGOV ID KLIG
SUBJECT: INDONESIA - MARCH 6 AVIAN INFLUENZA UPDATE


1. (SBU) Summary. On March 3, Bayu Krisnamurthi, head of the
National Committee for Avian Influenza Control and Pandemic
Preparedness (KOMNAS) announced that Indonesia has had four cases of
bird flu since the beginning of 2009. However, Ministry of Health
(MOH)officials have not provided permission for the World Health
Organization (WHO) to post the results. Although the WHO Jakarta
office was aware of these cases, officials revealed that Indonesia
has not been reporting positive confirmed AI cases within 24 hours
as required by International Health Regulations (IHR) nor publicly
announcing cases each month. WHO plans to meet with the Ministry of
Health over the next ten days to press for IHR compliance. WHO
noted that a misunderstanding between the World Health Organization
(WHO) and the Ministry of Health (MOH) on AI case confirmation has
been resolved and may speed up reporting. The U.S. Department of
Agriculture's Animal and Plant Health Inspection Service (USDA
APHIS) continues to support biosecurity training in the commercial
poultry sector. The Ministry of Agriculture's (MOA) Participatory
Disease Surveillance and Control monthly reports show that data
tracks with the up-tick in human AI infections common for this time
of year. End Summary.

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Human Cases and IHR Compliance
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2. (SBU) On March 3, Bayu Krisnamurthi, head of the National
Committee for Avian Influenza Control and Pandemic Preparedness
(KOMNAS) announced that Indonesia has had four cases of bird flu
since the beginning of 2009. Although the data is limited, WHO
states that under normal circumstances for the rainy season, it
expects to see between six to eight cases in the month of January.
Since the beginning of the year, the Directorate General of
Communicable Disease and Environmental Health (DGCDEH) reported four
positive cases of H5N1 to WHO.


3. (SBU) The reporting of cases to WHO was strained in February when
the Minister of Health stated that the Government of Indonesia would
not confirm H5N1 cases unless the neuraminidase (N1) was laboratory
confirmed. Since the National Institute of Health Research and
Development only tests for the hemagglutinin (H5),DGCDEH could not
report the cases to WHO. In late February, WHO provided the Director
General of DGCDEH with documentation stating that for International
Health Regulations (IHR) compliance, WHO requires reporting of
confirmed hemagglutinin (H5) -- regardless of the neuraminidase
confirmation. Dr. Endang, the Chief AI scientist at NIHRD told WHO
that reporting should be back to "normal" now that the neuraminidase
issue was clarified. WHO officials also noted that although the
MOH had committed to reporting positive cases to WHO within 24 hours
and posting results monthly, MOH is now missing these deadlines.
WHO plans to discuss this with MOH officials over the next two weeks
and press for adherence to IHR requirements.

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Animal Health Activities
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4. (SBU) USDA APHIS is working with the Ministry of Agriculture and
the poultry industry on biosecurity. They supported two training
workshops on Biosecurity Assessments in January: one with 40 members
of the Poultry Breeder's association on January 20-23, and one with
20 government animal health inspectors on January 27-29. APHIS also
sponsored a Regional workshop on Funding Mechanisms for Outbreak
Containment and Compensation for 50 government and poultry industry
participants from Indonesia and another 50 from ASEAN countries on
February 24-25 in Jakarta.

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Status of Poultry AI Outbreaks
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5. (SBU) The MOA's Participatory Disease Surveillance and Control
Monthly Reports document the AI outbreak status of villages in the
331 (out of 444) districts covered by the Participatory Disease
Surveillance and Response (PDSR) program. For the four month period
from October 2008 through January 2009 the MOA reports village
infection rates of 2.1%, 2.3%, 5.3%, and 8.5%, respectively. The
increased infection rates in December and January track with the

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beginning of Indonesia's rainy season and mirror similar trends
during the past three rainy seasons. Since May 2008, PDSR animal
health officers have visited 14,086 villages (29.4% of the villages
in the 331 districts). Over the past six months, the MOA reports
implementing voluntary focal culling in 22.7% of infected villages.



6. (SBU) Although Indonesia is experiencing a seasonal upsurge in
poultry outbreaks, MOA data indicates gradually decreasing poultry
AI detection rates from 2006 to the present, even with increasing
surveillance visits. The data further indicates decreasing
geographic spread of AI, with no outbreaks in Kalimantan in well
over a year, and greatly reduced outbreaks in East Java since
mid-2007. However, Bali has experienced five incidents in February
and East Java experienced clusters of increased outbreaks during
January and February. Animal health experts in the MOA and the
United Nations' Food and Agriculture Organization (UN FAO) are using
the information gleaned from the improved data collection to focus
and strengthen village-level AI control.


7. (SBU) AI remains entrenched in the western half of Java and
southern Sumatra and concern continues about conditions in
commercial poultry farms. USDA, the United States Agency for
International Development, and other donors are implementing and
expanding AI control efforts in partnership with commercial
industry. Over the past year, the MOA has also increased efforts to
partner with commercial industry; however, they will need to
overcome significant, mutual distrust and gaps in partnership
expectations.

HUME