Bird Flu - Archives
Indonesia: We Won't Share...Yet
Indonesia has confirmed that it will not share live samples of bird flu
virus with the World Health Organisation (WHO) until it is guaranteed access
to affordable drugs to fight the disease.
The WHO has accused Indonesia, which has suffered more cases of the disease
than any other country, of putting the world at risk by failing to share
Indonesian Health Ministry spokeswoman Lily Sulistyowati says her country
was waiting for a new mechanism to be put in place to govern the sharing of
August 12th, 2007
A Reservoir of Bird Flu
The director general of the World Organisation for Animal Health, Dr
Bernard Vallat, said Indonesia was struggling to control bird flu and had
become a reservoir from which the disease could spread to neighbouring
``It is dangerous for Australia,'' Dr Vallat said last night...
``The situation in Indonesia is not good because there is no national chain
of command,'' Dr Vallat said.
``Small regions are independent, they say what they want, which is not good
for managing disasters.
``Disasters need strong political decisions to save the whole country, not
only part of the country.''
July 12th, 2007
Indonesia - More Bird Flu Cases
The World Health
WHO can now confirm 15 additional cases, including 13 deaths of human
infection with H5N1 avian influenza that occurred in Indonesia from the end
of January 2007 up to the present and has updated its table of confirmed
human cases accordingly.
Testing for H5N1 influenza virus infections is not done routinely by many
laboratories and among the laboratories that do test for H5N1, experience
and levels of diagnostic capacities can vary....WHO had previously required
external confirmation of laboratory results from Indonesia, but following a
formal on-site assessment of the capacity of national laboratory in Jakarta
to diagnose H5 avian influenza viruses, WHO will now accept the results from
the national laboratory, in collaboration with the Eijkman Institute without
further external confirmation.
The assessment was carried out by a WHO team of virologists and laboratory
scientists from the WHO Collaborating Centre in Tokyo, Japan, the national
influenza centres of India and Thailand, the WHO Regional Office for
South-East Asia and the WHO Country Office of Indonesia.
May 17th, 2007
Indonesia - Flexing Muscle? Holding Hostage?
I thought it was irresponsible of the Indonesian government to attempt to
withhold samples of the bird flu virus from international health
authorities. But it seems they might have a case. Here's
Indonesia's bold decision to withhold human bird flu virus samples from
the World Health Organization has created an international ruckus, but it
has also sent a clear message that poor countries have some leverage over
But will developing countries band together to try to ensure their people
have access to a bird flu vaccine that could potentially save hundreds of
millions in the event of a pandemic?
Indonesia, currently alone in flexing its muscle, has been accused by some
experts of holding hostage a virus that could be the key to survival during
a human flu pandemic. But the cash-strapped government says it has to make
sure that any vaccine produced globally -- likely to be expensive and scarce
-- does not just reach wealthy countries like the United States.
March 6th, 2007
You Can't Be Serious
Indonesia - where bird flu is more of a problem than anywhere else -
happy about the new Australian bird flu vaccine:
News this week that the Australian pharmaceuticals company CSL had
developed a vaccine against the H5N1 bird flu virus was met with alarm by
Indonesian Health Minister Siti Fadillah Supari.
He says Indonesia is seeking intellectual property rights over the
Indonesian strain of the virus on which the vaccine is based.
But CSL spokeswoman, Dr Rachel David, says it is not possible to "own"
strains of bird flu.
Dr David also says the vaccine is not being developed for commercial
..."It's not something we can profit out of and in fact it's not something
that we see as being a commercial exercise at all."
February 1st, 2007
this hard to believe:
Indonesia, which has the world's highest bird flu death toll, plans to
ramp up its fight against the virus and hopes to beat it by the end of 2007,
a government official said on Friday.
December 30th, 2006
Indonesia - Such a Lot to Be Done
Bird flu remains a
concern in Indonesia, according to David Nabarro, the UN's coordinator
for bird flu:
“Indonesia has the virus probably in 30 out of 33 provinces… now
Indonesia has had to move fast to completely redesign its animal health
services… the Government certainly is committed together with the UN to
making this happen but… still there’s such a lot to be done.”
Even inside Indonesia,
people seem to agree. The Jakarta Post reports:
The effectiveness of the government's plan to cage fowls in residential
areas as a move to curb the spread of the deadly avian influenza virus has
been met with scepticism.
The Indonesia Consumers Foundation chief Husna Zahier said Sunday that the
plan would be ineffective without a careful study of poultry and the
relationship with their owners.
"If people don't keep their habitat and poultry cages clean, then the policy
would be pretty much useless," she told The Jakarta Post.
October 27th, 2006
An Indonesian man with bird flu
may have caught it from his sister. Bloomberg quotes Ira Longini, a
University of Washington epidemiologist:
These human clusters of cases in Indonesia with apparent human-to-human
transmission are great cause for concern.
September 15th, 2006
Indonesia - Getting Worse, Part III
Jakarta Post reports:
Indonesia is reducing its budget for fighting bird flu next year because
emergency spending following a rash of natural disasters has left it short
of money, the government said Thursday.
Financial Times reports:
The World Bank chided Indonesia on Thursday for planning to decrease its
budget for combating bird flu even though experts are predicting a shortfall
of more than $150m in the funding deemed necessary to fight the virus in the
world’s hardest-hit nation.
Rich countries need to help fight bird flu in Indonesia, where the virus
has killed an average of one person a week this year, because it poses a
``quite severe'' threat to its economy, a World Bank official said.
The World Health Organization on Wednesday confirmed the 60th case of
human infection with the H5N1 strain of bird flu after a 6-year-old girl was
tested positive of having the virus. In a statement, the WHO said the girl
from Bekasi in West Java Province developed symptoms on Aug. 6 and was
hospitalized on Aug. 11.
Jakarta Post reports:
Another suspected human case of bird flu was reported Wednesday in
Simalungun regency near Medan, North Sumatra, despite the government's
assurances it is doing its utmost to bring the deadly virus under control.
August 25th, 2006
Indonesia - New Cluster?
A 35-year-old Indonesian woman has
died of bird flu, a week after her nine-year-old daughter also died. A
new bird flu family cluster is feared.
August 21st, 2006
Indonesia - Getting Worse (Again)?
A 9-year-old Indonesian girl who died this week had bird flu, and the
village where she lived is rife with the disease.
August 18th, 2006
Welcome to Bird Flu Confusion
Welcome to the land of bird flu confusion, says the Jakarta Post. It
everyone's to blame:
The media's job is to ensure that state officials do not feel comfortable
about continuing a laid-back approach to combating the virus -- the kind of
approach that sees thousands of people die in avoidable disasters and from
preventable diseases every year.
Officials are extremely practiced at picking up the ball in a public show
and then quietly dropping it behind their backs. And it is all too easy for
them to do this when the media all-too-often exhibits an extreme form of
attention deficit disorder.
August 12th, 2006
Our Best Just Isn't Good Enough
Everyone's talking about Indonesia, where things just seem to get worse.
Here's the BBC:
Infected poultry flocks have now been found in 27 of the country's 33
provinces, and even the 44 recorded human fatalities have been spread right
across the country.
"We're doing our best to try to stop this disease, but it seems that our
best just isn't good enough," said Bayu Krishnamurti, secretary of a
national committee set up by the government to fight bird flu.
August 10th, 2006
Sue the Government
Most people seem to be accusing the Indonesian government of being lax in
its response to the bird flu crisis in the country. So I guess the following
headline from the Jakarta Post is inevitable:
Parents to sue government over bird flu scare
August 5th, 2006
Indonesia a "miracle" survivor of bird flu has been released from
July 25th, 2006
Indonesia - Getting Worse, and Apathetic
This report in the New York Times says it all:
Indonesia is about to surpass Vietnam as the country hardest hit by avian
flu. And while Vietnam has not had a single human case or poultry outbreak
this year, public health officials and experts say the situation in
Indonesia is likely to get worse.
here's the Jakarta Post:
News that Indonesia has surpassed Vietnam in its number of bird flu
deaths is receiving an indifferent response from the public, as
international agencies scramble to find ways to contain the disease.
...Eka Faradhila, a 27-year-old who regularly patronizes an American fried
chicken chain restaurant, said she did not care whether the country's bird
flu toll ranked the lowest or the highest in the world.
"All I'm wondering is when we'll stop talking about it," Eka said Wednesday.
"There are other diseases that are more life-threatening, like dengue and
typhoid. The government cannot stop even these illnesses, so why worry about
bird flu, which has killed 42 people?" she added.
July 22nd, 2006
Grim Milestone Approaches for Indonesia
WHO has confirmed Indonesia's
bird flu death. This is just one less than the total for Vietnam, which
currently is the country with the most deaths. And reports from Indonesia
say the country's
42nd death has occurred, though this has yet to be confirmed by WHO.
July 17th, 2006
Not Before Time
Indonesian authorities have
the official in charge of animal health.
An agriculture ministry spokesman said Sjamsul Bahri's departure was part
of a routine rotation of personnel.
But because Mr Bahri was closely involved in handling the outbreak, there is
speculation that the worsening crisis contributed to his transfer.
Indonesia has been accused of not doing enough to stop bird flu spreading.
Meanwhile, an Indonesian official has called for
more international aid to
help fight bird flu in his country. But the country does not seem to be
helping its cause with its
tardiness in releasing a WHO report into the recent "cluster" cases of
bird flu within a family group.
July 14th, 2006
Indonesia - Checking Out
No surprises in the headline in The Financial Times: "Indonesia
‘failed in its response to bird flu’."
Among several points in the report:
Indonesia’s response to a fatal bird flu cluster was littered with
failings...and would have speeded rather than slowed the global spread of
the virus had it involved a pandemic strain of H5N1.
Indonesia has asked for a considerable sum of money to fight bird flu:
“It’s a little bit absurd. I don’t know why people don’t call them on
this,” said one expert. “What is this money going to be used for? It’s going
to be used to build government institutions that should be there in the
first place. It’s not [bird flu] specific. It’s things...any civilised
country should have.”
And then there is this:
With no laws to stop him, the father who died in the cluster checked
himself out of the hospital and went into hiding even as epidemiologists
were examining samples from him.
June 29th, 2006
Indonesia - Where's Plan B?
row has broken out between Indonesian authorities and aid donors in the
West over what is perceived as Indonesia's lack of action in fighting bird
The Financial Times reports:
Experts from the WHO, the UN Food and Agriculture Organisation (FAO),
Unicef and agencies including the US and European centres for disease
control will meet in Jakarta from Wednesday, almost a year after Indonesia
reported its first human fatality.
The meeting comes amid growing criticism of Jakarta’s response to the H5N1
threat, in particular its failure to control the spread of the virus in
animals. There has also been criticism that while Indonesia continues to
convene meetings with international experts it is doing little to implement
...Suspicion on both sides appears to be contributing to a stalemate with
donors over how to finance Jakarta’s plans.
...Indonesia’s plan was fine as it stood, one expert said yesterday. “But
it’s sort of academic if you’re not going to implement it. And if you’re not
going to implement it unless you get grant financing then what’s your Plan
B? Right now they don’t have a Plan B.”
June 19th, 2006
Indonesian Health Authorities - Can We Trust Them?
Some people in Indonesia are
An animal health expert with the Surabaya-based Airlangga University,
Chairul A. Nidom, said he would not be surprised if the government had
kept...information to itself for a time.
"The question is: who has actually panicked -- the government or the
public?" said Chairul, who claimed that his laboratory research in Japan
last year showed some of the H5N1 virus spreading in Indonesia had adopted
into forms receptive to humans.
Chairul said the government must be more transparent on this issue by giving
detailed information to the public to involve them in containing bird flu.
"If only the government had started being honest three years go, we wouldn't
be in the present situation," he said.
Kemal [Siregar, who chairs the Association of the Indonesian Public Health
Experts] further warned that if the government fails to share vital
information on the virus' spread, it would not only put the public at
greater risk of being uninformed, but also would draw international
criticism should a pandemic occur.
Incomplete information given to the public can only let the virus keep
spreading among humans, and that could lead to a pandemic, he said.
"If a pandemic occurs in Indonesia due to public ignorance, the world will
condemn us," he added.
June 12th, 2006
Out of the Frying Pan...
Merlin, a British charity working in the earthquake zone in Java, has warned
disease risks to survivors taking shelter in chicken sheds.
Dr Yolanda Bayugo, Merlin's health director in Indonesia, raised concerns
today with the Ministry of Health and the World Health Organization in
Yogyakarta and has asked for more tents to be supplied.
"We are concerned that people using poultry sheds as shelter are at risk
from avian flu and salmonella," said Dr Bayugo.
"In Pundong sub-district of Bantul, where about 35,000 people are homeless,
we found more than 100 people taking shelter in six large poultry sheds,"
she continued. "The sheds, built from bamboo, are each about 200 metres long
and are the only surviving structures in the area. One shed was new and had
not yet been used to keep chickens. Others, which had been cleared recently,
were only partially cleaned and still had chicken droppings lying on bamboo
Also in Indonesia, a nurse who has not had contact with poultry, but who had
treated two children who died of H5N1, is
herself now in hospital with "bird flu-like" symptoms.
June 3rd, 2006
Fighting Bird Flu, Fighting Indonesia's Bureaucracy
The headline is pretty blunt: "Bird
Flu Explodes in Indonesia."
Here is how the story begins:
Indonesia averaged one human bird flu death every 2 1/2 days in May,
putting it on pace to soon surpass Vietnam as the world's hardest-hit
The latest death, announced Wednesday, was a 15-year-old boy whose
preliminary tests were positive for the H5N1 virus. It comes as
international health officials express growing frustration that they must
fight Indonesia's bureaucracy as well as the disease.
Even worse, Indonesia is probably
under-reporting bird flu outbreaks:
Indonesia's decentralized government system has made controlling the
disease particularly difficult, experts from the United Nations Food and
Agriculture Organization said, allowing the virus to skip from one village
to the next.
While some countries meticulously report every single outbreak to the World
Organization for Animal Health, which tracks the disease, there has been no
reporting from the Indonesian government since April 24, even though
scientists presume that outbreaks crop up constantly.
"In their decentralized system, information does not always get back to
Jakarta," said Juan Lubroth, a senior veterinarian at the F.A.O. "The
information in Jakarta doesn't reflect what's happening on the ground."
June 1st, 2006
He Didn't Believe Us
Excellent on-the-scene reporting from the AP of the North Sumatra
The sole survivor in a cluster of Indonesian relatives infected with bird
flu lies in an open-air hospital room, chickens pecking outside his door and
visitors shuffling in and out without masks or protective gear.
The patient, Johannes Ginting, is still very weak but seems unconcerned. He
even fled the hospital when he first fell ill with the H5N1 virus, and has
since resisted treatment, balking at the bird flu drug Tamiflu and other
"We had actually given masks and gloves to the family, and we informed them
how dangerous this disease is, but they didn't cooperate with us," said
Nurrasyid Lubis, deputy director of Adam Malik Hospital. "We also informed
him how dangerous it is, but he didn't believe us."
Separately, the World Health Organization has reported
Indonesian bird flu cases, three of them fatal. It brings to 48 the
number of cases in the country, including 36 fatalities.
May 30th, 2006
Indonesia – Not Pretty
Reuters reports that
dying in “unusually large numbers” in a remote area in Indonesia where
bird flu killed several members of a family.
epidemiologist Steven Bjorge: ”What we're finding out the longer our team
stays up in that area is that there are many, many outbreaks in chickens
that always go unreported."
tests indicate that a brother and sister in West Java are the
victims in Indonesia.
And check out
a report from
The Jakarta Post, suggesting that Indonesia could get a lot worse
before it gets better:
One trader in
Medan, Yakin Rusli, does not use any sort of protective gear
during his daily contact with hundreds of chickens.
we be afraid of being infected with the bird flu virus? If it's time for us
to die, then surely we'll die, no need to be afraid," says Rusli, who has
been in the business for 30 years.
chickens and birds from his house, where he also sells animals like puppies,
rabbits and even monkeys as pets, all from a single room.
67-year-old is assisted by five of his children. Like Rusli, they also
handle the poultry without using protective gear.
May 27th, 2006
You'll Never Know the
Cause, and That's a Problem
newspaper carries a good report on the bird flu
cluster outbreak in Indonesia, which has killed six members of one
A team of the world's
leading avian flu experts has arrived in the remote village of Kubu
Sembelang in North Sumatra to investigate the deaths, which occurred during
the past three weeks.
However, the director
of the World Health Organisation's Collaborating Centre for Reference and
Research on Influenza in Melbourne, Ian Gust, said most of the evidence
would already have been destroyed.
"We've found with the
investigation of clusters in the past that by the time the investigators get
there, it's too late," he said yesterday. "Any infected birds that might
have been around have gone or been killed.
"You can't take the
adequate samples and you'll never know the cause, and that's a problem."
officials were not responding quickly enough to potential cases of the
disease, Dr Gust told The Australian.
So what happened? The
general consensus seems to be that human-to-human transmission has occurred,
but that the virus has not – so far - mutated.
The WHO has said it
is possible the disease may have spread through limited human-to-human
transmission in the latest cluster of cases, but it doesn't appear to have
spread outside the family.
So far, most human cases
have been traced to direct contact with infected birds.
Steven] Bjorge said the family members were in close physical proximity
while they were sick, including sleeping near one another.
He said there is no
reason for alarm because rare cases of human-to-human transmission have been
"Even though so many
people were tragically affected in this case, it hasn't really changed the
picture of avian influenza in Indonesia at this time," he said.
Indonesia Bird Flu
Has human-to-human bird
flu transmission occurred in Indonesia? We still don’t know, but many are
worried. It is even one of the factors in the current shakiness in global
A lengthy report on the
CTV website includes the following:
"We think that it may have been possible for the initial case to pass
H5N1 bird flu to her nephew who is 10 years old who may have then passed it
to his father -- that would be two generations of spread," the WHO's Maria
Cheng told CTV Newsnet.
…"They are examining
what is going on and they can't find an animal source of this infection,"
Peter Cordingley, spokesman for the Western Pacific region of the World
Health Organization, told The Associated Press.
"This is the first
time that we've been completely stumped" by a source for the infection, he
…Steven Bjorge, the
WHO team leader in the village of Kubu Sembelang, told the wire agency none
of the poultry in the area had tested positive for the H5N1 bird flu virus.
"We're not surprised
that there is possible human-to-human transmission," Bjorge said.
"The thing we're
looking for is whether it's sustained beyond the immediate cluster."
Isolated cases of
very limited human-to-human transmission have been documented but such cases
do not necessarily mark the emergency of a pandemic flu strain.
has a good on-the-spot report, suggesting that if/when a global pandemic
begins, Indonesia could well be the starting point.
The government says it can not afford to kill that many animals and it
admits its education of the farmers and peasants is off to a slow start.
That was evident in
Kubu Sembilang where the people told this reporter they had never heard of
avian flu. And even after the death of their seven neighbors, most villagers
still believed that "evil spirits" killed the victims.
We Want Answers
Medical News Today has questions about Tamiflu:
Mike Leavitt, US
Health and Human Services Secretary, says US stocks of Tamiflu are being
sent to a safe location in some unnamed Asian country. He said this move is
to help the first line of defence in case a flu pandemic breaks out.
Many wonder why this
sudden move was announced. Why is the country unnamed?
And about that mystery
“cluster” of bird flu cases in a North Sumatra village:
Last week it was announced that 7 members of the same family in
infected with the H5N1 bird flu strain - six of them died. The World Health
Organization said it was unlikely that such a large cluster of human
infections was due to human-to-human transmission. However, nobody seems to
be able to locate the source of infection.
If a bunch of people
get infected and authorities cannot find any birds as the source, it is not
illogical to wonder whether these people may have infected each other. When
the WHO says this is unlikely, but cannot offer any other explanation
regarding the source of infection, people wonder.
They’re good questions.
How long will we have to wait for answers? (And check out
Recombinomics for a detailed analysis of the Indonesian cluster, and
Indonesia – Deepening
Indonesia seems to be
the focus of attention right now for bird flu watchers. Officials are
concerned that a “cluster” of cases in a North Sumatra village could mean
human-to-human transmission has occurred.
The Indonesian case cluster is the largest seen to date, with at least
seven members of an extended family - and perhaps more - falling ill to the
disease in the village of Kubu Sembelang in North Sumatra. Six of the seven
Only six of the cases
have confirmed as H5N1 cases; no samples were taken from the initial case, a
37-year-old woman who died and was buried in early May.
At least one
suspected additional case in the same family - the father of a 10-year-old
boy who died - has raised the spectre of possible person-to-person spread.
But more than three
weeks after the first woman fell ill, investigators from the WHO and
elsewhere are still trying to determine if the man is infected, what the
source of the infections is and how far, if at all, illness has spread.
Fear in the village
is running high, according to local reports, which also point to a
reluctance on the part of villagers to co-operate with authorities trying to
investigate the outbreak.
Read more at
Medical News Today. Meanwhile, an 18-year-old
shuttlecock maker has also been diagnosed with bird flu.
Seven Deaths in
Indonesia in 2006
reporting by WHO of two more bird flu deaths in Indonesia brings to
seven the confirmed fatalities from H5N1 in that country in 2006. Turkey is
next, with four deaths during 2006, followed by China with three deaths and
Iraq with one. Vietnam has reported the most bird flu deaths altogether – 42
in total – but none during 2006.
– the World Health
Organization has confirmed the country’s eighth bird flu death.
Altogether, there have been 13 confirmed cases of human infection in
Indonesian Health Ministry has announced
death – the country’s eighth – from bird flu.
will start manufacturing Tamiflu in three to five months. Roche, which has
production rights for the drug, and Gilead Sciences, which developed it, do
not hold an Indonesian patent. It is likely that manufacture will be carried
out by two state-owned drugs companies, PT Kimia Farma and PT Indofarma,
using raw materials sourced from China, India and South Korea.
Intellectual Property Office is likely to authorize
local production of Tamiflu, in violation of the rights of Roche and
executive Franz B. Humer has told the
York Times that it will announce in early December which companies
will be allowed to start their own Tamiflu production.
Doesn’t Need This
officials are investigating the deaths of dozens of chickens on the
island of Bali, in case of bird flu. Bali relies heavily on tourism, and
its economy has already been hit hard by terrorist bombings.
WHO has officially
announced another case of bird flu human infection in Thailand, a
seven-year-old boy who has now recovered. It is the country’s 19th
WHO has also reported
that in Indonesia a four-year-old boy has been confirmed as having had bird
flu. He has now recovered. And a man who died at the end of September is now
confirmed as having died of bird flu. These are Indonesia’s sixth and
seventh bird flu cases, with four deaths. This brings to 62 the total number
of deaths since the end of 2003.
Bangkok Post reports two possible new cases of human bird flu
infection. A poultry farm worker is in hospital in Nakhon Pathom province
and a young girl is being treated in Kanchanaburi province,
News Round-Up (Most of
The Thai government has
confirmed its first
bird flu fatality in a year. It is the country’s 13th bird
flu death. The official WHO announcement is
Australia, three pigeons – part of a shipment of 102 racing and show
pigeons from Canada – were found to have bird flu antibodies.
quarantine authorities had reportedly certified the infected birds as
has reportedly discovered H5N1-infected birds that were being smuggled in
A lengthy report in the
Washington Post says Indonesia has been engaged in a two-year cover-up
of its growing bird flu problem.
has an excellent report on the global fight against the virus.
Indonesian H5N1 Case
Health Organization has
human case of H5N1 flu has been confirmed in Indonesia. The patient is in
hospital in a stable condition. This brings to five the total number of
confirmed Indonesian cases, with three deaths,