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Bird Flu - Archives

 
Indonesia
 

Indonesia: We Won't Share...Yet
The ABC reports:

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 samples.

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 samples.

August 12th, 2007

 

A Reservoir of Bird Flu
A warning:

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 countries.

``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 Organization reports:

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 Business Week:

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 the rich.

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 - isn't 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 purposes.

..."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

 

Good Luck
I find 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

 

Another Cluster?
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

The 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.

The 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.

Bloomberg reports:

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.

Antara News reports:

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.

The 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)?
Reuters reports:

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 seems 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

 

Miracle Survivor
In Indonesia a "miracle" survivor of bird flu has been released from hospital.

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.

And 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 41st human 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 transferred 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?
A 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 flu.

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 their recommendations.

...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 worried:

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 of 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 slats."


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 country.

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 bird flu cluster outbreak:

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 medicine.

"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 six further 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 chickens are dying in “unusually large numbers” in a remote area in Indonesia where bird flu killed several members of a family.

 

According to WHO 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."

 

Preliminary tests indicate that a brother and sister in West Java are the latest 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.

 

"Why should 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.

 

Rusli sells chickens and birds from his house, where he also sells animals like puppies, rabbits and even monkeys as pets, all from a single room.

 

The 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

The Australian newspaper carries a good report on the bird flu cluster outbreak in Indonesia, which has killed six members of one family.

 

In summary:

 

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."

 

Indonesian health 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 AP reports:

 

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.

 

[WHO epidemiologist 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 observed previously.

 

"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.
May 26th, 2006
 

Indonesia Bird Flu Update

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 stock markets.

 

A lengthy report on the Canadian 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 said.

 

…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.

 

Newsweek 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.

May 25th, 2006

 

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
Indonesia were 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 more questions.)
May 23rd, 2006

 

Indonesia – Deepening Concerns

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 have died.

 

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 East Java shuttlecock maker has also been diagnosed with bird flu.

May 22nd, 2006

 

Seven Deaths in Indonesia in 2006

The 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.

February 14th, 2006

 

Bird Flu Round-Up

Indonesia – the World Health Organization has confirmed the country’s eighth bird flu death. Altogether, there have been 13 confirmed cases of human infection in Indonesia.

December 7th, 2005

 

Another Indonesian Death

The Indonesian Health Ministry has announced another death – the country’s eighth – from bird flu.

December 1st, 2005

 

Tamiflu Update

Indonesia 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.

 

The Taiwan Intellectual Property Office is likely to authorize local production of Tamiflu, in violation of the rights of Roche and Gilead.

 

Roche chief executive Franz B. Humer has told the New York Times that it will announce in early December which companies will be allowed to start their own Tamiflu production.

November 28th, 2005

 

Bali Doesn’t Need This

Indonesian 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.

October 28th, 2005
 

WHO Updates

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 case.

 

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.

 

Meanwhile, the 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,

October 25th, 2005

 

News Round-Up (Most of It Bad)

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 here.

 

In Australia, three pigeons – part of a shipment of 102 racing and show pigeons from Canada – were found to have bird flu antibodies. Canadian quarantine authorities had reportedly certified the infected birds as disease-free.

 

Taiwan has reportedly discovered H5N1-infected birds that were being smuggled in from China.

 

A lengthy report in the Washington Post says Indonesia has been engaged in a two-year cover-up of its growing bird flu problem.

 

The Economist has an excellent report on the global fight against the virus.

October 21st, 2005

 

A Fifth Indonesian H5N1 Case

The World Health Organization has reported that another 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,

October 13th, 2005