WHO: confirmation of H5N1 awaited in 2 Indonesian cases

Jul 21, 2005 (CIDRAP News) – The World Health Organization (WHO) announced today that only one of three deaths blamed on avian influenza in Indonesia this week is known so far to have been caused by the disease, saying test results are still awaited in the other two cases.

Meanwhile, the Indonesian government promised to take firmer measures to control the virus, which began killing poultry in the nation in 2003 but had caused no human deaths until now.

Indonesian officials announced yesterday that a 38-year-old man and his two young daughters were the nation's first H5N1 avian flu victims. The WHO said tests have confirmed that the man died of the illness. The daughters "died of severe pneumonia illness compatible with H5N1 infection," but confirmation was not yet available in their cases, the agency said.

"Limited samples were available from the 8-year-old daughter who died on 14 July, and the 1-year-old daughter who died on 9 July," the WHO said. Previous reports had listed the older daughter as being 9 years old.

The three victims lived near Jakarta. The 8-year-old fell ill on Jun 24 and was hospitalized Jun 28, the WHO said. The 1-year-old became ill Jun 29, and the father's symptoms began Jul 2. He died Jul 12 after about 5 days of hospitalization.

Samples from the father tested positive for H5N1 in WHO reference laboratories at the University of Hong Kong and at the US Centers for Disease Control and Prevention in Atlanta, the WHO said. Samples from the two children were still being tested.

Besides being Indonesia's first H5N1 deaths, the cases have raised concern about possible human-to-human transmission of the virus, because the three victims had no known contact with infected poultry.

Agence France-Presse (AFP) reported today that Indonesian officials promised to take stronger measures to control avian flu and admitted that they should have culled more poultry in past efforts.

Health Minister Siti Fadillah Supari said an outbreak occurred in April at a pig and chicken farm 9 miles from where the family lived, but only limited culling was done there, the AFP story said. Supari said it was possible that the victims were infected by the virus from the farm.

The story didn't specify whether the farm was one of several where pigs were found to be carrying the virus, as the government reported to the World Organization for Animal Health (OIE) in May. The farms were in the Tangerang district, where the three victims lived.

Supari said the poultry and pigs "should have been destroyed but it wasn't the case at that time because some of them were vaccinated," AFP reported.

She promised the government would take firm action, including culling, surveillance of people who might have been in affected areas, preparation of hospitals to treat patients, and an information campaign about the virus.

Agriculture Minister Anton Apriyanto said his agency would destroy animals on two pig farms in Tangerang and compensate the owners, according to a state news agency report cited by AFP. He said the ministry was allocating the equivalent of $10.7 million in emergency funds to tackle the disease.

Supari said 21 provinces have had avian flu outbreaks since 2003, the latest in North Sumatra; Jambi, part of Sumatra; and Banten, which includes Tangerang, the AFP report said.

The WHO said it was working with the Indonesian government and US Naval Medical Research Unit 2 to find potential sources of infection in the Indonesian cases.

Supari said about 300 people who had possible contact with the victims still have shown no signs of illness, AFP reported.

In other developments, the H5N1 virus was found in processed frozen duck meat shipped from China to Japan in 2003, according to an Associated Press (AP) report based on an article published online by the journal Virology.

The WHO said this was not the first time the virus had been found in processed meat, but added that the finding demonstrates the virus's toughness and widespread occurrence in Asian poultry flocks, the AP reported.

See also:

WHO statement
http://www.who.int/csr/don/2005_07_21a/en/index.html

Gift Opportunity

Ebola and Emerging Infectious Disease Fund

Your support is critical to ensure CIDRAP's capacity to respond. Your gift in any amount is deeply appreciated.

Newsletter Sign-up

Get news & practices.

Sign up now»

OUR UNDERWRITERS

Unrestricted financial support provided by

Bentson Foundation 3M United Health Foundation Gilead Become an underwriter»