CDC expecting H5N1 samples from Indonesia

Feb 22, 2008 (CIDRAP News) – An official from the US Centers for Disease Control and Prevention (CDC), which is a collaborating laboratory for the World Health Organization (WHO), today said Indonesia's health ministry is sending 15 H5N1 influenza samples for virus characterization, the first the country has shared since last year.

Nancy Cox, MD, chief of the CDC's influenza division, said today at a media update on the flu season that Indonesia's health minister called the CDC on Feb 20 to say the country would like to resume sending samples.

Cox said Indonesia's health ministry shipped 15 clinical samples to the CDC on Feb 22. She said the samples are from two patients whose infections were confirmed by the WHO on Feb 5 and Feb 12. The two patients were a 27-year-old woman from a Jakarta suburb who died on Feb 2 and a 15-year-old girl from another Jakarta suburb who was hospitalized with an H5N1 infection after her mother died of the disease.

"Based on past experience, the samples should arrive over the weekend or early next week," Cox said. "We expect to obtain results over the next 2 weeks."

In December 2006, Indonesia—the nation hardest hit by the H5N1 virus—stopped sending samples to WHO collaborating centers to protest pharmaceutical companies' use of the samples to develop vaccines that Indonesia said would be too expensive for developing nations to buy. A WHO group that has been meeting to resolve the virus-sharing issue failed to forge an agreement the last time it met in November.

Indonesia has shared only a few samples since the end of 2006. Last May it sent three to the WHO in advance of the World Health Assembly, but WHO officials later said the specimens contained no viable viruses. Indonesia also sent a sample to the CDC lab in August to show that an outbreak of human cases on the island of Bali did not involve a mutated strain.

Sari Setiogi, a spokeswoman for the WHO, told CIDRAP News today that the WHO has not received any details from Indonesia about the samples it is sharing and could not confirm the development.

Siti Fadilah Supari, Indonesia's health minister, said yesterday that the samples it sent are meant only for risk assessment, according to a report from the Associated Press (AP). "If they want to develop them into a seed virus they must notify us. If they make them into a vaccine our rights over [the vaccine] will be recognized," she told the AP.

Supari's announcement came at the end of a tumultuous week regarding the country's stance on sharing its H5N1 samples. Earlier this week, media outlets reported that Supari published a book alleging that the United States intended to produce a biological weapon with the H5N1 virus and the WHO was conspiring to profit from H5N1 vaccines.

Details about the book, titled Time for the World to Change: God is Behind the Avian Influenza Virus, were given in a Feb 8 press release from Indonesia's health ministry. However, the release did not list a publisher for the 182-page book.

Officials from the US State Department and WHO denied the claims Supari apparently made in her book, the Sydney (Australia) Morning Herald reported yesterday.

Indonesian President Susilo Bambang Yudhoyono reportedly ordered Supari to recall copies of her book, though he had authored its introduction, according to Morning Herald reports.

However, at a meeting with health ministry officials on Feb 20, Yudhoyono said he supported Supari's demand for fair international virus-sharing policies, according to a report from Reuters.

"We certainly need to form a partnership with WHO and friendly nations. We can only proceed if we agree on building and implementing a fair cooperation framework," he said at a news conference, according to Reuters.

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