Indonesia on high alert over avian flu

Sep 19, 2005 (CIDRAP News) – Indonesia was on high alert over H5N1 avian influenza today, with at least two children hospitalized with suspected cases and Jakarta's zoo closed because of infected birds.

The latest suspected cases, following the death of a 37-year-old woman last week, prompted Health Minister Siti Fadillah Supari to declare an "extraordinary incident," Agence France-Presse (AFP) reported today. The declaration, used previously in some dengue fever outbreaks, means officials will focus special attention on the problem, the story said.

A Reuters report quoted Supari as saying, "It's a high alert. Every region is on alert so if at any time it occurs in remote areas, we are ready." But she said the government had not declared an emergency.

Two children, aged 7 and 9, were being treated for suspected avian flu at Sulianto Saroso Hospital in North Jakarta, the Jakarta Post reported. The 9-year-old was said to be a close relative of the 37-year-old woman who died of avian flu. Supari said blood samples were sent to a Hong Kong laboratory for testing, according to the story.

Other reports mentioned other suspected cases or gave different ages for the same patients.

An AFP report cited three possible cases. Quoting a health ministry spokesman identified only as Sumardi, the story said a 6-year-old girl was beginning to recover from suspected avian flu at a Jakarta hospital.

Bloomberg News, quoting Supari in a story published today, said two girls, aged 3 and 6 years, were being treated in Sulianto Saroso Hospital in Jakarta.

An online report in the Australian newspaper The Age mentioned four suspected cases in children, but gave no details except to say that one was in a 9-year-old boy who was related to the 37-year-old victim.

Meanwhile, the Ragunan Zoo in Jakarta was closed today after 19 of 27 samples from captive birds tested positive for avian flu, according to the Post. The zoo was to stay closed for 3 weeks to allow treatment of infected birds and testing of other animals and of the zoo's 500 employees. A zoo official said all the animals and workers were in good health, according to the story.

However, a health ministry official said two zoo workers appeared to be infected and would be referred to Sulianto Hospital, according to a Channelnewsasia report published this afternoon.

The birds that tested positive included peacocks, mynahs, wild ducks, pigmy chickens, eagles, and herons, the Post reported. Zoo officials said about 2,100 birds at the zoo would be tested, according to other reports.

Four deaths in Indonesia have been attributed to H5N1 avian flu so far, including the 37-year-old woman and a 38-year-old man and his two young daughters who died in July. But the World Health Organization (WHO) recognizes just one case, that of the 38-year-old man, as laboratory-confirmed.

The WHO's representative in Indonesia, Georg Petersen, said the reports of new suspected cases there reflect increased watchfulness, according to a Voice of America report. "I think the fact that several cases have been popping up in a short time shows us that hospitals have been alerted," he said.

The anxiety in Indonesia comes amid increasingly urgent warnings from the WHO that H5N1 virus is likely to trigger a human flu pandemic. WHO Director General Lee Jong-Wook issued another warning at the annual conference of WHO's Western Pacific Regional Committee today on New Caledonia in the South Pacific.

"The only condition missing is the emergence of a virus that is capable of rapid transmission among humans," Lee said, as quoted by Reuters.

In other news, the WHO said today that Vietnam has officially confirmed that a 35-year-old farmer who died Jul 31 had avian flu. His case had been reported by the news media in August. The WHO now says there have been 114 laboratory-confirmed cases of H5N1 avian flu, including 59 deaths, since December 2003. Vietnam has had 91 cases with 41 deaths, according to the WHO.

See also:

Sep 19 WHO statement
http://www.who.int/csr/don/2005_09_19/en/index.html

Aug 9 CIDRAP News story on 35-year-old man's death
http://www.cidrap.umn.edu/cidrap/content/influenza/avianflu/news/aug092005avian.html

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