Wednesday, March 08, 2017

Watching Indonesia (Again)

Cirebon Indonesia


Although it may be an exercise in futility - since we often see cases reported in the Indonesian media only never to hear a follow up - Bahasan language media have been reporting on suspicious bird die offs, and suspected human infections with H5N1, on the island of Java for several days now.

This morning, the headlines are even more insistent, although these human cases are only `suspected' at this point.

A few examples include:
Two People Cirebon Declared Suspect Bird Flu  AFP

Two Residents Cirebon Insulated because Suspected Bird Flu Republika Online - 

2 Patient Suspect Bird Flu in Cirebon Treated in Isolation Room Jawa Pos (Press release) (blog)

The most recent report is:
Three Residents Suspect Bird Flu A Death Among

BANDUNG, (PR) .- A total of two people suspected of Cirebon suspect bird flu, is still undergoing treatment in hospital isolation room Gunungjati, Cirebon.

Meanwhile, a patient who is father of one of the patients, which is expected suspect bird flu, died Monday, March 6, 2017 last.

Outbreak of bird flu disease, causing hundreds of birds in Cirebon regency had to be destroyed. Two patients suspect bird flu had the initials AG (16), a resident Pangenan, and HS (64), a resident Greged, Cirebon. While died the DJ (57) who was the father of the AG. Both are undergoing treatment in hospital isolation room Gunungjati since Sunday, March 5, 2017.

"Both stated suspect bird flu," said Director General of Disease Prevention and Control Ministry of Health, M Subuh, while visiting Gunung Jati Hospital, Wednesday, March 8, 2017.

Both stated suspect bird flu after coming into contact with poultry infected with bird flu positive. According to Dawn, the certainty of the outcome, they have to wait for lab results. "Blood samples have been sent to the laboratory, the results will be known two or three days ahead," he said.

(Continue . .  )

Between 2005 and 2012 Indonesia reported roughly 190 human H5N1 infections -  well ahead of both Egypt and Vietnam, and sported one of the worst survival rates in the world. 

Poultry outbreaks were so numerous, they were no longer required to report them to the FAO.

Worse, reporting and surveillance out of Indonesia was often cloaked in secrecy, with the conspiracy-minded (now-ex) Health Minister Siti Fadillah Supari blocking the export of H5N1 virus samples to the WHO and shutting down America's NAMRU-2 (Naval Medical Research Unit) stationed in Jakarta.

The battle over Indonesia's official silence on avian flu cases became public in 2008 (see WHO: Indonesia Agrees To Resume Bird Flu Notifications), and while an agreement to report was evenutally announced, notifications remained patchy at best.
Gradually the number of human H5N1 cases reported by the MOH dwindled; from a high of 55 in 2006, to only 2 in 2015 and none last year. Exactly why cases have dropped so dramatically in Indonesia isn't clear.

The H5N1 virus is still endemic in Indonesia, and they are also vulnerable to seeing new strains or subtypes arrive via migratory birds.  So we'll keep one eye on these reports and hope we get some official clarification in the days to come.

No comments: