Photo Credit – FAO
# 6111
Virologist Chairul Anwar Nidom of the Institute of Tropical Disease, Airlangga University probably knows more about how the H5N1 virus is evolving in Indonesia than anyone else.
Regular readers of this blog have come across his name dozens of times over the past few years, including here, here, and here.
Dr. Nidom demonstrated in 2006 that 20% of feral cats he tested in Jakarta carried antibodies to the H5N1 virus (see here), and his team has detected the bird flu virus in pigs as well (see When Pigs Flu).
Today we’ve a long article by Dr. Nidom appearing in the Indonesian newspaper Kompas on the fight against bird flu, and some of the obstacles that lie ahead.
The bad news here is that his remarks are in the Indonesian language (Bahasan), and we must content ourselves with machine translations which can sometimes lose a bit in the process.
Despite this impediment, we can glean a good deal from Dr. Nidom’s article. A hat tip to Diane Morin and Sharon Sanders of FluTrackers for this find.
I’ve links to two different translations below - which I encourage you to read - followed by a bullet list of some of his main points.
As you’ll see, the finished product varies somewhat between the Google Translation and the Microsoft translation. It really takes reading both of them to get the most out of this story.
Via Microsoft’s Bing Translator:
and from Google’s Translator:
Among the points raised by Dr. Nidom:.
- Of the 33 provinces in Indonesia, 32 are endemic areas of bird flu in poultry and other animals.
- Control measures have not made visible progress over the past eight years.
- The National Commission on Bird Flu was disbanded last year, and they still await the Disease Control National Zoonoses program which they hope will have more impact.
- Unlike most cases in the past, officials have been unable to establish a link to infected poultry in the recent human cases in Bali, Jakarta and Tangerang.
- Dr. Nidom asks for a fatwa, or religious regulation so victims of bird flu or other contagious diseases can be autopsied (rarely done now due to cultural, societal, and religious reasons).
- He goes on to say that hospitals need to be trained to recognize and treat the H5N1 virus, and that it is likely that many cases go undiagnosed. He likens the number of cases we see to the `tip of the iceberg’.
- He calls for vaccination (when available) for people at the highest risk – particularly those living in the `triangle of bird flu, namely Jakarta, West Java, and Jakarta’, and suggests that Oseltamivir be made available over the counter.
- Dr. Nidom warns that the co-circulation of influenza viruses (H1N1, H3N2, H5N1) in Indonesia may lead to a reassortment, producing new – potentially dangerous – strains.
- At one point Dr. Nidom states (ToggleText Translation): In 2006, was carried out by the "artificial" mutation in the virus H5N1 from the poultry in Indonesia without the coalition. Evidently the virus H5N1 the poultry that formed a coalition with H3N2 more virulent (see PNAS: H3N2 And H5N1 Reassortment).
- One of the concerns expressed by Dr. Nidom in the past is that vaccines – as they lose their effectiveness – could mask the symptoms of bird flu in poultry, but still allow the virus to spread. (see Bird Flu: Confusing Reports Out Of Indonesia). He reports today: Healthy chickens positive for bird flu are located in Riau, Central Java, East Kalimantan, West Kalimantan and South Kalimantan.
- Dr. Nidom warns that a (shift/drift/coalition) of the virus could result in human-to-human transmission of the virus and concludes by saying: It is very important for Indonesia to confront the pandemic, given our region an ideal place of the coalition. All strains are available, while structuring the environment of animals and humans remains unclear.
While these are most of the highlights, there is more to glean from this article, and should we see a better translation I’ll certainly post the link.
In the meantime, there is much to consider here.
