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Viewing cable 06JAKARTA8259, INDONESIA - JULY 3 AVIAN INFLUENZA (AI) UPDATE

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Reference ID Created Released Classification Origin
06JAKARTA8259 2006-07-03 08:20 2011-08-24 01:00 UNCLASSIFIED//FOR OFFICIAL USE ONLY Embassy Jakarta
VZCZCXRO7447
PP RUEHCHI RUEHDT RUEHHM
DE RUEHJA #8259/01 1840820
ZNR UUUUU ZZH
P 030820Z JUL 06
FM AMEMBASSY JAKARTA
TO RUEHC/SECSTATE WASHDC PRIORITY 6616
RUEHPH/CDC ATLANTA GA PRIORITY
INFO RUEAUSA/DEPT OF HHS WASHINGTON DC PRIORITY
RUEHZS/ASSOCIATION OF SOUTHEAST ASIAN NATIONS
RUEHRC/USDA FAS WASHDC
RHEHNSC/NSC WASHDC
RHMFIUU/BUMED WASHINGTON DC
RHEFDIA/DIA WASHINGTON DC
RUEKJCS/SECDEF WASHDC
RHHMUNA/CDR USPACOM HONOLULU HI
RUEKJCS/CJCS WASHDC
RUEHBY/AMEMBASSY CANBERRA 9686
RUEHFR/AMEMBASSY PARIS 0906
RUEHRO/AMEMBASSY ROME 1896
RUEHIN/AIT TAIPEI 1823
RUEHHK/AMCONSUL HONG KONG 2153
RUEHBJ/AMEMBASSY BEIJING 3503
RUEHHM/AMCONSUL HO CHI MINH CITY 0089
RUEHGZ/AMCONSUL GUANGZHOU 0245
UNCLAS SECTION 01 OF 03 JAKARTA 008259 
 
SIPDIS 
 
SIPDIS 
SENSITIVE 
 
DEPT FOR EAP/MLS, EAP/IET, A/MED AND S/ES-O 
DEPT FOR G/AIAG/JLANGE AND RFENDRICK 
DEPT FOR OES/FO, OES/EID, OES/PCI, OES/STC AND OES/IHA 
DEPT PASS TO USDA/FAS/DLP/HWETZEL AND FAS/ICD/LAIDIG 
DEPT ALSO PASS TO USDA/FAS/FAA/DYOUNG AND USDA/APHIS 
DEPT ALSO PASS TO USAID/ANE/CLEMENTS AND GH/CARROLL 
DEPT ALSO PASS TO HHS/WSTEIGER/ABHAT/MSTLOUIS AND HHS/NIH 
PARIS FOR FAS/AG MINISTER COUNSELOR 
CANBERRA FOR APHIS/DHANNAPEL 
ROME FOR FAO 
NSC FOR JMELINE 
BANGKOK FOR RMO, CDC, USAID/RDM/A 
USPACOM ALSO PASS TO J07 
 
E.O. 12958: N/A 
TAGS: TBIO AMED CASC EAGR AMGT PGOV ID KFLU
SUBJECT: INDONESIA - JULY 3 AVIAN INFLUENZA (AI) UPDATE 
 
REF: A) Jakarta 7626 and previous 
 
JAKARTA 00008259  001.2 OF 003 
 
 
1. (SBU) Summary: A Government of Indonesia (GOI) chaired AI 
experts group concluded on June 23 that limited human-to- 
human transmission took place during the May 2006 North 
Sumatra cluster.  However, the group noted that the 
confinement of the human-to-human transmission to the 
affected family and the absence of a mutation in the H5N1 
virus means there was no danger to the wider population. 
The group concluded that, based upon the findings from the 
Medan family cluster, the global pandemic alert level should 
remain at Phase 3.  USAID signed a USD 350,000 pilot project 
on June 26 that aims to strengthen Indonesia's capacity to 
detect and respond to AI outbreaks in poultry in three high 
priority provinces using cellular technology and the 
internet.  The WHO Influenza/H5N1 Reference Laboratory at 
the University of Hong Kong and the Indonesian National 
Institute of Health Research and Development (Litbangkes) 
have confirmed AI infection in a deceased, 5-year old boy, 
bringing the total number of confirmed H5N1 cases in 
Indonesia to 54, with 42 deaths.  End Summary. 
 
WHO Technical Review and Expert Consultation 
-------------------------------------------- 
 
2. (U) Indonesia's National Committee for Avian Influenza 
Control and Pandemic Influenza Preparedness (KOMNAS) and the 
World Health Organization (WHO) co-hosted a AI "Technical 
Review and International Expert Consultation Meeting" on 
June 21-23 in Jakarta.  AI experts from the WHO Geneva, the 
CDC, NAMRU-2, USDA/APHIS, the UN Food and Agriculture 
Organization (FAO), the World Bank, UNICEF, and the national 
public health institutes from Japan and France participated. 
KOMNAS Executive Director and Chair Bayu Krisnamurti and 
Coordinating Minister for Peoples' Welfare Aburizal Bakrie 
represented the GOI; neither Minister of Agriculture Anton 
Apriyantono nor Minister of Health Dr. Fadilah Supari 
participated. 
 
3. (U) The general purpose of the meeting was to review the 
current status of AI infection among human and animal 
populations and to share findings with the GOI (i.e., 
KOMNAS) and donor agencies.  Specific objectives included: 
 
--Review the status of the H5N1 virus in humans and animals 
in Indonesia. 
--Develop recommendations on how to control AI infection in 
both animals and humans. 
--Review lessons learned for rapid response and containment. 
--Develop an authoritative risk assessment of avian 
influenza in Indonesia in both human and animals. 
 
4. (SBU) Not surprisingly, the experts group concluded that 
the H5N1 virus is endemic in avian populations in many areas 
across Indonesia and that sporadic human cases are likely to 
continue until the infection in poultry is reduced.  The 
experts added that the full extent of AI infection in 
poultry remains unknown, and they recommended increased 
surveillance and more responsive compensation following 
 
JAKARTA 00008259  002.2 OF 003 
 
 
culls.  The committee credited Indonesia with making 
credible efforts to combat the disease in humans, but called 
for a more forceful effort in investigating cases, 
coordinating rapid responses and providing a clear public 
message.  The committee said it found no evidence that 
viruses isolated from human samples in Indonesia had 
reverted to become more easily transmissible. 
 
5. (SBU) The committee noted, however, that epidemiological 
and virological data from the North Sumatra family cluster 
supports the possibility of limited human-to-human 
transmission among infected blood relatives, a point 
Ministry of Health officials vigorously debated.  (Note: 
This portion of the WHO's report on the North Sumatra 
cluster was quickly leaked to the press and received wide 
media attention, to the consternation of the GOI.)  The 
experts group concluded that the global pandemic alert level 
had not advanced past phase 3, based upon the findings from 
the Medan family cluster.  However, a senior WHO 
epidemiologist told us the WHO Geneva would review its 
system of pandemic alerts to reduce ambiguity and confusion. 
 
6. (SBU) Minister Bakrie thanked the committee for 
acknowledging the positive responses of the GOI towards the 
AI crisis.  He also stated that in order to control 
infection in Indonesia donors needed to use every means to 
provide full funding as soon as possible for the 
implementation of Indonesia's national AI and pandemic flu 
plan. 
 
USAID Pilot Project for AI Detection 
------------------------------------ 
 
7. (U) On June 26, USAID signed a USD 350,000, 9-month 
agreement with Winrock/Voxiva to implement a pilot project 
aimed at strengthening Indonesia's capacity to prepare for, 
detect and respond to outbreaks of HPAI in poultry in three 
high priority provinces.  One of the three targeted 
provinces is Banten, location of the Indonesia - Singapore - 
U.S. trilateral project.  Using cellular technology and the 
internet, Winrock/Voxiva will assist Ministry of Agriculture 
agents in collecting timely information on AI outbreaks 
through existing mobile phone networks.  If successful, this 
activity could help accelerate early warning and reporting, 
and potentially be applied to other aspects of AI 
surveillance and response. 
 
Human AI Case Profile 
--------------------- 
 
8. (SBU) Over the July 1-2 weekend, the WHO Influenza/H5N1 
Reference Laboratory at the University of Hong Kong and the 
Indonesian National Institute of Health Research and 
Development (Litbangkes) confirmed AI infection in a 5-year 
old boy who died on June 16 at Dr. Iskak Hospital in 
Tulungagung, East Java.  NAMRU-2 data indicates the 
following AI-related case profile as of July 3: 
 
-- Number of laboratory confirmed (positive PCR and/or 
 
JAKARTA 00008259  003.2 OF 003 
 
 
serology) human AI cases: 54, of which 42 have been fatal 
(case fatality rate of 78 percent). 
 
-- Number of probable AI cases: 4, with 2 deaths (fatality 
rate of 50 percent). 
 
-- Number of cases awaiting verification by the US CDC: 1. 
 
-- Number of possible AI cases under investigation (last 30 
days): approximately 10. 
 
Pascoe