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Viewing cable 07JAKARTA264, INDONESIA - JANUARY 30 AVIAN INFLUENZA (AI) UPDATE

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Reference ID Created Released Classification Origin
07JAKARTA264 2007-02-01 01:06 2011-08-24 01:00 UNCLASSIFIED//FOR OFFICIAL USE ONLY Embassy Jakarta
VZCZCXYZ0000
RR RUEHWEB

DE RUEHJA #0264/01 0320106
ZNR UUUUU ZZH
R 010106Z FEB 07
FM AMEMBASSY JAKARTA
TO RUEHC/SECSTATE WASHDC 3060
RUEHPH/CDC ATLANTA GA
INFO RUEAUSA/DEPT OF HHS WASHINGTON DC
RUEHRC/USDA FAS WASHDC
RHEHNSC/NSC WASHDC
RHMFIUU/BUMED WASHINGTON DC
RUEHBK/AMEMBASSY BANGKOK 7654
RUEHBY/AMEMBASSY CANBERRA 0364
RUEHRO/AMEMBASSY ROME 1972
RUEHFR/AMEMBASSY PARIS 0965
UNCLAS JAKARTA 000264 
 
SIPDIS 
 
SENSITIVE 
SIPDIS 
 
DEPT FOR EAP/MLS, EAP/IET, MED/DASHO/EMR AND MED 
DEPT FOR G/AIAG AND OES 
DEPT PASS TO USDA/FAS/DLP/HWETZEL AND FAS/ROSENBLUM 
DEPT ALSO PASS TO USDA/FAS/FAA/DEVER AND USDA/APHIS/ANNELLI 
DEPT ALSO PASS TO USDA/FAS/OTCB/ROSENBLUM AND USDA/AHHIS 
AUSTGEN 
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 
BANGKOK FOR APHIS/CARDENAS, RMO, CDC, USAID/RDM/A 
CANBERRA FOR APHIS/EDWARDS 
ROME FOR FAO 
NSC FOR JMELINE 
 
E.O. 12958: N/A 
TAGS: TBIO AMED CASC EAGR AMGT PGOV ID
SUBJECT: INDONESIA - JANUARY 30 AVIAN INFLUENZA (AI) UPDATE 
 
REF: A) Jakarta 00166    B) Jakarta 00107 
 
1. (SBU) Summary. The Mission is working to reverse a 
January 11 directive from the National Institute of Health 
and Research Development (NIHRD) instructing NAMRU-2 to no 
longer ship AI specimens to CDC until NAMRU-2 signs a 
Materials Transfer Agreement (MTA).  At a January 26 
ceremony, the Ambassador presented the GOI with 100,000 
USAID-provided kits of Personal Protective Equipment and 
1,000 decontamination kits for use in preventing the spread 
of bird flu.  USAID organized a 2-day workshop to harmonize 
mass media and behavior change communications messages on 
January 24-25.  On January 24, local press reports carried 
a claim by an Indonesian scientist that he had found the AI 
virus in flies.  Teams of health workers have slaughtered 
poultry in advance of Jakarta's February 1 ban on 
residential poultry.  The Mission's Naval Medical Research 
Unit (NAMRU-2) has confirmed two additional human AI cases 
since Ref A, both of whom have died. End Summary. 
 
NAMRU-2 Instructed To Stop Sample Shipments to CDC 
----------- ------------------------ --------------- 
 
2. (SBU)  On January 11, the National Institute of Health 
and Research Development verbally instructed NAMRU-2 to no 
longer ship AI specimens to the WHO Influenza Reference 
Center at the CDC until NAMRU-2 signs a Materials Transfer 
Agreement (MTA).  The decision came just a day after the 
GOI introduced text mandating an MTA during negotiations on 
a new NAMRU-2 Memorandum of Understanding.  The Mission is 
working hard to reverse this decision.  The Ambassador has 
raised the issue with Presidential Advisor Dino Djalal, 
Coordinating Minister for People's Welfare Aburizal Bakrie, 
and National Committee for AI Control and Pandemic 
Preparedness (KOMNAS) Executive Director Bayu Krisnamurthi. 
Djalal in turn told us he phoned Minister of Health Siti 
Fadilah Supari, who claimed the issue is a misunderstanding 
and promised to rectify it.  However, on January 31 NAMRU-2 
received a copy of a December 20 notice signed by Supari 
prohibiting the shipment of specimens out of Indonesia by 
any organization without the Ministry of Health's 
permission.  The DCM is scheduled to meet NIHRD Director 
Triono Soendoro on January 31 to further discuss the issue. 
 
Pascoe Presents Personal Protective Equipment 
---------- ---------------------- ------------- 
 
3. (U) On January 26, the Ambassador presented Coordinating 
Minister Bakrie with 100,000 kits of Personal Protective 
Equipment (PPEs) and 1,000 decontamination kits to be used 
in preventing the spread of bird flu here in Indonesia. 
The USAID-funded donation represents the first installment 
of a transfer of 200,000 sets of PPE and 2,000 
decontamination kits in 2007.  The PPEs and decontamination 
equipment include protective suits, respirators, goggles 
and gloves, and will enable Indonesia's AI Control programs 
to expand their efforts to increase avian influenza-related 
surveillance and detection.  The Ambassador also 
acknowledged the donation of almost 100K of equipment from 
USAID/NAMRU-2 for the AI laboratory at NIHRD. 
 
USAID Sponsors AI Communications Harmonization Workshop 
------------ -------------------------- ------------------- 
 
4. (U) USAID's Community-Based AI Control (CBAIC) program 
organized and sponsored a communications harmonization 
workshop on 24-25 January 2007 in Jakarta.  Over 70 
representatives from 25 Indonesian and international donor 
organizations attended the KOMNAS-hosted event.  The 
workshop resulted in agreement on communication strategies 
and messages in five key areas, including 1) bird to bird 
transmission; 2) bird to human transmission; 3) strategic 
positioning and branding; 4) pandemic simulation; and 5) 
institutional mechanisms for collaboration and 
coordination.  As a next step, a representative team formed 
from the workshop participants will finalize a 
communications guide book based on the results of the 
workshop.  Within the last 12 months, various GOI and donor 
agencies have launched eight separate communication 
initiatives without full coordination, raising the 
potential for conflicting or confusing messages. 
 
Indonesian Scientist Claims AI Found in Flies 
---------- ------------------------- ---------- 
 
5. (U) The Jakarta Post published an article on January 24 
claiming that Veterinary Pathologist Wasito of Gadja Madah 
University has found avian influenza virus present in 
flies.  Details of the research remain unknown.  If 
confirmed, the findings would suggest that flies may carry 
the virus in previously infected areas.  "We do not yet 
dare to say whether the avian influenza we found in the 
flies is low pathogenic or highly pathogenic.  We can only 
say that in flies, we also found the bird flu virus in 
organs," Wasito said.  Wasito did not say whether he 
planned to submit his research for publication. 
 
Health Teams Begin Jakarta Poultry Culling 
--------- ---------------------- ---------- 
 
6. (U) Throughout the week of January 21, teams of health 
works have slaughtered thousands of birds in Jakarta ahead 
of a February 1 ban on backyard poultry.  Until the end of 
January, the program to eliminate birds is essentially 
voluntary: residents may eat or kill their birds and will 
receive 12,500 rupiahs (about $1.40) compensation for each 
bird, if officials find no virus in the area.  Residents 
are not compensated if officials find evidence of infection 
nearby.  Effective February 1, authorities plan to 
confiscate without compensation all birds found on domestic 
premises without certification. 
 
NAMRU-2 Identifies Additional Cases 
--------------- -------------------- 
 
7. (SBU) NAMRU-2 reports two additional cases of human H5N1 
infection since Ref A, both of whom died.  The cases 
include a 32-year-old female from Garut and a six-year-old 
female from Magelang.  The 32-year-old female was admitted 
to the Dr. Slamet Hospital in Garut on January 16 and died 
January 20. The six-year-old was admitted to the Sardjito 
Hospital in Yogyakarta on January 19 after 11 days of 
illness and died the same day. She had initially been 
treated for typhoid fever at Morangan Hospital, near 
Magelang.  The NIHRD has not permitted NAMRU-2 to ship 
specimens from the two to the U.S. CDC. 
 
8. (SBU) NAMRU-2 data indicates the following AI-related 
case profile as of January 26: 
 
-- Number of laboratory confirmed (positive PCR and/or 
serology) human AI cases: 81, of which 63 have been fatal 
(case fatality rate of 78 percent). 
 
-- Number of probable AI cases: 4, of which 2 are fatal 
(case fatality rate of 50%). 
 
-- Number of cases awaiting analysis at the U.S. CDC: 0. 
 
-- Number of possible untested AI cases under investigation 
(last 30 days): 25. 
 
Note: NAMRU-2 data corresponds with Ministry of Health 
(MOH) data but may vary at times with AI case figures 
presented on the official World Health Organization (WHO) 
website, which usually lags NAMRU-2 data by one week.  The 
WHO website, last updated on January 22, notes 80 human AI 
cases in Indonesia with 62 deaths.  For WHO figures, log 
onto their website at 
www.who.int/csr/disease/avian_influenza. 
 
PASCOE