28 Jan 2004

Bird flu suspected in Balinese boy
Eva C. Komandjaja, The Jakarta Post, Jakarta

The Bali provincial health agency reported on Tuesday a suspected case of bird flu in a human being as the World Health Organization continued to recommend a mass cull of poultry in Indonesia.

Kadek Heri Darman, a child of 3.5 whose mother works at a chicken farm in Tabanan, was diagnosed of having symptoms similar to bird flu, the head of the Bali health agency, Made Molin Yudiasa, said.

He said a blood sample from the toddler would be sent immediately to Jakarta for further examination.

Yudiasa said the boy had been suffering from a fever for two weeks, and was taken to Sanglah hospital to have a blood sample taken.

"Information from my fellow physicians seems to indicate that he suffers from a flu that has similar symptoms to bird flu, but it will need a laboratory analysis to confirm whether he has been infected," Yudiasa said.

He said the boy was still at home and had begun to improve after taking medicine. Some of the boy's playmates had also suffered from flu but all had recovered.

The suspected case came only two days after the government confirmed a bird flu outbreak after keeping it secret from the public for months.

The government has claimed to have found no cases of bird flu crossing over into humans. The East Java health agency sent teams to several towns affected by the outbreak on Monday, but discovered no cases of bird flu in humans.

However, Gindo M. Simanjuntak, an epidemiologist from the National Institute of Health Research and Development, told The Jakarta Post that doctors had never diagnosed patients with bird flu symptoms as having been infected by the virus as the government had not acknowledged that the virus had reached Indonesia.

Separately, director of epidemiology at the Ministry of Health Indriyono Tantoro said on Tuesday that so far the government could not confirm whether the bird flu was caused by the H5N1 strain -- a highly pathogenic strain that can infect humans, until laboratory tests on blood samples taken from poultry farm employees had been completed.

The government, he said, would send the samples to WHO-sanctioned laboratories, such as the Centers for Disease Control and Prevention (CDC) in Atlanta.

It will take up to two weeks to get the test results.

Indriyono said the ministry had alerted provincial health agencies and Immigration Customs Quarantine (ICQ) offices across the country since Monday.

In Bangkok, Kumara Rai, director of communicable disease for WHO's Southeast Asia region, said he would urge Indonesia to kill poultry infected by bird flu, saying vaccination and other measures to fight the disease would not work.

Nine Asian countries have now confirmed they have been hit by bird flu, which has killed at least eight people and led to the slaughter or deaths of around 19 million chickens.

Rai said he would meet Indonesian officials at a conference in Bangkok Wednesday to discuss the outbreak and would "strongly recommend" they start a cull, AFP reported.
The Indonesian government has refused the standard measures, citing inadequate funds and fears that the move would be ineffective.

Georg Peterson, the WHO representative in Indonesia, told the Post that culling was necessary to control the disease as quarantining, the disinfection of poultry farms and vaccination would not be enough.

"But there is a possibility that the government will change its mind after a ministerial meeting in Thailand on Wednesday," Peterson said.

He hoped Indonesia would come up with a proper strategy in accordance with its situation so as to prevent the further spread of the disease.

According to the latest report, Thailand has exterminated some 9 million chickens while Vietnam has slaughtered more than 3 million. In Indonesia, over 40 percent of 4.7 million chickens have died from the bird flu.