29 Jan 2004, The Jakarta Post

Bali flu scare likely false alarm

A team of medical experts from the Ministry of Health that examined on Wednesday a toddler in Bali who was suspected of having been infected by bird flu concluded that he was suffering from a common acute respiratory infection.

However, they experts said but were still conducting tests to be on the safe side.
The 21-member team, which includes laboratory technicians and a pediatrician, visited Kadek Heri Dharmaputra at his family home in Senganan Kangin village, Tabanan, some 40 kilometers north of the provincial capital of Denpasar.

Heri, aged 3.5, was later examined by I Wayan Metri, a pediatrician with the Tabanan health agency.

"The boy displayed symptoms commonly associated with influenza. Dr. Metri later told me that it was a common respiratory infection," the head of the agency, I Ketut Sumiarta, told The Jakarta Post.

The boy's health had significantly improved but the agency still decided to take further samples of his body fluids for testing.

The director of the Bali health agency, Made Molin Yudiasa, had earlier said that Heri had been ill for 17 days, despite the fact that he had been brought to the local health facility, and that the medical team would determine whether his blood samples should be tested further in Jakarta.

The persistence of the symptoms and the fact that the boy's mother worked at a local poultry farm had worried the local health authorities. His mother had stressed that none of the fowl on the farm had displayed symptoms of avian influenza.

Health officials have advised all workers coming into contact with live poultry against returning home wearing their work clothes, and have advocated that hygiene be stepped up all round.

The Bali health agency has dispatched five teams across the province to check for any reports of bird flu infecting humans. The Ministry of Health has instructed that all farms suspected of housing fowl with symptoms of illness are to be quarantined. It is also taking blood samples from farm workers with symptoms of influenza.

The government admitted on Sunday the existence of bird flu in the country, saying that 40 percent of 4.7 million chickens had died of the disease since last August, but stressed there were was no proof that the strain of the virus in Indonesia could be passed on to humans.

Separately the government insisted that chickens from infected areas that were healthy could be sold on the market. However officials in Jakarta alone have admitted their lack of monitoring capabilities since 75 percent of the slaughterhouses in the nation's capital are illegal.

Coordinating Minister for People's Welfare Jusuf Kalla said Wednesday that ensuring adequate monitoring was the job of the country's governors.

As senior officials met in Bangkok to discuss bird flu, he reiterated that as farmers would cull sick chickens on their own, there was no need for the government to carry out a mass cull.

Despite farmers urging immediate action, Jusuf admitted that thus far there had been no coordination between his office and the ministries of agriculture, and trade and industry, which come under the supervision of the coordinating minister for the economy.

His office, Jusuf said, could not, for instance, push the Ministry of Trade and Industry to ban the transportation of the poultry products from infected areas.

In Yogyakarta, 500 farmers grouped in the Yogyakarta Poultry Breeders Association (Apayo) demanded that the provincial government immediately provide vaccinations free of charge and compensate them for the birds that had died or been culled.
Key facts on bird flu

* Avian influenza viruses are readily transmitted from farm to farm by mechanical means, such as by contaminated equipment, vehicles, feed, cages or clothing.
* The virus spreads to humans through air, and direct contact with birds' saliva and feces.
* The incubation period of the virus in humans is between one and three days. Highly pathogenic viruses can survive for long periods in the environment.
* Symptoms in humans include fever, cough, sore throat, muscle aches, eye infections, acute respiratory distress, viral pneumonia.

Source: World Health Organization