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Outbreak of killer virus 'ignored' JAKARTA - If statistics are anything to go by, Umar bin Aup should be dead. Seven weeks ago in his village, Rancasalak on the south-western coast of Java, dozens of hens including some of his family's 14 birds started dying for reasons no one could explain. Then, in early August, after hundreds of fowl had succumbed and at least three people in the area had died in mysterious circumstances, Umar, 16, came down with a fever. 'A day later, I was finding it hard to breathe and then I started vomiting,' he told The Observer as he convalesced at home surrounded by his nine siblings. 'I hadn't been sick for three years so it was a surprise to me.'

It was only after Umar's health had deteriorated for four days that his father, Aup, took him to the nearest health centre, six miles away via bumpy unpaved roads and dirt tracks. After assessing the symptoms, Dr Heri Winarto asked if any birds had been dying in the area. 'On hearing the answer "hundreds", I strongly suspected it was bird flu, particularly since we'd had a similar case from a neighbouring village the day before,' he said. Two days later Umar tested positive for bird flu and was in an isolation room in the nearest hospital, 55 miles away in Garut.

In addition to the three who died and were buried before samples could be taken, two other people from the area tested positive for bird flu. Both have died. At least 10 other people have been treated with suspected bird flu. That it took at least six weeks as well as the deaths of hundreds of hens and probably three people for the authorities to become aware of a massive bird flu outbreak in their midst demonstrates just how poorly the sprawling archipelago is coping with containing the disease, let alone stamping it out.

'To be honest, we were taken by surprise,' said Memo Hermawan, the deputy head of Garut district, which includes Rancasalak. 'We thought that there would never be an outbreak in such a remote area. Now we know better.' Public awareness of what to do in an outbreak, particularly in remote areas, is almost non-existent. 'When birds started dying we just threw them in the nearest river or on the rubbish dump,' said Dede Andi, as he watched his 13-year-old son Gilang recover in hospital. 'I still don't really know what bird flu is except that it makes people sick.'

Of 64 confirmed human deaths from bird flu around the world this year, 35 have been in Indonesia. Last month, it overtook Vietnam as the country with the most deaths since the global outbreak began in 2003. But while Vietnam has not recorded a human death for more than 18 months, Indonesia's death toll is rising steadily. It is likely to continue doing so for many months to come. Surveillance systems integrating animal and human health sectors have been established in only a few dozen of the more than 420 districts around the country. By the end of the year, with international donor funding, this figure is expected to reach 150.

It is not just the tardiness in developing systems that raises doubts about the Indonesian government's commitment to fighting the disease. The proposed budget for next year is being cut by 15 per cent from this year's 29m. International experts estimate between three and five times that amount is needed if Indonesia is going to gain control of the epidemic by its stated goal of 2008. 'Unfortunately we've got various other issues that need our attention,' said Buyu Krisnamurthi, chief executive of the national bird flu commission. 'Just in the last few months there has been a massive earthquake in Yogyakarta, a tsunami in Pangandaran and there are many other illnesses.

'Bird flu is a global problem that needs global commitment and a global response. If the world is really concerned about bird flu in Indonesia it needs to contribute more.' Amid the gloom, those involved in combating the disease are clutching at straws of hope. One is that despite 29 of Indonesia's 33 provinces having bird flu outbreaks at epidemic levels in poultry populations and human deaths showing no signs of slowing, the disease has yet to mutate into a form that could cause human-to-human transmission and thus a global pandemic.

But one Jakarta-based international expert warned that considering the level of ignorance in places such as Garut is still so high even after a significant outbreak then the worst-case scenario of a major human pandemic cannot be ruled out. 'We've been lucky here so far and considering everything that's going on - or rather not going on - we're going to have to continue to be lucky for months to come,' he said.

Link to related event Related event:
Bird flu in Indonesia

Related blog entries (category 'Bird Flu') Related blog entries (category 'Bird Flu'):
25 August 2006 · Bird Flu sweeps across Indonesia
24 August 2006 · World Bank urges Indonesia to raise bird flu budget
24 August 2006 · WHO confirms 60th bird flu case, urges sequence sharing
22 August 2006 · Bekasi girl tests positive for bird flu-official
21 August 2006 · Indonesia plays down likelihood of bird flu cluster

Posted in Bird Flu @ 26 August 2006 14:19 CET by Jeroen · 'Blog' RSS feed · permalink

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