VZCZCXRO2749
OO RUEHCHI RUEHDT RUEHHM
DE RUEHJA #6812/01 1510959
ZNR UUUUU ZZH
O 310959Z MAY 06
FM AMEMBASSY JAKARTA
TO RUEHC/SECSTATE WASHDC PRIORITY 5015
RUEHPH/CDC ATLANTA GA PRIORITY
INFO RUEAUSA/DEPT OF HHS WASHINGTON DC IMMEDIATE
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 9529
RUEHFR/AMEMBASSY PARIS 0881
RUEHRO/AMEMBASSY ROME 1880
RUEHIN/AIT TAIPEI 1807
RUEHHK/AMCONSUL HONG KONG 2141
RUEHBJ/AMEMBASSY BEIJING 3451
RUEHHM/AMCONSUL HO CHI MINH CITY 0075
RUEHGZ/AMCONSUL GUANGZHOU 0233

UNCLAS SECTION 01 OF 02 JAKARTA 006812 
 
SIPDIS 
 
SIPDIS 
SENSITIVE 
 
DEPT FOR EAP/IET, A/MED AND S/ES-O 
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/BILL STEIGER AND AMAR BHAT 
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: MAY 31 AVIAN INFLUENZA UPDATE 
 
REF: A) Jakarta 6495 and previous 
 
JAKARTA 00006812  001.2 OF 002 
 
 
¶1. (SBU) Summary: Three additional cases of H5N1 infection 
have occurred in two locations in Indonesia since May 22 
(ref).  Two of these have resulted in fatalities, including 
a 10-year old girl and her 18-year old brother, both whom 
died 21 May in Bandung, West Java.  NAMRU-2 and the Ministry 
of Health (MOH) have also determined H5N1 exposure in a 12- 
year girl hospitalized in Padang, West Sumatra who 
reportedly cared for the bodies of two family members that 
recently died with symptoms consistent with H5N1 infection. 
Centers for Disease Control and Prevention (CDC) influenza 
specialist Dr. Tim Uyeki returned to Jakarta from Medan May 
27 and continues to work with the MOH in the investigation 
of the North Sumatran family cluster and other recent human 
AI cases.  As of May 31, post reports 54 human AI cases as 
confirmed or probable, with 40 resulting in fatalities (74 
percent).   End Summary. 
 
North Sumatran Cluster Update 
----------------------------- 
 
¶2. (SBU) CDC influenza specialist Dr. Tim Uyeki returned 
from Medan May 27, but will continue to help Dr. Tom Grein 
from the World Health Organization (WHO) in Geneva and the 
Ministry of Health (MOH) with the ongoing investigation of 
the family cluster and other human AI cases that have since 
emerged.  There is no evidence of additional cases outside 
of the large family cluster.  MOH officials will continue to 
monitor close contacts of the victims.  It appears that 
surviving family members and villagers of Kubu Simbelang in 
the Karo District have been more cooperative with the WHO 
team, but less so with MOH officials.  District health 
workers continue to follow about 30 villagers who had 
contact with the family and many of these are receiving 
oseltamivir. 
 
¶3. (SBU) Dr. Uyeki said he supports the WHO's plan to 
conduct a serological survey at a later date, after careful 
planning.  A serological survey could provide important 
additional information, including information about possible 
sub-clinical AI infections. 
 
¶4. (U) Ministry of Agriculture (MOA) officials said the MOA 
sent serum samples obtained from pigs in the Karo District 
of Medan to VLA Weybridge, United Kingdom, on May 25 for 
further testing.  In addition, Consulate Medan presented 
North Sumatra Ministry of Health officials in 
Kabanjahe with USAID Jakarta-produced posters and other 
material that they will use to spread awareness of how to 
diminish the risk of catching or spreading avian flu. 
 
Additional Cases in Java 
------------------------ 
 
¶5. (SBU) Three additional cases of H5N1 infection have 
occurred in other locations in Indonesia since reftel report 
May 22, 2006. Two have them have been fatal.  Details 
follow: 
 
 
JAKARTA 00006812  002 OF 002 
 
 
--- NAMRU-2 and NIHRD have determined H5N1 infection in a 12- 
year girl who cared for the bodies of two other family 
members who recently died of probable AI infection. The 
patient remains hospitalized in Padang with AI symptoms 
Confirmation by the US CDC and UHK results are pending. 
 
--- Both the U.S. CDC and the UHK have confirmed H5N1 
infection in a 39-year old male who died May 21 at the 
Infectious Disease Hospital in Jakarta. (reftel). 
 
--- A 10-year girl and her 18-year old brother were 
reportedly admitted May 22 with AI symptoms to the state-run 
Hasan Sidikin Hospital in Bandung and died a day later.  Dr. 
Nyoman Kandun, Director General of Communicable Disease 
Control and Environmental Health (CDC-EH or P2M) told the 
local press that the victims were probably infected by sick 
poultry.  He added that dead chickens were discovered a few 
days before the pair fell ill.  Provincial Animal Health 
officials reportedly culled up to 500 poultry within a half 
a mile of the siblings' home after having found four H5N1 
infected chickens in the area.  NIHRD and NAMRU-2 found 
samples from both patients to be positive for H5N1.  The WHO 
lab in Hong Kong confirmed infection in the case of the 10- 
year old female, while results on the 18 year-old are 
equivocal. 
 
Human AI Case Profile 
--------------------- 
 
¶6. (U) In the past week, the number of confirmed H5N1 cases 
in humans in Indonesia rose from 44 to 47, with 36 deaths 
(77 percent). 
 
¶7. (SBU) NAMRU-2 data indicates the following AI-related 
case profile as of May 31: 
 
-- Number of laboratory confirmed (positive PCR and/or 
serology) human AI cases: 47, of which 36 have been fatal 
(fatality rate of 77 percent). 
 
-- Number of probable AI cases: 7, with 4 deaths (fatality 
rate of 57 percent). 
 
-- Number of cases awaiting verification by the U.S. CDC: 3. 
 
-- Number of possible AI cases under investigation: 
approximately 24. 
 
-- Number of excluded AI cases: 302. 
 
PASCOE