VZCZCXRO9267
PP RUEHCHI RUEHDT RUEHHM
DE RUEHJA #0140/01 2260412
ZNR UUUUU ZZH
P 140412Z AUG 06
FM AMEMBASSY JAKARTA
TO RUEHC/SECSTATE WASHDC PRIORITY 8649
RUEHPH/CDC ATLANTA GA PRIORITY
INFO RUEAUSA/DEPT OF HHS WASHINGTON DC PRIORITY
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 9844
RUEHFR/AMEMBASSY PARIS 0933
RUEHRO/AMEMBASSY ROME 1917
RUEHIN/AIT TAIPEI 1846
RUEHHK/AMCONSUL HONG KONG 2180
RUEHBJ/AMEMBASSY BEIJING 3590
RUEHHM/AMCONSUL HO CHI MINH CITY 0116
RUEHGZ/AMCONSUL GUANGZHOU 0266

UNCLAS SECTION 01 OF 03 JAKARTA 010140 
 
SIPDIS 
 
SIPDIS 
SENSITIVE 
 
DEPT FOR EAP/MLS, EAP/IET, A/MED AND S/ES-O 
DEPT FOR G/AIAG/JLANGE AND RFENDRICK 
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/WSTEIGER/ABHAT/MSTLOUIS AND HHS/NIH 
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 - AUGUST 11 AVIAN INFLUENZA (AI) UPDATE 
 
REF: A) Jakarta 09914 and previous 
 
JAKARTA 00010140  001.2 OF 003 
 
 
¶1. (SBU) Summary.  On August 9, Coordinating Minister for 
People's Welfare Aburizal Bakrie stated, according to the media, 
that Jakarta had yet to receive promised foreign aid to fight 
bird flu.  Bakrie's statement was puzzling and frustrating to 
donors.  The May 2006 Donor Coordination Meeting, hosted by the 
National Committee on Avian Influenza Management and Pandemic 
Alert (KOMNAS), identified over $30 million in donor assistance 
to Indonesia, with an additional $22 million in commitments of 
support.  Post continues to explore implications of the surprise 
August 3 announcement by the Minister of Health Siti Fadilah 
Supari about testing all AI samples using local laboratories. 
Dr. Triono Soendoro, the Director of the National Institutes of 
Health Research and Development (NIHRD), provided permission to 
ship samples to the U.S. Centers for Disease Control (CDC) on 
August 10.  Patients from the Medan H1N1 cluster recovered and 
several went home before being formally discharged on August 7. 
The Eijkman Institute continues to perform additional analyses on 
one sample from this cluster.  NAMRU-2 and the MOH held a USAID- 
funded conference in Bali to train 40 instructors to teach 
provincial officials how to respond to newly emerging human cases 
of H5N1.  According to the  media, Government of Indonesia (GOI) 
officials acknowledged on August 7 that avian influenza has 
spread to poultry in Papua.  NIHRD and NAMRU-2 identified two new 
fatal cases of H5N1.  Both victims (a 16-year-old male and a 17- 
year-old female) were from the greater Jakarta area.  Confirmed 
human cases of avian influenza in Indonesia are now at 58, with 
46 confirmed deaths, a 79 percent fatality rate.  End Summary. 
 
Bakrie Statement Puzzling 
------------------------- 
 
¶2. (SBU) At a meeting with senior GOI Agriculture and Health 
officials on August 2, Coordinating Minister for the People's 
Welfare Aburizal Bakrie stated Jakarta had yet to receive 
promised foreign aid to fight bird flu.  The statement was both 
puzzling and frustrating to donors.  The May 2006 Donor 
Coordination Meeting, hosted by KOMNAS, identified over $30 
million in donor assistance to Indonesia, with an additional $22 
million in commitments of support.  This assistance encompasses 
each of the goals identified in the National Strategy for Avian 
Influenza Control and Preparedness for Human Pandemic Influenza 
2006-2008.  The USG provides the greatest assistance with $14.65 
million obligated plus an additional $4 million projected. 
Additional foreign donor contributions include: Japan ($5.5 
million plus in-kind goods and services), Australia ($11.6 
million), Canada ($3.5 million) and the World Bank ($280,000 
obligated and finalizing a $10 million grant package.)  KOMNAS 
plans to host a two-day donor coordination meeting in Jakarta 
August 23-24, 2006. 
 
GOI to Use Domestic 
Laboratories, Including NAMRU-2 
------------------------------- 
 
¶3. (SBU) Post continues to research the implications of the 
August 3 surprise announcement about the GOI's intentions to test 
all AI cases using local laboratories.  Post is concerned that 
 
JAKARTA 00010140  002.2 OF 003 
 
 
under this new procedure, the NAMRU-2 practice of sending samples 
to CDC might be jeopardized.  On August 10, Dr. Triono Soendoro 
gave NAMRU-2 permission to ship samples from the two new cases 
(16 year-old male and 17 year-old female) to the U.S. CDC for 
testing.  The MOH also encouraged the release of sequence 
information on Indonesian-derived viruses from the World Health 
Organization (WHO)-Reference Laboratories at CDC and the 
University of Hong Kong.  In response, the CDC entered all data 
into GeneBank on August 4. 
 
Medan New Cluster 
----------------- 
 
¶4. (SBU) Samples from seven patients from the second suspected 
Medan Cluster (Kabanjahe district, Karo regency, North Sumatra) 
demonstrate that all were infected with an H1N1 Influenza virus. 
The patients recovered and left the hospital prior to formal 
discharge.  Some have joined in a lawsuit against the MOH and the 
President of Indonesia complaining of the stigma associated with 
suspected avian influenza.  Tests from a ten-year-old female from 
the cluster are ongoing at the Eijkman Insitute.  (Note: AI 
outbreaks in animals serve as a sentinel for possible human 
cases.  Identification of people with influenza-like illnesses in 
connection with animal outbreaks is a goal of the USAID-funded 
animal surveillance and response program.  It is necessary to 
identify human suspects early enough in their infection to 
receive proper health care, as well as to identify clusters.  As 
the animal surveillance and response program expands, we expect 
it will identify larger numbers of human suspects.) 
 
NAMRU-2 Training Seminar 
------------------------ 
 
¶5. (SBU) NAMRU-2 and the MOH organized a five-day, USAID-funded 
conference in Bali to teach teams of trainers how to instruct 
provincial and district outbreak responders about Avian 
Influenza.  Forty participants attended.  Dr. Erna Tresnaningsih, 
the Deputy Director of the National Institutes of Health Research 
and Development, opened the conference.  Both the WHO and USAID 
were represented. 
 
AI Infected Poultry in Papua 
---------------------------- 
 
¶6. (U) According to local media, the Indonesian Ministry of 
Agriculture acknowledged on August 7 that the AI virus has spread 
to Papua.  Based on laboratory analysis from the Bogor Veterinary 
Research Center conducted on July 19, three of 37 birds tested 
positive for H5N1.  On July 11, a farmer from a Sempan village in 
Timika reported to the provincial animal husbandry office that 
his chickens were sick.  Inspectors found birds with H5N1 
symptoms at his farm and also at the local traditional market. 
The regency culled 414 chickens from the area. 
 
Human AI Case Profile 
--------------------- 
 
¶7. (SBU) NAMRU-2 has confirmed two new fatal cases in the greater 
Jakarta area since last reftel, a 16-year-old male from Bekasi 
 
JAKARTA 00010140  003.2 OF 003 
 
 
and a 17-year-old female from Tangerang.  NAMRU-2 data indicates 
the following AI-related case profile as of August 11: 
 
-- Number of laboratory confirmed (positive PCR and/or serology) 
human AI cases: 58, of which 46 have been fatal (case fatality 
rate of 79 percent). 
 
-- Number of probable AI cases (awaiting WHO Laboratory 
confirmation): 4, with 2 deaths (fatality rate of 50 percent). 
 
-- Number of cases awaiting sequencing at the U.S. CDC: 2. 
 
-- Number of possible untested AI cases under investigation (last 
30 days): approximately 10. 
 
Note: NAMRU-2 data corresponds with Ministry of Health 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 August 9, 
notes 56 human AI cases in Indonesia with 44 deaths.  WHO figures 
can be accessed at www.who.int/csr/disease/avian_influenza. 
 
PASCOE