VZCZCXRO2271
PP RUEHCHI RUEHDT RUEHHM
DE RUEHJA #9914/01 2190848
ZNR UUUUU ZZH
P 070848Z AUG 06
FM AMEMBASSY JAKARTA
TO RUEHC/SECSTATE WASHDC PRIORITY 8386
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 9800
RUEHFR/AMEMBASSY PARIS 0924
RUEHRO/AMEMBASSY ROME 1908
RUEHIN/AIT TAIPEI 1836
RUEHHK/AMCONSUL HONG KONG 2171
RUEHBJ/AMEMBASSY BEIJING 3558
RUEHHM/AMCONSUL HO CHI MINH CITY 0105
RUEHGZ/AMCONSUL GUANGZHOU 0257

UNCLAS SECTION 01 OF 03 JAKARTA 009914 
 
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 4 AVIAN INFLUENZA (AI) UPDATE 
 
REF: A) Jakarta 09515 and previous 
 
JAKARTA 00009914  001.2 OF 003 
 
 
¶1. (SBU) Summary. On August 3, the Minister of Health Siti 
Fadilah Supari announced that, effective immediately, the 
GOI would no longer send samples to the WHO-Influenza 
Reference laboratory in Hong Kong.  Supari considers 
domestic laboratories, including U.S. NAMRU-2, sufficiently 
qualified to analyze samples.  The Ministry of Health (MOH) 
reported on August 3 that preliminary tests from an MOH 
laboratory were negative on seven individuals suspected of 
infection with avian influenza.  However, U.S. NAMRU-2 
tested samples from these same cases and found that one 
tested positive for H5N1 infection.  On August 2, the GOI 
announced that Avian Influenza (AI) has infected poultry in 
29 of the 33 provinces in Indonesia, including Bali.  On 
July 7, USAID started a new community-based program to 
combat AI via improved surveillance through volunteers that 
will reach villages in the most populated areas of 
Indonesia.  Teams are expected to be fully mobilized within 
three months.  As of August 4, data from the NAMRU-2 and the 
Ministry of Health (MOH) show a single new probable H5N1 
case in humans since reftel A.  Confirmed human cases of 
avian influenza in Indonesia remain at 56, with 44 confirmed 
deaths, a 79 percent fatality rate.  End Summary. 
 
GOI to Use Domestic Laboratories, 
Including NAMRU-2 
-------------------------------- 
 
¶2. (SBU) The Minister of Health Siti Fadilah Supari 
announced at an August 3 press conference that the GOI would 
stop sending samples to a World Health Organization (WHO)- 
sanctioned laboratory in Hong Kong, effective immediately. 
Supari considers that local laboratories, including the U.S. 
Naval Medical Research Unit-2 (NAMRU-2), laboratory are 
sufficiently qualified.  She also referred to the Eijkman 
Institute, a semi-autonomous institute that falls under the 
Ministry of Research and Technology.  NAMRU-2 will continue 
to send samples to the U.S. Centers for Disease Control 
(CDC). 
 
Medan New Cluster 
----------------- 
 
¶3. (SBU) Samples from seven ill residents of the Kabanjahe 
district, of the Karo regency, North Sumatra, the same site 
as the eight-member AI cluster in May, were tested for H5N1 
by both Ministry of Health and NAMRU-2 laboratories. (GOI 
routinely splits and shares samples of suspected AI cases 
with both laboratories.)  The MOH reported on August 3 that 
preliminary laboratory tests completed were negative. 
However, NAMRU-2 data indicates that one of the cases tested 
positive for H5N1.  NAMRU-2 will send this sample to CDC for 
confirmation.  Four of the seven individuals, all children 
remain hospitalized in Medan. 
 
AI Infected Poultry Discovered in Bali and Other Provinces 
--------------------------------------------- ------------ 
 
 
JAKARTA 00009914  002.2 OF 003 
 
 
¶4. (U) The Indonesian Ministry of Agriculture acknowledged 
that the AI virus has spread to 203 districts/cities in 29 
of the 33 provinces in Indonesia.  The GOI reported AI 
infected poultry in Bali on August 1.  Bali officials 
believe the source of transmission was poultry smuggled onto 
the island.  "The H5N1 strain of avian flu began sickening 
chickens on Bali about three weeks ago," said Memet 
Zulkarnain, an official at the Ministry of Agriculture's 
avian flu center.  Although the Bali provincial government 
has banned poultry imports, smuggling remains a problem due 
to the higher costs of purchasing poultry in Bali versus 
other areas.  For example, a duck purchased for ceremonial 
purposes in Bali would cost ten times the price (about USD 
5.10) of a duck acquired in Java (51 cents).  The provincial 
government conducted a culling of 273 ducks and native 
chickens.  The government is also spraying disinfectant 
around infected areas, slaughtering and burning the dead 
poultry.  The GOI has also reported outbreaks among poultry 
in Kupang (East Sumba) and East Nusa Tenggara.  So far, no 
cases have been found in West Nusa Tenggara. 
 
¶5. (U) The recent poultry outbreaks in Bali and North 
Sumatra were identified through USAID's animal surveillance 
program with the United Nations Food and Agriculture 
Organization (FAO).  The FAO teams began searching for AI in 
poultry and found it in Bali in late June and in Karo, North 
Sumatra in mid-July.  We have suspected that AI poultry 
outbreaks have been occurring on a regular basis in much of 
Indonesia and additional resources are helping to find them. 
When FAO identifies outbreaks, GOI response teams move in to 
contain with culling and other measures. 
 
USAID Assistance 
---------------- 
 
¶6. (U) As of July 21, 2006, USAID/Indonesia has fully 
obligated all Avian Influenza (AI) resources, including 
$11.5 million announced by Secretary Rice in March.  The 
total amount USAID/Indonesia has committed to fighting AI in 
Indonesia is $14.65 million.  USAID's comprehensive program 
for AI supports the Government of Indonesia National 
Strategy for Avian Influenza Control and Preparedness for 
Human Pandemic Influenza 2006-2008.  The program includes 
integrated public-and-private-sector AI surveillance and 
response for both animals and humans.  Other implementing 
partners include the U.N. Food and Agriculture Organization 
for animal sector surveillance and control; NAMRU-2 for 
human surveillance and support of vaccine development; WHO 
for human surveillance; and Winrock International for 
internet and mobile-phone-based rapid reporting and 
response. 
 
New USAID Community-Based Program 
---------------------------------- 
 
¶7. (U) USAID has established a new Community-Based Avian 
Influenza Control (CBAIC) program through a contract with 
Development Alternatives Inc. (DAI).  CBAIC will support a 
number of USAID initiatives, including assistance to 
 
JAKARTA 00009914  003.2 OF 003 
 
 
Indonesia's National Committee for AI Control and Influenza 
Pandemic Preparedness to facilitate coordination among all 
levels and sectors of the GOI.  The program will build upon 
existing community-based volunteer organizations whose 
members are already working in villages throughout the 
country.  The program will educate volunteers on AI 
preparedness, surveillance, prevention and containment, and 
on behavior change communications.  The CBAIC start-up team 
has been working in Indonesia since July 21. 
 
Human AI Case Profile 
--------------------- 
 
¶8. (SBU) NAMRU-2 reports a single new probable case since 
last reftel.  NAMRU-2 data indicates the following AI- 
related case profile as of August 4: 
 
-- Number of laboratory confirmed (positive PCR and/or 
serology) human AI cases: 56, of which 44 have been fatal 
(case fatality rate of 79 percent). 
 
-- Number of probable AI cases (awaiting WHO Laboratory 
confirmation): 5, with 2 deaths (fatality rate of 40 
percent). 
 
-- Number of cases awaiting verification by the US CDC: 1. 
 
-- Number of possible AI untested cases under investigation 
(last 30 days): approximately 11. 
 
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 July 26, notes 54 human AI cases in 
Indonesia with 42 deaths.  WHO figures can be accessed at 
www.who.int/csr/disease/avian_influenza. 
 
PASCOE