VZCZCXYZ0006
RR RUEHWEB

DE RUEHJA #0431/01 0470838
ZNR UUUUU ZZH
R 160838Z FEB 07
FM AMEMBASSY JAKARTA
TO RUEHC/SECSTATE WASHDC 3327
RUEHPH/CDC ATLANTA GA
INFO RUEAUSA/DEPT OF HHS WASHINGTON DC
RUEHRC/USDA FAS WASHDC
RHEHNSC/NSC WASHDC
RHMFIUU/BUMED WASHINGTON DC
RUEHBK/AMEMBASSY BANGKOK 7706
RUEHBY/AMEMBASSY CANBERRA 0444
RUEHRO/AMEMBASSY ROME 1984
RUEHFR/AMEMBASSY PARIS 0981

UNCLAS JAKARTA 000431 
 
SIPDIS 
 
SENSITIVE 
SIPDIS 
 
DEPT FOR EAP/MLS, EAP/IET, MED/DASHO/EMR AND MED 
DEPT FOR G/AIAG AND OES 
DEPT PASS TO USDA/FAS/HWETZEL 
DEPT ALSO PASS TO USDA/FAS/FAA/DEVER AND USDA/APHIS/ANNELLI 
DEPT ALSO PASS TO USDA/FAS/OTCB/ROSENBLUM AND USDA/APHIS AUSTGEN 
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 
BANGKOK FOR APHIS/CARDENAS, RMO, CDC, USAID/RDM/A 
CANBERRA FOR APHIS/EDWARDS 
ROME FOR FAO 
NSC FOR JMELINE 
 
E.O. 12958: N/A 
TAGS: TBIO AMED CASC EAGR AMGT PGOV ID
SUBJECT: INDONESIA - FEB 16 AVIAN INFLUENZA (AI) UPDATE 
 
REF: A) Jakarta 00310    B) Jakarta 00264 and previous 
 
¶1. (SBU) Summary: The Ministry of Health (MOH) has announced four 
new AI cases since Ref A, including two fatalities, but NAMRU-2 
tested samples from two of these cases as negative for H5N1 
infection.  The discrepancy has forced local WHO authorities to 
wrestle with the classification of official AI case numbers for 
Indonesia given absence of credible confirmation.  While some 
hospitals are blocking access, NAMRU-2 continues to receive samples 
from the majority of hospitals in its surveillance network.  The 
Ministry of Agriculture (MOA) turned down a request from a USDA 
research lab for AI virus isolate sharing, as well as an offer to 
conduct collaborative research.  The Indonesian press continues to 
run stories about the standoff between the Government of Indonesia 
(GOI) and the World Health Organization (WHO) over AI sample 
sharing.  According to REDI Center Director Dr. Rodney Hoff, 
officials from the Singaporean Ministry of Health claim the 
Indonesian MOH has named a Project Director for the Tangerang 
trilateral project.  However, a key official from the National 
Committee on Avian Influenza Management and Pandemic Alert (KOMNAS) 
told Hoff that MOH has not notified KOMNAS of the appointment.  End 
Summary. 
 
New AI Cases and Conflicting Tests Results 
------------------------------------------- 
 
¶2. (SBU) During the week of February 5, the MOH confirmed two new AI 
cases involving an 11 year-old female from Jakarta and a 30 year-old 
male from Bandung.  However, NAMRU-2 ran several molecular tests on 
separate samples from the two patients, as well as serologic tests 
on the samples taken over four time points, but did not find 
evidence of H5N1 infection in either patient.  Both patients 
survived and their cases' general clinical and epidemiological 
features are inconsistent with earlier H5N1 patients.  NAMRU-2 
identified a human AH3 virus (normal human influenza) in the 48 
year-old mother of the 11 year-old female. 
 
¶3. (SBU) On February 11, the MOH announced two additional deaths 
attributed to infection from AI.  The first involved a 22 year-old 
woman, and the second, a nine-year-old boy.  Officials report that 
the woman had contact with dead chickens a week before she died. 
However, investigators at the National Institute of Health Research 
and Development (NIHRD) did not share samples from these cases with 
NAMRU-2 nor report the infection in the nine year-old male during 
discussions with NAMRU-2 on February 14. 
 
¶4. (SBU) Given the lack of corroboration on the four cases, the 
Jakarta WHO office is wrestling with how to classify them.  The WHO 
and NAMRU-2 are reporting 81 cases and 63 deaths in Indonesia 
pending additional sampling, while the MOH is now claiming 85 human 
H5N1 cases, with 65 deaths.  NAMRU-2 has continued to receive 
greater then 90% of potential AI samples from hospitals within its 
surveillance network.  A few hospitals have ceased sending samples 
pending clarification of GOI sample sharing policy but are banking 
the samples with the hope of sharing them later if the MOH grants 
permission.  Meanwhile, MOH is no longer sharing with NAMRU-2 
samples from suspected H5N1 patients picked up outside the 
surveillance hospital system. 
 
GOI Turns Down USDA Research Opportunity 
---------------------------------------- 
 
¶5. (U) On January 24, USDA's South East Poultry Research Laboratory 
in Athens, Georgia requested that Indonesia's chief veterinary 
officer Dr. H. Musny Suatmodjo release recent H5N1 isolates to the 
laboratory for vaccine efficacy studies and challenge tests.  USDA 
also offered to provide 2-3 months of training for an Indonesian 
scientist to participate in research at the laboratory and co-author 
any research related journal articles.  On February 14, Dr. Musny 
refused the collaboration opportunity, noting in his response that 
"a memorandum of understanding between Indonesian Government and a 
veterinary-based private company has been currently established to 
conduct a similar project in Indonesia" and thus he was unable to 
accept the offers.  WE are unaware of the identity of the private 
company. 
 
Press Discusses AI Sample Impasse 
---------------------------------- 
 
¶6. (U) The Indonesian press continues to run stories about the 
controversy surrounding sample sharing. The recent re-emergence of 
AI in Indonesia generated 11 stories in local media during the past 
week.  Stories have included WHO concern about the lack of sample 
sharing and also the Baxter-MOH Memorandum of Understanding. The 
Minister of Health continues to make accusations about misuse of 
past samples.  One press story quotes her as saying "we sent the 
samples to Hong Kong and the CDC on the recommendation of WHO for 
further diagnosis but apparently they were used for other purposes 
without our approval. It's enough."   The press has been quiet about 
implementation of Jakarta's municipal decree on eliminating backyard 
chickens by February 1, presumably due to serious flooding in 
Jakarta. 
 
Tangerang Trilateral Project Update 
----------------------------------- 
 
¶7. (U) During a two-day visit to Indonesia, Dr. Rodney Hoff, 
Director of the REDI Center briefed us on the latest developments in 
the Tangerang Trilateral project.  According to Hoff, officials at 
the Singaporean Ministry of Health claim the Indonesian MOH has 
named Gindo M. Simanjuntak as Director for the project.  However, in 
later discussions, KOMNAS Secretary Dr. Tri Satya Putri Naipospos 
told Hoff she was unaware of this development.  Hoff also noted that 
Singapore and Indonesia have not yet finalized the Tangerang 
Trilateral Project MOU. 
 
PASCOE