VZCZCXRO9089
PP RUEHCHI RUEHDT RUEHHM
DE RUEHJA #2333/01 2361011
ZNR UUUUU ZZH
P 241011Z AUG 07
FM AMEMBASSY JAKARTA
TO RUEHC/SECSTATE WASHDC PRIORITY 5925
RUEHPH/CDC ATLANTA GA PRIORITY
INFO RUEAUSA/DEPT OF HHS WASHINGTON DC
RUEHRC/USDA FAS WASHDC
RHEHNSC/NSC WASHDC
RUEHZS/ASSOCIATION OF SOUTHEAST ASIAN NATIONS
RHHMUNA/HQ USPACOM HONOLULU HI
RHHMUNA/CDR USPACOM HONOLULU HI//J07/CATMED/CAT//
RUEHBK/AMEMBASSY BANGKOK 8102
RUEHBY/AMEMBASSY CANBERRA 1049
RUEHFR/AMEMBASSY PARIS 1026
RUEHGV/USMISSION GENEVA 7606

UNCLAS SECTION 01 OF 02 JAKARTA 002333 
 
SIPDIS 
 
SENSITIVE 
SIPDIS 
 
DEPT FOR EAP/MTS, G/AIAG AND OES 
USAID FOR ANE/CLEMENTS AND GH/CARROLL 
DEPT ALSO PASS TO HHS/WSTEIGER/MSTLOUIS AND HHS/NIH 
GENEVA FOR WHO/HOHMAN 
 
E.O. 12958: N/A 
TAGS: TBIO AMED CASC EAGR AMGT PGOV ID
SUBJECT: AVIAN INFLUENZA - BALI OUTBREAKS 
 
REF: A) Jakarta 2257 
 
¶1. (SBU) Summary. The confirmation of two human AI infections and a 
group of suspected cases have drawn international attention to Bali. 
 The Indonesian National Institute of Health Research and 
Development (NIHRD) determined H5N1 in two women from Bali and 
agreed to send the samples to the World Health Organization (WHO) 
Collaborating Center at the U.S. Centers for Disease Control (CDC) 
for research purposes only to ensure the virus had not mutated. 
NIHRD has determined the other suspected cases to be negative.  The 
Government of Indonesia (GOI) has deployed epidemiological teams to 
the villages of both victims to analyze possible transmission 
sources while authorities cull chickens.  Bayu Krisnamurthi, Chief 
Executive of the Indonesia National Committee for Avian Influenza 
Control and Pandemic Influenza Preparedness (KOMNAS) has assured us 
that the GOI and Bali authorities are aggressively handling the 
outbreaks.  He advised that local authorities are keeping the Bali 
tourism industry apprised of all developments.  End Summary. 
 
--------------------------------------------- --------- 
Human Cases: Two Confirmed Deaths, One Suspected Death 
--------------------------------------------- --------- 
 
¶2. (SBU) NIHRD has confirmed H5N1 in two recent deaths in Bali.  The 
first victim, a 29-year-old woman, died on August 12 in the Jembrana 
district. The woman's five-year-old daughter had died of an upper 
respiratory infection on August 4, but the family cremated the child 
before authorities could take a clinical sample.  On August 15, 
NIHRD authorized the transfer of a virus sample from the 29-year-old 
victim to the CDC for risk assessment purposes, to verify the virus 
had not mutated.  U.S. Naval Medical Research Unit Number Two 
(NAMRU-2) shipped the samples on August 16.  CDC authorities have 
confirmed H5N1 and are characterizing the isolated virus from the 
sample. 
 
¶3. (SBU) NIHRD confirmed H5NI in a second death at Bali's Sanglah 
Hospital in the Tabanan District on August 22.  The victim, who died 
on August 21, was a 28-year-old poultry distributor.  NIHRD 
authorized shipment of the sample, which NAMRU-2 sent to the CDC on 
August 23. 
 
¶4. (U) The Indonesian and international media have reported other 
suspected AI cases in Bali since August 22, including the infection 
of a 58-year-old male who came into contact with dead poultry at a 
waste disposal site where he worked. However, NIHRD tests conclude 
that these cases are negative for H5N1. 
 
--------------------------------------------- --------- 
Animal Outbreaks: Culling and Intensive Monitoring 
--------------------------------------------- --------- 
 
¶5. (SBU) Indonesian and U.N. Food and Agriculture Organization (FAO) 
authorities first detected avian influenza in poultry in Bali in 
¶2003.  Episodic outbreaks have continued in the Jembrana district 
and other districts since that time.  According to KOMNAS 
authorities, AI in the poultry population is endemic to 140 Bali 
villages. 
 
¶6. (SBU) Immediately following the reports of the H5N1 cases in 
Bali, Participatory Disease Surveillance and Response (PDS/PDR) 
teams deployed to both Jembrana and Tabanan districts and culled 
over 6,000 chickens.  The teams are also conducting ring vaccination 
around the infection area. Epidemiological teams and Balinese 
authorities are intensifying socialization activities among all 
villages so that residents will recognize and report poultry 
outbreaks.  A WHO doctor accompanied the GOI epidemiological field 
investigation team. 
 
----------------------------------------- 
Restaurants Remove Chickens from the Menu 
----------------------------------------- 
 
¶7. (U) In response to the recent deaths, a number of Balinese 
restaurants and hotels have dropped chicken from their menus. 
According to press reports, restaurants are taking this step as a 
precautionary measure.  The Head of the Bali Chapter of the 
 
JAKARTA 00002333  002 OF 002 
 
 
Indonesian Farmers Union reported that consumption remains average, 
adding that farmers have taken some bio-security precautions, for 
example, by spraying their chicken coops with disinfectant every two 
days. 
 
¶8. (U) Bayu Krisnamurthi, the Chief Executive of KOMNAS, has advised 
tourists to remain informed and be aware of precautionary practices. 
 Local authorities are keeping the tourist industry in Bali, 
including hotels, restaurants and tour companies apprised of 
developments. 
 
Hume