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1.6 Million Chickens Bird Flu Infected in Indonesia

Recombinomics Commentary
March 16, 2005

>>  Agriculture Minister Anton Apriantono confirmed that the H5N1 virus was found in West Java e south Sulawesi where, in the last two months, it has killed more than 18,000 and 26,000 chickens respectively. The Minister also announced that his ministry was banning all poultry sales in and from the two provinces to prevent the spread of the disease.

According to Musni Suatmodo, a West Java animal husbandry official, Cirebon, Subang, Sukabumi and Indramayu regencies (districts) are hardest hit. At least 1.6 million chickens in a population of 6 million have been infected, he said, affecting more animals than last year's outbreak.

Arifin Daud, deputy chief of the South Sulawesi Office of the Agriculture Ministry's Livestock Department, said that the government distributed 200,000 doses of a locally-manufactured vaccine to try and stop the disease from spreading. He explained that in his province infected birds flu were found in the regencies of Maros, Sidrap, Wajo, Pinrang, Soppeng and Parepare.  <<

Infection of 1.6 million birds with H5N1 is cause for concern.  Although Indonesia has elected to control bird flu spread by using locally manufactured vaccine, the large number of infected birds raises questions about the success of such an approach.  Earlier reports indicated poultry in Indonesia was infected by both H5N1 and H7N1.

Co-circulation of H5N1 and H7N1 is cause for concern.  Dual infections of the same host can lead to exchange of genetic information via reassortment and recombination.  Although there have been no reported human H5N1 infections in Indonesia, the 2003 and 2004 isolates from Indonesia were of the Z genotype,  This is the same genotype found in Vietnam and Thailand where significant numbers of human infections and human-to-human transmissions have been reported.

In 2003 there was an H7N7 outbreak in The Netherlands, and although the human cases were mild, the human-to-human transmission was very efficient.  Dual infections of H7N1 and H5N1 in Indonesia could lead to a novel virus capable of efficient human-to-human transmission.

Monitoring of bird flu infections is complicated by dengue fever outbreaks and alerts.  In the 1918 flu pandemic, dengue fever was a frequent misdiagnosis for flu infections.  This confusion is of more than historical note, because the most cited case of H5N1 transmission from daughter to mother began with a misdiagnosis of dengue fever in the daughter.

Both West Java and South Sulawesi are on dengue fever alerts, which is also present in East Timor.  The East Timor outbreak is being investigated by NIID in Japan, the same organization that identified the H5N1 false negatives in Vietnam.  Application of their more sensitive PCR test for H5N1 to dengue fever patients in Indonesia and East Timor would be warranted in light of the widespread outbreak of H5N1 in Indonesian poultry.

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