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Minimal H5N1 Monitoring in Jakarta Indonesia Raises Concerns
September 12, 2005
Despite the WHO recommendation, the government conducted only a minor cull in Legok area in Tangerang, following the death of Iwan and his two children. Only 31 pigs and 40 ducks confirmed to be infected with avian influenza were slaughtered.
The above comments describe the limited culling by Indonesia after the deaths of 3 family members in Tangerang. Indonesia filed an OIE report in August showing that H5N1 infections were widespread in the area. This was demonstrated even though testing was very limited. In the victim's neighboring village of Dandang, negative data was reported for 3 chickens. However 1 of 2 fecal samples from the birdcage across the street was positive. Positive PCR data was also reported for 10 pigs and 10 ducks in Rancha Luh village in the Panongan sub-district of Tangerang. 15 PCR positive ducks were also found in another sub-district, Legok. As noted above, culling in that district was limited (the OIE report cited higher numbers, 32 pigs and 192 ducks, but also acknowledge that the culled animals only represented partial stamping out).
The current fatality is from the same suburban area southwest of Jakarta. The proximity of the most recent case and the limited testing and stamping out of infected birds and pigs raises serious doubts about the extent and effectiveness of monitoring human populations. Thus far all lab confirmed cases have been fatal, and a clear cut source of the infections has yet to be identified.
As birds begin to migrate into the area (see map), the potential for more dual infections and recombination is increased. The failure of Indonesia to seriously address this bird flu problem could mushroom into an international issue because of the urban nature of the Tangerang / Jakarta area and proximity to international airports.