MSNBC Bird flu explodes in Indonesia

[Guest guest]

>Bird flu explodes in Indonesia

>Indonesia averaged one human bird flu death

>every 2 1/2 days in May, putting it on pace to

>soon surpass Vietnam as the world's hardest-hit

>country.

>http://www.msnbc.msn.com/id/13070050/

Bird flu explodes among humans in Indonesia

Hard-hit nation reports new death every 2 1/2 days in May

The Associated Press

 

Updated: 2:55 p.m. PT May 31, 2006

 

JAKARTA, Indonesia - Indonesia averaged one human

bird flu death every 2 1/2 days in May, putting

it on pace to soon surpass Vietnam as the world's

hardest-hit country.

 

The latest death, announced Wednesday, was a

15-year-old boy whose preliminary tests were

positive for the H5N1 virus. It comes as

international health officials express growing

frustration that they must fight Indonesia's

bureaucracy as well as the disease.

 

" We're tying to fix this leak in the roof, and

there's a storm, " World Health Organization

spokesman Dick Thompson said. " The storm is that

the virus is in animals almost everywhere and the

lack of effective attention that's being

addressed to the problem. "

 

Indonesia, an archipelago of 17,000 islands with

a population of 220 million people, has a

patchwork of local, regional and national

bureaucracies that often send mixed messages. The

impression, health officials said, is often that

no one is truly at the helm.

 

" I don't think anyone can understand it unless

you come here and see it for yourself, " said

Steven Bjorge, a WHO epidemiologist in Jakarta.

" The amount of decentralization here is

breathtaking. "

 

He said Health Ministry officials often meet with

outside experts to formulate plans to fight bird

flu, but they are rarely implemented.

 

" Their power only extends to the walls of their

office, " Bjorge said, adding that the advice must

reach nearly 450 districts, where local officials

then decide whether to take action.

 

Indonesia has undergone a sometimes rocky

transition to democracy since dictator Suharto

was ousted in 1998, with many powers held by the

central government being transferred to regional

and community control.

 

But the process has been haphazard, and funding

and policy decisions are often at the whim of

inexperienced officials, mayors and village heads.

 

National government officials concede there is a problem.

 

" The local government has the money, thus the

power to decide what to prioritize, " said

Hariyadi Wibisono, director of communicable

disease control at the Ministry of Health. " If

some district sees bird flu as not important,

then we have a problem. "

 

Indonesia has logged at least 36 human deaths in

the past year - 25 since January - and is

expected to soon eclipse Vietnam's 42 fatalities.

The two countries make up the bulk of the world's

127 total deaths since the virus began spreading

in Asian poultry stocks in late 2003.

 

Family ties

Attention has been fixed on one village on

Sumatra island where six of seven relatives died

of bird flu. An eighth family member was buried

before samples were collected, but the WHO

considers her part of the cluster.

 

Experts have not been able to make a direct link

between the relatives and infected birds, which

has led them to suspect limited human-to-human

transmission. But no one outside the family of

blood relatives - no spouses - has fallen ill and

experts say the virus has not mutated.

 

Scientists believe human-to-human transmission

has occurred in a few other smaller family

clusters, all involving blood relatives. Experts

theorize that may mean some people have a genetic

susceptibility to the disease.

 

On Wednesday, WHO said 54 uninfected relatives

and contacts of the Indonesian family cluster are

under quarantine and are taking the antiviral

drug Tamiflu and being monitored by health

workers. The quarantine is voluntary and the

teams are also visiting all the homes in the

400-household village in North Sumatra to look

for signs of illness. It said there are no signs

the disease has spread since May 22.

 

Bird flu remains hard for people to catch, and

most human cases have been traced to contact with

infected birds. Experts fear the virus will

mutate into a highly contagious form that passes

easily among people, possible sparking a pandemic.

 

Experts say the best way to battle bird flu in

Indonesia is to tackle it in poultry. But that

message is not always getting through. Many local

governments have refused to carry out mass

poultry slaughters in infected areas, and

vaccination has been sporadic at best.

 

Such measures helped other hard-hit countries

like Vietnam and Thailand curb outbreaks. Both

have strong central governments that have taken a

leading role in the effort.

 

The U.N. Food and Agriculture Organization has

been working with officials to improve poultry

surveillance in Indonesia and quicken response

times to outbreaks.

 

But public awareness and bio-security standards

remain low in the densely populated countryside,

home to hundreds of millions of backyard chickens.

 

" It's not quite so easy here, where you have to

have the local authorities and provincial

authorities and national all on board, " said Jeff

Mariner, an animal health expert from Tufts

University working with the FAO in Jakarta.

 

" We find outbreaks every week scattered

throughout Java. It's a diffusely endemic

disease. In most districts, you can find it at

any time, " he said. " It's a staggering

undertaking in a decentralized country. "

Copyright 2006 The Associated Press. All rights

reserved. This material may not be published,

broadcast, rewritten or redistributed.

 

URL: http://www.msnbc.msn.com/id/13070050/

© 2006 MSNBC.com

 

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