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Cablegate: Avian Influenza - Bali Outbreaks

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

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