Indonesia Confirms Bird Flu in Human

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By Alan Sipress
Washington Post Foreign Service
Thursday, June 16, 2005

JAKARTA, Indonesia, June 15 -- A farmworker in eastern Indonesia has tested positive for bird flu, health officials said Wednesday, in the country's first human case of the virus that has killed at least 54 people elsewhere in Southeast Asia.

The worker from southern Sulawesi island is healthy and has shown no symptoms of the illness, but two tests at a Hong Kong laboratory confirmed he had been infected by avian influenza, health officials said.

The laboratory results make Indonesia the fourth country to register a human case of bird flu, which international health experts warn could eventually undergo genetic changes, sparking a global pandemic.

Since 2003, the highly lethal disease has struck chickens, quail and other birds in 18 Indonesian provinces on seven islands, prompting the government to order a massive campaign to vaccinate poultry against the virus.

Indonesian health experts, however, had sought to ease public anxiety about the outbreak over the last year by saying the local virus was slightly different from the strain in other Asian countries and had demonstrated no capability to infect people.

Muhammad Nadhirin, chief of epidemiological surveillance at the Indonesian Health Ministry, confirmed that the Sulawesi laborer had tested positive for bird flu, adding that officials were hoping to conduct more tests on his sample.

The farmworker was first tested in late March after the epidemic spread to Sulawesi and killed at least 25,000 chickens. That outbreak prompted officials to limit the transfer of poultry off the island and take blood samples from laborers, veterinarians and others exposed to sick chickens. In total, 81 people were tested, and all but one of the samples came back negative, officials said.

Efforts to complete a second test in Hong Kong were prolonged in part because the farmworker had left his job and health investigators had to track him to his home village elsewhere on the island to get a sample.

The second test, finally completed this month, confirmed that the laborer had been infected but that the concentration of antibodies was relatively low, officials said. The finding meant the worker was no longer carrying the virus, but it was impossible to determine how long ago he had caught it, according to Hariadi Wibisono, a director of disease eradication at the Health Ministry.

Since late 2003, more than 100 people have been infected by bird flu in Vietnam, Thailand and Cambodia. In Vietnam, where the outbreak is most serious, health officials have reported at least five cases in which people had the disease but showed no symptoms.

Klaus Stohr, head of the World Health Organization's influenza program, said last month that it was not unprecedented for otherwise healthy poultry workers to test positive for bird flu. During a 1997 outbreak in Hong Kong, about 10 percent of workers in live poultry markets tested positive for the virus, health officials said.

Even if a person shows no symptoms, the infection still poses a serious health risk. Health experts worry that a human could catch avian influenza and an ordinary flu bug at the same time, presenting a chance for the viruses to swap genetic material and produce a new, lethal strain that could easily be passed among people. If this happens, WHO officials warn, tens of millions of people could die worldwide.

Researchers have also determined that bird flu has infected Indonesian pigs, another ominous development because a similar genetic change could occur in swine. Pigs, like people, can catch both avian and ordinary flu viruses.

Chairul Anwar Nidom, an influenza expert at Airlangga University in Surabaya, Indonesia, said in a February interview that he had discovered bird flu in blood samples taken from pigs on the outskirts of Jakarta. The pigs were from farms near a poultry outbreak in West Java province.

But despite Nidom's efforts to warn agriculture officials about his findings, the Indonesian government took weeks to follow up before conducting its own tests. Indonesia notified the World Animal Health Organization late last month that the virus had spread to pigs.

Special correspondent Yayu Yuniar contributed to this report.


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