Emergencies preparedness, response

Avian influenza- situation in Indonesia – update 26

29 July 2005

Laboratory evidence now shows that the 8-year-old girl from Tangerang, Banten Province, is a probable avian influenza A/H5 case, based on analysis of serological samples. Two WHO Reference Laboratories at the University of Hong Kong and the Centers for Disease Control and Prevention USA, detected high positive rising microneutralisation titres specific for H5N1 in 2 samples taken 3 days apart.

She was the daughter of the confirmed case reported previously. Laboratory results for the 1-year-old daughter are still pending. Genotyping of the PCR-amplified isolate from the confirmed case shows high homogeneity with other H5N1 isolates from poultry in Java, and no evidence of reassortment.

Extensive epidemiological and environmental studies are ongoing around this family cluster. The Minister of Agriculture stated that laboratory results detected H5-infected bird faeces in a bird cage opposite side of the road of the family's house; cloacal and throat swabs of the pet bird inside the cage were negative for H5. This is the first, and, thus far, the only, indication of a possible source of exposure. Other environmental sampling was negative.

The Ministry of Health is continuing to monitor over 300 contacts. None of the contacts have shown any symptoms to date. Seroprevalence results are still pending. Surveillance has been intensified in affected areas and throughout the country. Forty-four referral hospitals have been identified and are being prepared to receive possible cases. Health education campaigns are being conducted nationwide.

The government has reinforced coordination between relevant government bodies, including the Ministries of Health and Agriculture, and is monitoring the situation in close collaboration with the World Health Organization.