[Kabar-indonesia] Indonesia needs US$50m to beat bird flu in poultry: UN expert [+WSJ; ST]

[JoyoNews at aol.com]

also: WSJ: Details of Bird Flu Deaths Offer View Into Why, How the Disease 
Kills [incl: Indonesia]; and ST/Jakarta: 'Culling law needed' to tackle H5N1 
virus [Lack of funds for compensation a big drawback, says government]

Indonesia needs US$50 million to beat bird flu in poultry: UN expert

JAKARTA, June 21 (AP) - Indonesia needs donors to give it US$50
million (euro40 million) over the next three years to establish a
system capable of fighting bird flu in poultry, a U.N. animal health
expert said Wednesday.

Peter Roeder, from the world body's Food and Agriculture Organization,
said the money should be used to strengthen surveillance, coordination
and rapid response systems in the country's agricultural sector.

"If we had an injection of 50 million dollars over three years in the
ministry of agriculture, we could develop the capacity to deal with
avian influenza," said Roeder on the sidelines of an international
meeting of bird flu experts in the Indonesian capital.

Indonesia is on course to soon overtake Vietnam in human bird flu cases.

A WHO-approved laboratory in Hong Kong confirmed Tuesday that a
teenage boy from Jakarta died last week of the disease, pushing the
country's toll to 39, second only to Vietnam, which has 42.

Experts fear the virus will mutate into a form that is highly
contagious among humans, potentially sparking a pandemic. So far, most
human cases have been traced to contact with infected birds.

Eliminating the virus in birds is the best way to stop human infections.

Indonesia has said it will need US$900 million (euro710 million) over
the next three years to fight the H5N1 virus in humans and animals,
but has only budgeted US$59 million (euro46 million) for 2006.

The meeting in Jakarta comes a month after Indonesia reported the
world's largest reported family cluster. Six of seven family members
from a remote farming village on Sumatra island died after testing
positive for the bird flu virus. An eighth relative was buried before
samples could be taken, but WHO considers her part of the cluster.

Scientists have not been able to link the infected relatives to
contact with sick birds and believe limited human-to-human
transmission may have occurred. However, the virus has not mutated and
no one outside the family has fallen ill.

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The Wall Street Journal
Wednesday, June 21, 2006

Details of Bird Flu Deaths Offer View
Into Why, How the Disease Kills

By MATT PHILLIPS

Preparing the meal for a wedding party. Cleaning out gutters. Fertilizing a 
garden. Unknown.

Researchers will never know precisely how all the 130 people who have died of 
H5N1 avian influenza acquired the disease. But the details of their 
investigations offer glimpses into the lives of the victims -- who have been largely 
young, in close contact with poultry, and mostly from Southeast Asia.

While the fatality count has slowly ticked higher, the victims' stories -- or 
what little we know of them -- have sometimes been overshadowed by broader 
concerns about food safety, bird migratory patterns and feared mutations that 
could make the virus easily transmissible between people, potentially sparking a 
global pandemic.

Right now, the disease is hitting the developing world the hardest. Indonesia 
– where H5N1 recently ravaged an extended family and prompted concerns about 
human-to-human transmission -- and Vietnam have reported the most deaths. 
Nearby, China and Cambodia have reported deaths, and countries as far away as 
Egypt and Iraq have reported multiple fatalities from the disease, which is 
usually spread by close contact with infected birds or their droppings.

Gender doesn't appear to be a factor in mortality rates, based on the 
relatively limited number of cases so far. Deaths have been roughly split between 
males and females, according to data reported by the World Health Organization.

Age, however, does seem to play a significant role in who dies, 
epidemiologists say. More than 75% of the confirmed deaths from H5N1 infection were of 
people aged 30 years or younger. People age 20 and younger account for at least 
53% of WHO-reported fatalities; age and gender information wasn't available for 
every death reported by Vietnam.

So why do bird flu deaths skew younger? Epidemiologists say there isn't 
enough data to make a definitive call, though they do point to some theories. The 
first is a simple matter of demographics. In the fast-growing nations of 
Southeast Asia, populations tend to be younger. Also, younger people tend to be in 
close contact with chickens and other infected birds, they say.

"Whether it's in a workplace setting or whether it's a marketplace or in a 
yard where there are contaminated poultry, many people who are coming in contact 
with these infected birds are young," says Art Reingold, a professor and head 
of epidemiology at the University of California, Berkeley's School of Public 
Health.

Experts also point to a harmful immune reaction known as a "cytokine storm," 
where the immune system -- which produces proteins called cytokines -- runs 
amok, attacking not just virus-infected cells but healthy cells as well.

"Young people have a much more vigorous immune response than older people and 
it can tip over from something beneficial into becoming something harmful," 
says Gregory Poland, professor of medicine at the Mayo Clinic College of 
Medicine and director of the Mayo Vaccine Research Group at the Mayo Clinic in 
Rochester, Minn.

Some recent research also suggests the importance of "cytokine storm" in H5N1 
mortality rates. In the July 1 edition of the Journal of Infectious Diseases, 
University of Hong Kong researchers reported that avian influenza's H5N1 
strain caused immune cells from those over the age of 12 to produce higher levels 
of cytokines than immune cells from newborns, according to a report from the 
University of Minnesota's Center for Infectious Disease Research & Policy.

On Tuesday, the WHO said tests confirmed that a 14-year-old Indonesian boy 
died of bird flu, putting the official death toll at 130 -- out of 228 confirmed 
cases. Researchers find H5N1's high mortality rate troubling, although some 
speculate that there have been far more instances of human H5N1 that have gone 
unreported, making the death rate lower that it first seems.

The details of the teen's death are similar to dozens of other victims. He 
developed symptoms "after helping his grandfather slaughter diseased chickens at 
the family home."

Details from earlier case histories can paint vivid images of life in the 
developing world, where poultry flocks are an important food source and exposure 
to domestic birds is an everyday occurrence.

For instance, a family gathered in Vietnam's Thai Binh province in late 
December 2003 for a wedding celebration where ducks were prepared. By the end of 
January three siblings were dead. Two sisters were confirmed to have had H5N1. 
Their brother was thought to have died of the disease too, though no tests were 
made.

In West Jakarta, Indonesia, a 39-year-old man died of H5N1 on May 19. 
Investigators later reported he had cleaned pigeon feces from his blocked roof 
gutters shortly before he fell ill.

In North Sumatra, Indonesia, 37-year-old woman kept a small flock of chickens 
which she allowed into her house at night. She also reportedly used their 
dung as fertilizer for her garden. She developed symptoms in late April 2006 and 
died on May 4. But not before spending the night with nine family members in a 
small room, while she was very ill and coughing heavily.

Soon after that night, April 29, several family members fell ill. By the end 
of May, six were dead including two of her sons, her sister, brother and her 
niece and nephew. This was the largest cluster of cases, closely related in 
time and place, reported to date in any country and was carefully monitored by 
Indonesia's ministries of health and agriculture and by the WHO.

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The Straits Times (Singapore)
Tuesday, June 20, 2006

'Culling law needed' to tackle H5N1 virus

Lack of funds for compensation a big drawback, says government

Azhar Ghani, Indonesia Bureau Chief

JAKARTA - INDONESIA needs laws that would make it easier for the
government to cull poultry in areas affected by the deadly bird flu
virus if it is to get a grip on the problem, says one of the country's
leading animal health experts.

Speaking at a discussion on the country's bird flu situation, Dr
Trisatya Naipospos said yesterday: 'Within six months, we have to do
more practical culling...there is no other alternative.

'There is no way to cull chicken if you do not have a good law...There
has to be an effort to put legislation in place.'

Dr Trisatya, who was the director of animal health at the Agriculture
Ministry until September last year, now chairs the board at the Centre
for Indonesian Veterinary Analytical Studies.

Warning that the H5N1 bird flu virus was 'all over the place', she
emphasised that the best way to prevent infections in humans was to
control the virus at its source: domestic poultry.

The authorities have said they are drafting regulations to include
provisions for the prevention of bird flu in the existing laws.

Jakarta has also said it will enforce a law which empowers it to deal
with epidemics more strictly.

However, Indonesia has resisted mass cullings as recommended by United
Nations agencies, citing a lack of funds to compensate all the
affected bird owners.

Mass cullings of diseased poultry have been cited as the main reason
Thailand and Vietnam were able to rein in bird flu problems.

Jakarta has also said such cullings are not practical in a country
where some 300 million of the country's approximately one billion
chickens live in backyards.

Culling carried out at selected farms and their surroundings has been
the preferred method in Indonesia, where the H5N1 virus has been
reported in birds in most of the 33 provinces.

Speaking to The Straits Times, the secretary of the Indonesian
inter-ministerial committee on bird flu, Mr Bayu Krisnamurti, said:
'We have all these laws, but we cannot be too authoritarian about
implementing them.

'We must consider the appeals of bird owners and not act too rashly -
unless it is clear that the birds in question are diseased.'

Compensation for affected bird owners is a major issue, he said, as
all international donors had specified that their contributions were
to be used to buy vaccines.

The Agricultural Ministry has allocated 30 billion rupiah (S$5
million) to compensate villagers, which works out to 10,000 rupiah a
chicken, lower than the market price of 15,000 to 30,000 rupiah.

>From tomorrow to Friday, the bird flu situation will be discussed at a
meeting of health and animal experts from the UN and other countries
that the inter-ministerial committee is hosting.

Mr Bayu said: 'We hope the meeting will produce a road map on how we
improve the control of bird flu here. We also hope that the gathering
will be able to provide the international community and donors an
authoritative review and assessment of the situation.

'Good or bad, the experts' joint assessment would be welcome after all
the different things we have been hearing...I hope everyone will have
a better idea of what it is we are facing and what we need to do.'

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Joyo Indonesia News Service
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