INDONESIA WORRIES: QUAKE IS ALSO BIRD FLU EPICENTER

by Marwaan Macan-Markar

(IPS) BANGKOK -- Fears that Indonesia may emerge as the epicenter of a global bird flu pandemic are adding to the woes of a country struggling to cope with the aftermath of Saturday's temblor that left more than 5,500 people dead in central Java.

Reports of seven bird flu deaths in a single family, in northern Sumatra, have exacerbated the fears.

Indonesia has witnessed 33 bird flu deaths so far, compared to 42 in Vietnam. But, while Vietnam has recorded no outbreaks in its poultry flocks since December last year, the archipelagic country is still struggling to contain the deadly H5N1 virus that has spread to 27 of its 33 provinces.

Of all the countries that have been affected, Indonesia has suffered the highest number of human fatalities since the beginning of the year. The current global death toll stands at 124 in nine countries out of more than 220 infections in 10 countries.

Most worrying to epidemiologists and public health experts is the recent confirmation of a large cluster of bird flu deaths in Simbelang, a remote village in Sumatra. "This is unprecedented," Peter Cordingley, spokesman for the World Health Organization's (WHO) Western Pacific regional office, told IPS.

Over the weekend, international health experts decided to increase the number of Indonesians in Simbelang placed under quarantine in order to limit the possible spread of H5N1 virus through the human-to-human route. Fifty four villagers were confined to their homes, up from the initial 33 that WHO experts thought were vulnerable.

According to the WHO, most of the family members had died from bird flu during the first two weeks of May. But the Geneva-based health body also confirmed, last week, that the seven members of this family who succumbed to the virus may have infected one another.

As one Thai health expert explained, reports of such clusters are a cause for greater concern -- than reports of an isolated fatality --because of the possibility that the H5N1 virus could mutate into a strain that is capable of being passed among humans..

"For the moment we still have some good news from Indonesia," Dr Kamnuan Uengchusak, director of Thailand's communicable disease control office, said in an interview. "There are no new reports of outbreaks in that community. We must wait for 10 days, because that is the maximum incubation period."

Thailand, which has sent a team of experts to assist tests being conducted in Indonesia, had its own scare of human-to-human transmission of the H5N1 virus in 2004, when three members of one family died of bird flu. "What was clear then may also be the case with Indonesia now -- that transmission between humans happens after exposure to a patient over a long time," says Kamnuan.

Officials from the U.S. Centers for Disease Control, currently in Indonesia, offer a similar view. "It (the virus) does not appear, at least in the opinion of those who have been studying it, to be either efficient or sustained, in terms of transmission," Tony Snow, White House press secretary, was quoted as saying in a report on the U.S. state department website. "(There is) no obvious significant mutations."

Fears of a pandemic that could kill millions of people if the H5N1 virus mutates have been rife ever since the current outbreak of bird flu began in Southeast Asia in the winter of 2003. The WHO has drawn parallels to the 1918 influenza pandemic that killed an estimated 50 million people. It arose from a virus that jumped the species barrier -- from birds to humans.

Human immune systems lack the capability to fight the H5N1 flu strain and the prospect of a potent vaccine remains a distant hope.

The only remedy is the anti-viral 'Tamiflu' tablet that, the WHO confirms, is being given to Indonesians in Sumatra who are under quarantine.

Right now international attention has been diverted to central Java where a massive humanitarian relief effort is underway to help shelterless quake survivors. The region is also threatened by a possible volcanic eruption of Mount Merapi which has been reported spewing more smoke and lava this week.

Bird flu has been detected in over 50 countries, most of them Asian. Yet, as its spread in Southeast Asia indicates, it is becoming clear to experts that the virus is spreading through human activity, such as the unsafe trading and transport of poultry, or poultry-rearing without regard for bio-security measures.

According to the Food and Agriculture Organization, the successes recorded by Vietnam and Thailand in containing the spread of the H5N1 virus within poultry flocks offer hope that it can be stopped in its tracks. Earlier in the year, the UN food agency singled out such measures as greater community involvement and sound compensation schemes for poultry farmers as initiatives that have worked.