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Indonesia: Human Cases 20 June 2008 to 8 October 2008
AVIAN INFLUENZA, HUMAN (54): INDONESIA
****************************************
[As a consequence of the delayed announcement of these 2 deaths, the
current total number of avian H5N1 influenza cases and deaths in
Indonesia is unclear. Clarification is awaited. - Mod.CP]
Even CP is beginning to realize that the official H5N1 tally in Indonesia is just a shell game.
Latest update - released today - from KOMNAS FBPI, National Bird Flu Committee, related to Dep of Health.
Situation Update of Bird Flu Confirmed Human Cases
Jakarta, June 19, 2008 - Ministry of Health - Jakarta, June 19, 2008, Ministry of Health--The National Institute for Health Research and Development of the Ministry of Health and the Eijkman Institute of Molecular Biology in Jakarta announced Thursday that based on the genetic sequencing tests, the H5N1 avian influenza virus in Indonesia remains a poultry virus and has not yet mutated into forms that could easily transmitted between humans.
Therefore, the Ministry of Health urge the public to avoid contacts with sick or dead poultry and the environment that has been exposed to poultry droppings.
The Ministry's director general for disease control and environmental health Dr. I Nyoman Kandun calls on the public to maintain good practice of personal hygiene and healthy behaviors and preserve their environmental sanitation as well as to be alert on any flu-like symptoms to avoid late referral to medical services.
From January to June this year, Indonesia has recorded 18 confirmed cases of avian influenza on humans.
The two latest cases in May were a 15-year-old female Jakarta resident, identified only as IST and a 34-year-old SS from Tangerang District.
Indonesia has recorded a decline in number of confirmed cases by 50 percent compared to total cases occurred in January to May last year.
Number of human cases of bird flu that has been confirmed by the Ministry of Health is 133 positive cases, of which 108 are fatal. Up to date, the two new cases have not yeat been confirmed pending to the Minsitry of Health's announcement.
Indonesia Has Confirmed Its 134th Bird Flu On Human Case
Jakarta, May 14, 2008 - News Flash -
Test results from the Health Research and Development Center of the Ministry of Health and Eijkman Institute have confirmed that Isq, 15 year old girl from North Gandaria sub-district in South Jakarta was infected by H5N1 virus.
She had the symptoms of high fever, cough and faint. She was admitted to Gandaria Hospital on May 8 2008, where she was then referred to Persahabatan Hospital on May 11 2008. She died on May 12 2008.
Indonesia has now recorded 134 bird flu positive cases and 109 fatalities.
AVIAN INFLUENZA, HUMAN (55): INDONESIA, WHO
*******************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>
Indonesia: Avian influenza situation - WHO update 43
----------------------------------------------------
As of 19 Jun 2008, The Ministry of Health of Indonesia has announced
2 new cases of human H5N1 avian influenza infection. The cases are
not linked epidemiologically. The 1st is a 16-year-old female from
South Jakarta, DKI Jakarta Province. She developed symptoms on 7 May
2008, was hospitalized on 12 May 2008 and died on 14 May 2008.
Investigations into the source of her infection indicate exposure to
sick and dead poultry.
The 2nd case is a 34-year-old female from Tangerang District, Banten
Province. She developed symptoms on 26 May 2008, and was hospitalized
on 2 Jun 2008 and died on 3 Jun 2008. Investigations into the source
of her infection are ongoing.
Of the 135 cases confirmed to date in Indonesia, 110 have been fatal.
[This information resolves the uncertainty in the preceding
announcement from Indonesia with regard to the updated totals for the
numbers of human avian H5N1 influenza cases and deaths.
[see also:
Avian influenza, human (54): Indonesia 20080619.1912
Avian influenza, human (51): Indonesia, new policy 20080606.1811]
....................cp/ejp/dk
More from Bandung Hospital, West Java on the latest suspect patient, , this time called "V", hospitalized on June 18 .
Doctors see clinical signs of bird flu, but no infections source (chickens suddenly dying) is known.
Something is said about "H + 7" patients treated, not clear to me what that is about. Just guessing: "first tests are negative, however from experience we know after 7 tests a positive test is possible?" Just guessing.
The young girl RN is improving, tested negative , but still treated in the special bird flu ward.
See also post # 11 of this thread.
Again a suspect Bird Flu Patient is Treated in RSHS Bandung
The Hasan Sadikin hospital, Bandung again treated a patient who was expected suspect bird flu.
This patient was the patient to 118 that was treated in RS Hasan Sadikin.
The patient who was expected suspect that namely V, 26, the resident of the Kencana Rt Studio, Kelurahan Jatisari, of Kecamatan Buah Batu,
Kabupaten Bandung .V, since Wednesday night around struck 21 30 WIB was treated in poinciana tree space, RSHS.
Demikian was sent by Tim Doctor Penanganan Chairman and the Control of RS Hasan Sadikin Bird Flu, Hadi Yusuf, yesterday.
We still could not confirm whether this patient was correctly true positive or
negative.
Still was waiting for results of the blood inspection that was sent to Jakarta, said Hadi to SINDO.
The resident this Batu, was reconciled from RS Santosa since three days ago, to afterwards be treated intensively in RS Hasan Sadikin.
Hadi said, there were no direct contact between the patient suspect bird flu and the poultry.
He admitted to not yet knowing the cause of the infection by the AI virus to the patient's body.
I could the report if in the area of his residence did not have the chicken or anything. So did not know from where the arrival of this virus.
However, it was correctly not impossible true infected, because in other cities and regions, there was also the patient that not direct contact with the poultry, but was infected, he explained.
In the meantime, the child three years from the Subang regency, the RN, that already this week underwent the maintenance in RS Hasan Sadikin on the assumption suspect bird flu, his situation increasingly improved.
The team of the doctor admitted to accepting results test RN blood that was sent to Jakarta.
From results test now this, showed the better situation.
Temporary results of the negative, but we were still seeing results test after H + 7 patients were treated, said one of the team's members of the control doctor of bird flu, Djatnika Setiabudi.
Djatnika said, the ventilator implement that was installed to the RN body as respiratory aids was removed several previous days.
Although increasingly improved, the RN continued to have to undergo the maintenance in poinciana tree space.
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The resident this Batu, was reconciled from RS Santosa since three days ago, to afterwards be treated intensively in RS Hasan Sadikin.
We don't know how long this patient was in RS Santosa.
Also, what time is 21.30 in Indonesia? This is when the patient arrived. Seems to me it was quite late at night.
06/23/08 05:01
Bird Flu Cases Declining In Indonesia, But Prevalence Still Seen High Internationally
By Eliswan Azly
Jakarta, (ANTARA News) - It is a debatable question if we wish to see the progress made by Indonesia in eradicating the fatal bird flu virus (H5N1 in this largest archipelagic country.
It depends on where we start in seeing the progress and performance of eradicating the bird flu virus. At national level, it is true the number of bird flu cases in this country has declined compared to last year`s, but at international level, it is still high.
Health Minister Siti Fadilah Supari during her visit to Medan, North Sumatra, last week said that in the beginning of the second semester of 2008, the number of birdflu cases on human beings has dropped, and even reached a record low both in 2005, 2006 and even 2007.
The main cause of the decline is the increasing awareness of the people on bird flu, namely that one should immediately do something as soon as the person noticed some symptoms of the fatal disease.
At present each regional administration has a guidebook on bird flu for distribution to all layers of the society.
"Thank God we already have a handbook on bird flu, and we also have the support from some other countries, including Australia, Germany, India, and China," she said.
The minister also said that as the result of foreign media reports in 2006 that birdflu in Indonesia had already been transmitted from people to people after a whole family in Karo Regency, North Sumatra, had been affected by the bird flu virus, Indonesia had been avoided by the international community.
However, whatever containment efforts made by national authorities and the international community in dealing with the spread of the H5N1 virus, FAO in its report in March, 2008, still listed Indonesia as a country worst hit by avian influenza.
Perhaps, this country has made some progress in lowering the number of bird flue cases, but the progress is much smaller than the number of bird flu cases which attacked other countries in the world.
FAO Chief Veterinary Officer Joseph Domenech as quoted from the FAO News Room through emailed message said the human mortality rate from bird flu in Indonesia is the highest in the world. There will be more human cases if we do not focus more on containing the disease at the source in animals.
"Furthermore, I am deeply concerned that the high level of virus circulation in birds in the country could create conditions for the virus to mutate and to finally cause a human influenza pandemic," Domenech warned.
The avian influenza situation in Indonesia is grave and all international partners and national authorities need to step up their efforts for halting the spread of the disease in animals and making the fight against the virus a top priority.
More saddening, it was also reported that avian influenza had become deeply entrenched in Indonesia with 31 out of 33 provinces being infected. The virus is endemic in Java, Sumatra, Bali and southern Sulawesi with sporadic outbreaks reported from other areas. Since the first outbreaks in 2003 avian influenza has spread rapidly across Java into Bali, Kalimantan and Sumatra. In 2006 the virus spread further east infecting Papua and much of Sulawesi.
About twenty percent of the chicken population of 1.4 billion is scattered in around 30 million backyards, where people raise poultry for food or income. "Despite major control efforts taken by Indonesian authorities, the country had not succeeded in containing the spread of avian influenza in poultry," Domenech said.
Indonesia is facing an uphill battle against a virus that is difficult to contain. Major human and financial resources, stronger political commitment and strengthened coordination between the central, province and district authorities are required to improve surveillance and control measures.
According to him, a highly decentralized administration, under-resourced national veterinary services, lack of engagement with commercial poultry producers, insufficient international and national financial and human resources for control campaigns and the challenges of implementing a comprehensive communication strategy are the major constraints the country is facing.
"We have also observed that new H5N1 avian influenza virus strains have recently emerged creating the possibility that vaccines currently in use may not be fully protecting poultry against the disease. This issue is being addressed by the Indonesian Ministry of Agriculture with technical assistance from OFFLU (OIE/FAO Influenza Network of Laboratories) and funding provided by USAID and AusAID. Also required are more investigations and the development of better poultry vaccines," Domenech further stressed.
The major challenge is to immediately apply the main components of a successful national avian influenza control strategy, based on effective surveillance, emergency culling and compensation, vaccination, improved biosecurity, effective laboratory and quarantine procedures, and movement controls of poultry and poultry products.
To overcome this problem, FAO is supporting the Indonesian authorities in most of these areas. In addition, the agency has helped to train local teams of animal health professionals in participatory disease surveillance and response (PDS/R).
So far, more than 350 local government PDS/R officers have been trained and are actively working with village communities to prevent and control avian influenza. Surveillance and response teams are currently working in 193 out of 448 districts in Indonesia.
By June 2008, over 2,000 surveillance and response teams will be active in more than 300 districts in disease-endemic areas of the country.
In the meantime, Chairul A. Nidom, an Indonesian microbiologist who first identified the virus in Indonesia, a decline in bird flu cases as mentioned by health minister was undoubtedly true, as the government of Indonesia had acted actively to stamp the spread of the disease to human beings.
Compared to the beginning of the pandemic outbreak in 2003, the government had taken serious efforts in cooperation with foreign experts to deal with epidemic and there was no effort by Indonesia any more to cover the cases up and to neglect the spread of the virus until it began to sicken human beings.
If Indonesia was a worry to U.N. and other international experts in particular, it was only natural because partly it had Southeast Asia`s largest population of both people and poultry, Nidom said. (*)
OK - Human case numbers in North Sumatra are not matching up.
In a Health Ministry Report posted by Dutchy (June 5, 2008) there were a total of 8 positive cases and 7 fatalities from bird flu in North Sumatra (Sumatera Utara).
2008, 8 casualties was killed Terinfeksi Flu Burung in North Sumatra
Istimewah (Tebing Tinggi) - till 2008, the infection of Avian Influensa alias bird flu to humankind in North Sumatra, killed eight people. The biggest case happened in 2006, where six residents in the Karo Regency to casualties, the rest of one in Kab. Deli Serdang and other in Kab. Serdang Bedagai.
I don't think there are any reports of a human case or fatality from Kab. Serdang Bedagai in North Sumatra here at FT, although there were poultry outbreaks. This individual is also apparently not listed in the official WHO counts.
Hat-tip to Shiloh for bring this article to our attention.
Kumpulan berita lokal terbaru dari peristiwa, kecelakaan, kriminal, hukum, berita unik, Politik, dan liputan khusus dari berbagai daerah di Indonesia
(sorry can't translate now)
2nd patient, called `V`, also known under other initials is tested negative too, but will be tested again. Seems normal procedure: a series of tests.
Two patients was expected by results Bird Flu of the Negative
Two patients from Bandung that beforehand was expected by bird flu, were based on results pemeriksaaan the doctor RSHS Bandung was stated by the negative.
They were the RN (3) and V (26).
The RN that almost one week was more treated in RSHS Bandung, was stated by his condition the bird flu negative.
The child from the Baru RT Village village snip the Village of Mulyasari Kecamatan Pamanukan Subang this, beforehand was suspected of being infected by bird flu.
RN information that was freest bird flu was sent by Dr. Djatnika, one of the handling doctors of the bird flu patient of RSHS Bandung.
Was based on results pemeriksaaan and the Balitbangkes lab in Jakarta, the RN diapastikan the negative.
Moreover, at this time we will arrange RN repatriation to the hospital in Subang (RS Ciereng Subang, red) that the first time reconciled him to RSHS, he explained when being met in poinciana tree space of RSHS Bandung, on Tuesday (24/6/2008).
In the meantime V (26) that entered RSHS on Wednesday (18/6/2008), was suspected of contracting bird flu. Nevertheless, the doctor said now results of the negative. When entering, V his condition under investigation.
So, this still in the inspection, but for the time being the negative.
We were still being waiting for the inspection till seven days in the future, said Djatnika.
Djatnika added, around the V residence in Jatisari, Kec Buahbatu, was not found the poultry that died.
Padang, Padek - the Patient suspect bird flu had the initials HAP (15 months), on Tuesday (17/6), was permitted to come home. His article, results of the Polymerase Chain Reaction test or PCR that was carried out by three successive times showed the virus negative H5N1.
The head of the Layanan Medik Field RSUP M. Djamil Padang, Irayanti to Padang Ekspres, on Monday, (23/6) said, the resident of the Penang Village of Kelurahan Bungus Timur Padang was free the bird flu virus and only was stated contracted the respiratory tract infection.
"While undergoing the maintenance, the condition for his health continued to experience the pleasing development. Results of his test were negative, nevertheless, his condition has been healthy and good. Therefore we permitted him to come home," he said.
As being reported beforehand, HAP entered RSUP, on Friday (6/6), and underwent the maintenance in the room of the Irna C Penyakit Dalam RSUD isolation M. Djamil Padang, for approximately 12 days. At that time HAP experienced the high and breathless fever. Was based on the family's information beforehand the patient indeed had the story of contact with the chicken that suddenly died suddenly.
Said by Irayanti, although being stated healthy, but this patient continued to be reminded to continue always to maintain the cleanliness of the environment and to carry out the control if having the complaint no matter how small that was related to his health.
Present Situation and Clinical Features of A/H5N1 Human Infection
S. Giriputro, Sulianti Saroso Hospital for Infectious Diseases, Jakarta, Indonesia
Abstract
Human infection with Influenza A/H5N1 had been recognized since a decade ago. It can be regarded as one of newly emerging infectious diseases. To date the disease has affected many countries worldwide. Hundreds of cases had been reported to WHO with 50-60% fatalities. In Indonesia as of March 2008, 129 cases had been reported since 2005 with inevitably high fatality rate (81,4%). Some preliminary reports suggested that the high fatality rate may correlate with the virulence of the virus strain circulating in the country, high viral load and the dissemination of the virus into important organs outside the lung such as blood, brain and the gastro-intestinal tract. New cases is still taking place in the country due to many factors: geographic and demographic, poultry farming structure, vaccine availability, poultry movement, geopolitical (decentralization impact) and migratory birds may plays some roles.
The demographic characteristic showed that all age groups may be affected with slight predominance in young adult group. There is no significant different between male and female in term of prevalence. A proportion of the cases (about 50%) had history of direct contact with sick, healthy or died poultry, 30% had history of indirect contact with poultry in the environment either sick or healthy. In about 20% of the cases the history of contact to source of infection could not be concluded.
Fever, cough and breathlessness are the most frequent encountered clinical feature. For the purpose of screening some criterias for suspect are used: ILI, ARI or pneumonia with history of contact with AI source of infection, rapid progressive pneumonia leading to ARDS or fatality, unresponsive pneumonia treated adequately with antibiotics, clustering, or when viral infection is likely (leucopenia, lymphopenia). Antibiotics are used as initial treatment of CAP empiricly and when there is evidence of secondary bacterial infection. Antiviral treatment with oseltamivir has limited clinical benefit especially when given earlier.
The Interaktif TIME, Jakarta: the bird flu Illness in humankind often was wrong to be diagnosed as dengue fever and typoid.
This was seen from the list adiminstrasi giving of the medicine.
Director Rumah Sakit Sulianti Saroso Sardikin Giriputro in the conference in Kuala Lumpur said the diagnosis and giving of wrong medicine resulted in the height of the mortality rate.
"Wrongly the diagnosis as dengue fever, the bacteria penumonia, typhoid and the respiratory infection because of having the same clinical sign."
Said he.
Indonesia was the country with the death rate as a result of bird flu reached 81 percent, far above the world death rate of 60 percent.
Since 2003 was till at this time received by 135 cases konfirm, and 110 people died.
The recovery figure increased if medicine tamiflu was given less than two days after someone showed the sign was infected by bird flu.
Best was given in a period less than 24 or 36 hours after showing the sign.
The resident was sick was monitored Serious
Saturday, 28 June 2008
The government of the City (the Municipal Government) Blitar really menyeriusi the case of the virus attack avian influenza (AI) or bird flu in several poultry farms.
As the preventive step, the Health Service (Dinkes) the Blitar Municipal Government supervised serious the resident who was sick in the Plosokerep District and the Klampok District, the Subdistrict of Kepanjen Kidul. Menurut the Head of Dinkes Blitar Dr Ngesti Utomo, dinkes prepared medicine tamiflu as the act lanjut penanganan flu burung. The tablet tamiflu this was given to the contacting resident direct with the chicken poultry or it was suspected tertular. Although the bird flu attack on the poultry succeeded in being localised, the spread to humankind was not closed the possibility happened.
"was prepared by us tamiflu free for the handling to his humankind.
This as the form of anticipation of this AI illness spread to the resident.
Because, the poultry that died there positive terjangkit bird flu" he said yesterday.
Technical him, said Ngesti, each resident got two tablets tamiflu for the use one day.
Consumption tamiflu this only will take place very much.
The dose, said he, has been enough to fortify the health of humankind from the spread of the AI virus.
Together with penggelontoran tamiflu this, dinkes that involved the team in from the community health centre digging up information as much as possible the existence of the resident who complained was sick.
"Dari temporary observation in the field, we did not yet get the report on the resident was sick.
Hopefully condition that not occurred. Semua still was inventoried by us" he said.
In this week the bird flu virus attacked IV livestock breeding of the poultry of the sector chicken in the Plosokerep District and Klampok.
Hundreds of chickens died suddenly with the characteristics as flu burung. Kondisi this was reinforced with results rapid test (the fast test) that showed the bird flu virus as the cause of the death.
The head of the Perlindungan Dan Kesehatan Field of the Animal of Dinas Pertanian Kota Blitar Dr Purwo Riyanto said, in fact the Municipal Government not budget for specially in APBD concerning bird flu compensation.
Because from APBN the compensation program was not available.
However, the Municipal Government will use the budget from the Natural Disaster post.
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Last edited by Commonground; June 29, 2008, 07:26 AM.
Reason: translating additional words....
[So now it is told, to report to Community Center if you have a "fever". Just a fever.]
On Sunday, June 29 2008 Be Careful the Fever and Crowded Nafas the Indication of the Sign of Bird Flu
Blitar-Mewabahnya the flu virus in the Blitar City made the Pertanian Service (Diperta) local mewarning the community more was on the alert.
If experiencing the sign of the high fever successive ask for immediately reported to equipment or the closest community health centre.
The statement was sent by the Head of the Perlindungan Field and the Health of the Animal of Disperta Kota Blitar, Purwo Rijanto.
He said, usually the sign of the high fever is one of the signs of bird flu.
"Kalau indeed had worrying signs, as the high fever immediately reported to the village head's equipment or was carried to the community health centre then.
This to know whether possibly was caused by bird flu or the common illness, increasingly fast increasingly good," clear Purwo.
According to Purwo, in fact in the Blitar City was not yet found by the indication or signs aroused suspicion, the spread of bird flu from the animal to humankind.
Nevertheless, the community might not be careless.
His article, had a basis cases like in Tulungagung and other, the case of the spread of bird flu was known when being treated in the hospital.
How good, continued Purwo, is the community knew personally the sign of early.
"Untuk knew positive not him the spread of bird flu to humankind, indeed not was easy.
But for the prevention," he said.
Uptil now, continued Purwo, to learn the indication of bird flu to humankind, apart from the sign of the high fever, also was carried out with the blood test and breathless.
The person's blood that it was suspected was affected by bird flu was taken his sample that was further was researched.
The research until this still could not be carried out in the area.
"Dengan the blood test, could be known tertular or not," he said.
Only, related the handling medically et cetera hand over fully to the Kesehatan Service (dinkes) the Blitar City, as the authorised agency.
"Kami monitored the condition for his animal, if medical his humankind the affair dinkes," he said.
Until this, his side continued to carry out assistance and the monitoring as well as the socialisation.
He was also not shy menunjukkkan the rule.
In the Regulation Governor Nomor 23 last 2007, were explained the poultry that terindikasi was affected by the bird flu illness must be penned and might not diliarkan.
"Ada his rule, clear this " glasses-wearing man. As is known, the resident RT 1 RW 2 Plosokerep Kecamatan Sananwetan districts restless.
Dozens of chickens that were maintained died suddenly.
After being carried out pendeteksian the agricultural service, was known by chickens that died this was attacked by bird flu or AI. SEjauh this, Blitar Mayor, Djarot Syaiful Hidayat asked for the community to realise or legawa.
When having the chicken that signs died, preferably was destroyed by means of being burnt.
The Municipal Government will change him with money for appropriate compensation.
This report from Blitar, Java, (current outbreak in poultry) describes the currently used protocol to treat suspect bird flu patients. Authorities seems to take this outbreak seriously and take precautions.
The resident was sick was monitored Serious
The government of the City (the Municipal Government) Blitar really attacked the case of the virus attack avian influenza (AI) or bird flu in several poultry farms.
As the preventive step, the Health Service (Dinkes) the Blitar Municipal Government supervised serious the resident who was sick in the Plosokerep District and the Klampok District, the Subdistrict of Kepanjen Kidul .
Menurut the Head of Dinkes Blitar Dr Ngesti Utomo, dinkes prepared medicine tamiflu as the act lanjutpenanganan(advanced; furthered;handling; dealing with; taking care of) bird flu.
The tablet tamiflu this was given to the contacting resident direct with the chicken poultry or it was suspected to be infected.
Although the bird flu attack on the poultry succeeded in being localised, the spread to humankind was not closed the possibility happened.
Prepared by us Tamiflu free for the handling to his humankind.This as the form of anticipation of this AI illness spread to the resident.
Because, the poultry that died there positive infected by bird flu he said yesterday.
Technical him, said Ngesti, each resident got two tablets tamiflu for the use of one hari (day). Konsumsi tamiflu this only will take place very much.
The dose, said he, has been enough to fortify the health of humankind from the spread of the AI virus.
Together with penggelontoran (definition not found) tamiflu this, dinkes that involved the team in from the community health centre digging up information as much as possible the existence of the resident who complained was sick. From temporary observation in the field, we did not yet get the report on the resident was sick.
Was easy- mudahan that not terjadi.Semua still was inventoried by us he said.
In this week the bird flu virus attacked IV livestock breeding of the poultry of the sector chicken in the Plosokerep District and Klampok.
Hundreds of chickens died suddenly with the characteristics as flu burung.Kondisi this was reinforced with results rapid test (the fast test) that showed the bird flu virus as the cause of the death.
The head of the Perlindungan Dan Kesehatan Field of the Animal of Dinas Pertanian Kota Blitar Dr Purwo Riyanto said, in fact the Municipal Government not budget for specially in APBD concerning flu compensation burung.Sebab from APBN the compensation program was not available.
However, the Municipal Government will use the budget from the Natural Disaster post.
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said one of the team's members of the control doctor of bird flu, Djatnika Setiabudi.
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