Indonesia H5N1 virus has decreased

[Pathfinder]

The H5N1 virus trends Descending
Wednesday, 12 August 2009 - 22:47 wib

SUBANG - Trends spread of the virus avian influenza (AI) or the H5N1 virus in Indonesia has decreased significantly compared to the previous year. One indicator is the decline in recent years, mass poultry mortality has been increasingly hard to find.

Trends penuruan pensebarab virus H5N1 is strengthened Minister of Agriculture Anton Supriyantono on Persesmian Investigation and Laboratory Testing veteriner (BPPV) Subang, Kampung Werasari in Kelurahan Dangdeur, Subang, Wednesday (12/8/2009). According to Anton, in the last year no longer receive the reports, mass destruction of poultry in a number of areas.

"Currently we have less to do mass destruction poultry, which is the source of the virus H5NI. That indicates the spread of the virus has begun to decline, even in the Gorontalo and Maluku has been free of H5NI," said Anton.

One of the prevention efforts that have been done is to place eight staff responsive Participation Dease Surveyor (PDSR) to the District and the City in Indonesia. They perform data collection, and dive to the location and to report suspected cases of H5N1 in the area of work.

While itui d West Java, West Java Governor Ahmad Heryawan states since mewabahnya AI virus in the year ago in 2003, causing 63 people dead, either positive or suspect bird flu. Although as a preventive step, not less than 2 million head of poultry died of the cause kerugiam poultryman in West Java.

Irus spread of AI in Jaba, said Heryawan, 26 occurred in the district, which includes the 369 (62.33% and District 771 (13.28) village in West Java. However, outbreaks of the virus can be controlled, so a drop dramatically. "This can be evidenced with the number of dead birds yuang decline and there is no positive cases in humans, "said Heryawan in a speech read Dinhas Head Ranch

http://news.okezone.com/read/2009/08/12/1/247506/tren-penyebaran-virus-h5n1-menurun

[Treyfish]

Re: Indonesia H5N1 virus has decreased

Runnin out of chickens...or runnin out of reporters

[Vibrant62]

Re: Indonesia H5N1 virus has decreased

Since Indonesia only looks for infections after mass chicken deaths, there is also the possibility that a combination of vaccines and a degree of acquired immunity in the remaining chicken populations has arisen after some five years of infections and mass deaths. The virus is endemic, and I cannot see it going anywhere until it is displaced by something else.

So, until I can see published data that shows chickens are not carrying virus asymptomatically, I will not buy a statement that its prevalence is decreasing here - only that the number of chicken deaths are.

Is there any evidence to support this is the case? Any random sampling for infections in apparently healthy poultry?

[Pathfinder]

Re: Indonesia H5N1 virus has decreased

They just need a shovel to dig a hole. By quickly burying their dead poultry, there is nothing to report.

[kiwibird]

Re: Indonesia H5N1 virus has decreased

Perhaps they get their shovels from Malaysia - they do not seem to have had even a budgie die in the last year! Like this one:
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[Commonground]

Re: Indonesia H5N1 virus has decreased

...I don't believe you, Indonesia.

[Gert van der Hoek]

Re: Indonesia H5N1 virus has decreased

This last year we see more Indonesian newsreports, indicating a downward trend of chicken deaths and human cases .

My feeling is these reports are both true and not true. Basically we don't have hard data to know what is going on.

As others have said there are some things to keep in mind:


There were several studies reported , saying some Indonesian chicken breeds are resistant to H5N1.

Also several reports saying chickens can have H5N1, but don't show symptoms.

We saw reports stating no more vaccination of chickens is done; some regions still vaccinate. In case of an outbreak the focus seems to be on culling, on a limited scale. The reported numbers go down.

Apparently it is hard - very hard - to get infected for humans; however also reports indicating H5N1 is developing into a more infectious virus for humans.
This raises the question if it would be possible some humans to carry the H5N1 virus without falling ill, but may be infecting others?

If there is a report on a human case, often there is mentioning of other people with symptoms.

The policy of intervention via "rapid response" teams or via community health centers seems to work: suspect human cases are treated as fast as possible with Tamiflu, only if they don't improve they go to hospital.
No testing, no counting.

Also we know the use of Tamiflu can prevent a positive testresult.

I remember a health official from Riau, stating there were many more H5N1 cases than reported, because 'it is regarded as normal for people to die from fever".

Tens of thousands of Tamiflu courses were used, partly prophylactic probably.
Regularly reports said some regions or some hospitals needed new supply.
Now Tamiflu being widely used for patients with the H1N1 flu, the picture blurs here for H5N1.

Testing is not without problems, to say the least. Most testing is done with rapid tests, which are not reliable. Also the current rapid tests can be less susceptible because the virus is changing, which is normal for flu.
We saw reports on different H5N1 strains in poultry.

Same for PCR tests, these tests are not without problems too. Being no expert , I know you need a dedicated "primer" . For instance to test for the new H1N1 you need another primer than testing for H5N1.
It would not surprise me if the current primers used for testing H5N1 cannot "catch" all current H5N1 strains in Indonesia.

It is interesting to see that suspected H5N1 patients who are tested negative often still are counted, like in the article in post # 1. Official tally of fatal human H5N1 cases in West Java is not 63, about half are "suspect" cases.

The Indonesian authorities seem to have a pragmatic approach: if there is an outbreak or a case, you react. You give Tamiflu, you do monitoring of direct contacts. You check the poultry, may be other animals, you cull.
As long as the number of deaths is 'acceptable", there is no problem. In Jakarta region poultry is being banned. In the meantime you make sure there is Tamiflu. Also a human vaccine is being developed in Indonesia.

Sero surveillance studies were done, 2 by dr. Nidom and 1 by the Tangerang pilot-project, but they were not published.

So the Indonesian authorities do what authorities do all over the world: damage control. Also with limited ressources and help from sponsors abroad and Indonesian NGO's like Muhammadiya prevention projects are developed.
More lab capacity is build ( for instance new lab in Subang with Japanese money), vaccine is being developed.

For political reasons the information flow is not what we would like to see, but that is a fact of life.

Is the H5N1 trend down in Indonesia? I don't know.
What we can do is the same as for the current H1N1 pandemic: look for trends in hospitalisations and fatalities .

If bird flu goes pandemic, it could well come from an unexpected source, like we saw in the case of H1N1. A lot of countries have H5N1 , or H ..... .

[gsgs]

Re: Indonesia H5N1 virus has decreased

but it seems to decrease in other area too, like Siberia,Europe

[kiwibird]

Re: Indonesia H5N1 virus has decreased

Dutchy - Thank you. A good, level headed, assessment of the situation. Time will tell. All we can do is report what we find.

[hawkeye]

Re: Indonesia H5N1 virus has decreased

it's like the tide...up...down...up...down.