Threat of Bird Flu Pandemic Remains

INDONESIA - A report warns that although there have been no human cases of H5N1 highly pathogenic avian influenza (HPAI) since July, the threat of a pandemic still exists.

4 November 2008

5 minute read

Asia

Indonesia, the nation with the most bird flu deaths, said the threat of a deadly flu pandemic has not passed even though no new human cases of the H5N1 virus have been detected in the archipelago since July, according to Bloomberg.

The government has started work on its own H5N1 vaccine and allocated 700 billion rupiah ($64 million) in next year's budget to prepare for a pandemic, including building facilities to produce inoculations, Health Minister Siti Fadilah Supari said. The nation may also resume sharing H5N1 samples with the world next year if it can complete an agreement at a World Health Organization meeting next month.

Producing its own vaccine may strengthen Indonesia's position in demanding access to affordable shots for Asia in exchange for sharing H5N1 samples. The Southeast Asian nation, which accounts for 46 percent of bird flu deaths globally in the past six years, has withheld samples since December 2006, saying the viruses are its own intellectual property. Doctors can't produce up-to-date vaccines without the latest virus strains.

"We have made seasonal flu vaccine," Ms Supari said in an interview in Jakarta on 31 October. "The leap to avian flu vaccine won't be too hard." She said Indonesia has already developed a so-called 'seed vaccine', a genetically modified form of a virus that can be grown safely to mass-produce vaccines.

The H5N1 flu strain is known to have infected at least 387 people in 15 countries since 2003, according to the Geneva-based World Health Organization (WHO). Almost two of every three cases were fatal. Health officials worldwide are concerned the virus may mutate into a form easily passed between humans, touching off the first flu pandemic in almost four decades.

Negotiations Resume on Virus Sharing

Negotiations to resume virus-sample sharing "have come a long way," Ms Supari said. "The only obstacle left is the choice of tracking system," she said. Indonesia expects to reach an agreement on changes to the WHO's Global Influenza Surveillance Network at a meeting in Geneva in December and may resume virus-sharing next year, she said.

It's at least the second time Ms Supari has promised to resume sharing virus samples. In March 2007, she said Indonesia would recommence virus-sharing 'immediately' but in August last year, WHO said it was yet to receive any samples.

"We've heard some of these things before, so I guess we've just got to be patient and wait for them to be played out," said Ian Barr, deputy director of the WHO Collaborating Centre for Reference & Research on Influenza in Melbourne, Australia. "We would be very happy if Indonesia resumed sharing the viruses," Mr Barr said in a telephone interview.

'More Danger' in Withholding Viruses

Michael Leavitt, the outgoing US secretary of health and human services, last week urged his as-yet-unknown successor to 'strongly defend' the 60-year-old practice of nations sharing virus samples freely, and said countries that withhold viruses are exposing the world to 'even more danger'.

The deadly H5N1 bird flu virus has killed 112 people and sickened 25 others in Indonesia, according to the WHO. Most infections were caused by contact with infected poultry, such as children playing with them or adults butchering them or plucking feathers, according to the WHO.

No new human cases have been found since the last ones were detected in July, Ms Supari said, citing better public understanding about how to keep poultry safely.

"I can't say the threat has passed but at the moment, there's nothing that can trigger a pandemic except if it's man-made," Ms Supari said.

Laboratory tests and DNA analysis conducted by the health ministry's research centre and the government-funded Eijkman Institute for Molecular Biology on 'hundreds of samples' since the country stopped sending the virus to the WHO found no mutation toward a human-to-human transmission, she said.

Indonesia in April released a national plan for coping with an influenza pandemic. The plan assumes a pandemic flu virus will strike 30 percent of the world's fourth-most populous nation, or 66 million people, and kill more than 153,000, concludes the Bloomberg report.