Indonesia Cautious on Bird Flu Infection Transmission to Humans

JAKARTA, KOMPAS.com - Indonesia's Ministry of Health is aware of the tendency of the new clade of Avian Flu virus 2.3.4.4b infecting humans following the finding of a case in poultry in a farm in South Kalimantan.

"There are currently no reports of transmission to humans. However, we still have to be vigilant," Health Ministry’s director general of disease prevention and control Maxi Rein Rondonuwu said here on Monday, Feb. 27.

Although the risk of infection in humans is relatively low, Maxi affirmed that the government had increased early warning, given that zoonotic virus mutations are swift and consistent in mammals.

He said the ministry had issued a Director General of Disease Prevention and Control (P2P) Circular Letter No. PV.03.01/C/824/2023 on Precautions of Extraordinary Events for Avian Flu (H5N1) New Clade 2.3.4.4b, which was stipulated on Feb. 24 this year.

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The circular requests provincial, district, and regional health offices and heads of Port Health Offices (KKP) across Indonesia to coordinate and cooperate with relevant agencies to prevent and control bird flu in humans.

Regional administrations are also urged to prepare health facilities for the management of suspected cases of bird flu following established guidelines.

They were also urged to increase the capacity of public health laboratories for the examination of samples of cases with symptoms of suspected bird flu.

"Surveillance activities and the Fast Action Team, especially in detecting epidemiological signals in the field, also need to be improved," he said.

Meanwhile, areas that conduct sentinel surveillance for influenza-like illness (ILI) and Severe Acute Respiratory Infection (SARI) are also urged to increase early awareness of suspected bird flu cases in areas where Avian Influenza Extraordinary Incidents occurred in poultry.

For every suspected case of bird flu, the Community Health Center is requested to immediately report to the district and city health office in less than 24 hours through the Event-Based Surveillance System and the Early Alertness and Response System (SKDR).

Moreover, the Provincial District and City Health Offices are urged to immediately report to the PHEOC Directorate General of P2P in less than 24 hours and coordinate with the agency in charge of the local animal health function.

In a bid to exercise vigilance against the spread of the infection at the country's entry points, Maxi also instructed the KKP to step up supervision of domestic and foreign travelers at seaports, airports, and state land border crossing posts.

"We carry out examinations and handle cases if there are travelers, who show symptoms of ILI according to the applicable guidelines," he said.

"We also disseminate information and conduct cross-sectoral coordination in the KKP work area," he added.

He also called on the public to always practice clean and healthy behavior (PHBS) and to report to the livestock service in the event of a sudden and large number of poultry deaths in their environment.

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He urged the public to visit a health facility at the earliest if they experience symptoms of bird flu and have a history of contact with risk factors.

Head of the Communication and Public Service Bureau of the Health Ministry Siti Nadia Tarmizi said that mitigating the transmission of the new clade of Avian Flu virus 2.3.4.4b in Indonesia is prioritized in areas related to poultry and wild animals.

"The focus of mitigation is on the location of poultry farms or wildlife conservation areas that require close monitoring of the possibility of bird flu transmission to humans," she said.

She said the Health Ministry had coordinated with the Ministry of Agriculture and the Ministry of Environment and Forestry (KLHK) for the prevention of Bird Flu.

In the meantime, the Ministry of Agriculture has positively identified the H5N1 clade 2.3.4.4b virus through PCR testing and sequencing at unvaccinated Peking duck commercial farms in South Kalimantan.

"We have coordinated with the Ministry of Agriculture and the Ministry of Environment and Forestry to anticipate this situation by holding a coordination meeting on February 15, 2023," she said.

"This is in response to circular letter of the Director General of Livestock and Animal Health - Ministry of Agriculture No. 16183/2023 on Increasing Awareness of Highly Pathogenic Avian Influenza subtype H5N1 Clade 2.3.4.4b," she said.

Source: State News Antara