We're well into September and flu season is approaching. Seasonal likely won't peak for another four or five months in the US and Europe but we should expect to start seeing cases in the northern hemisphere soon. A pandemic strain could happen at any time. The 1918 flu's second wave started in late August, so the timing of the start of a pandemic is not so predictable. At least one things seems certain, however. We shouldn't expect to see it starting in the current hot spot for human bird flu, Indonesia. Because the Indonesian government, in the person of Health Minister Siti Fadilah Supari, is batching their bird flu death reports to 6 month intervals. This is a violation of the International Health Regulations but Indonesia doesn't seem to care. They just decide on their own which international agreements are in their national interest and which ones aren't. Who do they think they are? The United States?
Anyway, this week the government deigned to inform the world about two bird flu deaths that occurred a couple of months ago:
Bird flu killed two men on Indonesia's Java island in July, the health ministry said, in its first reports of cases in almost three months.Both fatalities occurred in Tangerang city in Banten province, according to the Ministry of Health. No cases of the H5N1 strain of avian influenza were reported in August, the ministry in Jakarta said in a statement on its Web site today.
Prior to these, Indonesia's most recent avian flu cases were reported by the World Health Organization on June 19, when the Geneva-based agency recorded 135 infections, including 110 fatalities. Indonesia accounts for more than a third of the global cases of H5N1, the strain world health officials say may mutate into a contagious form capable of touching off a pandemic.
Indonesia's Health Minister Siti Fadilah Supari said on June 6 that the government would delay reporting new avian flu- deaths by six months. She didn't give a reason for the decision.
Calls and a text message to a spokeswoman at the Indonesian health ministry seeking comment weren't immediately returned. (Bloomberg)
Of course delaying or covering up bird flu deaths is problematic so we can expect Indonesia to take an easier route: just don't make the diagnosis. There are hundreds of thousands of pneumonia deaths annually in this country of 240 million people, so a couple of dozen here or there will just get lost in the noise. While the Bloomberg piece says no reason for the decision to delay reporting was given, in fact Health Minister Siti Supari has said that being known as the world's bird flu hotspot reflects badly on her country and harms commerce and tourism. True. We can infer that reporting all sorts of infectious diseases would also reflect badly on Indonesia and harm commerce and tourism. So I think it is fair to assume that the Health Minister could be withholding all sorts of disease information that are bad for business.
That's why I suggested before that people take their tourism and business dollars elsewhere until we can be sure Indonesia is complying with the reporting requirements of the International Health Regulations. You never know what kind of pest house you'd be entering.
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It is quite disturbing that a country would withhold information crucial to the lives of millions around the world because it might hurt tourism. If a tourist gets sick while in Indonesia during a small outbreak, brings the virus to another country, and it spreads; Indonesia should be held responsible for each death as negligent homicide.
Revere, "Of course delaying or covering up bird flu deaths is problematic so we can expect Indonesia to take an easier route: just don't make the diagnosis..."
Indeed, Revere... This is what occurred with those three Air Batu fatalities a month or so ago -- the bodies were disposed of before H5N1 testing (or, if testing WAS carried out -- we've not been told yay or nay, just creepy media silence as if those deaths didn't happen which only serves to make me wonder what DID actually they die of...).
Anyway, have you read through the PNAS September 9, 2008 vol. 105 no. 36 paper, "A consensushemagglutinin-based DNA vaccine that protects mice against divergent H5N1 influenza viruses"?
Excerpt: "We conclude that this vaccine, based on a consensus HA, could induce broad protection against divergent H5N1 influenza viruses and thus warrants further study..."
Revere, do you know much about this vaccine? Are one of the major pharma companies going to produce it or is it a government financed enterprise -- if so, which government?
It is quite disturbing that a country would withhold information crucial to the lives of millions around the world because it might hurt tourism.
If memory serves, the bubonic plague outbreak in San Francisco circa 1900 was hushed up over economic concerns. And the 1994 plague outbreak in India was at least partially covered up for a little while, I think. Didn't do either of 'em much good, though....
I developed an interest in this subject [H5N1] when it became apparent a calamity of horrendous proportions was in the offing and that it was sitting on my doorstep [Jakarta]. So I went out in search of funding to produce something-anything type of PSA/community awareness video program about "we should all be aware" and "we need to all help to stop this" type video communication through Tv networks and community based. It took me eight months of slog to get anywhere. I'd phone an vast NGO or a company who had gotten press from giving heaps of money to an Indonesian health related agency and get a blank sense of interest in doing any comms or video for the masses [in early 2007]. Eight months later I was financed up enough [by the Danish Red Cross and MPI] to produce a 12 minute public awareness video that has since been distributed across the archipelago to heath clinics for the edification of the masses. Apparently it has been well accepted so this is at least one good thing I have been able to do. Still so much more needs to be done not only in the science area but the awareness/ self prevention areas.
It astonished me that living here, amidst all this dire possibility life goes on as if it is not in our midst. There is very little pumping of conciseness to the public on this issue - very little awareness programs. Bickering of the kind that say "its the federal government that should pay" by regional governments shows their attitude is way out of wak with the dangers that may lay in wait for their own families.
Enter the Indonesian Health Minister Siti Fadilah Supari - [paraphrased] - well done - It's my decision and it's my right - to deny the world let alone my own citizenry, the right to be kept informed about this potential cataclysm! I couldn't believe she could say that - to have so little disregard for so many. Yet it goes to show what little urgency some [or is it many] have for H5N1 even at the highest level of government here. I asked an associate at WHO if it was all true and he confirmed so and when I asked "since they won't tell us, can you people at WHO let the information slip out" - no way, they can't as it's against their legal relationship with the government of Indonesia and that has to be respected. Which leaves us where? And when I say us, I'm not just talking about we who are an hour away from the "hot zone" but you who is a mere 12 or 24 hours away from someone who can swiftly pass it on via an airline ticket. We definitely ALL need to be working on this. It's our community [the world one] and we need to close ranks.
I am still looking for financing to produce more films on this subject so if anyone is interested in me spreading the word by filming things on the ground here I am way open to suggestions.
Indonesia should be brought before the World Court on criminal charges of Crimes Against Humanity for planting the seeds of genocide against the human race.
Onya Geoffrey Mee,
Cheers:*) to your public health efforts irrespective of the roadblocks (psychological and political) put up.
The entire global scientific community DO take the subject seriously -- and, if you believe in God, you can sleep easy in the knowledge you have group-participated in mitigating the pointless loss of human life to transgenic pathogens...
Hey, please email me at photoniqueer(at)yahoo.com and, once my Aussie (Perth) bank has unfrozen my account, I'd like to send some AU$ to help your public H5N1 education efforts:*)
Absolutely outrageous about WHO!! Now we know why they will not say anything. Just outrageous!
Like Goju, I too think somebody needs to be brought up on charges and I've got one women in sight! We'll start there. ;-)
thanx