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Avian Influenza: Avian Influenza: Indonesian ExperienceIndonesian Experience
Amin SoebandrioAmin SoebandrioAssistant Deputy, Medical & Health Sciences, Ministry of ResearcAssistant Deputy, Medical & Health Sciences, Ministry of Research and h and
TechnologyTechnology
Tri Tri SatyaSatya Putri Putri NaiposposNaiposposDirector, Animal Health, Ministry of AgricultureDirector, Animal Health, Ministry of Agriculture
Agus SuwandonoAgus SuwandonoDirector, Disease Control Research Center, Ministry of HealthDirector, Disease Control Research Center, Ministry of Health
60%
30%
6% 4%
Population Map of Poultry in Population Map of Poultry in IndonesiaIndonesia
Source: FAOSTAT (2003)
Geographical Distribution of Bird Geographical Distribution of Bird Disease, Aug 03 Disease, Aug 03 �� Jan 04Jan 04
45
4044
41
423935
3736
383233
34
31
43
29
47
48
49
50
5152
53
54555657
58
59 60
61
6263
286425
26
27
7 8
9
11
10
12
13
19
1617
15
18
20
2224
2321
45
5 3
1
2
Source: Ministry of Agriculture
64
AGUSTUS 2003 ( 2 )AGUSTUS 2003 ( 2 )
JANUARI 2004 ( 17 )JANUARI 2004 ( 17 )DESEMBER 2003 ( 13 )DESEMBER 2003 ( 13 )OKTOBER 2003 ( 13 )OKTOBER 2003 ( 13 )
NOVEMBER 2003 ( 9 ) NOVEMBER 2003 ( 9 ) SEPTEMBER 2003 ( 2 )SEPTEMBER 2003 ( 2 )
Spread of Bird Disease Outbreak in Spread of Bird Disease Outbreak in Indonesia (Oct 03)Indonesia (Oct 03)
OKT �03
Spread of Bird Disease Outbreak in Spread of Bird Disease Outbreak in Indonesia (Nov 03)Indonesia (Nov 03)
NOV �03
KALIMANTANSELATAN
KALIMANTANKALIMANTANBARATBARAT
KALIMANTANTENGAH
KALIMANTANKALIMANTANTIMURTIMUR
(Laporan Dinas Peternakan)
TanahTanah LautLaut AreaArea
SampitSampit AreaArea
NOVEMBER 2003 ( 1 )
DESEMBER 2003 ( 1 ) FEBRUARI 2004 (2)
City of Pontianak
Pontianak Area
Distribution of Bird Disease Outbreak in Distribution of Bird Disease Outbreak in Indonesia (Nov 03 Indonesia (Nov 03 �� Feb 04)Feb 04)
Bird death,Bird death,AUG 03 AUG 03 -- APR 04APR 04
Source : Dinas Peternakan
0
500.000
1.000.000
1.500.000
2.000.000
2.500.000
Agst Sept Okt Nop Des Jan Peb Mar Apr
Reported Death
Serological Test ResultsSerological Test ResultsBPMSOH BPMSOH GunungGunung SindurSindur, 31 , 31 JanuariJanuari 20042004
AntiseraAntiseraH5N1 H5N1 (log 2)(log 2)
IsolateIsolate
9.9.
8.8.7.7.6.6.5.5.4.4.3.3.2.2.1.1.
NoNo
QuailQuail
LayerLayerLocalLocalLaLayyeerrLaLayyeerrBurasBurasLaLayyeerrLaLayyeerrLayerLayer
Type of BirdsType of Birds
66FKH UGMFKH UGMKlatenKlaten
77FKH UGMFKH UGMKlatenKlaten66FKH UGMFKH UGMYogyakartaYogyakarta88BPMSOHBPMSOHSemarangSemarang88BPMSOHBPMSOHTangerangTangerang99BPPV RBPPV R--IVIVWonosoboWonosobo1111BPPV RBPPV R--IVIVSukoharjoSukoharjo1010BalitvetBalitvetBlitarBlitar1010BalitvetBalitvetBogorBogor
InstitusiInstitusiPlace of Place of OriginOrigin
Main Strategy for AI OutbreakMain Strategy for AI Outbreak
!! VACCINATIONVACCINATION!! Mass Vaccination to all healthy birds within 6 Mass Vaccination to all healthy birds within 6
months, followed by routine vaccinationmonths, followed by routine vaccination
!! DEPOPULATI ONDEPOPULATI ON!! DEPOPULATION of all healthy birds sharing DEPOPULATION of all healthy birds sharing
facilities with sick birdsfacilities with sick birds
Justification for AI Control Justification for AI Control StrategyStrategy
1.1. Outbreak has been widely spreadingOutbreak has been widely spreading2.2. Control of outbreak is anticipated to be Control of outbreak is anticipated to be
difficult due to late initiationdifficult due to late initiation3.3. Bird farms in Indonesia consist of a large Bird farms in Indonesia consist of a large
number of small farms (chicken, local number of small farms (chicken, local chicken, quails, etc.)chicken, quails, etc.)
9 Control Strategy9 Control Strategy1.1. Improvement of BIOSECURITYImprovement of BIOSECURITY2.2. VaccinationVaccination3.3. DepopulationDepopulation4.4. Control of traffic of birds, poultry product, and Control of traffic of birds, poultry product, and
poultry wastepoultry waste5.5. Surveillance and tracing backSurveillance and tracing back6.6. RestockingRestocking7.7. StampingStamping--outout8.8. Public awarenessPublic awareness9.9. Monitoring and evaluationMonitoring and evaluation
Zoning as a base for AI controlZoning as a base for AI control
= AFFECTED AREA
= HIGH RISK AREA
= FREE AREA
NOV.03NOV.03
OKT.03
Depopulation: ConstrainsDepopulation: Constrains
Very low awareness among farmers and Very low awareness among farmers and industries, particularly in preventing of selling industries, particularly in preventing of selling sick chickensick chickenDepopulation procedure is not simple and must Depopulation procedure is not simple and must be followed by complete disposal procedure, to be followed by complete disposal procedure, to prevent the carcasses from becoming the next prevent the carcasses from becoming the next source of infectionsource of infectionDepopulation procedure was not performed in Depopulation procedure was not performed in accordance to the accordance to the animal welfare animal welfare principles.principles.
General Objectives of Outbreak General Objectives of Outbreak ControlControl
1.1. Rehabilitation of chicken and egg Rehabilitation of chicken and egg consumptionconsumption
2.2. Rehabilitation of poultry and its related Rehabilitation of poultry and its related businessesbusinesses
Objective of AI ControlObjective of AI Control
1.1. SHORT TERM (6 months, Feb SHORT TERM (6 months, Feb �� Jul 2004)Jul 2004)1)1) Control the outbreak by suppressing mortality rate Control the outbreak by suppressing mortality rate
down to zerodown to zero2)2) Control and reduce disease spread to other areas in Control and reduce disease spread to other areas in
IndonesiaIndonesia3)3) Protect the disease free areasProtect the disease free areas4)4) Prevent transmission to human by eliminating the Prevent transmission to human by eliminating the
source of disease in birdssource of disease in birds5)5) Poultry recovery Poultry recovery
2.2. LONG TERM (2005 LONG TERM (2005 -- 2007)2007)1)1) Gradually eradicate the diseaseGradually eradicate the disease2)2) ReRe--gain the AIgain the AI--free statusfree status
AI related ConcernsAI related Concerns
Poultry industries
Loss of human life
Food safety issues
Food security issues
Survival of small farmers
Regional and global problems
Poultry industriesPoultry industries
Loss of human lifeLoss of human life
Food safety issuesFood safety issues
Food security issuesFood security issues
Survival of small farmersSurvival of small farmers
Regional and global problemsRegional and global problems
AI AI VaccinationVaccinationLocally produced�PUSVETMA:AFLUVET �PT. VAKSINDO SATWA NUSANTARA:Vaksiflu AI�PT. MEDION:Medivac AI
8. Public Awareness Campaign8. Public Awareness Campaign
BOOKLETS POSTERS
VIDEOPRESENTATION
RADIO-ADS FLYERS Roll Up Banners
Collection of Human SamplesCollection of Human Samples
Bali 130Bali 130
BantenBanten 125125
DI DI YogyakartaYogyakarta 125125
West West JawaJawa 125125
Central Central JawaJawa 125125East East JawaJawa 128128
South Kalimantan 152South Kalimantan 152LampungLampung 136136
Respondent CharacteristicsRespondent Characteristics Respondent Criteria (N = 1046)
Contact (+) 829Control 217 Sex(N = 1046)
Male 664Female 382
0
50
100
150
200
250
300
350
400
450
1-10 11-15
16-20
21-25
26-30
31-35
35-40
41-45
46-50
51-55
56-60
61-65
66-75
Age Group (N = 1046)
Main job of RespondentMain job of Respondent
No.
%
Respondent (N = 1046)
Contact (+): 829 79.3 Slaughter 6 0.7 Farm worker 662 79.9 Product handler 80 9.6 Slaughter & Worker 77 9.3 Others 4 0.5Control (non-contact) 217 20.7
History of Influenza/URI Related History of Influenza/URI Related IllnessIllness
Variabel History of Illness
Current Illness
Province (N = 1046) Bali 25 8 Banten 33 6 DI Yogyakarta 16 0 West Jawa 9 8 Central Jawa 20 8 East Jawa 2 2 South Kalimantan 29 0 Lampung 21 11 T o t a l 155 29
Results of H5N1 TestsResults of H5N1 Tests
HI Test (Serum)
RT PCR Test (Nasal Swab)
PROVINCE
Tested Results Tested Results
Bali 130 130 (-) 8 8 (-) Banten 125 125 (-) 6 6 (-) DI Yogyakarta 125 125 (-) 0 West Jawa 125 125 (-) 8 Central Jawa 125 125 (-) 8 East Jawa 128 128 (-) 2 South Kalimantan 152 152 (-) 0 Lampung 136 136 (-) 11 In
Pro
gres
s
How Indonesia anticipates How Indonesia anticipates bioterrorismebioterrorisme??
Nat�l Focal Point
Nat�l Competent Authority
Nat�lBiosecurity Clearing House
Agency for Biological and Chemical Terrorism Control as the NCC (Nat�l Coordinating Committee)
Mnistries of Econ, Industry, & Trade, Agriculture, Defense, FDA, Quarantine, Custom, etc.
Ministries of Justice, Commuication & Information, Health, FDA
MoFA
The President
ConclussionsConclussions8 Provinces have been affected by AI8 Provinces have been affected by AI8,687,406 birds have been reported killed between Aug �03 and Apr �04None of 829 person with history of contact None of 829 person with history of contact showed positive result when tested by HI and showed positive result when tested by HI and RTRT--PCRPCRIndonesian Government (Indonesian Government (MoAMoA and and MoHMoH) has ) has taken strategic measures to control the diseasetaken strategic measures to control the diseaseIndonesia has seriously considered the Indonesia has seriously considered the possibility of the emerging and repossibility of the emerging and re--emerging emerging (infectious) diseases as bio(infectious) diseases as bio--attack.attack.
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