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Avian Influenza in Indonesia

Avian influenza H5N1 is entrenched in birds in Indonesia. Human cases occur sporadically, and famililal clusters of human-to-human spread of the disease have been recorded.  Over 160 human cases have been confirmed between 2005 and 2011, around 75% of which have been fatal.

Avian flu (bird flu) refers to a family of influenza viruses that mainly affect birds. One strain, H5N1, quickly kills domestic poultry flocks. It has been detected in more than 60 countries and is now permanently present in a number of them. H5N1 can infect humans. Infected people usually become severely ill, and about 60 percent of them die (see the WHO table).

The droppings, secretions, blood, and organs of infected birds contain virus. People who have close contact with sick birds are at the highest risk of contracting H5N1, since they are the most likely to inhale the virus or get it in their mouth, nose or eyes. Human cases most commonly occur among poultry farmers in underdeveloped countries - especially those who are unaware of the risk of avian flu, and/or cannot afford to follow internationally recommended precautions. Travelers and expatriates are at relatively low risk of infection.
H5N1 cannot currently spread easily from person to person. Almost all human cases have struck individuals. Very rarely, a small group of people has been infected. No large-scale human outbreaks have yet been reported. If the virus develops the ability to spread easily from person to person, it may cause the next influenza pandemic.

H5N1 can be killed by washing skin with regular soap and cleaning surfaces with regular detergents and disinfectants. It is killed in food via thorough cooking methods.

To reduce the chance of infection, when in affected countries:

• Avoid live animal markets and poultry and pig farms.
• Do not handle sick or dead birds or other animals, including cats.
• Avoid touching any surfaces that may be contaminated by poultry droppings, and do not swim in any body of water that is used by birds.
• Always maintain high levels of personal hygiene. Frequent handwashing is very important. Wash hands before and after food preparation.
• Thoroughly cook poultry products and eggs before eating. Avoid raw poultry products, such as raw duck blood. Also thoroughly cook pork products.

Additional info on Avian Flu from the US Center for Disease Control

If you have medical-related questions about living in Indonesia to ask of medical professionals, see Ask the Experts.

We trust this information will assist you in making correct choices regarding your health and welfare. However, it is not intended to be a substitute for personalized advice from your medical adviser.

Our appreciation to the Coordinating Doctors of International SOS, an AEA Company who have contributed this article in response to a health threat faced by expatriates in Indonesia.