Wednesday, July 27, 2005

Indonesian chickenshit, bullshit style

The source of the virus that infected and killed three members of the same household remains a mystery. Direct contact with infected poultry, the preferred explanation of those hesitant to admit the likelihood of human-to-human transmission has apparently fallen to last on the list. But WHO and Indonesian authorities have a new theory, which might be called the Chickenshit Theory (CST). Thus Georg Petersen, WHO's representative in Indonesia has raised the possibility that transmission took place from environmental contamination, specifically from poultry feces.
[Petersen] said that the transmission of Avian Influenza virus in Tangerang, which claimed three lives, might have taken place through environmental contamination.

For example, the transmission could have been through chicken dung, Petersen told Tempo by phone on Sunday (23/07). However, he declined to speculate on the sources of the virus and the transmission process. (Tempo Interactive)
Excuse me? He declined to speculate? It sure sounded like he was speculating there. No reticence for Indonesia's Queen of Speculation, Health Minister Siti Fadilah Supari.
Minister of Health Siti Fadilah Supari said the latest field tests performed by her office had found bird feces containing the deadly H5N1 strain of avian influenza. She said it was possible Iwan Siswara and his two daughters contracted the disease from the feces of infected poultry.

"We can only say that we discovered bird feces that tested positive for the virus, but it remains unknown where Iwan contracted the disease," Siti said.

She said it was unlikely Iwan and his daughters contracted the virus by eating chicken or through human-to-human transmission.

Minister of Agriculture Anton Apriyantono confirmed the discovery of feces containing the avian influenza virus around Iwan's neighborhood.

"We have found feces that contained the bird flu virus. But we cannot determine if the feces was the source of the virus that killed Iwan and his two daughters," Anton said during a press conference after meeting with President Susilo Bambang Yudhoyono.

Iwan lived in Legok, Tangerang, Banten, where the government culled dozens of pigs and ducks on Sunday that had tested positive for the virus.

There has also been speculation that Iwan and his daughters contracted the virus from infected pigs.

Avian influenza can be transmitted to humans through an intermediate host such as a pig.
Siti said Iwan and his daughters were the only known human cases of bird flu in the country. She was commenting on three people, including a Malaysian national, who displayed symptoms of avian influenza infection
Ah, yes. Those "other three." But no need to worry:
Two Indonesians, AS and AB, are being treated at Sulianti Saroso Hospital in North Jakarta after displaying symptoms similar to those associated with bird flu. Their blood samples have been sent to the WHO laboratory in Hong Kong for testing. It normally takes the laboratory at least one week to complete the tests.

The Malaysian national died last week and has been cremated.

"After going over the medical records of the Malaysian man, I am convinced that his death was not caused by the avian influenza virus. He had a high fever for about two weeks, which is more similar to typhoid," Siti said.

People who contract the bird flu virus usually only survive for three or four days if they suffer from a high fever. (Jakarta Post)
She has apparently received training at the Dr. Frist School of Long Distance Diagnosis. Well, at least the source of the infected feces will be taken care of with plans for extensive culling of chickens and pigs, widely reported in the media last week.
In a response to Indonesia's first three fatal human cases of avian influenza, officials killed some infected pigs and poultry yesterday, but not as many as they had planned to, according to news services.
Plans had called for culling about 200 pigs in a village near the Jakarta suburb of Tangerang, the home of a man and two daughters who died of avian flu this month. But officials instead killed only 18 pigs, along with "dozens" of chickens and ducks, according to a Reuters report yesterday.

The agriculture minister, Anton Apriyantono, told a radio station that the original plan would have hurt the local economy, the story said. But his spokesman, Hari Priyono, said the plan was to kill only the pigs that tested positive for avian flu.

He said only 18 pigs tested "truly positive" for the virus, and those 18 were slaughtered, according to the story. "In days to come, whenever we find a positive one here, we will slaughter it straight away," he was quoted as saying. (CIDRAP)
Maybe they're spinning it a bit, but at least health authorities have a reserve of credibility for their otherwise sterling performance in truth-telling:
Fish vendors at Pasar Anyar and Cikokol markets are also enjoying booming sales. In contrast, chicken sellers have seen their sales drop drastically.

"I feel so lucky because I am selling more fish than usual. On the other hand, it is difficult to enjoy because my friends who sell chickens are staring at piles of unsold chicken," said Amawi, 46, a fish vendor at the municipality's downtown market.

Falling chicken sales have been cited as a motive in the suicide of a 22-year-old poultry farm owner from Cisauk district, Tangerang regency. (Jakarta Post)
Apparently this trusting nature is not confined to the poorer segments of Indonesian society, either:
When a government auditor and his 2 young daughters died suddenly this month, there was panic in their middle-class suburb along with reports that they were Indonesia's 1st casualties of avian influenza. Neighbors anxiously traded rumors across the metal fences surrounding their neatly landscaped yards. Mothers kept their children from playing on the palm-lined streets. Some families in this quiet California-style subdivision of bankers, businessmen and doctors considered packing up their belongings in their SUVs and abandoning their homes.

Most residents of the Villa Melati Mas [commuter] community on the western outskirts of Jakarta had paid little [attention] to reports of avian influenza, which has devastated poultry flocks across Indonesia during the last 2 years and killed dozens of people in other Southeast Asian countries.


"I'm wondering why this happened. I'm confused. Can we get this? We're trying to be calm," a doctor's wife said anxiously as she stocked up on broccoli and cauliflower from a vegetable peddler plying the subdivision's cobblestone streets. She has forbidden her children to eat outside the home in case the virus can spread through food. "We've stopped going to Kentucky Fried Chicken," she said.

Stoking the neighborhood's fear is uncertainty about the outbreak's cause. Unlike the rural villages of Vietnam, Thailand and Cambodia, where other avian influenza deaths have occurred, there are no farmers or live chickens in Villa Melati Mas. (Alan Sipress in WaPo)
Well, maybe they think they have a nice, clean neighborhood, but Indonesian health authorities know it is really littered with poultry feces.

Or maybe it's bullshit.