During the period of 16 June to 23 July 2005, World Health Organization (WHO) has confirmed 5 human cases of H5N1 infection in Vietnam and 1 fatal human case in Indonesia. The Vietnamese patients (4 from northern Vietnam and 1 from central Vietnam) remained alive. The Indonesian case was a 38-year-old man who died in the Banten province on 12 July. He was the first confirmed human case in the country. His two daughters were also suspected to die from avian influenza. However, laboratory tests were still in progress to confirm the diagnosis.
In response to the recent human case detected, Indonesian authorities had taken various measures to prevent spread of the disease in human and poultry populations. 300 human contacts had been identified and they were put under quarantine for medical surveillance. So far none of them developed any symptoms. Animal farms in Banten province had been restricted and poultry surveillance was conducted within 20 kilometers of farms contaminated by the virus.
Outbreaks of H5N1 avian influenza in poultry populations resumed in some Asian countries after a quiescent period since early April 2005. According to World Organization for Animal Health (OIE) official reports, Vietnam reported 1 poultry outbreak in the southern province of Ben Tre with 6,000 birds dead and 700 birds destroyed. Indonesia reported 9 outbreaks (7 in Jambi, 1 in North Sumatra and 1 in East Kalimantan) with 13,000 birds dead and 1,500 birds destroyed. Thailand reported 5 poultry outbreaks in the province of Suphan Buri with 75 birds dead and 150 birds destroyed. China reported 1 poultry outbreak in Xinjiang autonomous region with 63 birds dead and 117 birds destroyed. Philippines reported 1 poultry outbreak in Bulacan province with 280 birds destroyed.
Multi-national collaborations and investigations of avian influenza outbreaks were further enhanced. In early July 2005, WHO sent an expert team to Vietnam to assess the current pandemic risk of H5N1 infection. The expert team concluded that current laboratory and epidemiological findings did not suggest H5N1 virus had extended its range in humans or had increased its transmission efficiency among human population. Nevertheless, WHO reiterated that the pandemic risk remained unchanged and the world should remain vigilant in its avian control efforts. In addition, UN Foods and Agriculture Organization (FAO), OIE and WHO jointly organized a consultation in Kuala Lumpur, Malaysia, during 4-6 July 2005. The objectives were to identify dangerous practices of the poultry industry in Asia, to assess the effectiveness of current regulatory controls, and to provide practical guidelines on how to improve regulatory controls on the poultry industry. The consultation unveiled a multi-point plan to reduce the risk of avian influenza spreading from poultry to human populations in affected countries. The plan included emergency support in the areas of laboratory diagnosis, vaccine development, surveillance, public education, and stockpiling of antiviral drugs and personal protective equipment.
As of 23 July 2005, WHO has confirmed a total of 109 human cases (55 deaths) of avian influenza infection in Thailand, Vietnam, Cambodia and Indonesia since early January 2004. The source of infection and possibility of human-to-human transmission of avian influenza in Indonesia have yet to be solved. CHP will closely liaise with WHO and Indonesian health authority to obtain latest information and conduct risk assessment.

Reported by
Respiratory Disease Office
Communicable Disease Surveillance Section
Surveillance and Epidemiology Branch
Centre for Health Protection