Jakarta – Suspected bird flu patients can be forced into hospital under "extraordinary" measures welcomed by the World Health Organization to counter a widening outbreak of the virus in Indonesia, officials said.
A day after declaring the country faces an "extraordinary incident" because of bird flu, Health Minister Siti Fadilah Supari said the number of cases has continued to rise in the country where four have died from bird flu over the past two months.
She said six patients are now being treated at a hospital for respiratory ailments. "Two are almost certain to be bird flu cases. Four others are still under observation but judging from the symptoms, they are similar to those of bird flu although there is yet no laboratory evidence that they are positive," the minister said after the opening of a regional health ministers' meeting.
On Monday Supari declared the "extraordinary incident" status after bird flu left a fourth person dead, three children with suspected infections and the Jakarta zoo shut down – all since last Friday. The government has previously declared an extraordinary health event for an outbreak of dengue fever.
"The national extraordinary condition was declared so that the people can remain calm and not panicking because the government is prepared to handle this in a national way," Supari said.
On Friday health official said tests confirmed that a Jakarta woman aged 37 had died of bird flu a few days earlier. The latest death brought to 63 the number of people in Southeast Asia known to have died from the H5N1 strain of the virus since 2003. Indonesia and Cambodia each have four reported deaths, Vietnam has 43 and Thailand 12. International concern is mounting that the disease could mutate into a major killer.
Indonesian officials said the country's first bird flu deaths came in July when an auditor and his two young daughters died in suburban Jakarta. The government said chicken droppings were suspected to have caused those deaths.
"An unusual outbreak requires extra efforts," said Haryadi Wibisono, a director of disease control at the health ministry. Under the extraordinary status patients with suspected bird flu can be admitted to hospital by force if necessary, Wibisono said.
He said free medicine will be given to patients suspected of bird flu infection, citizens will be encouraged to contain the outbreak and public places could be closed. "This is a serious problem for Indonesia and the whole world and therefore it should be dealt with seriously," he said.
Georg Petersen, the World Health Organization's Indonesia representative, welcomed Indonesia's efforts and said it is not easy in an underdeveloped country of about 212 million people. He called it "a serious situation" and said the H5N1 virus is widespread in Indonesia's poultry population.
"We are pleased for all the effort being done, recognizing the difficulties," he said, adding the WHO is satisfied that suspected cases are being investigated. He said massive culling of birds would be very difficult in Indonesia, where most chickens are backyard birds.
However, Petersen said authorities in Jakarta should look at how to improve the hygiene and handling of birds in the metropolis. A chicken seller and a bird owner in central Jakarta said they already practise good hygiene.
Nasaruddin, 65, who buys live chickens and cuts them up for sale, said he regularly cleans their coops and ensures they are properly fed and watered. "I'm not worried because I know how to select healthy chickens," he said.
Next door, 14 caged turtledoves hung over a small roadside restaurant operated by Sadli bin Ilin, 47. "I haven't thought about vaccinating them but the most important thing is we keep them clean," bin Ilin said.
Officials shut down the Ragunan Zoo in Jakarta for 21 days beginning Sunday after 19 of 27 samples taken from birds at the zoo, including pigmy chickens and eagles, were found to contain the bird flu virus.