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Commentary
 
Indonesia H5N1 Testing Raises Pandemic Concerns

Recombinomics Commentary

May 18, 2006

The H5N1 virus has been detected among poultry in almost all of the country's 33 provinces.

There are many poultry farms in the middle of crowded Indonesian residential areas. Around 30 percent of the country's more than one billion chickens are backyard fowl.

Kandun said leaders at all levels had to step up efforts to raise awareness among the public, including having a more robust campaign on the dangers of bird flu.

"There are so many people who do not know what has happened."

Unfortunately, the comment on people not knowing what happened in Indonesia is alarmingly clear.  The evidence for the source of the human H5N1 infections in Indonesia is strongly pointing away from poultry and toward a mammalian source.

The presence of a novel cleavage site in the only human H5N1 isolate that is publicly available has raised concerns that poultry is not the source of H5N1 infections in humans.  However, Indonesia is focused on poultry connections as requirements for H5N1 testing of patients with bird flu symptoms.

The testing policies in Indonesia would grossly underestimate human-to-human or swine-to-human transmission of H5N1 and is a major cause for concern.

The human H5N1 sequences from Indonesia should be released immediately.

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