RECENT ECONOMIC REPORTS

INDONESIA: ANTHRAX OUTBREAK IN WEST JAVA

Summary: An anthrax outbreak near Bogor, West Java has claimed six lives and hospitalized eight people since October 16. The virus may have affected as many as 65 people so far. Ministry of Health officials report that infected goat meat was the cause. To stem the spread of the virus, the GOI has ordered a quarantine of the affected villages, as well as the slaughter of all goats and goat pens in the district. Officials say they are tightening controls on livestock shipped to Jakarta-area slaughterhouses. Anthrax is endemic to this part of West Java - about 60 kilometers from Jakarta - due to poor animal husbandry practices as well as ineffective prevention and treatment. The government's response to this anthrax outbreak will be an early test of inter-ministry and central-regional coordination.

Anthrax Outbreak in Bogor Regency:

The district health office in Bogor, West Java reported that an anthrax outbreak had occurred in the village of Citaringgul, Babakan sub-district, on October 16. According to the health office, six people died and eight more were hospitalized after eating infected goat meat. The district health office said an initial health survey shows that the virus has affected as many as 65 people, the largest outbreak in years.

Anthrax is endemic to nearly all of Indonesia. However, it is particularly common to this sub-district in West Java, which covers 208 square kilometers and is home to 35 villages and over 430,000 people. Since 2001, the Bogor Health Agency has recorded 47 cases of anthrax infection and 11 fatalities. The bacillus anthraces bacteria is normally found in soil and ingested by livestock, who then transmit the virus to humans.

Central and Regional Governments Respond:

President Susilo Bambang Yudhoyono (SBY) reacted quickly, expressing condolences to the families of the victims and directing his ministers to take action. Health Minister Dr. Siti Fadilah Supario warned the public to report immediately to health facilities any evidence of anthrax symptoms in people or livestock. She also visited Bogor victims on October 23, informing them that the government would cover the costs of their medical treatment. Agriculture Minister Apriyanto ordered the distribution of 300,000 doses of anthrax vaccine across the country to prevent the spread of the disease. He also directed the Bogor district government and its agencies to isolate and ban inter-regional transportation of livestock from the affected sub-district of Babakan. Bogor agriculture officials have ordered locals to slaughter and burn all goats and goat pens in the sub-district. The Agriculture Ministry's director of Vector-Borne Disease Eradication also deployed an investigation team to the area.

The regional disease prevention health office has placed warning signs in nine villages within the endemic area. Additionally, the regional livestock office is vaccinating other cattle not yet infected by the anthrax virus. The office oversees the regular vaccination of livestock in the endemic area. The last anthrax vaccination occurred August 19-30 this year. The next vaccination will occur in November-December, prior to the January 2005 Idul Adha religious holiday. During Idul Adha, large numbers of livestock are slaughtered throughout the country and given as gifts to less fortunate people.

U.S. Mission Asked to Confirm Anthrax:

The National Institute of Health has asked the U.S. Mission's Naval Medical Research Unit (NAMRU-2) to confirm the presence of anthrax in five samples taken from the affected area. NAMRU-2 is currently testing those samples.

Obstacles to Anthrax Eradication:

According to the Health Ministry's director of Vector-Borne Disease Eradication, Dr. Rusmini, there are several reasons why anthrax is such a persistent problem in the Bogor district. He cited a 2002 study conducted by the National Institute of Health and Balivet Laboratory in Bogor, which noted the following concerns:

-- Longevity: anthrax bacterial spores can remain active for decades in dry soil. The study recommends that the central and regional governments relocate villagers and help them develop new farmland outside the endemic area.

-- Education: low education levels among the local population hinder government efforts to educate the public about anthrax prevention and control.

-- Limited Vaccine Supply: according to the study, the supply of anthrax vaccine is only enough to cover about 12 percent of at-risk animals.

Inadequate inspections and biosecurity measures also contribute to the recurring cycle of anthrax outbreaks. Animals transmit anthrax to humans before the onset of clinical and pathological signs. Pre-mortem or post-mortem inspection by competent officials can identify diseased animals/meat and prevent them from entering the food chain. However, it is common in rural areas of Indonesia for animals to be slaughtered in back yards or in unregulated abattoirs, where inspection officials and appropriate sanitary measures are completely absent. Weak slaughterhouse controls and lack of implementation on feed requirements (e.g., to prevent contamination of the feed supply) compound the risk.

Comment: Anthrax outbreaks are regular events in this area and local animal health authorities should have been closely monitoring livestock for telltale signs of disease. The public has praised the SBY government's quick response so far. However, enforcing the quarantine, destroying other diseased animals, and implementing biosecurity measures will provide an early test for the new Minister of Agriculture and his team. Indonesia has less than a stellar record in these areas. Stopping the cycle of outbreaks is a longer-term issue that will require closer monitoring of livestock in endemic areas and enhanced sanitary and inspection procedures.

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