Simposium Internasional Tantangan dan Implikasi Flu Burung

Jakarta, 2 Agustus 2006,

Simposium Internasional "Tantangan dan Implikasi Flu Burung terhadap Human Security: Berbagi Masalah, Berbagi Solusi". Yang dilaksanakan di Ballroom,Hotel Sahid Jaya,

Jakarta, 13-14 Juli 2006.

Simposium Internasional

Tantangan dan Implikasi Flu Burung terhadap Human Security,Berbagi Masalah, Berbagi Solusi.

Flu burung telah menjadi ancaman bagi negara-negara Asia sejak pertama kali terdeteksi pada unggas pada tahun 2003. Puluhan ribu unggas mati karena penyakit ini dan dimusnahkan. Penyakit ini bahkan kini menyebar ke Eropa dan Amerika. Dan menjadi isu global lintas batas.

kasus flu burung di peternakan segera diikuti oleh terinfeksinya manusia oleh virus flu burung yang terjadi di Thailand, Cina, Vietnam, Kamboja dan Indonesia. Diantara negara Asia , Vietnam paling banyak kasus flu burung mencapai 90 kasus. Di Eropa, Turki menjadi negara Eropa pertama ditemukan flu burung pada manusia pada tanggal 5 januari 2005. Nigeria menjadi negara pertama Afrika yang terjangkit virus dengan laporan 7 kasus H5N1 dengan 5 orang diantaranya meninggal dunia.

Menurut catatan WHO, 4 Juli 2006, terdapat 229 kasus flu burung pada manusia di seluruh dunia. Sebanyak 131 penderita meninggal dunia. Menteri kesehatan RI menyebutkan di Indonesia telah ditemukan 34 kasus dan 25 orang meninggal dunia. Kekuatiran ini makin menguat karena masih belum ditemukan obat teruji dan mampu menyembuhkan flu burung.

Bagi kalangan akademisi dan palaku kesehatan adalah kekuatiran selanjutnya adalah terjadinya penularan dari manusia ke manusia. Sebuah kondisi yang belum pernah terjadi sebelumnya. Kasus kematian 5 orang di desa kubu Simberalang, Karo, Sumatera utara menjadi sinyalemen kekuatiran tersebut. Sebagai tindakan pencegahan WHO dan Departemen Kesehatan RI telah mengkarantina 54 anggota keluarga yang selamat, mereka diawasi dan dijaga oleh tim dari departemen kesehatan.

Kasus di karo membuat departemen kesehatan, departemen Pertanian, praktisi kesehatan dan akademisi mencari kebijakan penangulangan yang tepat sasaran. dalam kerangka itu The Habibie Center (THC) dan Democratic Pacific Union (DPU) dengan di dukung oleh Direktorat Jenderal Pengendalian Penyakit dan Penyehatan Lingkungan, Departemen Kesehatan RI menyelenggarakan simposium Internasional yang menghadirkan para pakar patologi dari negara tetangga, diantaranya Thailand, Taiwan, peneliti biomolekular Indonesia, pihak rumah sakit infeksi pernafasan, perwakilan organisasi kesehatan dunia dan pejabat penanggulangan penyakit dan pengawasan lingkungan.

Simposium ini akan membahas berbagai aspek flu burung ditinjau dari kacamata domestik, regional dan global. Bagaimana pengaruhnya secara sosial ekonomi. juga bagi keamanan manusia serta faktor dan kondisi spesifik penyebaran flu burung di Indonesia dan negara asia lainnya.

Simposium ini mencari cara dan upaya bagaimana memperlakukan pandemi penyakit sehingga menghasilkan petunjuk strategis menanggulanginya, serta mencari kebijakan strategis dan penyebaran informasi masyarakat luas dalam meningkatkan kesadaran dan pencegahan terhadap flu burung.

Summary

International symposium

on the challenge and implication of avian influenza on human security:

sharing problems, sharing solutions

13-14 july 2006

Vaccination strategy

1. At the beginning of Avian Influenza outbreak, according to OIE and FAO, the stamping out policy was recommended to control the disease.
2. However, the recurrence of outbreaks after the stamping out policy was implemented highlighted the importance of vaccination as a complimentary strategy.
3. In some countries including Indonesia, vaccination is proven to reduce the incidence of morbidity and mortality and reduce virus shedding.
4. Vaccination may be conducted under particular conditions,such as using high quality vaccine product, appropriate vaccine program coupled with sustainable monitoring and evaluation of the vaccination program.
5. Vaccination should be done in conjunction with a rigorous monitoring and surveillance program.
6. Insufficient vaccination program and insufficient monitoring failed to stop the virus spreading, as shown in the case of pakistan.
7. Moreover areas with endemic status and high density of poultry population are more suitable for vaccination rather than stamping out policies due to high potential economic losses.
8. The vaccination has to complement a comprehensive strategy that includes improving biosecurity,controlling poultry movement and their products as well as public education to raise awareness.
9. Meanwhile, the stamping out program remains relevant for new infected areas.
10. The source of infection particularly in small-scale backyard poultry was difficult to control, indicated by poor coverage of vaccination and insufficient biosecurity measures including poor hygiene and sanitation.
11. Unlike other countries, the human Avian influenza in Indonesia was not precipitated by animal cases.

Biomolecular of Avian Influenza

1. This has raised a question of human to human transmission. The suspicion grew stronger when the karo cluster of North Sumatera appreared, the biggest cluster with 8 persons infected without any detected clinical symptoms in animals surrounding the area.
2. However, molecular analysis of the viral genomes of human isolates showed that the virus is still of avian origin. There is not enough scientific evidence to support the assumption of human to human transmission.
3. Currently, scientists managed to detect the presence of virus in healthy animals, a phenomenon dubbed as the sub clinical or silent infection.
4. These animals commonly waterfowls particularly ducks act as virus reservoirs and present a new source of infection for human.
5. Based on a phylogenetic analysis, the Avian Influenza H5N1 in Indonesia can be divided into three sublineages, A, B and C.
6. Java as a center for poulty farming and trading carries viruses of all sublineages, where as Sulawesi has sublineage A; Bali and Flores have sublineage B and Sumatra has sublineage C.
7. This sublineage of the virus does not mean variety of its pathogenicity.
8. Current tools to prevent Avian Influenza pandemic could come in the form of: Pharmaceutical intervention, for example the use of antiviral; non-pharmaceutical intervention, such as isolation, quarantine, and control of infection, in individual as well as in community level.
9. Paralell to these ,the rapid response is important to be done due to short incubation period of the disease.
10. Rapid response could be seen in the deployment of trained personnel,distribution of antiviral and PPE stockpile, implementation of prepared risk communication, establishment of social isolation and quarantine, and coordination of relevant institutions, such as WHO, military, local and national government, and regional collaboration.
11. High case fatality of Avian Influenza in human is related to the late diagnosis and treatment, due to the lack of early detection. Thus, there is a need to strengthen an early warning system though improving the detection of human cases; an integration of animal and human surveillance so that detection of a outbreak in animals leads to heightened surveillance in humans; supporting epidemiological investigation ( for example GOARN); coordination of research; and strengthen risk assessment.
12. To make an accurate diagnosis of Avian Influenza, the advanced methods are still needed, such as RT-PCR.

Recommendations

1. A good medical system is a necessity in preventing and controlling the dissemination of Avian Influenza.
2. This symposium recommends to governments-particularly of seriuosly affected countries to take more concrete and seriuos actions in dealing with the problem of Avian Influenza including pandemic preparedness.
3. A closer cooperation between nations especially in the Asia-Pacific region is an absolute necessity. Therefore it is highly recommended that all stakeholders-goverments, civil society, academics and communities alike-improve communication and cooperation.
4. International bodies such as WHO, FAO and OIE and other relevant international institutions take further measures to support affected countries to increase capacity of human resources and facilities though funding and assistance.
5. The Habibie Center and Democratic Pacific Union would like to extend gratitude to all speakers and all participants in making this symposium a success.

wassalam

Rachmad Yuliadi Nasir