INTERVIEW-Indonesia Needs Better Bird Flu Control

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Cock fighting and backyard chicken farming remain common in the sprawling archipelago, according to Sardikin Giriputro, head of Sulianto Saroso Hospital, the national hospital for infectious diseases in Jakarta.

"The virus is still circulating in poultry, not in commercial farms but in backyard farms which is very difficult to control," Sardikin told Reuters in an interview.

"We have to focus effort to control it. Public awareness is still inadequate.

"People don't follow advice from the government, it is difficult to change behaviour."

He was speaking on the sidelines of an international bird flu meeting organised by the Washington-based group New-Fields.

Indonesia has recorded 74 human cases with 56 deaths, including two cases confirmed on Monday. Only Vietnam has recorded more cases, 93 with 42 deaths, according to the World Health Organisation (WHO).

Many Indonesian families' livelihoods depend on keeping poultry which the government has encouraged over the years because the birds are a source of protein, Sardikin said.

"People still continue bird raising, cock fighting and bird singing contests. People still traffic live chickens from one area to another," he said.

His hospital has investigated more than 225 suspect bird flu cases, confirming 22 cases with 19 deaths to date, he said.

"Most of the patients who died came in the late stage. We gave Tamiflu but it was already 48 hours after (disease) onset," he said.

Tamiflu, by Swiss drugmaker Roche <ROG.VX>, is recommended by the WHO against bird flu but should be used within 48 hours.

The three patients who survived had received Tamiflu but two of them had only mild cases of bird flu, according to Sardikin.

Indonesia has only one laboratory with sufficient biosafety measures to confirm bird flu and this will rise to three labs next year, he said. "It can take days to diagnose cases. We think there may be some missed cases.

"It is a result of laboratory testing, which depends on quality and timing of the swabs. Sometimes the virus is no longer in the throat or on nose swabs even though clinically we may believe it is a case of avian flu but the laboratory can't prove it," he said.

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