Two recent deaths from bird flu in Indonesia highlight the need for continued vigilance against a possible resurgence of the deadly virus, an official and health expert warned.
On 16 January, a five-year-old girl from northern Jakarta died after being tested positive for the H5N1 bird flu virus. She was a relative of a 24-year-old man who died on 7 January, the World Health Organization (WHO) said, adding that the two had contact with the same pigeons in their neighbourhood.
According to WHO, the latest fatalities brought the death toll from avian influenza in the country to 152, out of 184 confirmed cases since 2006.
The Health Ministry's director-general of disease control and environmental health, Tjandra Yoga Aditama, said there was no evidence that human-to-human transmission was involved in the latest case.
"As long as there are still birds carrying the virus, there will be cases of bird flu in humans from time to time," Aditama told IRIN.
In 2011, there were 11 cases in Indonesia, and 60 in the world, Aditama said.
"We have to continue to maintain our vigilance," Aditama said. "The Indonesian government is taking the threat of bird flu seriously and is taking measures like countries in other parts of the world."
But Marius Widjajarta, chairman of the Indonesian Consumer Empowerment Foundation for Health (YPKKI), cited a lack of coordination among different government departments as hampering efforts to contain its spread.
"We can see that the Health Ministry, the Agriculture Ministry and local governments are doing their own things," Widjajarta told IRIN. "What if there was a pandemic?"
"All parties concerned must cooperate to promote changes in people's behaviour and attitude towards the threat of bird flu," he added.
Public awareness campaigns were done sporadically, he said, and official reporting of bird flu cases in poultry has been spotty.
The Health Ministry said bird flu was endemic in poultry in all but three of Indonesia's 31 provinces. The ministry has designated 100 hospitals across the archipelago nation as being well-equipped to treat bird flu patients.
According to WHO, 344 people in 12 countries have died of bird flu since 2003, with Indonesia reporting the most fatalities.
WHO said so far, transmission of H5N1 viruses from animals to humans had only resulted in sporadic human cases or small clusters among close contacts, with no evidence of community-level spread.
"These sporadic human cases and small clusters of human infection with variant influenza viruses are expected and are not considered unusual, and do not change WHO's current assessment of pandemic risk," WHO said in a statement released in December.
*This report was updated on the 31 January 2012