Sep 21, 2005 (CIDRAP News) – The death of a 5-year-old girl and a 2-year-old girl from suspected avian influenza fanned worries in Indonesia today as the government promised to destroy infected poultry flocks, according to news agencies.The Associated Press (AP) reported that nine people were hospitalized in Jakarta for treatment of suspected avian flu. Authorities were awaiting test results for them and the two deceased girls, the report said. Indonesia has had four deaths attributed to H5N1 avian flu so far, including that of a 37-year-old woman on Sep 10 (though the World Health Organization [WHO] has recognized only two cases as laboratory-confirmed).The 5-year-old died at Jakarta’s Sulianti Saroso Hospital for respiratory disease after being admitted Tuesday, according to an Agence France-Presse (AFP) report. Indonesian Health Minister Siti Fadilah Supari said the girl “most likely” died of avian flu, the Jakarta Post reported. But she also said an initial local laboratory test on the girl was negative, according to a Reuters report.An AFP report said the 2-year-old girl died at Jakarta’s Christian PGI Hospital after suffering a high fever and respiratory problems. A hospital spokeswoman named Rosiana said the girl’s illness should be considered a suspected case.Sardikin Giriputro, deputy director of the Sulianti Saroso Hospital, said the hospital had three new patients with suspected avian flu this afternoon, according to AFP. One was a 9-year-old girl who visited Ragunan Zoo in Jakarta just before it was closed this week after 19 captive birds there tested positive for avian flu. The other two patients were teenagers who had had contact with birds before they fell ill, the story said.The government promised today to destroy infected poultry flocks, something it has been reluctant to do until now because of cost concerns, according to the AP. Indonesia has many small backyard poultry flocks.Agriculture Minister Anton Apriyantono said mass slaughters would be carried out in areas found to be “highly infected,” meaning infections in 20% of the poultry, according to the AP and USA Today.Meanwhile, the ministry’s director of animal health told news services she had been fired for allegedly failing to control avian flu.A WHO official said today the agency is prepared to provide the antiviral drug oseltamivir (Tamiflu) if signs of a flu pandemic show up, according to a Voice of America (VOA) report. Shigeru Omi, director for the WHO’s Western Pacific Region, said the agency is prepared to send doses to Indonesia “if and when a pandemic starts.”A five-member team of US officials is in Indonesia to find out how the United States can help the country battle avian flu, AFP reported today. The team includes officials from the Centers for Disease Control and Prevention (CDC) and other agencies, according to the information from US embassy spokesman Max Kwak.The team, which is on a regional fact-finding mission, arrived Sep 18 and will leave Sep 24, the story said.Earlier this week, WHO Director-General Lee Jong-wook said the agency would not push for a generic version of oseltamivir to increase the supply for people in poor countries, according to a Sep 19 AP report.The story said some countries have suggested that Roche, the Swiss-based manufacturer of oseltamivir, should relinquish its patent so that other companies could produce cheaper versions of the drug. Roche announced in August it would give 3 million treatment courses of the drug to a WHO-managed international stockpile.Lee told the AP that with Roche “doing its part,” pressuring for a generic form of oseltamivir is not a good way to encourage the company to do more.In other news, 37 Asian countries represented at the WHO’s Western Pacific annual conference in New Caledonia approved a strategy for combating emerging diseases such as avian flu, according to an AFP report. The story didn’t spell out what the strategy involves.At the conference, Omi said the strategy cannot be implemented without the help of richer nations. He called on Asian countries to change their farming practices to prevent the spread of avian flu, the report said.According to a VOA report, Omi said it would cost $250 million over the next year to prepare for a possible flu pandemic.In the same story, Georg Petersen, the WHO representative in Indonesia, warned against complacency about the threat of a flu pandemic. “We need to prepare—every country—for an eventual massive influenza pandemic that puts up to 30 percent of the workforce in bed,” he was quoted as saying.