Indonesia struggling to cope - quake survivors at greater risk of bird flu

Indonesia's devastating earthquake on 27 May, has so far taken the lives of over 6,000 people and injured 30,000 more.

The government estimates that as many as 135,000 homes were destroyed, leaving some 647,000 people homeless living in makeshift shelters without toilets or water.

According to the UK medical aid charity Merlin, many of the Indonesian quake survivors are sheltering in poultry sheds and are increasing their risk of becoming infected with the H5N1 bird flu virus.

Following the quake in the Bantul district of Central Java, one of the worst affected areas, poultry sheds were the only structures left standing and the charity has found over 100 people sheltering in them.

What is more Merlin says many of the sheds still had bird droppings and had not been properly disinfected.

The charity is taking part in the rehabilitation efforts after the earthquake and has called for more tents to be provided for refugees.

The charity's medical director in Indonesia Dr. Yolanda Bayugo, says the unsanitary conditions in the poultry sheds also leave the survivors exposed to other infections, such as salmonella.

The poultry sheds are about 200 metres long and aid workers say that though some are new and had not yet housed chickens, others, had chicken droppings lying on bamboo slats where children were playing in bare feet.

They fear the overcrowded, unsanitary conditions in the poultry sheds may raise the survivors' risk of catching bird flu and then spreading bird flu to each other.

Scientists believe bird flu can sometimes be passed on from human-to-human if there is close, continuous physical contact and a common bloodline.

But the disease remains a disease of animals and human-to-human transmission is rare.

A cluster of 7 deaths in one Sumatran family last month happened when the humans infected each other because they all had shared and lived in a small room.

They were all blood relatives.

Bird flu has become established in Indonesia, and 75% of the country's provinces have experienced outbreaks of the H5N1 avian virus.

Last month a human infection of bird flu was reported in Indonesia every two days and the country is poised to supercede Vietnam if human infection rates continue at the same pace.

Vietnam has not had a human infection for several months.

Once H5N1 becomes established in a country its opportunities for mutating grow significantly.

The most likely scenario in which H5N1 might mutate so that it can transmit from human-to-human is if it infects a person who also has the usual human flu at that time.

The bird flu virus would then have the opportunity to exchange genetic information with the human flu virus and acquire the ability to become human transmissible.

If H5N1 mutates, it could trigger a serious human flu pandemic.

Indonesia was struggling to deal with the explosion in bird flu cases before the quake and already this year around 26 people have died from the deadly virus.

The current death toll from the virus is 37.

The country has now reluctantly begun to cull poultry in an effort to contain the deadly avian influenza.

Culling operations were effective in controlling the spread of the disease in Vietnam and Thailand.

According to World Health Organization figures, since 2003 127 humans have so far fallen a victim to the H5N1 virus, and most of those were in Asia.

Since then it has spread rapidly across Asia and Europe as well as Africa.

The virus is contracted from close contact with infected birds and their saliva, nasal secretions, and faeces.