Indonesia was bracing for more bird-flu deaths yesterday after the World Health Organization warned that the densely populated country could see more fatalities from the virus than hardest-hit Vietnam and Thailand.
Bird flu has claimed the lives of four Indonesians since July, and three children who died this week are suspected of having had the disease. Laboratory test results are expected within days, doctors said, noting that 13 other patients were under observation.
Despite concerns about the growing number of cases, the WHO said there was no evidence yet that the deadly virus was spreading between humans on the sprawling archipelago -- a nightmare scenario that could lead to a pandemic killing millions of people.
The Indonesian government -- accused of responding slowly to the outbreak -- has in recent days fired the country's chief of animal health control, ordered the mass cull of chickens in infected areas, and threatened to forcefully hospitalize anyone showing symptoms of the disease.
Indonesian Health Minister Siti Fadila Supari said Indonesia yesterday received 10,000 tablets of Tamiflu -- the only treatment so far proven effective against bird flu in humans. That's enough for about 1,000 victims, according to the manufacturer.
So far, most of the bird-flu victims have been in the capital Jakarta. But WHO representative Georg Petersen said he expected the virus to spread elsewhere on Java Island -- home to almost half of Indonesia's 220 million people -- and the tourist paradise of Bali.
"With the high human population density, we can expect to see more cases here, more perhaps than even in Vietnam and Thailand," he said.
Vietnam and Thailand account for more than 50 of the 63 deaths in Asia from the H5N1 strain of the virus, which has decimated poultry populations in large swaths of the region since 2003. Most human cases have been linked to contact with sick birds.
Margaret Chan, the WHO's top official in charge of monitoring avian influenza, said there was no evidence that Indonesia's current rash of cases represented the first stage of person-to-person transmission.
Authorities have been unable to determine the source of most of the infections in Indonesia, where the virus has killed millions of chickens in farms and backyards since 2003.
"Until we see further evidence, we are still at Phase 3 of the pandemic alert," Chan told reporters in Sydney.
WHO's pandemic alert has six phases, ranging from zero infection in birds and humans to a full-scale pandemic -- a multi-country outbreak in which the disease is passed from person to person.
The UN agency said on Wednesday that it was prepared to begin distributing large-scale quantities of the anti-viral drug oseltamivir, known commercially as Tamiflu, to Indonesia "if and when" a pandemic happens.
Vietnam, meanwhile, said it has received a donation of 600,000 Tamiflu tablets from Taiwan and was planning to buy another 70,000 for its national stockpile.