INDONESIA PREPAREDNESS AND RESPONSE ON EBOLA VIRUS DISEASE Coordination Meeting, 13 November 2014 dr. Wiendra Waworuntu, M.Kes Director of Surveillance, Imunization, Quarantine Health and Matra Health

About Ebola Virus DiseaseControl Plan and PreparationIndonesia Situation Outline

Ebola virus disease, previously known as Ebola hemorrhagic fever, is a rare and deadly disease caused by infection with one of the Ebola virus strains (Zaire, Sudan, Bundibugyo, or Tai Forest virus). Signs of Ebola include fever (≥38°C) and additional symptoms, such as severe headache, anorexia/ loss of appetite, lethargy, breathing difficulties, muscle pain, vomiting, diarrhea, abdominal (stomach) pain, difficulty swallowing, hiccup, or unexplained hemorrhage (bleeding or bruising). The incubation period of Ebola virus disease (EVD) varies from 2 to 21 days but the average is time 8 to 10 days. No vaccine available yet, no specific treatment. Supportive therapy is given based on patient condition. The Ebola virus is transmitted among humans through close and direct physical contact with infected bodily fluids, the most infectious being blood, faeces and vomit. Ebola Virus Disease (EVD)

Improving early case detection at PoE Improving early warning in all regions of Indonesia to detect suspect cases. This is done through provincial health office and district/city event-based surveillance. Continue coordination between Health programs and sectors. Prepare referral hospitals, Balitbangkes National Laboratory and veterinary laboratories for suspected human cases and animals. Risk communication to the public, especially for travelers to endemic areas. Provide regular information for community. Control Plan and Preparation

Case Detection in PoE and Province/ District

1.Circulate Official Letter DG PPPL No. IR / D / II.3 / 384/2014 to raise awareness regarding Ebola Virus Disease including suspect case identification. Letter circulated to all Provincial Health Offices, Chief Port Health Offices and other sectors. 2.Conduct Coordination meetings between Ministries of Health, Agriculture, Forestry, Religious Affairs and Coordinating Ministry of Social Welfare. 3.Provide SOP for case management, surveillance, laboratory, infection control and risk communication. 4.Share information and health promotion materials to the public, in particular risk groups such as travelers to endemic areas. 5.Preparation of laboratory capacity to examine EVD suspect case specimens, with enhancements of current BSL3 facility to BSL3 Plus, as well as procurement of additional logistics and reagents. 6.Preparation of reference hospitals with isolation facilities and trained health workers for Infection Prevention Control (IPC), now ready at 19 reference hospitals. 7.Conduct simulation of preparedness and response on Ebola Virus Disease (table top and field simulation) Action Conducted

No confirmed case found yet Five suspected cases was detected : 1.a male Ghana citizen who visited Indonesia and presented with symptoms aligned with EVD. He was tested negative for Ebola, positive for malaria. 2.Indonesian male who returned from Nigeria for work and presented with symptoms aligned with EVD. He was tested negative for Ebola, positive for malaria cerebral and DHF. 3. Indonesian male who returned from Liberia for work and presented with symptoms aligned with EVD. He was tested negative for Ebola. 4.Indonesian male who returned from Liberia for work and presented with symptoms aligned with EVD. He was tested negative for Ebola, positive for malaria and DHF. 5.Indonesian male who returned from Liberia for work and presented with symptoms aligned with EVD. He was tested negative for Ebola. Indonesia Situation

There were 29 Indonesian who returned form Liberia for work. Two of them developed symptoms on their 21 days followed up and tested negative for Ebola virus disease. The others now is under surveillance until they complete a 21 day follow up on 15 November So far, they don’t develop any symptoms aligned with EVD. Indonesia Situation Continue

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