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[UPDATED] Suspected Wuhan coronavirus in Indonesia: What we know so far

Indonesia has no confirmed cases as of Feb. 11.

Devina Heriyanto (The Jakarta Post)
Jakarta
Mon, January 27, 2020

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[UPDATED] Suspected Wuhan coronavirus in Indonesia: What we know so far A person checks the temperature of a passenger (right) wearing a facemask to help stop the spread of a deadly virus that began in the Chinese city of Wuhan, as he arrives at the Sultan Mahmud Badaruddin II International airport in Palembang on Jan. 26. (AFP/Abdul Qodir)

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s the death toll in China steadily rises, more cities are put under lockdown and suspected cases are found in other countries, fears over an outbreak of the new coronavirus have reached Indonesia.

On Jan. 24, President Joko "Jokowi" Widodo said he had ordered Health Minister Terawan Agus Putranto to increase the government’s vigilance regarding 2019 novel coronavirus (2019-nCoV), also referred to as Wuhan coronavirus.

“We should be ready to examine everyone entering Indonesia or anyone who potentially carries the virus in their body,” he said. “However, as of today, according to the information I have received, and I hope it would stay this way, no one has been infected with coronavirus in Indonesia,” he added.

Indonesia has no confirmed cases as of Feb. 11.

Suspected patients as of Feb. 6

On Feb. 11, various media outlets reported that Indonesia had at least four suspected coronavirus patients, or in Indonesian health authority terms, four people had been “put under observation”.

Tegal, one patient, suspected

Kardinah General Hospital in Tegal, Central Java, announced in a press conference on Feb. 4 that it had one patient suspected of having the coronavirus infection, according to kompas.com. The medical team

chair, Reni Arimartani, said that the hospital had sent his throat swab sample for further examination.

The patient had fever, flu, coughing and breathing difficulties for a few days after meeting with a colleague who had just returned from China. According to Reni, the patient will be isolated for the next nine days.

"The first lab test shows that the patient's lungs are within normal limits, despite the first stage of pneumonia," Reni said.

As of Feb. 11, there were no updates on this patient.

Health Ministry officials take the temperatures of newly arrived passengers at Abdulrachman Saleh Airport in Malang, East Java, on Jan. 27.
Health Ministry officials take the temperatures of newly arrived passengers at Abdulrachman Saleh Airport in Malang, East Java, on Jan. 27. (JP/ Nedi Putra AW)

Sorong, West Papua, one patient suspected

A 39-year-old Chinese traveler has been admitted to Sele Be Solu General Hospital in Sorong. The hospital's director, Mavkren Kambuaya, said the hospital was coordinating with the West Papua and Sorong Health Agency on further action, kompas.com reported.

"The bottom line is, we don't have to worry because it's still suspected. We have not performed an examination because we have to send the [blood] sample to Jakarta first," Mavken said on Sunday.

The patient had been on his way to Raja Ampat, a well-known diving spot, when he developed a fever and was taken to Pertamina Hospital.

As of Feb. 11, there were no updates on this patient.

Kendari, Southeast Sulawesi, one patient suspected

One male Kendari resident is suspected to have been infected by the virus and has been put under observation, according to Antara. Bahteramas Kendari Regional Hospital Director Sjarif Subijakto said that the patient had two criteria of coronavirus infection.

"The patient has fever, nasal congestion, and breathing difficulties -- those are the first criteria. The second criteria is that the patient had just returned from South Korea. It's safe to say that it's suspected, even though it's not yet certain that it is coronavirus," he said.

South Korea is one of the countries to have confirmed coronavirus cases. The patient visited South Korea with eight other people for four days and arrived in Kendari on Jan. 29.

He started having fever on Saturday and was taken to a community health center (puskesmas). On Sunday, the patient's condition worsened and he was taken to the emergency unit of Bahteramas Regional Hospital. He's currently put in the isolation room.

As of Feb. 6, this patient is still in the isolation room, Antara reported.

Kediri, East Java, one patient suspected

A 52-year-old woman from Kediri, East Java, is under observation at the isolation ward of Iskak Public Hospital in Tulungagung after showing symptoms consistent with the novel coronavirus.

Identified as YM, the woman had traveled to South Korea early last month to visit her newborn grandchild and returned to Kediri on Thursday. She soon began complaining of a fever and a sore throat.

She was treated for bronco-pneumonia at a hospital in Kediri but was transferred to Iskak Hospital as the latter has been appointed by the government to handle patients showing symptoms of the novel coronavirus in the western part of East Java. 

As of Feb. 11, there were no updates on this patient.

Supposedly negative

Since Jan. 19, Indonesian health authorities have handled several patients who return from abroad and complained of fever and respiratory problems. The authorities have claimed they tested negative for the coronavirus, sometimes without any clear information on whether the conclusion was reached after lab results or not. By Feb. 11, at least 24 people had tested negative for the coronavirus.

Antara reported that the Health Ministry has declared 62 specimens from patients across 16 provinces in Indonesia to have tested negative for the coronavirus, with two more specimens under examination by Balitbangkes as of Feb. 11.

- Cirebon: One Chinese national identified only as XC, 25, was declared negative on Feb. 11 as reported by Antara news agency. He was admitted to Gunung Jati Hospital in Cirebon, West Java, on Feb. 4 after showing symptoms of coronavirus infection: fever and breathing difficulties. The patient came from Hubei, the province where the new coronavirus epidemic first broke out.

- Cilacap: A 19-year-old female student was declared negative on Feb. 7, kompas.com reported. She was put into isolation in Margono Soekarjo General Hospital in Purwokerto, Central Java for having fever and flu symptoms after returning from China on Jan. 1.

- Manado: One 2-year-old Chinese toddler put under observation for symptoms associated with the new coronavirus at Manado’s Prof. Kandou General Hospital tested negative. The family has been in Manado since Jan. 21. He had been experiencing fever and was coughing for the previous nine days.

- Kutai Kartanegara: A 39-year-old male patient from Malaysia was declared negative after being admitted to the Haji Muhammad Parikesit General Hospital in the regency in East Kalimantan, as reported by the local Kaltim Post. The patient was coughing and had a fever and sore throat since arriving in the regency on Feb. 2 to work at an oil palm plantation, as reported by kompas.com.

- Purwokerto, a 29-year-old tourist from Shanghai, China, who was on a family vacation, had been declared negative. She was sent home from Margono Soekarjo General Hospital on Feb. 4, kompas.com reported.

- Sidoarjo, one patient declared not to have the coronavirus on Feb. 3 following a lab test in Jakarta, Antara reported. The patient is a migrant worker from East Nusa Tenggara (NTT) who worked in Hong Kong. She was suspected of having the coronavirus upon arrival in Indonesia.

- Bogor, one patient declared not to have the coronavirus on Feb. 3 following a lab test in Jakarta, according to kompas.com. The patient was admitted to the Eka Hospital in Cibubur, Bogor, on Jan. 29 and was put in the isolation room for seven days before the test result was out.

- Batam, a patient who was suspected of having coronavirus infection was declared negative on Feb. 2 following a lab test in Jakarta, according to tempo.co. The patient previously fell ill after arriving in Batam from Singapore, where he was working. 

- Semarang, an Indonesian PhD student from Wuhan was under observation at Karyadi Hospital was sent home after his condition improved. 

- Bandung, Hasan Sadikin Hospital (RSHS) Bandung director Nina Susana Dewi announced on Jan. 30 that two people who had been previously suspected to have the coronavirus had been declared clear. The patients were admitted to an isolation room on Jan. 26 and their blood specimens were sent to the health research and development Department.

 - Tarakan, North Kalimantan, one patient who had just come back from Liaoning, China, was released from Tarakan General Hospital on Jan. 27 after laboratory results came back negative for coronavirus, authorities said on Jan. 28

- Purwokerto, a Chinese tourist claimed not to have the coronavirus on Jan. 28

- Jakarta, one patient declared not to have the coronavirus on Jan. 27 following a lab test

- Jambi, one patient claimed not to have the coronavirus on Jan. 26

- Surabaya, East Java, one patient from China claimed not to have the coronavirus on Jan. 26 following an X-ray

- Denpasar, Bali, two patients from China declared not to have the coronavirus on Jan. 25 following a lab test

- Denpasar, Bali, a Mexican national who visited China declared not to have the coronavirus on Jan. 24, following a lab test

- Riau Islands, four patients from Wuhan, China, declared not to have the coronavirus on Jan. 24

- Jakarta, a Huawei employee declared not to have the coronavirus on Jan. 23.

A medical officer pushes a trolley at an Isolation Room at Soetomo Regional Hospital in Surabaya, East Java, on Jan. 27. A visitor from China was being treated in the hospital but hospital officials claimed he had tested negative for the new coronavirus.
A medical officer pushes a trolley at an Isolation Room at Soetomo Regional Hospital in Surabaya, East Java, on Jan. 27. A visitor from China was being treated in the hospital but hospital officials claimed he had tested negative for the new coronavirus. (Antara/Moch Asim)

Is Indonesia prepared?

The Health Ministry has ordered the use of 135 thermal scanners at Indonesia's port of entries and designated 100 hospitals as referral hospitals for coronavirus cases in Indonesia. The hospitals previously received referral cases during the avian influenza outbreak.

Sulianto Saroso Hospital in Jakarta has been appointed the referral hospital at the national level, Health Ministry directorate general of prevention and disease control Anung Sugihantono said in a statement posted on the ministry's website. The hospital will also hold a webinar for 100 other referral hospitals.

In West Java, RSHS and Rotinsulu Lung Hospital have been chosen as referral hospitals for infection in West Java. RSHS's director of medics and care, Nucki Nursjamsi, said hospitals with suspected coronavirus cases must file a request via an online system first and wait for approval before sending a patient to RSHS to ensure the safety of other patients.

RSHS has prepared isolation room Kemuning for suspected patients. The room is equipped with sterilization tools, negative air pressure and is only accessible to special staffers who must wear a hazard suit.

The Adam Malik General Hospital in Medan, North Sumatra, has formed a special team called New-Emerging and Re-Emerging Infectious Disease (Pinere) consisting of 20 medical specialists. The team will care for suspected coronavirus patients and handle referral cases from Aceh, North Sumatra and Riau.

Pinere coordinating head Ade Rahmaini said on Friday that the team had dealt with one suspected patient in early January. The patient was admitted to Adam Malik Hospital after showing flu-like symptoms upon returning from a trip abroad. However, after three days, the patient was declared coronavirus-negative.

Politics of language

The government through Health Minister Terawan Agus Putranto has insisted that the country has zero suspected coronavirus cases.

“No one is suspected of being infected [with the Wuhan coronavirus],” Terawan said on Sunday, despite reports of suspected cases in several regions.

Hospital authorities across the country have also advised media outlets against using the term “suspected”. Some have call such reports “hoaxes”. This has caused contradicting reports in the media because the authorities have been quick to that declare a patient test negative of the coronavirus even though there was no standard lab result and the patient was in fact still under observation.

The government appears to have applied a stricter definition of people suspected of being infected with the coronavirus.

Read also: Experts warn against complacency as Indonesia reports zero cases of coronavirus

According to case definition guidelines published by the World Health Organization, the term "suspected case" is used when a patient shows clinical signs and symptoms, even without laboratory evidence.

A probable case means a suspected case with supportive laboratory data and/or epidemic links.

It is only a "confirmed case" that needs laboratory evidence.


Arya Dipa, Jon Afrizal, Apriadi Gunawan, Kusumasari Ayuningtyas, Andi Hajramurni, Suherdjoko, Djemi Amnifu and Ganug Nugroho contributed to this report.

Editor's note: This article was updated on Feb. 11.

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