Molecular Epidemiology of Influenza in Bali, Indonesia (BaliMEI)


Supported by: Hoffmann La Roche

Indonesia is of key strategic importance for influenza surveillance and research, as it continues to report the majority of highly pathogenic avian influenza (H5N1) outbreaks worldwide. However, research on the ecology and evolution of influenza viruses in Indonesia has been severely limited. Within Indonesia, the island province of Bali might be a particular hotspot for mixing of influenza viruses from different geographic regions and host species, due to high densities and close proximity of humans, poultry and pigs, along with its status a popular tourist destination.

The Molecular Epidemiology of Influenza A in Bali project (“BaliMEI”) aims to conduct five years of active surveillance and characterisation of influenza viruses in Bali. The project utilises a network of 21 health facilities across all nine districts of Bali to collect nasopharyngeal swabs from patients presenting with influenza-like illness. The swabs are screened for Influenza A and B, and Influenza A-positive samples are subtyped and tested for genetic markers of resistance to oseltamivir. Case-history questionnaires are also administered to patients to measure socio-demographic and other risk factors which may be associated with infection. Sequencing and phylogenetic analysis of samples is planned to take place at a later stage. 

 Project Leader: James Rudge

Email: James.Rudge@lshtm.ac.uk 

Key outputs 

๐ Characterisation of spatiotemporal patterns in circulation of influenza virus subtypes in Bali

๐ Identification of levels of resistance to antiviral drugs (specifically, neuraminidase inhibitors) among circulating viruses

๐ Improved local laboratory capacity for infectious disease research in Bali

๐ A new collaborative network of researchers from institutes in Indonesia, UK, Thailand and Singapore

๐ A library of influenza isolates for future analyses (e.g. genetic sequencing)

Collaborators include:


London School of Hygiene & Tropical Medicine

Udayana University 

 University of Indonesia


Duke - NUS