Identifier
Created
Classification
Origin
05KUWAIT4516
2005-10-20 06:30:00
UNCLASSIFIED//FOR OFFICIAL USE ONLY
Embassy Kuwait
Cable title:  

KUWAITI PREPARATIONS FOR AVIAN INFLUENZA

Tags:  AMED CASC KSCA SENV TBIO KU 
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VZCZCXYZ0014
PP RUEHWEB

DE RUEHKU #4516/01 2930630
ZNR UUUUU ZZH
P 200630Z OCT 05
FM AMEMBASSY KUWAIT
TO SECSTATE WASHDC PRIORITY 1429
UNCLAS KUWAIT 004516 

SIPDIS

SENSITIVE
SIPDIS

E.O. 12958: N/A
TAGS: AMED CASC KSCA SENV TBIO KU
SUBJECT: KUWAITI PREPARATIONS FOR AVIAN INFLUENZA

Sensitive but Unclassified. Not for Internet distribution.

UNCLAS KUWAIT 004516

SIPDIS

SENSITIVE
SIPDIS

E.O. 12958: N/A
TAGS: AMED CASC KSCA SENV TBIO KU
SUBJECT: KUWAITI PREPARATIONS FOR AVIAN INFLUENZA

Sensitive but Unclassified. Not for Internet distribution.


1. (U) SUMMARY On October 17, Emboffs met with officials of
the Department of Public Health (DPH) to discuss the GOK's
preparations for a possible Avian Influenza (AI) outbreak in
Kuwait. A recently formed committee has been charged with
formulating the GOK's preparations to combat AI. The
committee is tasked to present a comprehensive plan to the
Prime Minister within three weeks' time. DPH believes that
Kuwait is at "high risk" for a pandemic both because of the
large number of expatriate workers from Asia and the
extensive international travel common to Kuwaitis. At this
time the GOK does not have any supplies of Tamiflu (the
anti-viral drug used to treat AI) but has on order doses for
one million people. END SUMMARY


2. (U) On October 17, Econcouns, Medoff, and Econoff
(notetaker) met with Director of Public Health Dr. Rashed
Al-Owaish and Head of the Communicable Disease Control Unit
Dr. Mussab Al-Saleh of the Department of Public Health to
discuss the GOK's preparations for a possible Avian Influenza
(AI) outbreak in Kuwait. Al-Owaish explained that he heads a
committee comprised of himself, Al-Saleh (who is the
committee coordinator),the Director of the Public Health
Laboratory, the head of the Infectious Disease Hospital, the
Director of the Ambulance Service, a representative from the
private hospitals in Kuwait, and two representatives from the
drug industry. This committee is charged with planning and
coordinating the GOK's preparations for, and response to, any
AI outbreak. The committee, which has met twice within the
last week and had another meeting scheduled for October 18,
uses WHO guidelines for responding to an epidemic as well as
the GOK's 2003 experience in preparing for bio-warfare, and
later for Sudden Acute Respiratory Syndrome (SARS).
Al-Owaish said he anticipates the creation "soon" of a higher
level AI committee organized by the Cabinet of Ministers and
staffed by all major ministries at the undersecretary level.


3. (U) Both Al-Owaish and Al-Saleh agreed that Kuwait is at
a "high risk" for AI, citing the high number of expatriate

workers (about 60% of the population, many of them from Asia)
and the frequency with which Kuwaitis travel. To that end,
once the WHO declares a Stage 1 pandemic, cameras and
infrared temperature monitors, previously used during the
SARS outbreak, will be re-deployed at the airport. Travelers
on flights originating from affected countries, as well as
those with passports indicating travel to those same
countries, will receive additional screening. Al-Saleh said
that the PM is seriously concerned about AI, especially the
economic impact on government services and Kuwait's oil
industry if large numbers of workers get sick. Al-Owaish
stated that the PM's interest ensures that the committee's
planning recommendations are likely to be adopted.


4. (U) Al-Saleh estimated that an AI pandemic in Kuwait
would likely affect 900,000 people overall, with 400,000
needing medical attention, as many as 9,000-12,000 requiring
hospitalization, and up to 3,000 deaths. He said that
Kuwaiti hospitals currently have about 4,700 beds (80% in
government hospitals) and that the capacity could be pushed
to 6,000 beds by using the Ambulance Service's medical tents.
Responding to Medoff, Al-Saleh said that Kuwaiti hospitals
have very few rooms with "negative flow" ventilation and a
relatively small number of isolation rooms in Intensive Care
Units (ICU); there are about 650 ICU beds in Kuwait.
Although the number of beds is well below his own projection
of the number of potential persons needing hospitalization,
Al-Saleh insisted that the Kuwaiti hospital system can handle
a pandemic with a quarantine and at-home treatment
supplementing the hospitals.


5. (U) Responding to Econcouns's query about what
preparations are now underway, Al-Saleh said that the
committee is working on a public information campaign
composed of Arabic language brochures and also preparing
lectures for doctors and other medical personnel. Econoffs
suggested that brochures in English would be useful as well,
given that most of Kuwait's residents speak more English than
Arabic. Additionally, the committee is formulating
quarantine and treatment protocols by which hospitals can
process affected patients in the most efficient way.
Al-Saleh said that DPH epidemiologists are resident in each
hospital and that initial cases would be sent to the
Infectious Disease Hospital for quarantine. If and when the
Infectious Disease Hospital reaches capacity, each hospital
would establish an isolation ward; Al-Saleh said that
designating specific hospitals as AI-only would upset
Kuwaitis who likely would demand that they be allowed to go
to the nearest hospital regardless of its designation.


6. (U) Al-Owaish said that the GOK does not have any Tamiflu
stocks at present but has ordered 10 million tablets, enough
to treat 1 million patients. However, because of the
worldwide shortage of AI anti-viral drugs he does not expect
to receive the drugs until June 2006. Because of this delay,
Al-Owaish said, the committee intends to propose that the GOK
order the drug Relenza, which has been effective in some
cases and is more widely available. Al-Saleh reiterated that
the PM is very interested in the response planning, and said
that the initial proposal was for buying 6 million tablets,
and that the PM told them to "make it 10 million."
Additionally, Al-Saleh said that Kuwait is in line for the AI
vaccine that is being developed and has 5 million doses on
order. Al-Saleh worried that, in the event of a serious
pandemic and a continued shortage of anti-viral drugs, AI
might come to be seen as a national security issue, and that
some countries may declare all drugs and vaccines produced in
those countries for domestic use only, severely restricting
the ability of nations without pharmaceutical industries to
obtain medications. He said that both Germany and France,
traditional medical suppliers for Kuwait, have banned export
sales in the past due for national security reasons.


7. (U) Reflecting reftel concerns, Econcouns noted GOK's
preparations for educating the general public as well as
health care professionals; and the committee's plans to test,
isolate, and report suspected AI cases to the WHO and other
responsible international bodies promptly. When asked what
obstacles he sees to the GOK's response, Al-Saleh noted his
concern that medical professionals may downplay the
seriousness of an AI pandemic, which would hamper efforts to
coordinate quarantines. He related that some doctors think
the DPH is "crying wolf" about health threats, particularly
after stockpiles of anthrax vaccines (obtained prior to the
Iraq invasion) were never used, and because SARS was a
non-event in Kuwait despite DPH warnings. Al-Saleh also said
that he was concerned about panic among the general
population should an outbreak occur.


8. (U) Econ/C asked what help the USG might provide. Both
officials were primarily concerned with the availability of
drugs. Al-Owaish asked that the U.S. help speed their order
of Tamiflu, press for a suspension of IPR protections to
allow generic firms to manufacture Tamiflu, and to share U.S.
stockpiles of the drug. Al-Saleh also said that any planning
assistance from CDC would be welcome.
LEBARON