AVIAN AND PANDEMIC INFLUENZA INFORMATION - FRANCE

UNCLAS SECTION 01 OF 03 PARIS 007838 SIPDIS SENSITIVE STATE FOR OES/IHA (SINGER/DALEY),INR (LESTER),AND EUR/WE HHS FOR INTERNATIONAL STEIGER/BUDASHEWITZ E.O. 12958: N/A TAGS: TBIO SENV ECON EAGR EAID PREL FR SUBJECT: AVIAN AND PANDEMIC INFLUENZA INFORMATION - FRANCE REF: A. STATE 209622 ¶B. PARIS 7573 ¶C. PARIS 7132 ¶D. PARIS 6191 ¶E. PARIS 5816 ¶1. (U) Detailed GOF reactions and responses to date to the possibility of an avian flu pandemic are contained in reftels (B) - (E). The following paragraphs respond to reftel A queries. -------------- Preparedness/Communication -------------- ¶2. (U) Following news that the H5N1 virus had hit the Urals in August 2005, the GOF announced the appointment of an interministerial delegate to coordinate the GOF's pandemic prevention measures, Professor Didier Houssin, who serves concurrently as the Director General of Health in the Ministry of Health. The Ministry of Health serves as the lead French agency, although a number of French ministries and agencies are also engaged in preparation efforts. During a meeting with the Ambassador in September, Minister of Health Xavier Bertrand expressed his opinion that an influenza pandemic constituted a "real risk," and pandemic preparedness consumes much of his time. ¶3. (U) Assuring a concerned public, fanned in large part by recent front-page reports of the H5N1 virus in birds in Romania and Turkey, Prime Minister de Villepin confirmed on October 14 high French government priorities: to prevent the spread of the disease in birds, and to protect the health of the population. While the GOF sought to strike a reassuring note, Professor Houssin sees his goal as preparing France "as if the pandemic was to occur tomorrow." In October, the GOF earmarked an additional 200 million euros from the 2005 budget to fund preventive measures. Paris also announced it would revise its national plan to fight a "pandemic flu" on which experts started working five years ago. The plan was last revised in May 2005 (text, in French, available on the Health Ministry website: http://sante.gouv.fr. An updated version is expected shortly. ¶4. (U) In material terms, the pledge to "protect" the population consists largely of quantities of sanitary masks and anti-viral medicine: France has stockpiled some 50 million masks, which have been distributed amongst French hospitals and other authorities which deal with the public. Another 150 million will be available by 2006, with a reported GOF goal of eventually stockpiling 600 million masks. Government health authorities claim to be in possession of between five to nine million anti-viral treatments,and have announced that 14 million more such treatments will be available by end 2005. GOF officials reportedly plan to cover the anti-viral needs of 30 percent of the French population, both in France and abroad. In anticipation of the emergence of a Tamiflu-resistant virus, the GOF has also reportedly begun negotiations with GlaxoSmithKline to stockpile anti-viral treatment, Relenza'. Health Minister Bertrand has said that the GOF will maintain the stockpile of anti-virals and distribute them -- under the strict supervision of the French army -- at no cost as needed in case of a pandemic. ¶5. (U) France's plan to "prevent" the spread of the disease in birds, thus far,follows closely EU guidance concerning domestic poultry. GOF does not deem it necessary to vaccinate poultry, however it has announced a number of measures to ensure: -- The confinement of poultry in 26 departments at particular risk of contact with migratory fowl, covering roughly 25 percent of French territory; -- Banning of certain types of hunting -- Suspension of the assembling of birds at markets -- Increased surveillance of migratory birds; -- Screening of domestic poultry for avian flu; -- Stricter controls to prevent the introduction in France of already banned birds and bird products (feathers, etc.); -- Improved reporting of suspect deaths by both farmers and people in contact with wild birds (hunters, people working in natural parks, environmentalists). ¶6. (U) On November 3-4, French authorities sealed off a poultry farm in Brittany to test their ability to handle a bird flu outbreak. The purpose of the exercise was to validate containment mechanisms in infected areas, test coordination, and evaluate numbers of personnel and equipment necessary in case of a real emergency. The exercise quarantined poultry and assessed the threat. Additionally, following the postulation of a confirmed contaminated bird, personnel engaged in the slaughtering of poultry and protection of deployed personnel. ¶7. (U) In mid-November, Embassy officers contacted France's Sanofi-Pasteur to inquire about its H5N1 vaccine production activities. At the moment, the company is undertaking clinical trials of a prototype vaccine based on the H5N1 strain, and plans to reveal results by the end of the year. When asked how long it would take to fill the GOF's order when and if the mutated human strain is identified, a company representative said it depends on the productivity of the strain. The representative estimates anywhere between four-and-a-half to six months will be required to produce vaccine. Sanofi-Pasteur will ask all governments purchasing its vaccine to assume liability for the vaccine it receives from the company. ¶8. (U) In addition to news articles, Paris informs its citizens and health community about the avian flu in a number of ways. Both the Ministry of Health and the Institute for Veille Sanitaire have websites with information about the virus, including a phone number for people to call for information and recommendations about traveling outside of France (websites in french include: www.invs.sante.fr/display/?doc=presse/2005/ le point sur/grippe aviaire 141005/index.html; and www.sante.gouv.fr/gtm/dossier/grippe/interfac e.htm). Further, posters are located at major airports to inform the public about precautions to take when traveling to or from contaminated countries (you can view these in English at www.sante.gouv.fr/htm/dossier/grippe aviaire/affiches.htm). ¶9. (SBU) We consider the GOF highly capable of executing its national avian flu preparedness plan. The well-established public health system, biological research laboratories and domestic vaccine production capabilities are all positive factors. Additionally, we believe the GOF would be truthful in reporting an outbreak of avian flu in either the human or animal populations. While the Embassy has not reviewed national laws to ensure they are consistent with International Health Regulations, France takes pride in its internationally reputed medical and surveillance systems. France, together with the U.S., calls for early implementation of the new WHO International Health Regulations. A member of the U.S.-initiated International Partnership on Avian Pandemic Influenza, France is fully engaged internationaly on pandemic preparedness with an emphasis on supporting the work of the WHO, FAO, and OIE. -------------- Surveillance/Detection -------------- ¶10. (U) The medical and biological research communities, including Institut Pasteur, as well as the veterinarian community possess the capability to detect new strains of influenza among people and animals as quickly as the detection techniques allow. Institut Pasteur is involved in recent detection of H5N1 cases in Asia. In addition to reference laboratories, Institut Pasteur and its affiliates maintain 15 P3 containment facilities in France and six in Asia where isolation and detection tests can be conducted. Further, Institut Pasteur is developing a rapid detection technique to help decrease the time it takes to diagnose H5N1. At the current rate, it can take several days to diagnose a suspect virus. -------------- Response/Containment -------------- ¶11. (SBU) The government of France is engaged in a major effort to stockpile antiviral medicine and protective gear, particularly masks--see paragraph four above. Embassy believes that French authorities would order quarantines and social distancing measures as the circumstances warrant. We further expect that if required, the GOF would call on its police and military to effect critical measures. ¶12. (SBU) The veterinary community is also well positioned to contain an outbreak amongst poultry, as guidelines are already in place and much poultry in France is confined to commercial spaces (see paragraph five above). For those regions deemed to be more vulnerable because either they are on the path of migratory birds or they have significant areas of lakes and dormant waters, which attract waterfowl, the poultry are confined indoors, (although this regulation will be difficult to enforce). ¶13. (SBU) We believe France's ability to respond and contain an outbreak to be good given its centralized public health sector, its experience containing other contagious illnesses, and its reasonably large, per capita, stockpile of anti-virals, mentioned above. In Paris the GOF has selected two public hospitals as the first line of defense for all cases of the avian flu in order to reduce the risk of contamination to other hospitals. Further, the GOF has identified SAMU, an ambulance service, to serve as first responders to any potential case of the avian flu to limit contamination. While the details to coordinate these efforts are not yet fully transparent, it is clear that preparatory action is well underway. Please visit Paris' Classified Website at: http://www.state.sgov.gov/p/eur/paris/index.c fm Stapleton