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