CZECH REPUBLIC: AVIAN AND PANDEMIC INFLUENZA

UNCLAS SECTION 01 OF 02 PRAGUE 001638 SIPDIS SENSITIVE STATE FOR EUR/NCE, OES DSINGER AND RDALEY E.O. 12958: N/A TAGS: TBIO SENV ECON EAGR EAID PREL EZ SUBJECT: CZECH REPUBLIC: AVIAN AND PANDEMIC INFLUENZA INFORMATION REF: A. STATE 209622 ¶B. PRAGUE 01533 ¶1. (U) This cable responds to the request for information in reftel A in the same order as the original questionnaire. ¶2. (SBU) Preparedness/Communication: -- The GOCR has a preparedness plan for pandemics that was submitted to the WHO in 2000 and updated in April of 2004. It can be found at the following website: http://www.who.int/csr/disease/influenza/czec hplan.pdf. The plan offers a detailed overview of the capabilities of the Czech Republic to respond to a pandemic. Per reftel B, however, the country does not appear to be prepared to implement this plan. Hospitals that we contacted at the working level were unaware of the plan. One main problem is a lack of consistent leadership at the Ministry of Health, which has seen six Ministers in as many years. The current Minister of Health, Dr. David Rath (appointed November 4),is distracted by a battle for control of the country's largest medical insurance company at the moment, but his Deputy Minister and the Chief Public Health Officer of the Czech Republic, Dr. Michael Vit, is up to speed on the pandemic plan and is the primary government representative to this week's EU pandemic simulation exercise. -- The GOCR will likely be truthful in reporting the scope of any disease outbreak among people and among animals. -- Preparing for an avian flu human pandemic does not rank high among government priorities as illustrated by the absence of any apparent training on the pandemic plan or any large scale media campaign to inform the public about the disease. Per reftel B, the Minister of Health has made public statements to the effect that the disease is not a threat or major concern. The Minister, Dr. Rath, would be the individual most capable of elevating the importance of this subject in the government but is engaged in other political battles and will likely remain otherwise occupied with his political role as the 2006 elections are on the horizon. The working POC for USG officials remains Dr. Vit from the Ministry of Health or Dr. Zbynek Semerad from the State Veterinary Administration. -- National laws do not pose a barrier to avian flu detection, reporting, containment or response. -- The Czech government is working within the EU framework and with the WHO to prepare for any possible flu pandemic. Government leaders are not likely to ask the USG for assistance, but have previously been receptive to information from the USG at both the bilateral and multilateral level. -- The country does administer flu shots, but was unprepared for the large volume of requests for flu shots this year and quickly ran through their original stockpile (an additional 120,000 shots have been ordered and will arrive by early December). Czech citizens appear to consider the flu shot as a prophylactic against avian flu. Usually only 7% of Czech citizens get a flu shot (well below the EU average of 20%) but the numbers will be much higher this year. The Czech Republic does not produce these flu vaccines domestically, nor do they produce a flu vaccine for poultry. The country is not developing an H5N1 vaccine. There is a registration requirement for donors/makers of vaccines that would either have to be complied with or waived by the government. If the vaccine is registered as safe or exempt from the regulation, there would indeed be a liability shield according to the State Veterinary Administration. -- The population is relatively aware of the threat of an avian flu human pandemic based upon media coverage in print and on television. However, there is a wide misunderstanding that the regular flu vaccine would prevent avian flu which the government is attempting to combat via fact sheets on the Ministry of Health web page and occasion TV interviews. According to the State Veterinary Administration, should there be a real health threat due to avian flu, additional information would be broadcast through print, radio, and television media, as well as via regional government offices and town mayors. ¶3. (SBU) Surveillance/Detection -- The medical and agricultural sectors are competent and capable of detecting a new strain of influenza. If it cannot be subtyped here in the Czech Republic, it would be sent to the EU reference lab in the UK and it would take 1-2 weeks to get a final result. -- The critical gap in disease detection and outbreak response capabilities is at the working level. The State Veterinary Administration seems to be well-prepared for handling detection and poultry extermination should the need arise, but the Ministry of Health seems to be prepared only on paper. It is doubtful that the country's medical facilities could absorb any surge in patient levels and coordination within the government on a human pandemic response would likely be haphazard. However, the simulation run by the EU the week of November 20 should help to identify any egregious faults in the Czech system and hopefully they will be in a better position to respond on the heels of this exercise. ¶4. (SBU) Response/containment -- The country has 600,000 doses of Tamiflu and has ordered two million more (but they are not expected until the middle of next year). It is sufficient to treat first-responders and the elderly, but other at-risk groups in the population, such as young children, would be in dire straits. -- Personal protective gear is available for veterinary officials, first responders, and military chemical contamination specialists only. -- The response capability for animal outbreaks and for the culling of birds is good. The State Veterinary Administration has two emergency destruction centers, and has an up-to-date plan to respond to any infectious diseases. Rapid response to human outbreaks would be acceptable for small outbreaks, but would be quickly overwhelmed if the numbers climb. -- The Czech government's pandemic plan does not take large-scale quarantines into consideration. Enforcement of social distancing measures would likely be difficult, and military involvement in the process is uncertain. CABANISS