INFORMATION ON AVIAN INFLUENZA

UNCLAS SECTION 01 OF 03 SAN SALVADOR 003433 SIPDIS E.O. 12958: N/A TAGS: TBIO SENV ECON EAGR EAID PREL ES AVIAN FLU SUBJECT: INFORMATION ON AVIAN INFLUENZA REF: A. SECSTATE 209622 ¶B. USAID RAPID ASSESSMENT FOR AVIAN AND PANDEMIC INFLUENZA PREPAREDNESS ¶1. Post, through USAID and the Regional Medical Officer (RMO),is coordinating with Salvadoran authorities to support local efforts to control avian influenza and assess their capability to respond to an influenza pandemic. Responses to Ref. A questions are included in paragraph 2; they are based on information provided by USAID in response to a similar tasking (Ref. B.) and also information gathered during a seminar on avian influenza hosted by the RMO on November 29 that was attended by officials from the Ministry of Health (MOH) and Ministry of Agriculture (MAG). ¶2. Begin survey response: A) Preparedness/Communication Does the government have a preparedness plan/strategy for preventing avian flu from becoming a pandemic and containing a pandemic once it occurs? If the country has a strategy, how capable is it of implementing it? Please provide a copy of the plan or the internet address for the plan. --The Government of El Salvador (GOES),with MOH and MAG taking the lead, has developed a preparedness strategy that includes general anti-avian flu measures. It was developed with support from the World Health Organization (WHO). Post will forward a copy to OES. The GOES will face significant resource and technical constraints in implementing its strategy to prevent or contain a pandemic. How truthful will the government be in reporting the scope of any disease outbreak among people? Among animals? What incentives could be offered that would likely result in more transparency? --The GOES will likely be forthcoming in reporting the scope of any disease outbreak among people and animals. However, it is likely that individual poultry farmers would hide cases should they occur. Where does preparing for an avian flu human pandemic rank among government priorities? Who and what would most influence the country to give the issue a higher Priority? Who is the key "go-to" person, office or Department (i.e., Minister for Health, Prime Minister, etc.) for USG officials to engage on this issue? --This issue is not currently a national priority and is unlikely to become one until it poses a more immediate threat to public health. The MOH and MAG are the most active within the GOES, but there this a national task force on avian influenza that also includes the National Emergency Committee, armed forces, Ministry of Governance (public security),Ministry of Education, Ministry of Public Works (transportation) Ministry of Foreign Relations, local governments, and the parastatal water company. A vaccine against H5N2 is used regularly by commercial poultry producers. MAG officials believe this vaccine is also effective against H5N1. El Salvador bans the import of raw and live poultry from outside Central America. Have national laws been reviewed to ensure that they are consistent with the international health regulations and do not pose barriers to avian influenza detection, reporting, containment, or response? --There has been no formal legal review in response to this issue, but Salvadoran laws are generally consistent with international health regulations. Legal review would likely occur only if a specific barrier to avian influenza detection, reporting, containment, or response were identified in practice. Is the host country already working with international organizations or other countries on the avian flu issue? Are government leaders likely to ask for assistance from the United States or other countries? Would government leaders be receptive to messages from U.S. leaders through a bilateral approach, at a multilateral forum such as the United Nations (WHO, FAO, etc.) or APEC, or through bilateral contacts by a third country? What would the country want from the United States in return for its efforts? --El Salvador is already working with the World Health Organization (WHO) and Pan American Health Organization. USAID has developed an effective coordinating group for bilateral and multilateral donors that is active on this issue. Officials in the Ministries of Health and Agriculture are working with counterparts in other Central American governments to develop a coordinated approach to the issue. Does the country currently administer annual flu shots? If not, might it consider doing so? What is the production capability (i.e. how many doses of the annual Trivalent flu vaccine can the country make) for human influenza vaccines in the country? Does the country produce influenza vaccine for poultry and if so how much? If the country is developing an H5N2 vaccine, where is it in production and testing? Are there any licensing issues? Is there a liability shield for foreign makers/donors of vaccines? If not, any prospects of one being enacted? --The GOES administers free annual flu shots to children under 5 and adults over 60. Funding constraints limit the extension of this program to others outside these high-risk groups. There is currently no human influenza vaccine production in El Salvador, nor is there influenza vaccine manufactured for poultry in El Salvador. Local pharmaceutical companies are not capable of developing or manufacturing an H5N1 vaccine in El Salvador. How well informed is the population about the avian flu threat and about measures they should take to mitigate the threat? What mechanisms are available for providing additional information to the population, particularly in rural areas and how effective are these measures? --Press reports on the spread of avian influenza in Asia and Europe have featured prominently in print, radio, and television news. The Ministers of Health and of Agriculture and representatives of the WHO have appeared in television interviews. B) Surveillance/detection How capable are the medical and agriculture sectors of detecting a new strain of influenza among people or animals respectively? How long might it take for cases to be properly diagnosed, given other endemic diseases? Can influenza viruses be subtyped in the country, if so by whom, and if not where are they sent? Does the country send samples to a WHO/EU/U.S. reference laboratory? --Local laboratories can identify the virus but cannot identify its genotype. To determine genotype, samples are sent to CDC in Atlanta, and results are usually available within 30 days. The CDC and U.S. Army have collaborated with technical assistance and processing/analysis of blood samples taken from avian stock at five sentinel sites. What are the critical gaps that need to be filled in order to enhance the country's disease detection and outbreak response capabilities? What is the country's greatest need in this area from the United States or international organizations? --El Salvador lacks resources, both technical and financial, needed to enhance the country's disease detection and outbreak response capabilities. Post will continue to serve as a source of information on the virus for the Salvadorans. CDC's continued cooperation on genotype testing is important as well. C) Response/Containment Does the country have a stockpile of medications, particularly of antivirals, and if so how much? If some has been ordered, how much and when is it expected? --El Salvador has limited stockpiles of most medicines, but does not have antiviral stockpiles. El Salvador hopes to begin acquiring antivirals to treat humans in 2007, but has not yet ordered any medicines. Does the country have a stockpile of pre-positioned personal protective gear? --El Salvador has limited stockpiles of personal protective gear. What is the rapid response capacity for animal and human outbreaks? Are guidelines in place for the culling and vaccination of birds, disinfection of facilities, and limitations on animal movement? --The national task force on Avian Influenza is developing guidelines for culling and vaccination of birds, disinfection of facilities, and limitations on animal movement. How willing and capable is the government of imposing quarantines and social distancing measures (closing schools, public gatherings, mass transit)? Would its military enforce quarantines? --If required, the government would attempt to impose quarantines, but resource constraints would limit their effectiveness in doing so. The military would support quarantines. End survey response. Barclay