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05VILNIUS1239 2005-11-23 14:17:00 UNCLASSIFIED//FOR OFFICIAL USE ONLY Embassy Vilnius
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1. (SBU) SUMMARY: The GOL has plans in place to manage a
possible outbreak of avian influenza or human pandemic
influenza. An outbreak of extremely virulent human pandemic
influenza would undoubtedly strain Lithuania's capabilities,
but the GOL likely would report its situation truthfully and
seek assistance from both its allies and international
organizations. Lithuania has the technical means to detect
any outbreak rapidly, and we expect that it would use both
police and the military to effectively enforce a quarantine
if the situation required.


2. (SBU) The GOL's Ministry of Health (MOH) has an "Influenza
Pandemic Preparedness Plan," and the State Food and
Veterinary Service (SFVS) has an "Avian Influenza and
Newcastle Disease Contingency Plan." Localities and other
ministries also have plans, but the MOH and SFVS plans are
the most important. We will send a copy of these plans via
e-mail to the POCs listed in reftel. We have no reason to
doubt that the GOL will implement these plans if avian or
pandemic influenza occurs in Lithuania. An outbreak would
likely strain Lithuania's resources and the GOL likely would
seek support from the EU and possibly from the USG.

3. (SBU) We expect that the GOL would report truthfully the
scope of any disease outbreak among people or animals. The
GOL has promised to compensate farmers for losses if their
flocks need to be culled, and we expect that farmers will be
cooperative if an outbreak occurs in Lithuania.

4. (SBU) Preparing for avian or pandemic human influenza is a
high priority for the MOH and the State Food and Veterinary
Service, but it is not among the GOL's most pressing issues
at present. Foreign Minister Valionis, Prime Minister
Brazauskas, or President Adamkus would be able to raise the
profile of this issue in Lithuania, but we would recommend
working with Lithuania's capable Health Minister, Zilvinas
Padaiga, first.

5. (SBU) The Director of the SFVS told us that he is working
closely with EU officials and that the GOL has implemented
all detection, containment, and reporting guidelines
recommended by the EU.

6. (SBU) The MOH's "Influenza Pandemic Preparedness Plan"
spells out the GOL's intention to cooperate with both the EU
and WHO. We would not expect the GOL to ask for assistance
unless there would be an outbreak in Lithuania large enough
to strain local resources or if there were an outbreak
elsewhere that demonstrated clearly that the influenza was
poised to become a major world catastrophe. The GOL would
likely turn first to the EU, but GOL leaders would also
welcome approaches from the USG in either a bilateral or
multilateral setting.

7. (SBU) Annual flu shot are available in Lithuania, and an
increasing number of Lithuanians get them, presumably in
response to the MOH's public encouragements. Many
Lithuanians, however, still do not routinely get flu shots.
Lithuania produces no flu vaccine and is not developing an
H5N1 vaccine. In general, foreign makers or donors of
vaccines would not enjoy a liability shield. The Director
General of the MOH's Drug Control Agency told us, however,
that this is a very complicated issue and is difficult to
address as a hypothetical situation. He offered to make his
agency's lawyers available to us if we wanted to ask more
detailed questions on liability.

8. (SBU) The GOL health and veterinary establishment is very
well informed about avian influenza. Among the general
public, however, awareness is quite low. The GOL is taking
steps to raise awareness among farmers, particularly poultry
farmers. The MOH updates every two weeks its strategic plan
for distributing information about avian influenza. As
outlined in this plan, the MOH uses mass media, public
conferences, and networks of healthcare professionals to
raise public awareness of avian influenza.


9. (SBU) The medical and agricultural sectors are capable of
rapidly diagnosing a new strain of influenza among people or
animals. The SFVS told us that if it positively diagnosed a
new strain of influenza, it would send the sample to an EU
reference laboratory in the UK for a final diagnosis.
Lithuania does not have the capability to subtype viruses.

10. (SBU) Lithuania still has not acquired an adequate supply
of Tamiflu (see para 11). In addition, the GOL may be unable
to communicate quickly with outlying regions in the event of
a rapidly occurring outbreak. Many residents of these rural
regions tend to be poor, and may not have televisions or
radios, the media of choice for communicating the GOL's


11. (SBU) Lithuania has a stockpile of most medicines, but it
does not yet have Tamiflu. The MOH's Health Emergency
Situation Center (HECS) told us that it ordered enough
Tamiflu to service 30 percent of Lithuania's population of
3.4 million and that it expects these drugs to arrive by
"early next year."

12. (SBU) HECS told us that Lithuania has a stockpile of
prepositioned personal protective gear.

13. (SBU) Lithuania has the capability to respond rapidly to
either human or animal outbreaks. The SFVS action plan
contains the guidelines for culling/vaccination of birds,
disinfection of facilities, and limitations on animal

14. (SBU) The GOL has in the past quarantined hospitals where
outbreaks of infectious diseases occurred, but it has never
had to deal with an epidemiological situation as complicated
as pandemic influenza would be. The SFVS action plan,
consistent with EU requirements, calls for establishing a
"protection zone" within a radius of 3 km of an outbreak.
The GOL, using both the police and the military, would
restrict or prohibit the movement of people, transport, and
animals to and from this zone. Although the GOL has never
had to employ these kinds of resources in response to a
health crisis, it has used both the police and military
successfully to restrict movements to and from areas hit by
flooding. In a crisis situation, the GOL's Civil Defense
Agency would take the lead role in coordinating all of the
agencies involved.


15. (SBU) Lithuania has taken many reasonable steps to
mitigate the threat posed by avian influenza and a possible
human influenza pandemic. While the issue does not yet raise
tremendous concern among the general public, the GOL takes
the threat seriously and is responding accordingly.