Identifier
Created
Classification
Origin
06ALMATY925
2006-03-13 05:09:00
UNCLASSIFIED
US Office Almaty
Cable title:  

ALMATY AVIAN INFLUENZA PREPAREDNESS UPDATE

Tags:  APER AMGT AEMR AMED KPAO KFLU KZ ECONOMIC 
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UNCLAS SECTION 01 OF 03 ALMATY 000925 

SIPDIS

SENSITIVE BUT UNCLASSIFIED

DEPT FOR NEA/SA/EX PMO FRANK LEDAHAWSKY; SCA/CEN; S/ES-
O/CMS - OFFICE OF CRISIS MANAGEMENT SUPPORT

E.O. 12958: N/A
TAGS: APER AMGT AEMR AMED KPAO KFLU KZ ECONOMIC
SUBJECT: ALMATY AVIAN INFLUENZA PREPAREDNESS UPDATE

REFS: A) ALMATY 0001; B) STATE 219189; C) DOS/MED DRAFT

PANDEMIC INFLUENZA PLAN

UNCLAS SECTION 01 OF 03 ALMATY 000925

SIPDIS

SENSITIVE BUT UNCLASSIFIED

DEPT FOR NEA/SA/EX PMO FRANK LEDAHAWSKY; SCA/CEN; S/ES-
O/CMS - OFFICE OF CRISIS MANAGEMENT SUPPORT

E.O. 12958: N/A
TAGS: APER AMGT AEMR AMED KPAO KFLU KZ ECONOMIC
SUBJECT: ALMATY AVIAN INFLUENZA PREPAREDNESS UPDATE

REFS: A) ALMATY 0001; B) STATE 219189; C) DOS/MED DRAFT

PANDEMIC INFLUENZA PLAN


1. (SBU) Summary: The Embassy Almaty Emergency Action
Committee Pandemic Influenza (PI) Subcommittee has re-
convened to discuss and execute the "Preparedness
Checklist" (Ref C). Participants in the PI Subcommittee
include the DCM and representatives from MED, CDC, ADM,
PAS, RSO, Principal Officer Embassy Branch Office (EBO)
Astana, USAID and Peace Corps. For the purposes of PI
planning, the current plan for EBO Astana is included in
the overall preparedness plan for the Mission. End
Summary.


2. (SBU) Introduction:

- Host Country AI/PI update: There have been no reported
cases in Kazakhstan of Avian Influenza in bird populations
since summer 2005. Migratory birds are expected to
reappear in the region during the spring northward
migratory season, and may bring H5N1 influenza strains to
domestic flocks. The Government of Kazakhstan (GOK)
Ministry of Health has a surveillance program in place to
test for H5N1 strains when suspicious avian deaths are
reported. There have been no confirmed human cases of
Avian Influenza in Kazakhstan.


3. (SBU) Preparedness Checklist - 1. Structure for
planning and decision making: The multidisciplinary
planning committee has been created and consists of the
Emergency Action Committee Pandemic Influenza (PI)
Subcommittee. The coordinator is RMO Monte Makous with
alternate coordinator CDC Country Director Michael Favorov
or his designee from CDC. Members of the planning
committee include representatives from Management, DCM,
GSO, HR, RSO, IT, PAS, DAO, CA, POEC, USAID, PC, Foreign
Commercial Service, MED Astana, PO Astana, GSO Astana,
ECON Astana, and USAID Astana. The committee liaison in
the GOK Ministry of Health is Dr. Kenes Ospanov of the
Republican Sanitary and Epidemiology Station. Dr Ospanov
also provides linkage with the host country emergency
preparedness group.


4. (SBU) Preparedness Checklist - 2. Development of a

post specific written pandemic influenza plan: Ref A
delineates Post tripwires and actions and includes
elements as listed in the Pandemic Influenza Plan. The
organizational structure to operationalize the plan and
the responsibilities of key personnel will reflect what
currently is in place for the post EAP. Post plans on
conducting a tabletop simulation exercise per further
guidance on this from M/MED.


5. (SBU) Preparedness Checklist - 3. Elements of a
Pandemic Influenza Plan: Surveillance Plan: Per guidance
of the DOS/MED Pandemic Influenza Plan, the Health Unit
has established surveillance procedures for influenza-like
illness, and has criteria in place to distinguish pandemic
influenza. A system for internal review of pandemic
influenza activity is in place.


6. (SBU) Preparedness Checklist - Communication Plan:
- External communication has been assigned as follows:
Public health reporting to DOS/MED - RMO Monte Makous, CDC
country Director Michael Favorov, or designee; Clinical
spokesperson - RMO Monte Makous or designee; Media
spokesperson - PAS Information Officer Jacqueline
McKennan.

- Key points of contact: Local health ministry - Dr.
Ospanov of the Republican Sanitary and Epidemiology
Station; Local CDC contact - Michael Favorov, CDC
Director; Newspaper and radio contact - PAS Officer;
Public official contact through the Embassy front office
or PAS Officer.

- The list of other healthcare facilities with whom it is
necessary to maintain communication: The International SOS
Clinic, International Medical Clinic, and Peace Corps
Medical Officers.

- Due to the substandard medical facilities in Kazakhstan,
a meeting with local healthcare facilities is not
applicable. (Ref A, para 2)

- A plan for updating key facility personnel daily has
been established. It will entail the RMO or designee
briefing the COM or DCM by telephone or in person.

- A strategy for regularly updating the Health Unit staff
on the status of pandemic influenza has been established
and will consist of daily briefings in person or by
telephone.

- A plan for informing patients and the Mission community
about the level of pandemic influenza activity has been
established and will entail announcement at Country Team
Meetings, the issuance of Administrative Notices, emails
to the appropriate staff, use of unofficial email
distributions, use of radios, and use of the Mission
telephone tree.


7. (SBU) Preparedness Checklist - Education and Training
Plan:
- Language and reading level-appropriate materials have
been identified by utilizing the PowerPoint program
available on the DOS/MED intranet website with translation
into the Russian language.

- Means for accessing DOS/MED and federal web-based PI
training programs have been identified. This includes
links to the Pandemic Influenza materials on the Office of
Medical Services website and the HHS Pandemic Influenza
website.

- A system for tracking personnel who have completed
pandemic influenza training has been set up.

- Post plans on issuing an administrative notice to
recruit and train non-health unit personnel when the
health unit reaches surge capacity.


8. (SBU) Preparedness Checklist - Health Unit Personnel
Training: LES nursing staff, laboratory technician and
receptionist have received training on Post's Pandemic
Influenza Plan. Those providers with CERT training will
be informed of the Post PI Plan.


9. (SBU) Preparedness Checklist - Triage Plan: Patient
triage will be primarily by telephone contact followed by
home visit by a medical provider if deemed appropriate.
Those entering the facility seeking care will be directed
to the HU and examined immediately in a separately
designated room. Signage to instruct those with possible
PI is under development. Criteria for determining which
patients need evaluation are based on Ref C.


10. (SBU) Preparedness Checklist - Facility Access:
Criteria and protocols to limit public gatherings, closing
the mission to outside visitors and limiting visitors to
the HU have been established. RSO has been a key partner
in designing procedures for enforcing facility access
controls.


11. (SBU) Preparedness Checklist - Occupational Health
Plan:
- A system for delivering vaccine or prophylaxis to
healthcare personnel has been developed, and has been
tested during the non-pandemic influenza season.
Prioritization based on risk has been established.

- Thermometers have been procured for all Mission
employees to be used for self-screening at home. Those
with fever or respiratory symptoms will be required to
stay at home. This has been tested as a table-top
exercise.

- A policy for managing healthcare personnel with symptoms
of PI or documented PI has been established.

- Developing alternative worksites for those with high-
risk medical conditions will be done as needed on a case-
by-case basis.

- Mental health resources at Post are minimal, and will be
identified on an ad hoc basis.

- Post will accommodate personnel with child care
responsibilities on a case-by-case basis.


12. (SBU) Preparedness Checklist - Vaccine and Antiviral
Use:
- A prophylaxis priority list of patients and healthcare
personnel has been developed. Exact forecasts cannot be
determined due to the inherent fluctuations of counting
these individuals. There are approximately 20 first
priority personnel, 150 second priority personnel, and 550
remaining personnel.

- A system for distributing the prophylaxis has been
developed.


13. (SBU) Preparedness Checklist - Issues Relating to
Surge Capacity: Persons responsible for assessing day-to-
day clinical staffing needs during an influenza pandemic
are RMO Makous, LES Nurse Almaty, and LES Nurse Astana.
When necessary, an announcement will be made to the
Mission community to recruit those with medical
background. Post awaits further guidance from DOS/MED and
DOS legal counsel regarding liability issues and
credentialing.

14. (SBU) Preparedness Checklist - Needs for Anticipated
Durable and Consumable Resources: Post is developing a
plan to address supply shortages to "shelter in place"
that is subsumed into the current emergency disaster plan.

ORDWAY