TURKEY: AVIAN INFLUENZA CAUSES TWO HUMAN DEATHS

UNCLAS SECTION 01 OF 02 ANKARA 000055

SIPDIS

USAID FOR TROSTLE, BLANCHET AND CARROLL
HHS FOR WSTEIGER/PBUDASHEWITZ
FAS FOR ITP/MACKE/THOMAS, CMP/DLP/WETZEL, FAS/JDEVER
FAS PASS FSIS AND APHIS
VIENNA PASS APHIS
BRUSSELS PASS APHIS/FERNANDEZ
GENEVA PASS HEALTH ATTACHE

SIPDIS

E.O. 12958:N/A
TAGS: TBIO AMED EAID CASC SENV EAGR KPAO TU
SUBJECT: TURKEY: AVIAN INFLUENZA CAUSES TWO HUMAN DEATHS

Ref: ANKARA 20 AND PREVIOUS

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1. Summary. Turkey's Ministry of Health has confirmed two
human deaths from H5 Avian Influenza. N Sub-type has not
been determined, but H5N1 is suspected. It appears that the
victims caught AI from handling sick birds. There is no
indication of human to human transmission. The GOT
continues to implement containment and culling procedures in
areas of suspected outbreaks in the east. End Summary.

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Two Human Deaths from AI Confirmed
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2. The GOT Ministry of Health (MOH) has confirmed three
positive H5 test results from humans. Two of these have
died (Jan 4 and 5). Four cases are under treatment at a
hospital in Van, coming from two separate families from
Dogubayazit in eastern Turkey. The victims were reported to
have handled and had close contact with sick birds on family
farms.


3. The MOH previously reported negative results in the
first battery of testing in Ankara (Reftel). The second
round of tests included lung tissue from the first death's
autopsy and broncho-aspirate samples from the others. The
positive result was obtained during the day of January 4,
but the MOH waited to confirm with a third round of testing
in Istanbul - before making a public announcement at 11:00pm
local time January 4. The initial false negative was
attributed to poor sampling (using nasal swabs). The MOH
has sent the total of six samples to the WHO lab in London
for confirmation and sub-typing.


4. The Press has reported higher numbers of cases under
treatment and/or observation, but these are not confirmed.


5. The EC Mission, like us, is following events closely.
The WHO has been keeping the Commission in Brussels
informed. The EC expects to send a team today or tomorrow
from the European Center for Communicable Diseases. The EC
rep gives GOT credit for taking appropriate measures and
communicating, but asserted that although Turkey is an
observer in the EU "Network for Communicable Diseases" alert
network, it has not passed any info through this channel
(MOH reps told us they had been using appropriate EU
reporting channels).

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Poultry Outbreaks and Government Actions
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6. On December 15, 2005, 1200 poultry died from the H5
virus in the town of Aralik in the province of Igdir, near
the Armenian border (Reftel). On December 27, 2005, the
Ministry of Agriculture released an official statement
announcing this second AI outbreak in the country. (The N
subtype has not yet been determined. Samples were sent after
the New Year to a laboratory in London and results are
pending.) The GOT imposed a strict 10 km. quarantine zone
around the city of Aralik, in Igdir. About 700 birds were
killed in the first 3 kilometers and entry and exit of
poultry and trucks has been forbidden. The next 7
kilometers are under surveillance. (This area is not near
any commercial poultry operations. Villagers use the

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poultry - turkeys and laying hens - for family consumption.)


7. According to the Ministry of Agriculture, poultry also
died in Horasan, in the province of Erzurum, and in
Dogubeyazit, Agri Province, during the beginning of the week
of January 2, 2006. Samples from the sick and dead poultry
from Erzurum and Agri were sent to the laboratory in Izmir
for AI testing. Lab results are pending.


8. On January 4, 2006, The Ministry of Agriculture's
Protection and Control General Directorate released a
statement regarding the following 5 cities: Igdir, Kars,
Agri, Ardahan and Erzurum, which declared that entrance and
exit of all poultry to the above mentioned cities is now
banned. Transportation of poultry within the cities is also
banned. In Erzurum there are 2 minor, regional commercial
establishments and they are allowed to transport poultry but
the requirements are very strict (i.e. requirement to use a
container, etc). Also, the sale of live poultry is banned
in open markets.


9. On January 5, the Governor of Yozgat, a province in
Central Anatolia, announced that about 50 poultry died in
Akdagmadeni, Yozgat Province, on January 3, 2006. As
precautionary measures, 668 additional birds were culled.
It is not clear whether the birds died of AI, but the
samples were sent to the laboratory in Izmir. The region
surrounding Akdagmadeni is under quarantine as a
precautionary measure. The head of government in the city
of Akdagmadeni confirmed these statements to the Embassy.


10. In addition, the director of the laboratory in Izmir,
which tests for AI in poultry, also confirmed to the Embassy
that he has received numerous samples from all over Turkey
and is in the process of examining them. He is unable to
give any results at this time.


11. Comment: The GOT has been generally perceived as
reacting quickly to contain at least two separate rounds of
outbreaks of AI in poultry (1. In October in the west,
confirmed as H5N1, and 2. Current suspected outbreaks in the
east, sub-type still not established). The GOT's previous -
and now disproved - assurances that associated victims did
not have AI will feed public anxiety and general mistrust of
the government. The GOT may not have adequate capacity to
address surveillance, containment, and communication in the
event of multiple outbreaks.

MCELDOWNEY