UPDATE 1: AVIAN INFLUENZA IN DJIBOUTI

UNCLAS SECTION 01 OF 02 DJIBOUTI 000578

SIPDIS

SIPDIS

LONDON, PARIS FOR AFRICA WATCHER

E.O. 12958: N/A
TAGS: AMED CASC TBIO KFLU EAID EAGR DJ
SUBJECT: UPDATE 1: AVIAN INFLUENZA IN DJIBOUTI

REF: DJIBOUTI 564

DJIBOUTI 00000578 001.4 OF 002



1. SUMMARY. Three poultry cases, and one human case of H5N1
Avian Influenza were confirmed in Djibouti on May 11. The
Government of Djibouti is actively engaging the international
community on measures to address this issue, but many
unknowns still remain.

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WHAT WE KNOW
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2. An eight-year old girl in Djibouti has contracted the H5N1
strain of Avian Influenza, confirmed by NAMRU-3 in Cairo on
May 11. The Government of Djibouti announced the case on
national TV and Radio stations. She and her family of 13 are
living in Damerjog, a small village approximately 15 km south
of Djibouti city, and is under medical surveillance. Two of
her siblings are currently exhibiting flu-like symptoms, one
of whom is undergoing treatment with tamiflu. These sibling
have been tested, but results are not yet available. The
family reportedly owns "four or five" chickens. One of the
chickens appeared to be sick when the family was visited by
health officials on May 12. A sample was taken from this
chicken, but results are not yet determined. It is unknown if
the family had other birds who recently died.


3. H5N1 has been confirmed in at least two chickens and one
turkey in Djibouti city. These chickens were kept on a
compound owned by the First Lady of Djibouti. The whole
flock, consisting of at least a dozen birds, was culled.
Testing among other chickens continues. Humans who worked on
the compound have been tested, and so far all results are
negative. There are no large flock or poultry farms in
Djibouti, but Djiboutian families often own two or three
chickens. The Government of Djibouti has banned all imports
of live poultry, and has announced that culling will take
place. However, the government has not outlined a
compensation plan for affected citizens.

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WHAT IS BEING DONE
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4. The Embassy's Emergency Action Committee convened on May

11. ConOff held a warden meeting on May 14. Embassy-wide
staff briefings will be held on May 15. The Ambassador will
host a town hall meeting for all U.S. Citizens in Djibouti on
May 16. USAID is providing technical support and advising the
government, as well as monitoring progress. USAID is also in
close collaboration with partners and donors such as WHO and
the World Bank on how to best coordinate a combined response.
The Embassy continues to receive local updates from
Djiboutian Government officials who hold daily briefings at
1800 hours.


5. Djibouti's Minister of Health called a meeting of the
donor community on May 14 to announce that the Government of
Djibouti had developed a budget, and appealed to the
community for support. The financial request for the
immediate emergency totaled $4 Million, and included such
things as tamiflu stock, lab testing materials, logistical
support for transportation, safety equipment, decontamination
materials, and money for paying out compensation to families
who lose chickens to culling. The surveillance system is
working on a minimal level, which has assisted the government
to get to this point, but technical support for surveillance
and sampling is still needed. Djibouti is coordinating with
neighboring countries, and WHO confirmed that it too is
working with neighboring WHO offices. The Health Minister
assured people that although the situation was an emergency,
it was not catastrophic, and people should proceed with their
normal routines. The Minister of Health thanked the donor
community, in particular USAID and the U.S. Military, who
have aided them in this effort.

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LIMITATIONS
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6. Although unofficial tests for H5N1 can be done locally at
the French Military Hospital, the closest level-3 certified
lab is located at NAMRU-3 in Cairo. Human test samples can
only be sent through the WHO to Cairo on Tuesday evenings,
causing a delay in obtaining results in a timely manner.
There is currently no official method for sending animal
samples since FAO does not have a presence in Djibouti.

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WHAT WE DON'T KNOW
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7. Since all live poultry imports into Djibouti have been
banned, it is not yet clear how H5N1 developed in Djibouti.
It is also unclear how the two cases of H5N1 in Djibouti are
related, if at all. The Government of Djibouti estimates the
poultry population at 3000 birds, but this number cannot be
substantiated.


8. COMMENT. The Government of Djibouti is a willing partner
in addressing this issue, but heavily relies on outside
donors to assist in implementing action and prevention. The
early recognition, diagnosis, and reporting of H5N1 in
Djibouti has been possible with the help of foreign
assistance, including USAID and CJTF-HOA. Overall, the
Government of Djibouti continues to coordinate its efforts
with the international community, but there are reports that
the Minister of Agriculture failed to show up for sampling
and surveillance runs at the index sites in spite of the
government's pronouncements. END COMMENT.
RAGSDALE