UPDATE 2: AVIAN INFLUENZA IN DJIBOUTI

UNCLAS SECTION 01 OF 02 DJIBOUTI 000614

SIPDIS

SIPDIS

LONDON, PARIS FOR AFRICA WATCHER

ADDIS AND ASMARA FOR CONSULAR SECTION

E.O. 12958: N/A
TAGS: AMED CASC TBIO KFLU EAID EAGR DJ

SUBJECT: UPDATE 2: AVIAN INFLUENZA IN DJIBOUTI

REF: DJIBOUTI 564
DJIBOUTI 578


1. (U) Summary. Since our last update, very little new information h
confirmed. In reftel we referred to a confirmed case in an eight-yea
Since then we have learned that the child in question was only two-ye
She has since recovered nicely. We believe she may be one of the you
survivors of H5N1 to recover without Tamiflu being administered withi
first 48 hours of symptom onset. Two of her siblings and her health-
provider have fallen ill and samples from the three individuals were
NAMRU-3 in Cairo for testing, as well a sick chicken that the family
All returned negative. It is still not clear how the two-year-old gi
infected. The Government of Djibouti (GoD) was offering daily briefi
Ministry of Health. These briefings have been canceled until further
because of the lack of results in carrying out activities that are pl
these meetings, in particular the culling of chickens in the capital.
Summary.

What Djibouti is doing:
--------------

2. (U) When H5N1 was confirmed in a person in Damerjog, the GoD annou
that all chickens in the Damerjog area should be culled and that bird
would be recompensed for their loss. The GoD sent representatives to
Damerjog, to initiate the culling, but when the birds were presented
announced the compensation would be given at a later (undetermined) d
Most bird owners took their chickens and left the area. The GoD has
trying to cull chickens in Damerjog but no official reports have been
with details of results.


3. (U) Comment. This policy has the potential to bring together infe
uninfected birds in one area, as upon finding they will not be paid,
return them to their homes, possibly having cross-contaminated previo
healthy birds. However, the 26 samples that were collected all teste
tests performed locally in the French Military hospital and official
will come from NAMRU-3.


4. (U) At the urging of USAID, the World Health Organization (WHO) an
French military the Ministry of Agriculture announced through a commu
on May 21 that it would soon begin culling operations in the capital,
full cooperation of the population in order to succeed. The communiqu
provide details such as date or methodology for carrying out this ope

What the French are doing:
--------------

5. (U) The French military hospital has the capability to test to ide
both birds and people. The hospital does not have a level-3 approved
laboratory, so samples with positive findings are sent to Cairo to be
by NAMRU-3. The French also provided Tamiflu to Djiboutian health
officials to administer to the three patients that had been awaiting
well as the index case of the two year old.


6. (SBU) Reportedly the French military got fed up with the daily Dji
briefing at the Ministry of Health after indications that the GoD was
and providing no new information. The French announced that they wou
attend no more meetings until the GoD or WHO had something to report.
meetings have therefore been suspended until further notice.


7. (U) ConOff also met with representatives from the French Consulate
information about the situation in Djibouti. The French representati
poorly informed, and hungry for reliable information. Comment: USAI
representative has heard doubts expressed by the French that Avian Fl
exists in Djibouti. End Comment.

What the U.S. is doing:
--------------

8. (U) USAID and Embassy representatives attended the daily briefings
they were suspended. We continue to communicate one on one with our
immediate counterparts in the French embassy/consulate and with local
representatives. Also, USAID is working with WHO to develop the
communication plan which WHO will execute. USAID will provide $50,000
funding to WHO to support this activity which includes production of
television/radio materials as well as dissemination of these material
support and general awareness-raising in the population. USAID is als
providing Personal Protective Equipment (PPE) to GoD and US Military,
distributed 50 sets thus far. Fifty more have arrived and another 200
way as well as two lab specimen kits and one decontamination kit.
USAID/Washington has said that it could make available up to another

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$100,000 as needed.


9. (SBU) The U.S. military sent several medical personnel to the area
Damerjog to look for and sample sick people. However, they expected
Ministry of Agriculture to be sampling chickens. When it became clea
Ministry was not, the U.S. medical personnel attempted to locate chic
test them. The military considered it essential to identify the sour
infected child's illness. If H5N1 cannot be traced to a chicken with
girl had direct contact, new questions are raised. As yet, all fowl
that area have tested negative, and the source has not been definitiv
identified.


10. (U) On May 14 ConOff held a Warden Meeting. It was well attended,
all but one Warden appearing. USAID rep for health issues presented
know about AI in Djibouti, as well as basic information about the vir
to protect oneself. Information pamphlets were distributed. On May
Ambassador held a Town Hall meeting in which CJTF-HOA and USAID
participated. This meeting was poorly attended by AmCits, but severa
ahead of time to inquire as to the content of the meeting, so we are
message got out through Wardens. Contact with several AmCits after t
Hall confirmed that they were aware, but did not feel sufficient anxi
H5N1 to warrant attending the meeting. However, the meeting was atte
several non-AmCits who wanted to know what information we had to shar
(specifically: the panel physician, a CDC representative and the Fren
Consulate.)


11. (U) Embassy Djibouti will continue to transmit to Washington and
American community information as it becomes available.
RAGSDALE