Identifier
Created
Classification
Origin
07ACCRA1094
2007-05-16 16:15:00
UNCLASSIFIED
Embassy Accra
Cable title:  

AVIAN INFLUENZA (H5N1) OUTBREAK IN GHANA

Tags:  GH KFLU MARR MASS CASC 
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VZCZCXRO7331
OO RUEHMA RUEHPA
DE RUEHAR #1094/01 1361615
ZNR UUUUU ZZH
O 161615Z MAY 07
FM AMEMBASSY ACCRA
TO RUEHC/SECSTATE WASHDC IMMEDIATE 4454
INFO RUEHZK/ECOWAS COLLECTIVE
UNCLAS SECTION 01 OF 02 ACCRA 001094 

SIPDIS

STATE FOR G/AIAG SUMMERS

SENSATIVE
AIDAC
SIPDIS

E.O. 12958:N/A
TAGS: GH KFLU MARR MASS CASC
SUBJECT: AVIAN INFLUENZA (H5N1) OUTBREAK IN GHANA

REF: ACCRA 00872

ACCRA 00986
ACCRA 00960

UNCLAS SECTION 01 OF 02 ACCRA 001094

SIPDIS

STATE FOR G/AIAG SUMMERS

SENSATIVE
AIDAC
SIPDIS

E.O. 12958:N/A
TAGS: GH KFLU MARR MASS CASC
SUBJECT: AVIAN INFLUENZA (H5N1) OUTBREAK IN GHANA

REF: ACCRA 00872

ACCRA 00986
ACCRA 00960


1. (U) Summary: Ghana confirmed its first case of H5N1 on April 28,

2007. Since then, the GoG has done a significant amount of work to
manage and contain the epidemic. To date there are four confirmed
outbreak locations, all in Tema municipality (approximately 20-25 km
east of Accra). No human cases have been reported. The government
of Ghana veterinary services, with the support of USAID, has been
carrying out active surveillance to identify infected birds as well
as carrying out culling and decontamination efforts when infected
birds have been identified.
End summary.

Identifying the problem
--------------


2. (U) Two adjacent poultry farms in Tema were affected. Deaths of
chickens were first noticed o/a April 14, 2007; samples from the
index farm cluster ("farm 1") tested positive for H5N1 at a U.S.
Navy supported local lab (Noguchi Research Institute) on April 28
and were confirmed at NAMRU-3 (Naval Medical Research Unit),a WHO
world reference lab in Cairo on May 2. Chickens from two adjacent
farms ("farms 2 and 3") tested positive for H5N1 on May 3 and May 8.
The fourth farm was identified and tested positive for H5N1 on May

10. The GoG publically announced the outbreak on My 2.


3. (U) The manner in which the virus was introduced to Ghana is not
clear. Nor has any clear link yet been established between the
first two farm clusters, which lie more than 9 km apart. Tema is
not only a port, but is also the crossroads of several major
East-West and North-South land routes. The Tema area is also an
important landing site for migratory birds from Europe, Asia and
coastal regions of West Africa. An initial evaluation of the Ghana
strain of virus at the NAMRU lab in Cairo suggests that the Ghana
virus is similar to strains that were found in recent outbreaks in
the neighboring countries of Cote d'Ivoire, Burkina Faso and
Nigeria. The analysis, which is ongoing, also suggests the virus is
closely linked to strains of H5N1 found in Germany and Siberia.

The Response
--------------


4. (U) The Ghana veterinary service has mounted a vigorous response

effort, in collaboration with the Ghana Health Service (GHS),
Ministry of Interior and other government agencies, USAID, NAMRU,
WHO, and FAO. The national Avian Influenza Task Force is
coordinating the response following the framework of the national
preparedness and response plan that was finalized in 2006 with USAID
support.


5. (U) Following reports of high numbers of bird deaths on these
farms, 1,823 birds on farm 1 and approximately 10,300 birds on farms
2 and 3 were destroyed. Close to 400 birds were destroyed on farm

4. To date, 69 other area farms have been evaluated for reports of
sick and dying birds, and the appropriate clinical and laboratory
evaluations have been undertaken. None of these other farms have
tested positive for avian flu, although about half of these lab
tests are still being run.


6. (U) The GoG has imposed a ban on the movement and sales of
poultry in the Tema area, although enforcement capacity is limited.
On each affected farm, birds are known to have been sold off between
the time rapid die-off began and the
time vet services destroyed all remaining birds. The GHS is
monitoring workers on the affected farms and has sensitized local
health care workers. Tamiflu has been stockpiled by the GoG, and
other efforts to improve readiness for possible future human cases
of avian flu are underway.


7. (U) A USG team consisting of USAID, CDC, and NAMRU personnel has
made numerous direct observations of the veterinary and human
surveillance and disinfection operations in the field area.
Technical assistance and commodity support have been provided, and a
set of recommendations developed. Based on these recommendations,
USAID is providing an initial $200,000 in emergency support funds to
the GoG. The avian influenza unit at USAID has already provided
4,450 personal protection equipment (PPE) kits, 45 decontaminate
sprayer kits and two lab sampling kits, all housed at vet services.
USAID will also be providing a veterinary/epidemiologist to assist
in this effort. CDC and WHO will provide ongoing technical
assistance to support the human health side.

Comment
--------------

8. (SBU) The outbreak has tested the past year and a half of
USG-supported training, capacity building and preparation. Overall,
the Government response has been good, with the veterinary services

ACCRA 00001094 002 OF 002


clearly ahead of the human health side. Reports of new bird
die-offs and positive lab results continue every 2-3 days, with no
end in sight yet. Stricter enforcement of restrictions on bird
movements in/out of affected areas will be crucial for containment.
There is mounting concern over the lack of transparency regarding
compensation of farmers for culled birds. While the Ministry of
Agriculture states that a compensation plan exists (this plan will
only cover 60-90% of the costs),no farmers have been paid to date.


9. (U) Since this outbreak is for the time being confined to birds,
the greatest impact will be economic. Mass cullings will exact an
economic toll, but the greatest impact will result if consumers
refuse to purchase poultry products on a large scale. The media and
public were sensitized to AI issues in 2005-06 and have responded
calmly so far. USAID is supporting a communications campaign
targeted at poultry farmers, traders, veterinarians, and health
workers. Some messaging for the public has gone out on radio and
print media and this would be broadened if the outbreak spreads.


10. (SBU) Preparedness for identification of a human case and for
case management is weak. An assessment team consisting of
representatives of the GHS (Institutional Care) and the CDC
evaluated the local hospitals and found that the only available
facility with the capacity (after some minor modifications) to
manage an isolation room is the Military 37 Hospital in Accra.
Additional help would have to be provided to improve the hospital's
referral system.


11. (U) USAID and NAMRU will continue to work on the ground to help
monitor and manage the situation. With additional resources and
technical assistance, the response in Ghana on the veterinary side
may prove to be a model for the rest of Africa.

CHEEMA