Jordan Continues to Strengthen Avian Influenza

UNCLAS SECTION 01 OF 02 AMMAN 004174 SIPDIS STATE FOR OES, M/MED, NEA/RA (LAWSON) STATE PASS USAID FOR GLOBAL HEALTH USDA FOR APHIS GENEVA FOR WHO REPRESENTATIVE ROME PASS US MISSION FAO AIAG FOR WINN SENSITIVE SIPDIS E.O. 12958: N/A TAGS: TBIO KFLU XF JO SUBJECT: Jordan Continues to Strengthen Avian Influenza Preparedness REF: Amman 1276 SENSITIVE BUT UNCLASSIFIED. HANDLE ACCORDINGLY. ¶1. (SBU) Summary: Embassy Amman's Avian Influenza (AI) Task Force met October 9 with representatives from the Government of Jordan (GoJ) to share information on avian flu preparedness. The meeting focused on: tracking the progress of avian flu; surveillance and detection training; and preparedness and treatment options. The GoJ reported that they have a comprehensive preparedness and prevention plan, but still lack adequate supplies of tamiflu or personal protective equipment to respond to a human pandemic outbreak. Jordan also continues to cooperate on AI preparedness with Israel and the Palestinian Authority. End Summary. -------------- Background -------------- ¶2. (U) During an October 9 meeting with the Embassy's AI Task Force, GOJ officials from the Ministry of Agriculture (MOA) and the Ministry of Health (MOH) reported that no new cases of AI in poultry and humans have been detected in Jordan since March 2006 (Ref A). However, with the annual wild-bird migration season approaching, the risk of AI cases increases. -------------- Current Status of Avian Flu -------------- ¶3. (SBU) Centers for Disease Control and Prevention (CDC) Resident Advisor Gerber gave an overview of the global avian influenza situation, currently at the WHO's phase three definition (cases in birds, but no efficient human-to-human transmission). Gerber noted that since January 2007, confirmed occurrences of H5N1 avian flu in poultry and wild birds have been reported in Nigeria, the U.K., Egypt, Hungary, Russia, Afghanistan, Kuwait, Pakistan, Thailand, Laos, Vietnam, Indonesia, Korea, and Japan. He noted the AI in humans has a high case fatality (over 60%),and that incidences of H5N1 have been highest in those below the age of thirty. Gerber stressed the importance of surveillance for AI detection. -------------- -------------- Jordan's Actions on AI Preparedness and Prevention -------------- -------------- ¶4. (SBU) Dr. Adel Belbessi, Assistant Secretary General at the Jordanian Ministry of Health (MOH),said that Jordan has been preparing seriously for avian flu through development of an avian influenza preparedness plan. He also stated that Jordan has 3 million capsules of tamiflu for roughly 300,000 treatment doses for human H5N1 treatment, which would treat approximately 3 percent of Jordan's population. The MOH, through USAID assistance, has in stock 6,000 sets of personal protective equipment (PPE) and is expected to receive another 4,500. Belbessi noted that these numbers were not adequate. He said that in case of an AI outbreak, the tamiflu and the PPE's would be distributed mainly for staff who deal with AI patients and for the individuals who support the core services in the country, such as police and civil defense. ¶5. (U) The MOH has designated twelve hospitals around Jordan that are ready to face avian flu cases if they occur. The Ministry of Health also has labs across the country with two trained persons per lab. Those labs can do rapid H5N1 and Polymerase Chain Reaction (PCR) tests. Belbessi noted that there is minimal contact with AMMAN 00004174 002 OF 002 Syria on AI, but the GOJ works closely with their Palestinian Authority and Israeli counterparts, with whom a joint AI exercise is planned for later in 2007. MOH conducts three kinds of training: hospital training to handle AI cases; infection control training at the hospitals; and surveillance training. ¶6. (SBU) Dr. Mohammed Abu Rumman, Head of the Veterinary Lab at the Ministry of Agriculture (MOA),said that the PCR units are available at the Ministry's labs and that they collaborate with the Ministry of Health. Rumman mentioned that the MOA has already vaccinated 90% of the country's backyard local birds and that they have available vaccines in stock. GOJ interlocutors confirmed that backyard flocks continue to be Jordan's main concern, given that commercial flocks are generally isolated from wild birds and outside contact. Rumman added that the MOA conducts drills to train their staff as well as staff of other ministries to deal with AI. They have already done a drill in Mafraq (Eastern desert) and Zarqa (East of Amman). -------------- FAO/UN Avian Flu Program in Jordan -------------- ¶7. (U) Dr. Laura Sawalha, Head of the Epidemiology Unit at the Ministry of Agriculture (MOA) and National Project Director of the FAO-funded AI Program, described the expected outcome of the program to develop and establish national active surveillance systems for backyard, commercial, and migratory birds. She mentioned that the MOA has benefited from FAO technical assistance to develop its laboratory capacity. The FAO's initial assistance was USD 90,000 to cover training and laboratory and field equipment (PPE's). ¶8. (U) Sawalha described the current program in which a project coordinator in each governorate regularly visits poultry farms and fills a coded questionnaire that is submitted monthly to the central epidemiology unit for data processing and analysis. The project coordinator also monitors the production parameters, mortality, feed and water intake, clinical signs such as respiratory signs and decrease in egg production, and bio security measures. The coordinators take samples for rapid testing if they suspect any cases. Active sampling is expected to begin in a few months time. Visit Amman's Classified Website at: http://www.state.sgov.gov/p/nea/amman HALE