YELLOW FEVER UPDATE

UNCLAS ASUNCION 000103 SIPDIS SIPDIS FOR WHA/BSC KREAD, BFRIEDMAN, MDRUCKER; CA/OSC/WHA SCRAWFORD; EMBASSY LA PAZ FOR WQUILLIN; USAID FOR OFDA E.O. 12958: N/A TAGS: EAID PREL AEMR CASC MASS SOCI TBIO AFSN PGOV PA SUBJECT: YELLOW FEVER UPDATE ¶1. As of February 15, there are 46 reported cases of yellow fever in Paraguay. Twenty-six are live cases; only five cases have been confirmed to date. The first case of yellow fever surfaced January 15 in San Estanislao, San Pedro Department. A team of experts dispatched to the region found five more cases between January 17 and 30. A second team of experts from the Central Laboratory was dispatched to the region January 23 and found five more suspected cases. While the investigation is ongoing, preliminary indications are that the disease was spread by monkeys from Brazil into Paraguay. Health authorities confirmed five cases of yellow fever February 4. Since then, the virus spread to the suburbs of Asuncion and the number of reported cases has doubled. The first urban case was reported in San Lorenzo, a suburb of Asuncion. ¶2. Public fears of an epidemic are surging. Health Minister Oscar Martinez declared a ?national epidemiological alert? February 8. Two days later, the Health Ministry announced that it had run out of vaccines. The shortage has created chaos in some communities and complicated the GOP?s ability to manage the outbreak. On February 5, the day after the Health Ministry confirmed the presence of yellow fever, thousands flooded health centers for vaccines. Following 13,000 vaccinations, the Health Minister announced February 6 that its supply was almost depleted and that the remaining vaccines would be used in San Pedro. According to February 13 press reports, thousands of people residing in areas with confirmed cases of yellow fever were turned away from clinics when supplies were exhausted. Approximately 4,000 residents of San Lorenzo protested the lack of vaccines by blocking a major highway February 13. The government?s public communications program has been spotty and ineffective. ¶3. The Pan-American Health Organization pledged to provide Paraguay with 400,000 vaccines (scheduled to arrive within 10 days); Brazil loaned Paraguay 50,000 vaccines February 14 and has offered 400,000 more. Peru promised approximately 300,000 doses, with 144,000 to be delivered February 15-17 and 250,000 more to arrive February 23-24. However, health officials estimate they will need 2 million vaccines to cover the north central part of the country and the greater Asuncion area. If the outbreak multiplies exponentially, up to 4 million vaccines could be required. Per the CDC, when outbreaks occur among unprotected populations, case-fatality rates range from 15 percent to more than 50 percent infected persons. Approximately 430,000 Paraguayans have been vaccinated in the last three years. ¶4. President Duarte Frutos formally declared a national emergency February 15. The Health Minister formally asked the Ambassador in writing February 15 for the provision ? either as a loan or donation ? of yellow fever vaccine. The Health Ministry also asked USAID February 15 to participate in an ad-hoc emergency situation committee stood up by PAHO. In response, the Ambassador declared an emergency February 15, thus triggering USD 50,000 in emergency assistance. Ambassador is seeking all possible assistance from USG and private sources. Embassy officials are working with SOUTHCOM and OFDA in an effort to explore the purchase of vaccines. SOUTHCOM will also dispatch a Naval Medical Research Institute (NAMRID) epidemiological team based in Peru February 18 at the specific request of the Health Ministry. The vast majority of direct-hire Americans and Peace Corps volunteers in country have been vaccinated; Embassy is working with the Peruvian Embassy to secure vaccines for approximately 150 LES. Embassy has been in frequent communication with the unofficial American community about the outbreak and current vaccines stocks, and will continue to keep the community abreast of developments. CASON