Serbia Declares H1N1 Epidemic

UNCLAS SECTION 01 OF 02 BELGRADE 001332 SENSITIVE SIPDIS E.O. 12958: N/A TAGS: AEMR KFLU AMGT PREL CASC PINR SR SUBJECT: Serbia Declares H1N1 Epidemic REF: BELGRADE 579; BELGRADE 703; BELGRADE 1240 BELGRADE 00001332 001.2 OF 002 ¶1. (U) On November 11 the GOS responded to mounting public and media concerns about H1N1 influenza and formally declared an epidemic. H1N1 is widespread in a number of Serbian cities; however, the majority of cases are not severe, with nine deaths reported thus far out of 258 confirmed cases. The media and public are heavily focused on H1N1. Schools have extended the autumn break period and a vaccination program announced last week did not quell public concerns and media hype. Designating an epidemic opens the possibility of event cancellations and travel bans; however, no such measures have been taken yet and Health Ministry officials stated "life must go on." End Summary. Current Statistics -------------- ¶2. (SBU) To date in Serbia, more than 350 persons have been hospitalized, with 258 cases confirmed and nine deaths attributed to H1N1. (Note: The number of cases and number of flu-related deaths are not out of the ordinary.) Health Minister Tomica Milosavljevic told reporters on November 12 he estimated that perhaps 20,000 - 30,000 people were currently infected with H1N1. The majority of cases, however, are mild, and laboratory testing has been limited to hospitalized patients. Milosavljevic, and Predrag Kon, the head of a special working group for pandemic influenza, noted at a well attended November 6 press conference the flu was "epidemic" in 10 cities (Cacak, Kraljevo, Kragujevac, Nis, Paracin, Pozega, Uzice, Ivanjica, Prilike and Leskovac and Juznobacki region). Readiness -------------- ¶3. (SBU) The Health Ministry and a special working group began preparation and training for a possible flu epidemic two years ago. Efforts have been largely focused on H1N1 at the expense of ordinary seasonal flu. Previously, citizens were able to obtain seasonal flu vaccinations from government outpatient health centers, private medical offices or private pharmacies. This year, supplies of the seasonal flu vaccine are limited due to higher demand and respirators are reportedly in short supply. In recent weeks health officials have emphasized the need to treat all cases using standard flu treatments and cautioned against waiting for test results to begin treatment. 
 Procuring Vaccine -------------- ¶4. (SBU) On October 3 the GOS ordered three million doses of the H1N1 vaccine through a bidding process, with Novartis winning the contract on November 9. The first delivery of 500,000 doses is expected by mid-December, and the remainder should arrive in January 2010. In addition, Serbia's Institute of Immunology and Virology will begin domestic production of the vaccine in early ¶2010. The vaccine will first be available to approximately 900,000 "priority patients," (i.e., children with chronic diseases, pregnant women, and public service employees). Afterwards the vaccine will be made available to the public at large. The Health Ministry has strongly encouraged vaccination against H1N1, and said refusal of the vaccine would be noted on patients' health records. Milosavljevic said the Health Ministry would request $5 million be reallocated for flu monitoring and immunization programs. Media Overreacts -------------- BELGRADE 00001332 002 OF 002 ¶5. (SBU) Media reports focus on the sensationalist elements of H1N1, such as the decision by a leading grocery chain to purchase masks for all of its employees. The coverage has heightened public anxiety. According to the Health Ministry, the majority of cases are mild and, there are sufficient antiviral stockpiles to treat patients. Milosavljevic urged the media "not to spread misinformation" about the availability and efficacy of the vaccine. Declaring an Epidemic, Dispelling Fears and Other Next Steps -------------- -------------- ¶6. (SBU) Officials first raised the possibility of declaring a countrywide H1N1 epidemic on November 8 in light of growing concerns that "something must be done", and declared an epidemic on November 11 following a three hour Parliamentary debate. Epidemic status provides the authority for officials to close schools and cancel public events, and impose quarantines, import and travel restrictions. To date, the only measure the government imposed was a ban on prison visits. The Working Group will prepare a set of recommendations to be implemented if the disease continues to spread. ¶7. (SBU) With an epidemic declared, the GOS and Working Group members shifted their focus to dispelling fears and assuring the public that this step was taken to ensure the GOS has the necessary tools to act should it be necessary. Milosavljevic underscored that public events remained open and students should report to school next week as scheduled. Group member and epidemiologist Branislav Tiodorovic encouraged citizens to continue with their lives by attending holiday events and concerts, and stressed his plans to attend an upcoming Tom Jones concert. Comment -------------- ¶8. (SBU) Serbia is experiencing an increasing H1N1 outbreak; however, most cases are relatively mild. Sensationalist press reports have created considerable mythology around H1N1, escalating public anxiety. The government has done a commendable job of attempting to dispel fears and focus efforts on treating patients. These reports and resulting public fears encouraged the GOS to declare an H1N1 epidemic to mobilize resources, if needed, and demonstrate responsiveness. We continue to believe the government is taking prudent actions to address the growing epidemic. End Comment. BRUSH