TFFLU01: H1N1 INFLUENZA OUTBREAK AND BRAZIL: SITREP # 5

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SUBJECT: TFFLU01: H1N1 INFLUENZA OUTBREAK AND BRAZIL: SITREP # 5

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1. (SBU) This report provides an update on developments in Brazil
regarding the H1N1 influenza outbreak.

NEW REPORTED CASES:


2. (SBU) There are no confirmed cases of the H1N1 flu in Brazil,
which is most likely due to the fact that Brazil does not yet have
the ability to perform the necessary testing. The Minister of
Health Jose Gomez Temporao has announced that he expects when Brazil
has this testing capability it will confirm the presence of the
virus in Brazil. The Brazilian Ministry of Health, in coordination
with the National Agency on Health Vigilance (ANVISA),has
identified 25 suspected cases of H1N1 in nine different states
within the country, and is monitoring 36 other cases spread
throughout 16 of Brazil's 27 states. As of the afternoon of May 1,
the Brazilian press is reporting that a 50 year old woman died in a
hospital in the State of Rio de Janeiro with symptoms of the H1N1
flu. The woman was placed in isolation at the hospital after
arriving in Brazil two days ago on a flight from Michigan, USA with
H1N1 flu-like symptoms. Samples from the women have been sent to
ANVISA medical labs, and the press reports that the results should
be available by Wednesday, May 6.

BRAZILIAN GOVERNMENT'S RECENT ACTIONS:


3. (SBU) In public statements last Friday, May 1, Brazil's Minister
Temporao asserted that the Health Ministry believes a confirmed case
will inevitably arise, and that the government and Ministry of
Health are prepared to confront the disease. He also encouraged the
general population again not to prematurely self-medicate as a
preventative measure against the virus, and not to rush out and buy
medical masks. In interviews with the Brazilian Press, the
Assistant Director of World Health Organization, Feiji Fukuda,
refused to comment on Minister Temporao's statements, and only said
that each country should be prepared for the possibility of H1N1
appearing within their borders.


4. (SBU) Last week, officials from the Ministry of Health and other
Brazilian Government agencies stated that the Brazilian government
would not send any virus samples abroad to be tested. The Ministry
said that all cases would be tested in Brazilian laboratories and
initially stated that the Brazilian Government would produce the
necessary primers domestically based on genetic information provided
by the WHO. However, sources within the Ministry have indicated to
the Embassy that they may seek to purchase an initial supply of
primers to speed the process of testing suspect cases. NOTE. While
the Brazilian Government has not explained why it will not send
samples abroad, some press sources have speculated that it is linked
to intellectual property rights issues related to vaccines or
treatments that may be developed using samples provided to the WHO.
END NOTE.


5. (SBU) Ministry of Health and ANVISA authorities continue to
disperse information to passengers at all of Brazil's international
airports regarding the H1N1 flu. To date, 800,000 pamphlets printed
in Portuguese, English and Spanish have been handed out, and the
government is printing an additional 500,000 pamphlets to be
dispersed in the upcoming weeks.


6. (SBU) COMMENT: Brazil is about to enter the winter flu season,
which typically lasts from June to September. Since the government
has not yet developed specific medical tests to identify H1N1 cases
in the country, it will become increasingly difficult to determine
which of the current suspected and monitored flu cases are
attributable to H1N1 and which represent cases of the normal flu
season. This may be part of the reason that the Ministry of Health
has adopted a diagnostic definition for H1N1 that is more specific
than the WHO's definition. However, the use of this definition is
likely to result in an underreporting of potential cases until a
specific H1N1 test is deployed in Brazil. END COMMENT.

DEVELOPMENTS WITH MISSION BRAZIL:

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7. (SBU) Mission Brazil will begin to contact visa applicants who
have scheduled or will schedule appointments for May in order to
encourage them to reschedule if they are experiencing flu-like
symptoms. They will be asked to contact the Mission's scheduling
contractor, CSC, and the Mission will give them priority in
rescheduling.

SOBEL