H1N1 INFLUENZA OUTBREAK AND BRAZIL: SITREP #17

UNCLAS SECTION 01 OF 02 BRASILIA 000871 DEPT FOR OES/IHB AMBASSADOR LOFTIS DEPT FOR WHA/BSC USDA PASS TO APHIS HHS PASS TO CDC HHS FOR OGHA SENSITIVE SIPDIS E.O. 12958: N/A TAGS: TBIO KFLU CASC AEMR AMED ASEC KSAF PREL PINR AMGT KFLO, KPAO, TF, BR SUBJECT: H1N1 INFLUENZA OUTBREAK AND BRAZIL: SITREP #17 BRASILIA 00000871 001.2 OF 002 (U) THIS MESSAGE IS SENSITIVE BUT UNCLASSIFIED AND NOT FOR INTERNET DISTRIBUTION. PLEASE HANDLE ACCORDINGLY. ¶1. (SBU) This report provides an update on developments in Brazil regarding the H1N1 flu outbreak. NOTEWORTHY DEVELOPMENTS: - REPORTED CASES: ¶2. (SBU) As of July 10, 2009 the Brazilian Ministry of Health has confirmed 977 cases of the H1N1 virus spread throughout 25 of the country's 26 states and the Federal District: Sao Paulo (444 cases), Rio de Janeiro (102 cases),Santa Catarina (56 cases),Mato Grosso (5 cases),Minas Gerais (90 cases),Tocantins (5 cases),Rio Grande do Sul (118 cases),Alagoas (5 cases),Bahia (11 cases),Ceara (6 cases),Federal District (31 cases),Espirito Santo (11 cases), Goias (10 cases),Maranhao (4 cases),Parana (37 cases),Paraiba (5 cases),Para (2 cases),Amapa (1 case),Acre (1 case) Amazonas (1 case),Pernambuco (14 cases),Rio Grande do Norte (3 cases),Mato Grosso do Sul (4 cases),Piaui (5 cases),Sergipe (5 cases). Of the 977 confirmed cases, 563 (or 57.6%) were contracted internationally, and 278 (or 28.5%) were contracted within Brazil. Of the cases contracted internationally, the Ministry of Health asserts that Argentina was the source for 359 of Brazil's cases, the United States of America was the source of 97 of the cases, and Chile was the source of 61 cases. Further, 495 (or 50.7%) of the victims are women and 49.3% are men. People younger than 25 years of age represented 50% of the cases. In terms of severity of the disease, the Ministry of Health reports that 99.6% of the cases are light to moderate, and 0.4% are severe, and of these, only 1 case has resulted in death. There are currently 2973 suspected cases. ¶3. (SBU) Note: Since July 3, the Ministry of Health has changed its procedures for confirming cases of H1N1 flu. Previously, samples of individual biological material were used to confirm the presence of the virus in each individual patient. Under the new procedure, when there is a laboratory confirmation of the H1N1 virus in one victim, any person with an epidemiological link to that person who exhibits symptoms of H1N1 will be considered infected. - BRAZILIAN GOVERNMENT'S RECENT ACTIONS: ¶4. (SBU) On July 6, 2009, the Ministry of Health released a report reinforcing the World Health Organization's recommendation that all health authorities and the whole clinical body maintain the secrecy of the suspected and confirmed H1N1 cases, in order to avoid social stigma and prevent a breach in doctor-patient confidentiality. The Health Ministry also stresses that the flu transmission in Brazil is limited, without evidence of a sustained transmission from person to person, considering that all of these cases have an epidemiological link to imported cases. There is an active search and monitoring of all the close contacts of this case. ¶5. (SBU) In schools, workplaces, prisons, and social establishments, epidemiological investigation officials may declare a suspension of activities if there is a discovery of an aggregation of H1N1 cases. In such occasions, the health officials are supposed to take into consideration the number of victims, the characteristics of the location, and the number of at-risk citizens in the area. It is also necessary to maintain the secrecy of confirmed cases and to avoid discriminatory conduct towards the infected. The Ministry of Health, however, recommends avoiding unnecessary closure of these areas, in order to prevent panic within the population. Furthermore, the Ministry of Health maintains that the use of protective masks is only effective in hospital locations, and does not have a significant impact in reducing the transmissibility of the H1N1 virus when used by the general community, except when indicated by the local health authority. ¶6. (SBU) In reference to travelers departing to H1N1 infected countries, the Ministry of Health has presented the following suggestions: all travelers to countries with H1N1 present should rigorously follow the recommendations of local health officials, avoid areas with large conglomerations of people, avoid contact with the sick, and immediately seek medical attention in case of illness, BRASILIA 00000871 002.2 OF 002 being sure to report the history of their contact with the sick and the schedule of their trip to the country. ¶7. (SBU) In a report developed by Health Minister Jose Gomes Temporao on July 3, the Minister warns medical agencies to be wary of unnecessary use of antibiotics in patients, in order to reduce the potential resistance of the H1N1 virus towards these current treatments. Minister Temporao further commented that the great majority of patients with H1N1 recover without any medical treatment. SOBEL