ARGENTINA: H1N1 DEATH TOLL CLIMBS TO SIX

UNCLAS BUENOS AIRES 000721


DEPT FOR OES/IHB - P. MURPHY AND D. WILUSZ

E.O. 12958: N/A
TAGS: TBIO SOCI PGOV PREL AR
SUBJECT: ARGENTINA: H1N1 DEATH TOLL CLIMBS TO SIX


1. Summary: H1N1 cases in Argentina continue to increase. In
response, the Ministry of Health (MOH) has begun to focus on defined
risk groups. Reacting to an increased pattern of local transmission
rather than contagion from outside the country, the MOH has moved
from a strategy of containment toward one of mitigation. The MOH
has announced plans to open additional testing centers around the
country. End Summary.


2. According to information provided by the Ministry of Health
(MOH),the number of confirmed H1N1 cases in Argentina has increased
to 946. Fifteen of these individuals are currently hospitalized, 12
of them in intensive care units. To date, six people confirmed with
H1N1 have died, at least five of which come from a defined risk
group: a prematurely born three-month baby, another infant, a
ten-year-old girl with symptoms of meningitis, a child with
respiratory problems, and a twenty-eight-year old who had undergone
a bone-marrow transplant.

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New Risk Groups Defined
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3. In view of this pattern, the MOH has defined specific risk
groups. These include people living in the critical areas of Buenos
Aires or La Plata with a temperature of at least 38 degrees Celsius
and symptoms of respiratory illness, and who also have preexisting
respiratory, heart, or metabolic problems, are receiving
immunodepressant drugs (HIV, cancer, or transplant patients),
individuals under 2 years old or over 65, pregnant women, and
smokers. Under this definition, the risk population in Argentina is
eight million, or 20% of the total population. Health authorities
from both the City and Province of Buenos Aires have expressed
concern about the rapid development of illness in a 15-year-old male
patient who was hospitalized with symptoms, had not been diagnosed
with a preexisting illness, and died within 48 hours of
hospitalization. Although he tested positive for H1N1, health
authorities are trying to determine if the cause of death was H1N1
or pneumonia that attacked simultaneously.


4. The Ministers of Health of these critical areas believe that
there are approximately 50% more cases of flu than the 90,000
currently reported. This is not unexpected given the onset of the
flu season here, and helps to explain why specific testing for H1N1
will now be done only on individuals who are part of a defined risk
group. The MOH has said it plans to treat all individuals with
symptoms in these risk groups with oseltamivir. They have increased
their purchase of oseltamivir to two million treatments per Pan
American Health Organization recommendations.

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Mitigation Replaces Containment
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5. While the MOH still collects documents filled out by travelers
at ports of entry self-certifying that they are free of symptoms and
uses thermal scanners in airports to check travelers' temperatures,
recent H1N1 transmission rates appear to have increased more from
local contact than from international travel. As such, the MOH has
adapted their original strategy from containment to one of
mitigation. Since school closures do not seem to have been
sufficiently effective at stopping the spread of H1N1 among
children, MOH has said it will only resort to this measure if there
is more than one confirmed case in the same school. They have
ordered school authorities to strictly control children with regular
flu symptoms attending classes. In addition, the MOH has
recommended that students stay away from large gatherings and group
travel. (Note: It is a common ritual for students finishing high
school to travel to winter resorts such as Bariloche for their
"end-of-the-year trip" during the winter holidays in July.)


6. National Minister of Health Graciela Ocana has promised to open
19 additional laboratories around the country in an effort to
provide a more efficient testing system for potential cases that
develop in the provinces. For now, tests from all over the country
are still carried out only in the Malbran Institute, located in the
city of Buenos Aires.

KELLY