(C) ARGENTINA: H1N1 DEATHS SURGING

C O N F I D E N T I A L BUENOS AIRES 000748 SIPDIS DEPT FOR OES/IHB - P. MURPHY AND D. WILUSZ WHA/BSC FOR J. SHOWELL E.O. 12958: DECL: 06/26/2019 TAGS: TBIO SOCI PGOV PREL AR AMED SUBJECT: (C) ARGENTINA: H1N1 DEATHS SURGING REF: BUENOS AIRES 0721 AND PREVIOUS Classified By: CDA Tom Kelly for reasons 1.5 b and d ¶1. (C) Summary: Argentina's Ministry of Health (MOH) puts the number of confirmed H1N1 cases at 1486, 335 of whom are currently hospitalized. Officially, 23 patients have died, but several sources claim that there have been at least 15 additional deaths and a broader incidence of cases. Eighty patients are in intensive care units with respirators. Health experts estimate that as many as 20% of the population of greater Buenos Aires currently suffer from some form of influenza. The possible declaration of a sanitary emergency has been delayed until after this Sunday's legislative elections, which the Health Minister reportedly recommended postponing. End summary. -------------- Official Numbers Tip of the Iceberg -------------- ¶2. (C) The head of Infectious Diseases at the School of Medicine at the University of Buenos Aires, Dr. Horacio Lopez, believes that the number of cases of influenza and deaths due to H1N1 is much greater than what MOH records indicate. (We have also heard this from a number of other well-connected sources, and the claim has also appeared in the local press.) He anticipates that the current cycle of influenza, which started in earnest about four weeks ago, will peak during the next two weeks in greater Buenos Aires, thus lasting a total of 8 weeks. This pattern is expected to repeat itself in major cities around the country as the disease spreads from the capital. ¶3. (U) Certain trends stand out: almost 46% of the confirmed cases correspond to children from 5 to 15 years old; the greatest number of deaths has been recorded in adults from 30 to 50 years old; two-thirds of the deaths occurred in patients who had a pre-existing medical condition. Medical experts are concerned by the high mortality rate, which is similar to that of Mexico. To complicate matters, the H1N1 virus coexists with seasonal influenza and a high number of cases of pneumonia in which serious complications have developed, requiring respiratory support with ventilators. Eighty of these patients are currently hospitalized. The contagion rate of H1N1 seems to be higher than that of the seasonal variety and is estimated at 22 to 23%. According to the head of Epidemiology of the Ministry of Health, Hugo Fernandez, the risk of contracting H1N1 is now greater than contracting seasonal flu. The MOH has instructed physicians to consider all patients with a fever of more than 38 degrees Centigrade (100.4 degrees Fahrenheit) and symptoms of fatigue as potential H1N1 cases. These individuals will be x-rayed and hospitalized if diagnosed positive with pneumonia. -------------- Existing Hospital Staff Hard-Pressed -------------- ¶4. (U) The Minister of Health of the Province of Buenos Aires, Claudio Zin, believes that 20% of the total population (11 million) of the Province of Buenos Aires will suffer from some form of influenza during the course of this flu season, double that of a typical flu season. In contrast, Dr. Stamboulian, a well-known Argentine epidemiologist, believes 20 to 25% of the population has already contracted some form of the flu. Worried that the health system could be overwhelmed, provincial health authorities are considering summoning retired doctors and fourth-year medical students to supplement existing hospital staff. ¶5. (U) The MOH has set up mobile health centers in central gathering places in Buenos Aires such as train and bus stations in an effort to minimize the pressure on emergency waiting rooms. They have also announced the opening of new H1N1 diagnostic laboratories and centers which will make Oseltamivir (Tamiflu) available to ensure wider and more efficient distribution. Some hospitals have started to adopt in-house measures in an effort to improve the service provided to the increasing number of incoming patients. Hospital Posadas, one of the largest public hospitals in the Province of Buenos Aires, has declared its own "Institutional Emergency" requiring all personnel be "on call." -------------- U.S. Technical Assistance -------------- ¶6. (U) The Centers for Disease Control (CDC) are collaborating with the Pan American Health Organization (PAHO) through the Global Outbreak Alert and Response Network (GOARN) to help Argentina evaluate and respond to H1N1. GOARN is an institutional collaboration that pools human and technical resources for the rapid identification, confirmation and response to outbreaks of international importance. It provides an operational framework to keep the international community advised of outbreaks. Two CDC experts will be working with PAHO and the MOH in a general study of the H1N1 virus behavior. -------------- Brazilian Health Warning -------------- ¶7. (U) The Brazilian Minister of Heath has recommended that Brazilians avoid traveling to both Argentina and Chile. He noted that these are the two countries with the highest number of H1N1 cases in South America. The Government of Brazil has adopted special precautionary measures on flights coming from Argentina, similar to those which Argentina already has in place. Airlines are required to provide passenger lists with contact information. Passengers are required to complete a special form and will be isolated if exhibiting flu symptoms. (Note: Brazilian tourism has been especially strong in recent years to Argentine winter ski resorts such as Bariloche, to the extent that some locals refer to it as "Braziloche"). -------------- Public Health Rumors -------------- ¶8. (SBU) A meeting by the Crisis Committee, chaired by President Cristina Fernandez de Kirchner's Chief of Cabinet Sergio Massa, has been postponed several times. Rumors abound of drastic measures that will be announced after this Sunday's legislative elections. This could include the closure of schools (which typically close for the austral winter vacation during the last two weeks of July) and the suspension of all public gatherings, including cinemas and shopping centers. Minister of Health Graciela Ocana earlier this week suggested that the elections be postponed to prevent contagion amongst voters, but was roundly ignored by all political entities, which have invested heavily in an election that has already been advanced by four months. In response to voters' health concerns while voting in the upcoming election this Sunday, the media is providing health tips such as waiting outdoors if possible, standing one meter apart on the waiting line, not licking the envelope with the ballot, not touching railings or door knobs if possible, washing one's hands after voting, and not taking children to the voting site. Health authorities are expected to declare a sanitary emergency for the Capital and greater Buenos Aires area after Sunday's elections. KELLY