(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