Identifier
Created
Classification
Origin
09BUENOSAIRES778
2009-07-06 11:41:00
UNCLASSIFIED
Embassy Buenos Aires
Cable title:  

H1N1: ARGENTINA DECLINES TO DECLARE H1N1 EMERGENCY--FOR

Tags:  TBIO SOCI PGOV PREL AMED ELAB AR 
pdf how-to read a cable
VZCZCXYZ0007
RR RUEHWEB

DE RUEHBU #0778/01 1871141
ZNR UUUUU ZZH
R 061141Z JUL 09
FM AMEMBASSY BUENOS AIRES
TO RUEHC/SECSTATE WASHDC 3991
INFO RUCNMER/MERCOSUR COLLECTIVE
RUEAUSA/DEPT OF HHS WASHINGTON DC
UNCLAS BUENOS AIRES 000778 

SIPDIS

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

E.O. 12958: N/A
TAGS: TBIO SOCI PGOV PREL AMED ELAB AR

SUBJECT: H1N1: ARGENTINA DECLINES TO DECLARE H1N1 EMERGENCY--FOR
NOW

REF: BUENOS AIRES 0752

UNCLAS BUENOS AIRES 000778

SIPDIS

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

E.O. 12958: N/A
TAGS: TBIO SOCI PGOV PREL AMED ELAB AR

SUBJECT: H1N1: ARGENTINA DECLINES TO DECLARE H1N1 EMERGENCY--FOR
NOW

REF: BUENOS AIRES 0752


1. SUMMARY: The death toll in Argentina attributed to H1N1
influenza has reached 55. In the midst of this crisis, the
Government of Argentina (GOA) has appointed a new Minister with
extensive public health experience (reftel). Although the new
Minister declined to declare a national health emergency, numerous
provinces have done so, and local governments are looking for local
solutions. The GOA has liberalized its policy on influenza
treatment and offered their stock of oseltamivir to public and
private health care providers. Both the Centers for Disease Control
and the Pan American Health Organization are working with the
Ministry of Health (MOH) to develop a methodology to provide more
reliable information. Indications are that the MOH will take
additional measures next week. END SUMMARY.

--------------
OFFICIAL NUMBERS
--------------


2. As of June 28, Argentina's Ministry of Health (MOH) reported
1804 confirmed cases of H1N1 out of 3632 samples tested from suspect
cases (49.7% positive); they reported an additional 967 suspected
cases with testing still pending, and 55 confirmed deaths. There
are 46 additional deaths under investigation. Of note, of the
confirmed deaths where information is available, 27 out of 32 had
underlying high risk conditions. The median age of the deaths was
28 years. The median age of cases was younger. There have been
cases reported in most areas of the country, but up until now, most
of the cases (over 1300) have been concentrated in Buenos Aires
province and in the Capital District.

--------------
HEALTH MINISTRY CHANGES HANDS
--------------

3. Minister of Health Graciela Ocana resigned the day after the
legislative elections. Her resignation came as no surprise. It was
in the works for a long time, and can be attributed to exhaustion
fighting dengue, influenza, and labor leader Moyano (see Buenos
Aires 0752). Ocana had been under fire for the government's
handling of the current influenza pandemic and the outbreak earlier

this year of mosquito-borne dengue fever. Argentine media had
reported that Ocana had recommended postponing midterm elections,
but was overruled. (Note: The elections took place Sunday, and many
poll workers donned surgical masks).


4. The national H1N1 Crisis Committee met after Ocana's
resignation. President Cristina Fernandez de Kirchner, government
officials and epidemiology experts decided not to declare a national
health emergency. In a press conference, the Chief of Cabinet
Sergio Massa mentioned that no measures would be taken at that time
"out of respect" to the incoming Minister of Health, Juan Luis
Manzur, who was officially appointed on July 1. (Note: The
minister was sworn in at the Casa Rosada, seat of the executive
branch, in a room where some 500 government officials and guests had
convened, ironically ignoring prior city and provincial
proclamations recommending that people avoid public gatherings.)
Juan Luis Manzur began his medical career as a surgeon, and has a
Master's degree in Public Health. Prior to his appointment, he
had served as the Secretary of Health in the municipality of La
Matanza and Deputy Minister of Health in the province of San Luis.
As Minister of Health in the Province of Tucuman, he was credited
with reducing infant mortality, refurbishing provincial hospitals,
and creating primary care centers around the province. He was until
recently the Lieutenant Governor of Tucuman, and has summoned six
trusted colleagues from Tucuman to assist him.

--------------
Health Emergency Declarations
--------------

5. The Province of Buenos Aires declared an official health
emergency on June 30, giving health authorities special powers to
cut through red tape to buy medical supplies and pay for additional
personnel. The provincial Minister of Health, Claudio Zin, approved
a measure July 2 to summon retired doctors and students of medicine
in order to increase the number of health care providers. The
province also announced both an extension and an advanced start of
the austral winter school recess. It will start two weeks early on
July 6, doubling from two to four weeks.


6. The City of Buenos Aires also declared an official health
emergency on the same day and similarly changed school vacation
dates. Both the province and the city allowed public gathering
places such as restaurants, shopping centers, public transportation
and movie theaters to remain open, but advised against large
gatherings to avoid contagion, particularly in the case of children
during the extended winter holidays.


7. The new national Minister of Health, Juan Luis Manzur, in his
first official statement on July 1, announced plans to boost public
health spending by US$263 million. He declined to declare a
national health emergency, but announced that pregnant women and
other at risk groups would be permitted to stay at home without
losing pay for 15 days to avoid contracting influenza. He
recommended that schools around the country be closed for the next
four weeks as the city and province of Buenos Aires has done.
Seventeen provinces had already declared such measures. (Note: In
the absence of a declaration of national emergency, the Minister can
only recommend the closing of schools, as they mostly fall under
provincial governments.) Manzur promised that if beds were lacking
in public hospitals, the government would pay for hospitalization in
private hospitals for those without insurance. Although the
national government has no current plans to shut down public
buildings or transportation, he added that "we will continue
monitoring day by day". As of July 2, each of Argentina's 23
provinces has moved their school holidays forward, and 12 of the
provinces have declared a health emergency.

--------------
New Emphasis on Oseltamivir Treatment
--------------


8. Chief of Cabinet Massa said that the national government would
provide the public and private health care system antivirals such as
oseltamivir (Tamiflu). The medicine will also be provided to
prophylax health care workers in contact with influenza patients.
In addition, all patients suspected of being infected with H1N1 will
be treated with oseltamivir. Previously, oseltamivir was not
administered until a patient exhibited serious symptoms. According
to the government, two million treatments of oseltamivir are
available. Critics claim that this would be insufficient if the
situation worsens, and that distribution has been a serious problem.
The drug is still unavailable in local pharmacies. Critics have
suggested that Argentina has restricted prescribing oseltamivir
because there was not enough available. (Note: Chile has been
administering oseltamivir in all suspected cases to contain the
virus. This might help to explain why their mortality rate is
less.)

--------------
Additional Measures by Local Governments
--------------


9. In addition to the limited prevention measures taken by the
national government, reports are starting to trickle in of various
local governments and institutions shutting down their
administrative offices. The province of Santa Fe has even delayed
until August 9 local primary elections that had been scheduled for
July 5. Some public and private universities have extended their
winter holidays, the Supreme Court has moved their winter break
forward, and some theatres have decided to shut down temporarily and
reschedule their planned shows for the month of August. President
Kirchner will present a special program "Learn at Home" for children
to study during the winter holidays. Employees from the Province of
Buenos Aires with children of 14 or less can request special leave
to take care of their children. Changes have been implemented in
local religious services; priests will now put communion in a
person's hand instead of in the mouth. The Rugby Association has
suspended all matches, and the casino in Mar del Plata that boasts
never to close has finally done so.

--------------
Determining the True Extent of H1N1
--------------


10. Experts from the Centers for Disease Control (CDC) are
assisting the Pan American Health Organization (PAHO) and the MOH in
developing a surveillance program to develop reliable figures for
the H1N1 virus. Efforts are underway to enhance surveillance
throughout the country, and in particular to do additional work in
three provinces to monitor clinical (to follow the presentation of
symptoms of patients and/or severity changes),virologic (to monitor
for changes in the virus and/or its susceptibility to antiviral
medication),and epidemiologic characteristics (age and gender of
those affected, risk factors for severe disease, rate of infection
in the population, etc.) of the outbreak.
--------------
Comment
--------------


11. The influenza season in Argentina is expected to peak over the
next two to three weeks. All levels of government and private
organizations are starting to take measures to minimize the further
spread of H1N1. We expect the announcement of additional measures
that will be driven by new statistical information currently being
developed.


KELLY