ARGENTINA: H1N1 EPICENTER OF THE WORLD

UNCLAS BUENOS AIRES 000806 SIPDIS DEPT FOR OES/IHB - P. MURPHY AND D. WILUSZ E.O. 12958: N/A TAGS: TBIO SOCI PGOV PREL AMED ELAB AR SUBJECT: ARGENTINA: H1N1 EPICENTER OF THE WORLD REF: BUENOS AIRES 0778 ¶1. SUMMARY: A Mexican H1N1 expert believes that Argentina is now the epicenter of the worldwide H1N1 pandemic. To aggressively counteract the disease's spread, a consortium of Argentine health experts and officials agree to standardize treatment with oseltamivir. In preparation, hundreds of thousands of treatments have been ordered. The Centers for Disease Control (CDC) donated 120,000 treatments to Argentina this week. Although the incidence of H1N1 appears to be declining in the capital city, it appears to be on the rise in the provinces. Emergency declarations at different levels of government and their health effects are inconsistent, although the negative economic ripple-effect is felt countrywide. The GOA is finally seen to be starting to catch up with the virus' spread and treatment, inviting Mission representatives to a briefing on its efforts on July 8 END SUMMARY. -------------- Mexican H1N1 Expert Visits Argentina -------------- ¶2. Mexican infectious disease specialist Alejandro Macias, one of the coordinators of the Mexican H1N1 emergency committee, has characterized Argentina as the current center of the H1N1 pandemic. His visit to Argentina has two purposes: to collaborate with Argentine infectious disease colleagues and to learn about the virus' development here in order to prepare for next year's influenza season in Mexico. He said the scenario in Argentina will provide insight to next winter's influenza season in the northern hemisphere. -------------- National Treatment Regime Established -------------- ¶3. Newly appointed National Minister of Health Juan Luis Manzur, after a meeting of the Argentine Federal Health Council that groups health authorities from the 23 provinces and the City of Buenos Aires, announced a new treatment regime. All patients older than 15 with acute respiratory illness and a temperature of more than 38 degrees centigrade will be administered the antiviral treatment oseltamivir. The Minister opposes a blanket shutdown of public places to combat the H1N1 flu strain. However, the Government of Argentina (GOA) has declared Friday, July 10, as a "sanitary" day off from work for federal employees. Some provinces are complying with their own cancellations. Coupled with Thursday's Independence Day holiday, this "sandwich day" would create a four-day weekend to further mitigate contagion. In contrast, the City of Buenos Aires has declined to declare a similar holiday. An informal poll of Embassies shows a mixed response, with some to remain open and some to close. After consultations with the Ministries of Foreign Affairs and Health, the U.S. Embassy will remain open. -------------- Current Status of H1N1 Cases -------------- ¶4. The most recent official data refer to 2485 confirmed cases and 70 deaths attributed to H1N1. Press reports today indicate 79 H1N1 deaths. Minister Manzur said that 90% of current influenza cases are H1N1. He infers from the limited figures currently available that an estimated 105,000 individuals have been infected with influenza this season so far, and estimates that 340,000 individuals will be infected by the end of the season. He said the GOA has already distributed 300,000 oseltamivir treatments. An additional 120,000 from the U.S. National Strategic Stockpile provided by CDC under the auspices of Pan-American Health Organization (PAHO) will arrive this week. Another 500,000 treatments are expected from other sources shortly. The Minister claims the existing stock and scheduled shipment of antiviral treatments is enough to cover demand but one report says the GOA is trying to renegotiate the date of delivery earlier than mid-August as originally planned. The GOA currently controls virtually all oseltamivir in the country. It has promised to make the drug available commercially in pharmacies but Marcelo Peretta, head of the Argentine Union of Pharmacies and Biochemists, said last week that the private sector had so far received only 24,000 treatments. As of today, none were available in local pharmacies. -------------- Local Health Facilities -------------- ¶5. Visits to local hospital outpatient clinics in the Buenos Aires metropolitan region have declined this past week along with fewer pediatric cases in Intensive Care Units, and physicians are cautiously optimistic that this indicates a positive trend. However, this could also be a result of people afraid of going to hospitals for consultations and calling doctors for house visits or prescriptions. Responding to the increased need for beds to treat influenza cases, hospitals have suspended elective surgeries. As a precaution, they have asked high risk hospital workers such as pregnant women to stay at home. The Children's Hospital has set up a separate outpatient facility for those suspected of having influenza, and a separate ward dedicated to flu cases. A field hospital with two dozen beds has been set up, but to date has not been needed. The outbreak appears to be stabilizing in the Buenos Aires metro area, but anecdotal reports suggest that it is picking up in other areas of the country. Doctors agree that the great majority of cases are mild and can be treated as outpatients. -------------- Health Emergency Declaration Not Needed, But... -------------- ¶6. The GOA has been criticized for its delay in declaring a national health emergency, something the previous Minister of Health, Graciela Ocana, had urged. Current Minister of Health Manzur says the federal government does not need to declare an emergency because the administrative emergency that has been on the books since 2002 is sufficient to distribute necessary funds faster than normal. Nonetheless, lawsuits have been filed against President Cristina Kirchner and Governor of Buenos Aires Daniel Scioli. They have been accused of negligence for hiding information, providing false data on the number of infected citizens, and disregarding recommendations by international organizations such as the World Health Organization. The plaintiff has requested that the Congress summon former Minister of Health Graciela Ocana to testify about rumors that despite several requests, the President declined to suspend public gatherings and the June 28 elections or to take additional preventative measures. The suit says the lack of action constitutes a criminal offense that caused unnecessary deaths. -------------- Economic Effects of Declarations -------------- ¶7. Mitigation measures are starting to affect the economy. Tourism hot spots such as Iguazu Falls, which typically receive substantial income during the austral winter holidays, are seeing declines of up to 70 percent in reservations compared to the previous year. Theatre Association members decided to close for ten days. Cinemas will remain open, but are experiencing a 33% drop in attendance during a period when they usually do their best business. -------------- Comment -------------- ¶8. Health authorities are taking aggressive measures against the spread of H1N1, but the lack of overall coordination of efforts on local, provincial and national levels is resulting in mixed, occasionally contradictory messages that are causing confusion. The meeting held by the Argentine Federal Health Council earlier this week which standardized influenza treatment countrywide and a comprehensive briefing today for Embassy officials by the Ministry of Health are positive indications that the GOA may be turning the corner in its efforts to provide a coordinated response to the H1N1 outbreak here." KELLY