H1N1 POSITIVE AMERICANS QUARANTINED IN HYDERABAD

UNCLAS HYDERABAD 000063 DEPT FOR CA/OCS/ACS E.O. 12958: N/A TAGS: CASC KFLU IN SUBJECT: H1N1 POSITIVE AMERICANS QUARANTINED IN HYDERABAD ¶1. SUMMARY: To date, Hyderabad ACS has verified the U.S. citizenship of five persons quarantined for H1N1 influenza in our consular district. Two adults have been released, while three Amcit minors have tested positive and continue in quarantine. Several LPRs (U.S. legal permanent residents) have also been isolated. Post is concerned about the generally substandard quarantine conditions and medical care, and conoffs have made two visits to the designated facility. END SUMMARY ¶2. The quarantine center in question is the Andhra Pradesh (AP) Government Chest Hospital at Erragadda, Hyderabad. Five American citizens have been isolated there (the only cases known to Post in our district). The first two (both adults) tested negative and were released after 18 hours. The three other Amcits, all minors, have tested positive and remain in quarantine. There they will stay until finishing a full ten-day course of Tamiflu and receiving a clean bill of health from state medical authorities. NOTE: doctors informed conoff that children require longer treatment - adults get five days. END NOTE ¶3. Post first visited Government Chest Hospital on May 27, after receiving complaints about the dismal state of the quarantine facility. The AmCit complainant had originally sought treatment at a private hospital for an unrelated cardiac event and dehydration. For some reason, this raised suspicions that she was infected with H1N1, and the District Medical Officer sent an ambulance to collect her for quarantine and testing - a state of affairs that left her deeply unhappy. Upon visiting, conoff donned protective gear and met with the Amcit in the quarantine area. He noted the lack of basic amenities such as A/C or a phone, and formed the opinion that the medical staffs' failure to communicate (re prognosis and treatment) with the patient had exacerbated her anxiety. Afterwards, conoff conferred with the Superintendent of the Chest Hospital, Dr. S.V. Prasad, and the AP State Coordinator for H1N1 Influenza, Dr. Subhakar Kandi - both promised to look into the situation and improve what they could. ¶4. Over the weekend of June 13 - 14 local media reported that several children had arrived from the United States and tested positive for H1N1. Post contacted authorities, who informed of three minor Amcits (from two families) in quarantine. One is aged 20 months, while the other two are 4 and 8 year old siblings. The hospital was unwilling to release further information before the Consulate General contacted the parents and received approval. When contacted, parents expressed serious reservations about the quality of both the facility and treatment. They noted that, despite repeated requests, the hospital staff had not provided any medical reports or other information on treatment and prognosis. They also complained that the children were only irregularly seen by doctors (who seemed reticent to approach the patients). The LPR mother of the siblings (also quarantined) described a situation where a "cleaning lady" brought two pills into the room and gave them to the children - though both were actually intended for the mother. ¶5. Armed with these complaints, ACS Chief visited the facility on June 18 and once again met with Superintendent Prasad and H1N1 Coordinator Subhakar. Dr. Prasad, while cordial, stated that his hospital staff was "doing the best possible in the given situation. We can't be perfect. As we gain experience, we will be more patient-friendly." He tried to explain away the erratic doctor visits by emphasizing the high cost of respiratory masks and body suits (INR 250 - 300),and claimed that the doctors perform morning and evening rounds (adding as an aside that if the patient is doing well the frequency is reduced to lessen risks). Dr. Prasad asserted that all patients were given a description of the course of treatment when first admitted and so "should already understand the procedures." Dr. Prasad did allow that he would prepare an informative brochure for patients and family members. He also noted that the Chest Hospital had installed an "interactive voice system" which could be accessed in each room and through which the patients could communicate with medical staff. ¶6. Conoff pressed the two doctors to be more proactive in notifying the Consulate General about admitted Amcits, especially minors. Dr. Prasad said he would have to inform his government of each case, which could then decide to notify the USG. Seeing this as a recipe for inaction, ACS Chief left a stack of business cards and asked that they give one to any patient believed to be an Amcit. To this they agreed. KEUR