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