TFFLU01: UPDATE ON KUWAIT H1N1 CASES

C O N F I D E N T I A L SECTION 01 OF 02 KUWAIT 000515 SIPDIS STATE FOR NEA/ARP, OES/UHB, MED, AIAG STATE PASS TO AID HHS FOR OGHA HHS PASS TO CDC USDA PASS TO APHIS AMMAN FOR ESTH HUB OFFICER BAGHDAD FOR ECON/ESTH E.O. 12958: DECL: 05/20/2019 TAGS: KFLU AEMR ASEC AMED CASC KFLO TBIO KSAF KPAO PREL, PINR, AMGT, TF, KU SUBJECT: TFFLU01: UPDATE ON KUWAIT H1N1 CASES REF: A. KUWAIT 498 ¶B. KUWAIT 455 ¶C. KUWAIT 449 Classified By: DCM Alan Misenheimer for reasons 1.4 (b) and (d) ¶1. (C) SUMMARY: Army Central Command (ARCENT) officers report that 18 cases of novel type A H1N1 influenza have been confirmed among U.S. military personnel transiting through, or assigned to, U.S. military installations in Kuwait. All these cases were mild and the affected personnel have recovered and returned to active duty, with 16 of the 18 now in Iraq. A further 25 individuals are currently sequestered for monitoring at Camp Buehring; H1N1 test results are expected May 22. Given the GOK's authorization for ARCENT to handle all aspects of these confirmed cases per the U.S. military's request -- in U.S. military facilities completely removed from the Kuwaiti population -- Post believes that primary responsibility for reporting these cases to public health authorities lies with the USG, rather than the GOK. In addition, Post notes the USG's formal reservations to the 2005 WHO International Health Regulations (Appendix 2),which state that the USG is not obligated to notify the WHO if such notification "would undermine the ability of the U.S. Armed Forces to operate effectively in pursuit of U.S. national security interests." Due to the high sensitivity of this issue in Kuwait, Post recommends that information pertaining to H1N1 flu cases among U.S. military in Kuwait be kept close hold. END SUMMARY. ¶2. (C) According to ARCENT officers May 20, further analysis by the U.S. Naval Medical Research Unit (NAMRU-3) in Cairo confirmed an additional 10 cases of H1N1 influenza among 26 samples dispatched in early May, bringing the total number of confirmed cases to 18 among U.S. military personnel transiting or working in Kuwait. All 18 were sequestered and treated at Camp Buehring. 15 of the 18 arrived on a military commercial charter flight from Fort Bliss, TX on May 1. Another confirmed case arrived on a military commercial charter flight from Fort Bliss on May 4. Two of the 18 are medical staff at Camp Buehring. All the affected individuals had mild symptoms, have recovered, and, in the case of the 16 Fort Bliss soldiers, have departed Kuwait and are now on active duty in Iraq. ¶3. (C) A further 25 military personnel are currently sequestered for monitoring and treatment at Camp Buehring, according to ARCENT officers. Some of those sequestered had or have flu-like symptoms; others are being sequestered because of their recent contacts with those individuals with flu-like symptoms. The 25 personnel arrived in Kuwait on different charter flights at different times between May 1 and May 11. Military doctors told emboffs that at least some of these cases are likely to be H1N1 and that, it appears, some of these 25 had contracted the flu at Camp Buehring rather than outside Kuwait. Samples from all 25 are being sent to NAMRU-3 on May 21 and results are expected on May 22, according to ARCENT officers. Most of the 25 are from Fort Bragg, NC and Fort Hood, TX. ¶4. (C) ARCENT, working with personnel from NAMRU-3, expects to have H1N1 influenza testing capabilities in Kuwait within a matter of days. ¶5. (SBU) Currently, ARCENT reports confirmed cases of H1N1 influenza to Central Command (CENTCOM),which in turn relays such information to the Armed Forces Health Surveillance Center (AFHSC) via one or more of three intermediary facilities: the Center for Health Promotion and Preventive Medicine (CHPPM),U.S. Air Force School of Aviation Medicine (USAFSAM) and the Navy Marine Corps Public Health Center (NMCPHC). ¶6. (C) ARCENT's public affairs unit forwarded a media inquiry to Post's Acting PAO May 21. The Fayetteville Observer transmitted an inquiry to ARCENT asking if any personnel from the 659th Maintenance Company has or had H1N1 influenza. (Note: on May 17, ARCENT informed emboffs that one of those KUWAIT 00000515 002 OF 002 sequestered at Camp Buehring was from the 659th Maintenance Company. End Note). Post's Public Affairs Section has referred this inquiry to CENTCOM and, separately, has forwarded draft press guidance to State's NEA Public Affairs office in Washington, DC. COMMENT -------------- ¶7. (C) Ambassador has been in email contact with AIAG Coordinator Ambassador Loftis regarding this issue. Post notes the GOK's reluctance to make public information regarding confirmed H1N1 influenza among U.S. military personnel in Kuwait, given (i) the likely negative political fallout of such revelations; (ii) the potentially negative impact on maintaining a permissive operating environment for U.S. military operations in Kuwait, and (iii) the fact that all the confirmed cases pertain to personnel who did not leave U.S. military facilities and did not come into any contact with the local population. Given these factors, Post believes primary responsibility for notifying public health authorities rests with the USG, rather than the GOK. ¶8. (C) With respect to WHO notification obligations laid out in the 2005 WHO International Health Regulations (IHR),Post notes that Appendix 2 contains USG reservations and understandings with respect to the IHR. The second such understanding concerns Article 9 of the IHR, which obligates states "as far as practicable" to notify the WHO of a public health risk that may result in the international spread of a disease. Specifically, this understanding states that USG is not obligated to notify the WHO if such notification "would undermine the ability of the U.S. Armed Forces to operate effectively in pursuit of U.S. national security interests." END COMMENT. ********************************************* ********* For more reporting from Embassy Kuwait, visit: visit Kuwait's Classified Website at: http://www.intelink.sgov.gov/wiki/Portal:Kuwa it ********************************************* ********* JONES