GOK ESTIMATES H1N1 CASES EXCEED 16,000

C O N F I D E N T I A L SECTION 01 OF 02 KUWAIT 000903 SIPDIS STATE FOR NEA/ARP, OES/IHB, MED, AIAG STATE PASS TO AID DEFENSE FOR OSD DEFENSE PASS TO CENTCOM HHS FOR OGHA HHS PASS TO CDC USDA PASS TO APHIS AMMAN FOR ESTH HUB OFFICER E.O. 12958: DECL: 09/10/2019 TAGS: KFLU MARR PREL TBIO KPAO KU SUBJECT: GOK ESTIMATES H1N1 CASES EXCEED 16,000 REF: A. KUWAIT 765 ¶B. KUWAIT 702 ¶C. KUWAIT 633 Classified By: Economic Counselor Oliver John for reasons 1.4 (b) and ( d) ¶1. (C) Summary: While publicly reporting over 1,600 confirmed H1N1 influenza cases, the GOK's Ministry of Health (MOH) privately estimates that over 16,000 citizens and residents have been, or are, infected with the virus. There have been five fatalities, all relating to individuals with pre-existing conditions. The GOK has ceased testing those with mild or moderate symptoms and is only providing anti-viral medications to those with severe symptoms and/or with underlying health conditions. Separately, U.S. Army Central Command (ARCENT) in Kuwait has informed post of a doubling of confirmed cases among U.S. military personnel in Kuwait in the past three weeks, with 329 H1N1 cases confirmed since April. As of September 9, ARCENT is awaiting test results for 183 additional personnel who have exhibited, or are exhibiting, influenza-like illnesses. End Summary. 90 PERCENT OF CASES NOT REPORTED; FIVE DEATHS -------------- ¶2. (SBU) The Director of the MOH's Infectious Diseases Department, Dr. Musaab Al-Saleh, told Econoff September 8 that the GOK estimates that for every laboratory-confirmed case of H1N1 influenza, 10 cases go unreported; he said that experts from the WHO regional office in Cairo concur with this estimate. With approximately 1,600 cases confirmed, the Ministry believes that more than 16,000 Kuwaitis and residents have been, or are, infected with the H1N1 virus. Saleh stated that 80% of the confirmed cases have been Kuwaiti nationals. (Note: Approximately two-thirds of Kuwait's population is expatriate. End Note). He said that 70% of confirmed cases are aged between 15 and 50 and that infants and those over the age of 65 count for less than 5% of such cases. There have been five fatalities thus far, relating to individuals with pre-existing health conditions or, in one case, advanced pregnancy. (Note: Kuwait's current mortality rate of 0.3% falls within the U.S. mortality rate range of 0.1% to 0.3%. However, with a youthful population and high levels of obesity and diabetes and certain other conditions, the Kuwaiti populace arguably has several of the risk factors for H1N1 mortality. End Note). ¶3. (SBU) The MOH has overhauled its testing and treatment policies, given the hundreds of new cases in the past few weeks. Patients are now placed in one of three categories: (i) those with mild to moderate symptoms who do not have underlying health conditions, or who are not infants or elderly; (ii) those with mild to moderate symptoms and who have underlying health conditions and/or are infants or elderly, and (iii) those with severe symptoms. The first two categories are advised to remain at home, with only the second category receiving Tamiflu antiviral medication. Those in the third category are being hospitalized, either at the Infectious Diseases Hospital or in specially designated wards in the MOH's six general hospitals. The MOH has ceased testing those with mild to moderate symptoms. Saleh emphasized that these measures had been reviewed and approved by experts from the WHO regional office in Cairo. (Note: Reportedly, the MOH lab responsible for testing for H1N1 is overwhelmed, and some people have been told that the result of their tests will take days to obtain. Some of the private clinics, however, are now also providing testing services. End Note.) ¶4. (SBU) The GOK has approximately 8.5 million doses of Tamiflu, with a further two million on order. The Ministry has ordered two million doses of the new H1N1 vaccine from GlaxoSmithKline, though Saleh lamented that delivery was slated for March 2010, with only 45,000 doses committed for delivery in late October or early November. POLITICIZING THE VIRUS KUWAIT 00000903 002 OF 002 -------------- ¶5. (SBU) A number of parliamentarians have attempted to make political hay out of the proliferation of confirmed H1N1 cases in recent weeks, with a number of MPs even calling for a special session of the National Assembly to discuss the Government's response. Saleh said that these MPs ratcheted down their rhetoric after meeting with officials from the MOH and the Ministry of Education, who explained the Government's treatment measures and plans for dealing with outbreaks in schools. The GOK has still not finalized precise plans for school closings, though there have been several calls for further delays in school openings. Saleh noted that the WHO is advising the Government to resist the temptation to consider mass closings in the event of cases among school-age children. Saleh said that speculation regarding resignations of MOH officials was "rubbish." HAJ AND UMRAH -------------- ¶6. (SBU) Saleh said that the GOK is advising citizens with underlying health conditions to avoid travel to KSA for the Haj or Umrah, adding that the Ministry of Awqaf and Religious Affairs is considering issuing a fatwa to this effect. U.S. MILITARY CASES -------------- ¶7. (C) The GOK's tally of confirmed cases does not include cases involving U.S. or coalition military personnel. Post and ARCENT continue to abide by an agreement whereby the GOK is responsible for making public U.S. military H1N1 cases. Embassy informs the MOH of new U.S. military cases on a weekly basis, based on daily updates provided to Embassy by ARCENT. Despite these updates, the GOK has not reported publicly any new U.S. military H1N1 cases since May 23, when a U.S. newspaper reported that 18 soldiers were infected. In aggregate, there have been 329 H1N1 cases confirmed among U.S. military personnel in Kuwait since April. As of September 9, ARCENT is awaiting test results for 183 additional personnel who have exhibited, or are exhibiting, influenza-like illnesses (ILIs). ¶8. (C) Kuwait Air Force medical personnel continue to oversee screening of all U.S. personnel arriving from the U.S. at Abdullah Al-Mubarak air base (adjacent to Kuwait International Airport). As of September 8, just under 100,000 U.S. military personnel have been screened by joint Kuwait Air Force-ARCENT medical teams since May 29. ********************************************* ********* For more reporting from Embassy Kuwait, visit: visit Kuwait's Classified Website at: http://www.intelink.sgov.gov/wiki/Portal:Kuwa it ********************************************* ********* JONES