NICARAGUA: STILL NO CONFIRMED CASES OF H1N1

UNCLAS SECTION 01 OF 02 MANAGUA 000525

SIPDIS

E.O. 12958: N/A
TAGS: TBIO KFLU KSAF ECON AMED CASC ASEC NU
SUBJECT: NICARAGUA: STILL NO CONFIRMED CASES OF H1N1

REF: A. MANAGUA 0435

B. MANAGUA 0454

C. 2008 MANAGUA 0350


1. (U) Summary: As of May 26, 2009, Nicaragua has reported no
confirmed cases of H1N1 Influenza. In response to the H1N1
epidemic, the Ministry of Health (MINSA) is implementing its
National Plan for Prevention of and Response to Human
Influenza Epidemic, focusing on surveillance at ports of
entry and prevention through education. U.S. Embassy Managua
is assisting MINSA with USAID-funded community health
training and rapid response team training at the municipal
level. On May 9 the U.S. Department of Defense's SOUTHCOM
Humanitarian Assiatance Program (HAP) delivered 5,000 units
of Personal Protective Equipment (PPE) designed for use by
MINSA medical personnel. End summary.


2. (U) As of May 26, 2009, Nicaragua has reported no
confirmed cases of H1N1. The Ministry of Health (MINSA) is
the lead Nicaraguan agency on H1N1 preparation and response.
MINSA has mobilized nationwide surveillance measures, an
education campaign, and a plan to deal with the possible
appearance of H1N1 Influenza. MINSA reports that it has
administered 55 rapid diagnostic tests for Influenza A, but
none has proved positive. MINSA is actively monitoring 49
suspicious cases, all of which are described as "under
control." Minister of Health Guillermo Gonzalez has
recognized publicly that it is only a matter of time before
H1N1 reaches Nicaragua.

Surveillance and Prevention
--------------


3. (U) In response to the H1N1 epidemic, the Ministry of
Health (MINSA) is implementing its National Plan for
Prevention of and Response to Human Influenza Epidemic. The
plan focuses on surveillance at all ports of entry and
prevention through education. At ports of entry, most
particularly Managua's Sandino International Airport, health
personnel closely screen passengers entering the country for
flu symptoms and distribute information pamphlets. Before
disembarking in Managua, all airline passengers complete
forms describing medical symptoms, which authorities review
as passengers pass through immigration control. Health
officials use infrared imagers to screen airline passengers
for high body temperature. On May 20, 2009, in fact, a
passenger arriving from Miami was interviewed by health
officials and transferred to a local hospital for observation
and testing after infrared images revealed he had a fever.
Test results proved negative for H1N1 Influenza.


4. (U) Surveillance for H1N1 among the general population is
nationwide, but is most robust in Managua. MINSA has mounted
a major education campaign designed to prevent the
transmission of influenza. The Government of Nicaragua has
designated local Citizen Power Councils, or CPC's, as the
primary point of contact for the Nicaraguan people (Ref C).
Nicaraguans with influenza are advised to remain at home and
to contact their local CPC to arrange for a home medical
visit by MINSA staff for testing and possible treatment.
While politically motivated and controlled, there is no
evidence at this time that the CPC's are applying partisan
criteria to the provision of medical services related to
H1N1. MINSA's influenza epidemic plan also calls for the
mobilization of 35,000 health volunteers (brigadistas) to
lead community-level activities nationwide.

USAID Playing a Positive Role
--------------


5. (U) A USAID-funded community health project called
FamiSalud, working in 70 of Nicaragua's poorest
municipalities, is assisting MINSA to educate the public on
H1N1. FamiSalud trains volunteers, conducts community
meetings, and distributes written material on H1N1.
FamiSalud has also briefed members of the Nicaraguan private
sector. USAID also assists MINSA with rapid response team
training at the municipal level and with the development of
municipal response plans for pandemic influenza.

Testing and Medical Supplies
--------------


6. (U) The Ministry of Health's national laboratory recently obtained the reagents necessary to test specifically for the H1N1 virus and continues to send samples to the Centers for Disease Control (CDC) in Atlanta for confirmation. Authorities report they have stockpiled 73,000 courses of antiviral medication to treat an H1N1 outbreak -- enough treatments to cover about 1% of the population.


7. (U) On May 9 the U.S. Department of Defense's (DOD)
SOUTHCOM Humanitarian Assistance Program (HAP) delivered
5,000 units of Personal Protective Equipment (PPE) designed
for use by MINSA medical personnel. The Ministry of Health
accepted the PPE's and will distribute them as needed to
hospitals and other care centers throughout the country. The
DCM, along with USAID and DOD representatives, officially
donated the items in a ceremony on May 12, which received
wide press coverage.

Embassy Preparedness and Outreach
--------------


8. (U) The Embassy posted a warden message on H1N1 Influenza
on April 28 and will release another message should Nicaragua
confirm a case of H1N1, or if the WHO raises its alert level
to Stage 6 (indicating a full pandemic). The Consular
Section has updated links and information on its website
related to H1N1 and is staying in close contact with wardens
to monitor developments in their areas of responsibility.


9. (U) Comment: MINSA's response to the outbreak has been
impressive, given the lack of resources in the country. The
question remains as to how effective MINSA will be should an
outbreak occur.
CALLAHAN