Identifier
Created
Classification
Origin
09MONTERREY434
2009-11-18 18:33:00
UNCLASSIFIED//FOR OFFICIAL USE ONLY
Consulate Monterrey
Cable title:
NUEVO LEON PROJECTS INCREASE IN H1N1 CASES
how-toVZCZCXRO1755 PP RUEHCD RUEHGD RUEHHO RUEHNG RUEHNL RUEHRD RUEHRS RUEHTM DE RUEHMC #0434/01 3221833 ZNR UUUUU ZZH P 181833Z NOV 09 FM AMCONSUL MONTERREY TO RUEHC/SECSTATE WASHDC PRIORITY 4120 INFO RUEHME/AMEMBASSY MEXICO PRIORITY 5205 RUEHXC/ALL US CONSULATES IN MEXICO COLLECTIVE RUEAUSA/DEPT OF HHS WASHINGTON DC RUEHPH/CDC ATLANTA GA PRIORITY 0003 RUEHMC/AMCONSUL MONTERREY 9744
UNCLAS SECTION 01 OF 02 MONTERREY 000434
SENSITIVE
SIPDIS
STATE PASS OES/IHB
E.O. 12958: N/A
TAGS: PGOV SOCI CASC ECON MX
SUBJECT: NUEVO LEON PROJECTS INCREASE IN H1N1 CASES
REF: MONTERREY 178; MONTERREY 397
MONTERREY 00000434 001.2 OF 002
UNCLAS SECTION 01 OF 02 MONTERREY 000434
SENSITIVE
SIPDIS
STATE PASS OES/IHB
E.O. 12958: N/A
TAGS: PGOV SOCI CASC ECON MX
SUBJECT: NUEVO LEON PROJECTS INCREASE IN H1N1 CASES
REF: MONTERREY 178; MONTERREY 397
MONTERREY 00000434 001.2 OF 002
1. (SBU) Summary: Nuevo Leon Health officials are preparing
for a sharp increase in H1N1 cases over the winter months that
could be as high as 300%. However, state government stocks of
antiviral medication remain low and, in some private pharmacies,
unavailable. The state has yet to receive a supply of H1N1
vaccinations and its priority list for them does not target
those most at risk of contracting the disease. End summary.
State Preparing for Precipitous Rise in H1N1 Infections
-------------- --------------
2. (SBU) On November 6, Dr. Nemecio Lopez Vargas, Under
Secretary of Disease Control and Prevention at the Nuevo Leon
Secretariat of Health, told EconOffs that his state was
preparing for an increase of "up to 300 percent" in H1N1 cases
during the winter months. Of Mexico's 61,633 confirmed H1N1
cases (as of 11/11),3,582 have been in Nuevo Leon, resulting in
46 deaths (as of 11/13) and 83 hospitalizations. Of the state's
51 municipalities, 34 have reported H1N1 cases. Lopez cautioned
that the number of actual H1N1 cases was probably much higher
since state health authorities only count those with severe
complications for infection. (Comment: Nuevo Leon, with around
3.8% of Mexico's population has accounted for about 9.5% of the
country's recorded H1N1 fatalities. However, this could be a
reflection of better disease monitoring systems in the
relatively prosperous state. End comment.)
Sufficient Antivirals - For Now
--------------
3. (SBU) Lopez explained that, while many private pharmacies
are currently out of antiviral medication, Nuevo Leon's public
hospitals still had wide availability of the drugs. The state
hospitals were filling prescriptions for private patients who
could not otherwise find these medications through local
pharmacies.
4. (SBU) However, he held out the possibility of shortages of
the drug if infections increase, explaining that pharmaceutical
companies would not be able to supply enough antiviral
medication to meet a large demand surge. (Note: The state
currently has a shortage of children's liquid Tamiflu dosages -
pharmacists are crushing the adult tablets to formulate an oral
suspension suitable for children. End note.) Since April, the
Secretariat has purchased around 36,000 antiviral treatments and
currently has 4,000 doses remaining in its 'strategic reserve'
with an outstanding order for 25,000 more doses, Lopez said.
More Ventilators Ordered
--------------
5. (SBU) Lopez recounted that the state's hospitals, most of
which are located in Monterrey, have around 300 ventilators to
accommodate the most severe cases. To meet an expected rise in
demand, the state has purchased 20 additional ventilators and
has another 20 on order.
Some Vaccines Expected in December
--------------
6. (SBU) Lopez said Nuevo Leon should receive 700 - 800
thousand H1N1 vaccine doses out of Mexico's total order of 30
million (five million from Swiss pharmaceutical company Novartis
and 25 million from the U.S. subsidy of Sanofi-Aventis). He
MONTERREY 00000434 002.2 OF 002
expects the first vaccine shipments to arrive in mid-December.
However, due to an expected rise in world demand, Lopez does not
know how much the state (or Mexico) will receive in the first
shipment. As a result, per federal government guidelines, the
state is prioritizing delivery to: health care workers,
diabetics, pregnant women, HIV/AIDS patients, those over 60 and
children under five.
Disconnect in Vaccination Priorities
--------------
7. (SBU) Federal priorities for vaccination are at odds with
actual H1N1 experience, Lopez explained. He said that children
and youths from 5 - 24 years old have accounted for around 64
percent of H1N1 cases and have a higher mortality rate than
other age groups. Part of this higher susceptibility, Lopez
noted, is because those in these age groups are usually
concentrated together in schools, facilitating disease
transmission. Yet, federal authorities have, thus far, refused
to change the vaccination priority to include these age groups,
despite Lopez's suggestion that they do so.
School Closing Policy
--------------
8. (SBU) Nuevo Leon state policy calls for closing individual
classes when two or more H1N1 cases occur in a classroom.
Should two or more classes in any given school meet this
criterion, the state Secretariat of Health, in coordination with
the State Secretariat of Education, will shut down the school
for a week. According to Lopez, state schools have prescreeners
stationed at each entrance to examine children for flu before
they enter the facilities. If a child exhibits symptoms, he/she
is sent home. In a worst case scenario, Lopez did not rule out
an ordered closure of the state's 6,000 educational institutions
until early-January (when they would be scheduled normally to
reopen after the Christmas holiday break).
Comment
--------------
9. (SBU) Nuevo Leon's health care infrastructure could be
hard-pressed to handle a sharp rise in H1N1 cases, much less a
worst case scenario. Pharmacy executives have told post that
their outlets have not been receiving supplies of anti-viral
medications to handle even current demand. Despite Lopez's
assurances of drug availability at state hospitals, the state's
current stock of 4,000 dosages looks meager should cases rise
significantly (Nuevo Leon has a population of over 4 million),
even with the additional supply on order. In this scenario,
those living outside of the Monterrey metropolitan area will
most likely have a difficult time accessing medication and
treatment. Given worldwide demand for vaccines, it is probable
that the state will wait some time before it receives sufficient
doses to cover it's at risk population. Even then, state
adherence to the federal policy on vaccination priority appears
misdirected, which could further complicate efforts to combat
the disease.
WILLIAMSONB
SENSITIVE
SIPDIS
STATE PASS OES/IHB
E.O. 12958: N/A
TAGS: PGOV SOCI CASC ECON MX
SUBJECT: NUEVO LEON PROJECTS INCREASE IN H1N1 CASES
REF: MONTERREY 178; MONTERREY 397
MONTERREY 00000434 001.2 OF 002
1. (SBU) Summary: Nuevo Leon Health officials are preparing
for a sharp increase in H1N1 cases over the winter months that
could be as high as 300%. However, state government stocks of
antiviral medication remain low and, in some private pharmacies,
unavailable. The state has yet to receive a supply of H1N1
vaccinations and its priority list for them does not target
those most at risk of contracting the disease. End summary.
State Preparing for Precipitous Rise in H1N1 Infections
-------------- --------------
2. (SBU) On November 6, Dr. Nemecio Lopez Vargas, Under
Secretary of Disease Control and Prevention at the Nuevo Leon
Secretariat of Health, told EconOffs that his state was
preparing for an increase of "up to 300 percent" in H1N1 cases
during the winter months. Of Mexico's 61,633 confirmed H1N1
cases (as of 11/11),3,582 have been in Nuevo Leon, resulting in
46 deaths (as of 11/13) and 83 hospitalizations. Of the state's
51 municipalities, 34 have reported H1N1 cases. Lopez cautioned
that the number of actual H1N1 cases was probably much higher
since state health authorities only count those with severe
complications for infection. (Comment: Nuevo Leon, with around
3.8% of Mexico's population has accounted for about 9.5% of the
country's recorded H1N1 fatalities. However, this could be a
reflection of better disease monitoring systems in the
relatively prosperous state. End comment.)
Sufficient Antivirals - For Now
--------------
3. (SBU) Lopez explained that, while many private pharmacies
are currently out of antiviral medication, Nuevo Leon's public
hospitals still had wide availability of the drugs. The state
hospitals were filling prescriptions for private patients who
could not otherwise find these medications through local
pharmacies.
4. (SBU) However, he held out the possibility of shortages of
the drug if infections increase, explaining that pharmaceutical
companies would not be able to supply enough antiviral
medication to meet a large demand surge. (Note: The state
currently has a shortage of children's liquid Tamiflu dosages -
pharmacists are crushing the adult tablets to formulate an oral
suspension suitable for children. End note.) Since April, the
Secretariat has purchased around 36,000 antiviral treatments and
currently has 4,000 doses remaining in its 'strategic reserve'
with an outstanding order for 25,000 more doses, Lopez said.
More Ventilators Ordered
--------------
5. (SBU) Lopez recounted that the state's hospitals, most of
which are located in Monterrey, have around 300 ventilators to
accommodate the most severe cases. To meet an expected rise in
demand, the state has purchased 20 additional ventilators and
has another 20 on order.
Some Vaccines Expected in December
--------------
6. (SBU) Lopez said Nuevo Leon should receive 700 - 800
thousand H1N1 vaccine doses out of Mexico's total order of 30
million (five million from Swiss pharmaceutical company Novartis
and 25 million from the U.S. subsidy of Sanofi-Aventis). He
MONTERREY 00000434 002.2 OF 002
expects the first vaccine shipments to arrive in mid-December.
However, due to an expected rise in world demand, Lopez does not
know how much the state (or Mexico) will receive in the first
shipment. As a result, per federal government guidelines, the
state is prioritizing delivery to: health care workers,
diabetics, pregnant women, HIV/AIDS patients, those over 60 and
children under five.
Disconnect in Vaccination Priorities
--------------
7. (SBU) Federal priorities for vaccination are at odds with
actual H1N1 experience, Lopez explained. He said that children
and youths from 5 - 24 years old have accounted for around 64
percent of H1N1 cases and have a higher mortality rate than
other age groups. Part of this higher susceptibility, Lopez
noted, is because those in these age groups are usually
concentrated together in schools, facilitating disease
transmission. Yet, federal authorities have, thus far, refused
to change the vaccination priority to include these age groups,
despite Lopez's suggestion that they do so.
School Closing Policy
--------------
8. (SBU) Nuevo Leon state policy calls for closing individual
classes when two or more H1N1 cases occur in a classroom.
Should two or more classes in any given school meet this
criterion, the state Secretariat of Health, in coordination with
the State Secretariat of Education, will shut down the school
for a week. According to Lopez, state schools have prescreeners
stationed at each entrance to examine children for flu before
they enter the facilities. If a child exhibits symptoms, he/she
is sent home. In a worst case scenario, Lopez did not rule out
an ordered closure of the state's 6,000 educational institutions
until early-January (when they would be scheduled normally to
reopen after the Christmas holiday break).
Comment
--------------
9. (SBU) Nuevo Leon's health care infrastructure could be
hard-pressed to handle a sharp rise in H1N1 cases, much less a
worst case scenario. Pharmacy executives have told post that
their outlets have not been receiving supplies of anti-viral
medications to handle even current demand. Despite Lopez's
assurances of drug availability at state hospitals, the state's
current stock of 4,000 dosages looks meager should cases rise
significantly (Nuevo Leon has a population of over 4 million),
even with the additional supply on order. In this scenario,
those living outside of the Monterrey metropolitan area will
most likely have a difficult time accessing medication and
treatment. Given worldwide demand for vaccines, it is probable
that the state will wait some time before it receives sufficient
doses to cover it's at risk population. Even then, state
adherence to the federal policy on vaccination priority appears
misdirected, which could further complicate efforts to combat
the disease.
WILLIAMSONB