H1N1 PREPAREDNESS IN THE CZECH REPUBLIC

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C O R R E C T E D C O P Y (ADDED ADDITIONAL TAGS)

SIPDIS
SENSITIVE

E.O. 12958: N/A
TAGS: KFLU KSTH PREL SENV CDC HHS EZ WHO NIH
SUBJECT: H1N1 PREPAREDNESS IN THE CZECH REPUBLIC

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1. (U) Summary: Although cases of H1N1 in the Czech Republic
(CR) have generally been few and mild, the Czech government
is taking a number of steps to prepare for a potential
pandemic. Steps include anti-viral stockpiles, vaccine
purchases, a PR campaign about preventing infection, and
updating the national pandemic plan.

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Situation on the Ground
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2. (U) To date, the Czech Health Ministry has confirmed 351
cases of H1N1 in the CR and thousands have been tested for
the virus. Infected persons have all either recently
returned from countries with high H1N1 infection rates
(including but not limited to the U.S., United Kingdom,
Spain, and Greece) or have come in direct contact with
persons recently returned from these places. There has been
one death attributed to H1N1 in the CR. The victim, however,
suffered from a chronic heart condition and had had a recent
kidney transplant, and doctors considered her health to be
precarious prior to infection. One other patient who suffers
from a chronic pulmonary disorder has been infected and is in
critical condition. All other patients have experienced only
mild symptoms. Most infected persons are assigned home
quarantine and are not prescribed anti-virals. Only one
additional patient, an American citizen, was hospitalized but
reportedly did not receive anti-virals. (Comment: although
the hospital could not release details about his condition,
Post believes that the patient was hospitalized as a means of
quarantine, not because his symptoms were more serious than
those of previous patients. End Comment)

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Anti-Virals and Vaccines
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3. (U) Through a series of purchases over the last four
months, the Czech Republic has stockpiled enough Tamiflu to
treat 2.5 million people and enough Relenza to treat 500,000
people (together covering 30 percent of the CR's population).
On August 21, the Czech government signed a 220 million CZK
($12.3 million) deal with GlaxoSmithKline (GSK) to purchase
one million doses of its (at the time) not-yet-EU registered
H1N1 vaccine. Though previously believed to be enough doses
to vaccinate only half a million people, research now
indicates that the Czech supply could treat 1 million people
since 1 dose per person may be sufficient. Czech Health
Minister Jurasova,s original plans included contracts to
purchase 5 million doses of vaccines from GSK or Novartis,
once either had competed testing for side effects and gained
EU approval. GSK, however, leveraged the short supply of
vaccines and looming threat of a fall pandemic to reach an
earlier agreement. The U.S. company Baxter, which has a
production facility in the Czech Republic, had reportedly
promised all of its vaccine to other customers. Last month,
Baxter, GSK, and Novartis all received EU approval for their
vaccines.


4. (SBU) The Czech government plans to begin administering
the vaccine next month to emergency workers, doctors, persons
who hold vital roles in the functioning of the CR's
infrastructure, and persons with chronic conditions resulting
in impaired immune systems. According to media reports, many
doctors are threatening to refuse the H1N1 flu vaccine
because vaccine manufacturers have not agreed to accept
liability for possible side effects. Health Ministry
Epidemiology Department Officer Sylvia Kvasova told us GSK is
scheduled to deliver vaccines in November, though the
contract between GSK and the GoCR does not include penalties
for late delivery.

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More Mixed Signals
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5. (U) Starting in September, the Czech government launched a
campaign to encourage people to get ordinary flu vaccines,
fearing that while each may be manageable, the combined
effects of seasonal flu and H1N1 flu could be severe or even
deadly. However, several prominent doctors have publicly
endorsed a Canadian study showing that a seasonal flu vaccine
could make someone more susceptible to H1N1 flu and more
likely to have more severe symptoms. To date, less than 8
percent of Czechs have received seasonal flu vaccines,
according to Health Ministry Legislative Section Head Jan
Klusacek.

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Emergency Preparedness
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6. (SBU) The Czech Republic has a 26-plan emergency

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preparedness framework, including a national pandemic plan
(NPP). In preparation for a possible H1N1 flu pandemic, the
government has reviewed and updated this plan (which was last
updated in response to the avian influenza threat, according
to Interior Ministry Security Threats and Crisis Management
Unit Officer Oldrich Krulik). Although all ministries are
involved in the NPP, the Health Ministry would be responsible
for overall coordination and oversight. The NPP includes
provisions for transformation of college dormitories into
health care facilities, deployment of medical students to
assist in patient treatment, and institution of a special
regime at the Czech Republic's borders.


7. (SBU) Conclusion: Despite a steady climb through July,
August and September and predictions of an exponential
infection increase, infection rates have slowed considerably
since mid-September. While experts and policy-makers expect a
second wave of infections this winter, they are hesitant to
cause public panic over an infection that has thus far been
limited in scope and has caused generally mild symptoms.
Potential shortcomings in Czech national preparedness include
vaccine shortage in the event of widespread outbreak and
shortage of respirators, should respiratory symptoms grow
more severe in future outbreaks. Still, the Czech government
is taking the theat seriously and preparing accordingly.
Thompson-Jones