H1N1 PREPAREDNESS IN THE CZECH REPUBLIC

UNCLAS SECTION 01 OF 02 PRAGUE 000642 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 PRAGUE 00000642 001.4 OF 002 ¶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. -------------- Situation on the Ground -------------- ¶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) -------------- Anti-Virals and Vaccines -------------- ¶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 �0A;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. -------------- More Mixed Signals -------------- ¶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. -------------- Emergency Preparedness -------------- ¶6. (SBU) The Czech Republic has a 26-plan emergency PRAGUE 00000642 002.4 OF 002 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