KOSOVO: H1N1 PREP UNDERWAY AS VIRUS STRIKES

UNCLAS SECTION 01 OF 02 PRISTINA 000487 SIPDIS SENSITIVE DEPT FOR EUR/SCE, EUR/PGI, MED, USAID E.O. 12958: N/A TAGS: ECON PGOV TBIO KFLU KV SUBJECT: KOSOVO: H1N1 PREP UNDERWAY AS VIRUS STRIKES PRISTINA 00000487 001.2 OF 002 SENSITIVE BUT UNCLASSIFIED - PLEASE PROTECT ACCORDINGLY ¶1. (SBU) SUMMARY: The first suspected cases of H1N1 influenza have appeared in Kosovo, according to the Director of Kosovo's National Institute of Public HEALTH (NIPH). At the same time, NIPH and other elements of Kosovo's public HEALTH infrastructure continues preparations to deal with a possible widespread outbreak. We confirmed that the USG cannot provide Kosovo with doses of H1N1 vaccine, but were told by Dr. Naser Ramadani, NIPH Director, that Kosovo had been promised two hundred thousand free doses of the vaccine at a recent WHO meeting in Istanbul. With treatment regimes and supplies lacking, prevention and isolation are the main weapons in Kosovo's arsenal against H1N1. Large numbers of severe cases could quickly overwhelm an already inadequate medical system. END SUMMARY H1N1 - PRESENT BUT UNCONFIRMED -------------- ¶2. (SBU) On November 3 we met with Dr. Naser Ramadani, Director of Kosovo's National Institute of Public HEALTH (NIPH),and his Deputy, Dr. Selvete Hoxha-Krasniqi. Based on observation of current patients, Dr. Ramadani said he believes there are already cases of H1N1 in Kosovo. Local laboratories lack the sophistication to confirm definitively the diagnosis, however. Samples must be sent abroad for testing and quality control. While prior cases of H1N1 in Kosovo were all transiting tourists or persons visiting from the Kosovo diaspora, NIPH staff are convinced that the virus is here to stay. EDUCATING THE PUBLIC, SLOWLY -------------- ¶3. (SBU) Ramadani and his team are focused on Kosovo's H1N1 preparedness, including vaccine acquisition and distribution; public outreach campaigns; and treatment regimens. NIPH is repeating a poster-and-leaflet campaign from last spring to educate people about H1N1 and about basic hygiene practices to minimize chances of infection. The program uses both WHO-designed and locally produced materials to targets schools, border crossings and the airport. NIPH has also enlisted monitoring assistance from schools, encouraging them to report all absences for illness. NIPH tell us that the government is prepared to close schools if necessary to contain outbreaks. VACCINE: AN UNEXPECTED WINDFALL -------------- �A; ¶4. (SBU) Drs. Ramadani and Hoxha-Krasniqi believe Kosovo needs five hundred thousand (500,000) doses of H1N1 vaccine to protect at-risk groups. This number is approximately 25 percent of total population. We told them that we received an official request October 30 from Kosovo's Minister of HEALTH for donation of ONE hundred thousand (100,000) doses of vaccine, and noted, based on official guidance, that such a donation is not possible at this time. Dr. Ramadani said in response that during a recent WHO workshop on deployment of H1N1 vaccine, held October 26-30 in Istanbul, Kosovo was promised two hundred thousand doses of vaccine free of charge. While Kosovo is not on the official list of eligible recipients for WHO donated vaccine, WHO apparently made an exception. WHO's Pristina office has confirmed the donation as part of its global strategy for vaccine deployment. TREATMENT REGIMENS AND SUPPLIES SORELY LACKING -------------- - ¶5. (SBU) While Medical facilities in Kosovo are not up to Western standards, the NIPH has taken a few steps to deal with what they predict is an inevitable crisis. There will be two treatment tiers. For those with a less complex form of the virus, especially if they are not in a high-risk group, self-quarantine at home will be used to "break the chain" of infection. Those with more virulent cases will be hospitalized for treatment and closely observed. PRISTINA 00000487 002.2 OF 002 ¶6. (SBU) ONE of the most promising treatments for H1N1 is Tamilfu. Kosovo currently has 27 thousand (27,000) doses of Tamiflu available, but is negotiating to purchase more. The Ministry of Health has sent ONE thousand doses of Tamiflu pills to the Kosovo Serb-majority enclave of Gracanica, following a request from Gracanica hospital director Rada Trajkovic. ¶7. (SBU) Only 10-12 ventilators exist nationwide, and not all of those are fully functional, making treatment of extreme cases difficult. Plans for an infectious disease intensive care unit will add ten more ventilators, all in Pristina, but they have neither been purchased yet, nor installed. Personal Protective Equipment, such as face masks and gloves, is available for HEALTH care workers. Prevention and isolation are the main weapons in Kosovo's arsenal against H1N1. COMMENT -------------- ¶8. (SBU) Kosovo's NIPH team is keenly aware of the limitations it faces, and acknowledges gaps in its planning. They seem to be making the most of what limited resources exist, but a heavy outbreak and large numbers of severe cases could quickly overwhelm an already inadequate system and lead to panic. We are already hearing concerns from Locally Employed Staff worried that there will be no help for their families. We remain in close contact with local officials. Embassy contacts for H1N1 reporting are Econ/Commercial Officer Kristin Westphal and Foreign Service Medical Practitioner Eileen Drummond. DELL