TFFLU01: BURMA HEALTH MINISTRY DETAILS A/H1N1

UNCLAS SECTION 01 OF 03 RANGOON 000253 SENSITIVE SIPDIS STATE FOR EAP/MLS, CA/OCS/ACS/EAP, OES, G/AIAG PACOM FOR FPA USDA FOR FAS/PECAD, FAS/CNMP, FAS/AAD, APHIS BANGKOK FOR USAID:JMACARTHUR, APHIS:RTANAKA, REO:HHOWARD DEPT PLEASE PASS TO HHS FOR OGHA STEIGER AND HICKEY PASS TO CDC ATLANTA FOR CCID AND COGH E.O. 12958: N/A TAGS: KFLU AEMR ASEC CASC KFLO TBIO EAID KPAO PREL PINR, AMGT, BM SUBJECT: TFFLU01: BURMA HEALTH MINISTRY DETAILS A/H1N1 ACTION PLAN REF: A. RANGOON 246 ¶B. RANGOON 241 ¶C. RANGOON 238 RANGOON 00000253 001.2 OF 003 Summary -------------- ¶1. (SBU) During a May 4 meeting with the diplomatic corps, the Burmese Ministry of Health (MOH) detailed its A/H1N1 action plan, including surveillance and quarantine procedures. Since April 28, MOH officials have screened incoming travelers at all ports of entry, including two international airports, one seaport, and 16 border crossings. The MOH designated two hospitals for A/H1N1 quarantine and treatment, although it has yet to quarantine anyone. The MOH has 50,000 tamiflu doses available, and expects to receive another 50,000 from the World Health Organization in upcoming weeks. The Ministry has requested donor assistance to implement fully its action plan, including additional tamiflu, masks, personal protective equipment (PPEs),Centers for Disease Control and Prevention (CDC) rapid test kits and a Polymerase Chain Reactor (PCR) thermal cycler, and thermal scanners. Please see action request in paragraph 10. End Summary. Still no Cases; MOH Details Action Plan -------------- ¶2. (SBU) During a May 4 meeting with diplomats, Ministry of Health Director of Disease Control Dr. Soe Lwin Nyein emphasized that there are still no reported cases of swine flu in Burma. Both the Ministry of Health (MOH) and Ministry of Livestock and Fisheries (MOLF) continue to work with the UN and international organizations to monitor the disease. Dr. Soe Lwin Nyein explained that the MOH and MOLF established and implemented A/H1N1 action plans, based on existing avian influenza action plans. The Burmese Government also set up two new committees -- the Central Committee for Prevention and Control headed by the Minister of Health and the State/Division Committee for Prevention and Control led by the State/Division Health Directors; members include representatives from MOH, MOLF, Customs, Ministry of Information, and Ministry of Immigration. ¶3. (SBU) Since A/H1N1 is not currently present in Burma, the GOB's response is focused on improving and increasing surveillance of both humans and animals. On April 28, the MOH began screening incoming travelers at the international airports in Rangoon and Mandalay, the Rangoon international port terminal, and 16 selected border crossings, surveying more than 30,000 people daily. Both the MOH and MOLF have deployed 17 State/Division-level and 65 district-level rapid response surveillance teams to potential hotspots throughout Burma, Dr. Kyaw Hsan, Deputy Director of the Livestock Breeding Veterinary Department, explained. The MOLF met with the Myanmar Livestock Federation on April 28 to discuss ways to improve biosecurity measures on farms (Ref B). ¶4. (SBU) According to MOH officials, the Burmese Government has a strict quarantine procedure to prevent the spread of A/H1N1 in Burma. The MOH set up a thermal scanner at the Rangoon International Airport and is using infrared temperature gauges to screen passengers in Mandalay, at the port, and at border crossings. Dr. Soe Lwin Nyein noted that RANGOON 00000253 002.2 OF 003 all visitors must fill out an influenza surveillance form detailing health symptoms and travel history. Should visitors show signs of influenza, the MOH will quickly transport them for quarantine at one of two infectious disease hospitals, Wei Bagi Hospital in Rangoon or Kandaw Nagi outside of Mandalay. The MOH will take smear samples of suspected A/H1N1 cases and will send them to Tokyo or Center for Disease Control (CDC) Atlanta for testing, as the MOH does not have diagnostic capacity to test for the disease (Ref A). Dr. Kyaw Nyunt Sein, Deputy Director of Health, acknowledged that the MOH has limited quarantine plans for those entering along the border, although he highlighted that the MOH and WHO recently upgraded 17 border hospitals to include isolation wards. ¶5. (SBU) The MOH has yet to quarantine any visitors, although it continues to monitor the health of two persons who arrived in Rangoon with a fever. The GOB's A/H1N1 action plan was tested on May 5, with the arrival of a cruise ship with 391 passengers, including 262 American citizens, at the Port of Rangoon. (Note: Embassy consular personnel were present at the port to assist Amcits as needed during health screening procedures. None of the passengers had the flu and none were quarantined.) ¶6. (SBU) The MOH and MOLF recently began educational outreach to explain the dangers of A/H1N1. UNICEF is translating A/H1N1 documents into Burmese for dissemination and is looking into printing awareness posters, WHO Country Representative Adik Wibowo told us. Burma's borders are extremely porous, so GOB awareness efforts will target both legal and illegal border crossings, Dr. Kyaw Nyunt Sein explained. Should an Outbreak Occur -------------- ¶7. (SBU) The Ministry of Health announced it has a stockpile of personal protective equipment (PPEs) and 50,000 tamiflu doses available for treatment, should an outbreak occur. (Note: approximately 10,000 of these doses expired in October 2008 and MOH is seeking guidance on whether they can still be used.) WHO expects delivery of an additional 50,000 tamiflu doses in the next two weeks. Tamiflu stocks are currently stored in Rangoon, and the MOH will begin to disburse medicines to Mandalay and border hospitals within the next week. Dr. Kyaw Nyunt Sein, Deputy Director of Health, told us that the two infectious disease hospitals can treat up to 35 patients each, and that tamiflu will be made available to patients, regardless of nationality. The MOH will designate additional hospitals for A/H1N1 treatment, should it become necessary. Limited Supplies and Resources -------------- ¶8. (SBU) MOH officials emphasized that while the GOB is actively responding to the A/H1N1 situation, it lacks the equipment and resources necessary to combat the disease, should an outbreak occur in Burma. The MOH and MOLF have requested donors to provide the following: -- CDC A/H1N1 rapid tests and a Polymerase Chain Reaction (PCR) Thermal Cycler (cost USD 50,000) to conduct the tests; RANGOON 00000253 003.2 OF 003 -- N95 masks; -- 100,000 additional courses of tamiflu; -- Additional stocks of PPEs; -- At least three new thermal scanners and any additional temperature gauging equipment; -- Disinfectants; and -- Funding for educational outreach. ¶9. (SBU) The MOH and MOLF both inquired whether existing funding and equipment for avian influenza (AI) programs (from USAID, AusAID, and the European Commission) could be used to respond to A/H1N1. AusAID agreed, but noted that because AI is endemic to Burma and A/H1N1 is not, the majority of funds should be used for AI programs. Action Request -------------- ¶10. (SBU) Embassy Rangoon encourages the Department and USAID to assist the World Health Organization, the Food and Agricultural Organization, and the Burmese Government to prepare for A/H1N1, modeling our response after our successful AI program in Burma. We urge the Department and USAID to consider providing WHO with CDC rapid test kits and a PCR thermal cycler, as well as additional PPEs and tamiflu. Additionally, Embassy Rangoon seeks clarification about whether USAID AI funds can be used to address pandemic flu preparedness. DINGER