BURMA: MINISTRY OF HEALTH PREPARES FOR A/H1N1

C O N F I D E N T I A L SECTION 01 OF 03 RANGOON 000370 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: DECL: 06/18/2019 TAGS: KFLU AEMR ASEC CASC KFLO TBIO EAID KPAO PREL PINR, AMGT, BM SUBJECT: BURMA: MINISTRY OF HEALTH PREPARES FOR A/H1N1 PHASE 6 PANDEMIC REF: A. RANGOON 253 ¶B. RANGOON 246 ¶C. RANGOON 241 ¶D. RANGOON 238 RANGOON 00000370 001.2 OF 003 Classified By: Economic Officer Samantha A. Carl-Yoder for Reasons 1.4 (b and d). Summary -------------- ¶1. (SBU) During a June 16 meeting with the diplomatic corps, the Burmese Ministry of Health (MOH)reviewed its A/H1N1 action plan, detailing surveillance procedures. MOH asserts there are still no confirmed cases of A/H1N1 in Burma. Since April 28, MOH officials have screened more than 1.3 million incoming travelers at all ports of entry, and conducted home and hotel surveillance on 3,310 travelers, ninety percent of whom entered Burma via the Rangoon airport. GOB officials reiterated requests for donor assistance to implement its action plan fully, including additional Tamiflu, masks, personal protective equipment (PPEs),Centers for Disease Control and Prevention (CDC) rapid test kits and a Real Time PCR, and thermal scanners. End Summary. Still No H1N1 in Burma -------------- ¶2. (SBU) During a June 16 meeting with diplomats, Ministry of Health Director of Disease Control Dr. Soe Lwin Nyein asserted that even though A/H1N1 is present in neighboring countries, there are still no confirmed cases of A/H1N1 in Burma. Both MOH and the Ministry of Livestock and Fisheries (MOLF) continue to work with the UN and international organizations to monitor for the disease and implement A/H1N1 action plans (Ref A). MOH Monitoring Travelers -------------- ¶3. (SBU) On April 28, MOH began screening incoming travelers at the international airports in Rangoon and Mandalay, the Rangoon international port terminal, and 16 selected border crossings using either thermal scanners or digital thermometers. All incoming travelers must fill out a health declaration card, which MOH uses as a basis for potential surveillance. To date, MOH has screened more than 1.3 million travelers, the majority of whom enter Burma via land crossing points. Dr. Soe Lwin Nyein noted that since May 8, MOH officials have conducted either home or hotel surveillance on 3,310 people who demonstrated potential signs of A/H1N1. Ninety percent of those people entered Burma at the Rangoon airport. This involves daily visits by MOH doctors to individuals to determine whether their symptoms have worsened and if they require hospital care. None of these cases were positive for A/H1N1, he noted. ¶4. (SBU) Dr. Soe Lwin Nyein told diplomats that the MOH National Reference Laboratory now has the capacity to test for A/H1N1, using its own Polymerase Chain Reactor (PCR) RANGOON 00000370 002.2 OF 003 machine and primers and test kits donated by a Japanese university. Results are available after eight hours, and MOH sends all samples to the National Institute of Health in Tokyo for confirmation. Dr. Soe Lwin Nyein could not confirm how many samples MOH has tested, but emphasized that all tests came back negative. He acknowledged that the vast majority of cases surveyed were detected in Rangoon rather than in other ports of entry. MOLF Monitoring Animal Movements -------------- ¶5. (SBU) Dr. Kyaw Sann, Director of Disease Control at the Livestock Breeding and Veterinary Department, informed diplomats that MOLF is adapting its H5N1 action plan to include H1N1. Dr. Murray Mclean, FAO Avian Influenza specialist, noted that FAO and MOLF are currently surveying animals for both diseases and are working with farmers to employ proper biosecurity measures. Using USAID funding, FAO will begin a study on swine movements across the Thai-Burma and China-Burma borders. Needs Still Exist -------------- ¶6. (SBU) Both MOH and MOLF are doing what they can with limited resources to prevent the spread of A/H1N1 into Burma, officials claimed, but they lack the equipment and resources necessary to combat the disease should an outbreak occur. MOH and MOLF reiterated their request for donors to provide the following: -- CDC A/H1N1 rapid tests and a Real Time Polymerase Chain Reaction (RT-PCR) Thermal Cycler to conduct the tests; -- N95 masks; -- 100,000 additional courses of Tamiflu; -- Additional stocks of PPEs; -- At least three new thermal scanners and additional temperature gauging equipment; -- Disinfectants; and -- Funding for educational outreach. ¶7. (C) The Singapore Embassy is considering donating a RT-PRC to MOH, although the Singapore DCM stated a decision has yet to be made. WHO already provided the MOH with an additional 50,000 doses of Tamiflu and stands ready to provide more should an outbreak occur. USAID and AusAID have authorized both the WHO and FAO to utilize existing H5N1 funding for H1N1 surveillance and training. According to the Japanese Economic Counselor, the Japanese Government has no plans at this time to provide any H1N1 assistance. He noted, however, that private Japanese organizations may provide additional assistance. Comment -------------- ¶8. (C) In order to improve surveillance and potential treatment of an A/H1N1 outbreak, Burma is in need of all of the products listed above. While the GOB is adamant there RANGOON 00000370 003.2 OF 003 are no cases of A/H1N1 in the country, we and others in country are skeptical of MOH's ability to detect the disease, particularly along the border. Of the 3,310 people surveyed by MOH officials, more than 3,000 of them were identified at the Rangoon International Airport, the only port of entry with a thermal scanner. With more than 30,000 people entering Burma daily via legal and illegal land crossing points, most from countries that have confirmed A/H1N1 cases, there is a strong possibility that someone with A/H1N1 has already entered Burma undetected. DINGER