SITREP: YEMEN'S H1N1 PANDEMIC AND PANIC

UNCLAS SECTION 01 OF 02 SANAA 001850 SENSITIVE SIPDIS NEA/ARP FOR ANDREW MACDONALD E.O. 12958: N/A TAGS: KFLU AEMR ASEC CASC KFLO TBIO KSAF KPAO PREL PINR, AMGT, TF, YM SUBJECT: SITREP: YEMEN'S H1N1 PANDEMIC AND PANIC PREPARATIONS REF: A. SANAA 1134 ¶B. SANAA 875 ¶1. (U) Summary. Yemen has 266 confirmed H1N1 influenza cases, and the number is increasing across the country. Since the end of August, most of the H1N1 cases in Yemen have come from local transmission. The 266 infected people have been treated with Tamiflu and either sent home or hospitalized, depending upon the severity of the cases. In the short-term, the ROYG appears to be handling the 266 Yemeni cases of H1N1 influenza appropriately, following WHO guidelines for detection and treatment of the sickness. If the H1N1 pandemic approaches panic-level proportions, the ROYG will have to ramp up its awareness campaign efforts, as current efforts are not enough to educate the public effectively and alleviate anxiety. End Summary. 266 H1N1 CASES CONFIRMED -------------- ¶2. (U) Yemen has 266 confirmed H1N1 influenza (informally known as swine flu) cases, Dr. Abdulhakeem Ali al-Kohlani, Director General of Disease Control and Surveillance at the Ministry of Public Health and Population, told EconOff on October 5. Of the 266 people who have contracted H1N1 influenza, eight have died, and 215 have completely recovered. The other 43 cases are under isolation and undergoing treatment, mostly at home, while severe cases are treated in hospitals. According to Kohlani, the number of cases is increasing across the country. ¶3. (U) Since the end of August, most of the H1N1 cases in Yemen have come from local transmission, starting with two locally-transmitted cases identified in Seyoun, and one diagnosed in Sana'a. Still, in comparison to neighboring Gulf states, which have thousands of confirmed H1N1 cases, the numbers of confirmed cases are limited in number. (Note: According to Kohlani, Saudi Arabia has over 4000 confirmed cases and 30 deaths from H1N1 influenza, and Oman has over 1700 confirmed cases and 19 deaths. End Note.) Kohlani told EconOff that he believes that the limited numbers in Yemen are due to the lack of transit through the country. He also suggested that for each case diagnosed, there are ten additional cases in existence. ¶4. (U) The victims of H1N1 influenza tend to be young. According to Kohlani, only five percent are more than 50. The eight who died were between the ages of 19 and 40 years old. Of those who succumbed to the disease, seven of them sought medical treatment very late (6 days or more) after becoming sick, and, as a result, all had severe pneumonia. The eighth case was a pregnant woman, who sought medical treatment after the third day of sickness. Suffering from bronchial asthma, she died while being transferred to a hospital in Mukalla (Hadramaut governorate). YEMEN PARTICIPATES IN WHO REGIONAL COMMITTEE -------------- ¶5. (U) Yemen's Minister of Public Health and Population, Abdul-Karim Rase, is currently participating in the 6th annual round of the Regional Committee of World Health Organization (WHO) for the Middle East in Morocco. According to Kohlani, Rase will raise the issue of how to ensure wider vaccine distribution and how to work together to vaccinate people going on the hajj (Muslims' annual pilgrimage to Mecca, which peaks this year between November 22 and December 6). The ROYG has requested 1.75 million doses of the vaccine from the WHO. According to an October 3 official Yemen News Agency (SABA) article, the ROYG has also benefited from WHO support of its Epidemic Monitoring Program. YEMEN'S PANIC AND PANDEMIC PREPARATIONS -------------- ¶6. (U) As the number of H1N1 cases has risen rapidly, the level of anxiety has likewise increased. In order to mitigate anxiety, the Ministry of Public Health and Population has started to make weekly announcements updating the number of cases, instead of daily announcements. The ministry continues to run quarantine offices equipped with thermal imaging devices in all three international airports (Sana'a, Aden, and Mukalla) as well as at major border crossings to Saudi Arabia and Oman (REF B). Kohlani admitted to EconOff that the quarantine offices are still in operation mainly to keep the public satisfied. Now that H1N1 influenza SANAA 00001850 002 OF 002 is largely being transmitted locally, the quarantine offices are not as useful. When pressed by EconOff, Kohlani admitted that the ministry has identified only six cases at the airport and that only 25 of all the cases in Yemen came from outside the country. ¶7. (U) The Ministry of Public Health and Population has also introduced a public awareness campaign to preclude panic. The ministry has produced pamphlets and posters and placed advertisements on the radio and television to inform the public of the realities of H1N1 influenza. Members of the High Committee for Fighting H1N1, which includes members of Parliament, the Ministry of Education, and the Ministry of Endowments, have given interviews with the media to clarify the situation. On advice from the Health Ministry, which is afraid of a severe outbreak, the Ministry of Education has delayed the opening of schools in Sana'a and Seyoun, where the H1N1 outbreak is concentrated. Grades 10-12 will start on October 10; Grades 7-9 will start on October 24; and Grades 1-6 will start on October 31. (Note: All other schools started on October 3 with just a one-week delay. End Note.) Teachers have been instructed to monitor students and send them home if sick. If a single positive case of H1N1 influenza is identified, the students in that class should be sent home for one week. If more cases are identified, the entire school should close. These measures are ostensibly in synch with WHO technical committee recommendations to countries with less than one percent of their populations affected by H1N1 influenza and employed in order to reduce the spread of the disease. ¶8. (U) The ROYG currently has enough oseltamivir phosphate (Tamiflu) to treat 76,000 patients. In the face of an outbreak of overwhelming proportions, the Health Ministry plans to vaccinate people in the following order: 1) medical staff, 2) soldiers, 3) pregnant women, 4) children and the elderly, and 5) people with chronic diseases. Kohlani claimed that soldiers need to be treated so that they can "quell unrest" if/when the pandemic reaches panic proportions. EMBASSY SANAA'S SITREP -------------- ¶9. (SBU) Post's Health Unit continues to monitor Embassy staff for influenza and keep the Embassy community updated on the risks of H1N1. The level of anxiety amongst Locally Employed Staff (LE Staff) has risen along with traffic through the Health Unit. Health Unit staff continue to reassure Embassy staff about the risks of H1N1 influenza. The Health Unit has the ability to collect a nasal swab sample, can perform rapid tests for influenza A/B, and continues to have enough Tamiflu to treat all Embassy Americans and LE Staff, should H1N1 reach overwhelming proportions in Yemen. (Note: The Health Unit has enough Tamiflu for 588 courses. End Note.) COMMENT -------------- ¶10. (U) The ROYG appears to be handling the 266 Yemeni cases of H1N1 influenza appropriately, following WHO guidelines for detection and treatment of the sickness. The ROYG response also appears to be in coordination with regional efforts through the WHO Regional Committee. If the numbers of cases increase to levels seen in neighboring countries, however, ROYG resources may not be enough to handle overwhelming proportions or associated panic. If the H1N1 pandemic reaches panic-level proportions, the ROYG will have to ramp up its awareness campaign efforts, as current efforts are not enough to educate the public effectively and alleviate anxiety. End Comment. SECHE