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