FIRST H1N1 DEATH IN ESTONIA RAISES CONTROVERSY

UNCLAS TALLINN 000380 SIPDIS E.O. 12958: N/A TAGS: CASC AMED TBIO KFLU EN SUBJECT: FIRST H1N1 DEATH IN ESTONIA RAISES CONTROVERSY ¶1. Summary. Estonia reported its first confirmed H1N1-related death on November 23. The death of the otherwise healthy 13-year old boy has focused press attention on decisions made by local health practitioners, and raised questions as to whether the death was avoidable. The Estonian Social Ministry continues to scramble to obtain H1N1 vaccine in order to implement a modest campaign directed at high-risk groups, scheduled to commence in December. Post is engaging Estonian health authorities to ensure that resident American citizens will be eligible to obtain the vaccine in the planned campaign. End Summary. H1N1 Situation in Estonia ¶2. 269 persons have been confirmed to have been infected with H1N1 in Estonia, although the Estonian Health Protection Inspectorate discontinued routine testing for the virus in mid-November. The Inspectorate has noted that the flu season arrived in Estonia two months earlier than in previous years, and has suggested that the actual number of H1N1 cases is likely considerably higher than 269. Numerous schools (at least 12) have temporarily closed throughout the country as absentee rates among students have skyrocketed, as parents decide to keep their children home rather than risk illness at school. First H1N1-Related Death Raises Controversy ¶3. The first confirmed H1N1-related death in Estonia, a 13-year old boy who died on November 23, is being scrutinized closely by the local press. The teenager, living in a rural area near Tallinn, was not known to suffer from any chronic health conditions. Health authorities continue to investigate the matter, and the press is speculating why an otherwise athletic teenager could deteriorate so quickly. Some have pointed to the fact that the teenager had received routine vaccinations for measles, mumps and rubella just before falling ill, giving rise to general fears about the safety of regular vaccination programs, particularly during the current flu season. Others have questioned treatment by the nurse at the school the teenager attended, as well as the family's doctor, neither of whom were reported to have prescribed anti-viral medication to the boy, despite the widespread availability of Tamiflu (oseltamivir) in Estonia. Plans for H1N1 Vaccination Campaign Accelerated ¶4. The Estonian Social Ministry has announced its intent to implement a limited vaccination campaign in December, finalizing a plan to procure surplus vaccine from the Netherlands. Originally expected to forego a vaccination program during the current flu season, the Social Ministry accelerated its plans after considerable public pressure, including an open letter from a local doctors' association and regular press coverage of an orderly vaccination campaign underway in neighboring Finland. Meanwhile, Estonians continue to debate the best way to avoid infection, often relying on folk remedies such as fresh garlic. ¶5. Estonian health authorities have stated that eligibility for the proposed H1N1 vaccination campaign will be determined by the enrollment register in the country's national health plan (Haigekassa). In September, Conoff received oral assurance from the Chairman of the Estonian Health Care Board that American citizens in Estonia who are members of specified high-risk groups (e.g., pregnant women) would be included in the H1N1 campaign, even if they are not enrolled in the national health plan. Post continues to engage the Estonian health authorities to ensure that otherwise eligible American citizens are not inadvertently excluded from the planned vaccination campaign. DECKER