MGSF01 AUGUST 19 UPDATE ON H1N1 OUTBREAK IN JAPAN

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SUBJECT: MGSF01 AUGUST 19 UPDATE ON H1N1 OUTBREAK IN JAPAN

REF: TOKYO 1171 and previous

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1. (U) Summary: Three people have died from the H1N1 virus in Japan
during the past week, Japan's first H1N1 related deaths, and the
National Institute of Infectious Diseases (NIID) is reporting
nationwide infection rates that are at epidemic levels. On August
19, the Minister of Health, Labor and Welfare announced that H1N1
has reached the full-scale epidemic stage in Japan and requested
that the public take measures against further infections. End
Summary.

H1N1 APPROACHES EPIDEMIC LEVELS IN JAPAN
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2. (U) The H1N1 infection rate in Japan has increased dramatically
this summer. The latest NIID report (for the August 3-9 period)
indicates an average of 0.99 patients per facility exhibiting
flu-like symptoms, based on a nationwide reporting network of 5000
designated medical institutions. This approaches the epidemic
threshold of one patient per facility and represents a sharp
increase over 0.55 infected patients per facility noted in the July
27-August 2 report. The total number of nationwide infections was
estimated to be 60,000 during the August 3-9 reporting period. On
August 19, the Minister of Health, Labor and Welfare, Yoichi
Masuzoe, held a press conference declaring an epidemic and asked the
public to take preventive measures. NIID estimates that 79 percent
of the influenza cases reported from May 5, 2009 to August 9, 2009
have been H1N1.


3. (U) According to the NIID report, H1N1 has entered a full-scale
epidemic stage in Okinawa with an average of 20.36 patients reported
per facility. Separately, Okinawa Prefectural Government (OPG)
officials report that the influenza infection rate in Okinawa
prefecture continued to increase between August 10 and August 16;
they estimate that there are currently 20,000 H1N1 infected patients
in Okinawa prefecture, with an average of 29.6 cases per facility.
This new data triggered the OPG to issue a public warning that
Okinawa is experiencing an influenza epidemic on August 19. U.S.
military public health officials in Okinawa are also reporting a
spike in flu-like symptoms on U.S. bases compared to last year.
Experts note that while influenza infection rates do tend to spike
during the summer months in Okinawa, this increase is larger than
usual.


4. (U) Five other prefectures surpassed the 0.99 infections per
facility denoting an epidemic: Nara (1.85),Osaka (1.80),Tokyo
(1.68),Nagasaki (1.50),and Nagano (1.44) during the latest
reporting period. (Note. We do not have data on absolute numbers
of infected persons in Japan since the NIID only publishes the
results of a survey of 5000 designated medical institutions. The
NIID methodology controls for population size in prefectures. End
note).

JAPAN'S FIRST H1N1 RELATED CASUALTIES
--------------


5. (U) The first three H1N1-related deaths have been confirmed in
Japan. On August 15, a 57 year old man suffering from kidney and
heart illness in Okinawa became the first person to die of H1N1. On
August 18, a man in his late 70s, also suffering from kidney
disease, died in the city of Kobe from H1N1. On August 19, a female
patient in her 80s suffering from multiple myeloma died of
complications associated with H1N1 in Nagoya.

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6. (U) A senior researcher at NIID commented in the Nikkei
Newspaper that a full-fledged outbreak of influenza is expected on
Honshu, Japan's largest and most populous island, after schools
re-open in September. The Ministry of Health, Labor, and Welfare
(MHLW) expects to secure vaccine for 14-17 million courses by the
end of this year and hopes to start inoculations in October.

ROOS