MGSF01: LIBYA REPORTS FIRST DEATH DUE TO H1N1, WITH 84

UNCLAS SECTION 01 OF 02 TRIPOLI 000948

SENSITIVE
SIPDIS

STATE FOR NEA/MAG; OES/IHA, OES/IHB, CDC ATLANTA FOR CCID

E.O. 12958: N/A
TAGS: SOCI CASC LY KFLU AEMR ASEC KFLO TBIO KSAF KPAO
PREL, PINR, AMGT, MG, ECON
SUBJECT: MGSF01: LIBYA REPORTS FIRST DEATH DUE TO H1N1, WITH 84
CONFIRMED CASES

REF: STATE 00120578

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1. (SBU) Summary: According to Libyan state-run media, a
pregnant 40-year old Libyan woman recently died in the country's
first reported H1N1-related death. The number of H1N1 cases in
the country reached 84 as of December 1, a jump from the
official figure of 20 provided by the Libyan National Center for
Infectious Disease Prevention and Control on November 21.
International schools in Tripoli, including the American School,
have reported several H1N1 cases among students. To prepare for
the expected outbreak of influenza, , including H1N1, Libya's
General People's Committee for Health and Environment (Ministry
of Health-equivalent) expanded the mandate of an existing avian
flu committee to cover various types of pandemic flu, with the
aim of preparing the Libyan health establishment to deal with a
probable outbreak of flu, including H1N1. The H1N1 vaccine is
not yet publicly available in Libya, although a rumor is
circulating that the vaccine can be purchased for a fee of USD
1,000. Since May, incoming travelers have been screened for flu
symptoms at international ports of entry, including Tripoli
International Airport and the Tunisian border. Due to the poor
state of the Libyan healthcare network, it is unclear how the
state system would respond to a serious health crisis. Post
will hold an EAC later today to review and update pandemic
tripwires. End summary.

2. (SBU) On November 29, Libyan national television announced
the country's first H1N1-related death -- that of a 40-year old
Libyan woman, who was 25 weeks pregnant. In press reports on
November 30, the Secretary of Health (minister-equivalent)
Mahmoud Mohamed al-Hijazi stated that the deceased's case had
initially been misdiagnosed and that she had been prescribed
antibiotics to control her infection, rather than the H1N1
treatment. Her symptoms worsened, requiring hospitalization, at
which point she was diagnosed with the H1N1 virus but was too
ill to respond to the appropriate treatment. The website of
the Libyan National Center for Infectious Disease Prevention and
Control (nidcc.gov.ly) announced on December 1 there were 84
confirmed cases of H1N1 in Libya, all of which were being
treated and controlled. (Comment: The figure of around 84 cases
is a marked increase in a short amount of time, given that 20
cases were reported to be confirmed as of November 21. It is
unclear whether surveillance methods are improving or whether
authorities realized more accurate figures would need to be
provided to the public. End comment.)

3. (SBU) On December 2, the website of the General People's
Committee for Health and Environment reported that Secretary
al-Hijazi convened a meeting of the committee for Pandemic Flu
Preparedness to discuss the status of the pandemic in Libya. He
confirmed that the figures (of 84 cases) that had been published
by the National Center for Infectious Disease Prevention and
Control were correct. He explained that although the current
situation of the virus is under control, he predicted that the
number of cases would increase with the start of the winter
season. He also provided a hot-line telephone number that
people could call to report flu symptoms and to be referred to
treatment centers. (Note: The Embassy called the number on
December 2 but the number was out of service. End note). He
also cautioned Libyans against taking unnecessary overseas
trips, especially to Europe.

4. (SBU) Confirmed cases of H1N1 among students at Tripoli's
international schools - including three cases at the American
School - have been reported. Two cases at the French school
were reported the week of November 22, and there were
unconfirmed reports of H1N1 cases at the German school during
the same week. While there are reports of many cases of
seasonal flu and colds among students and teachers at the
International School of Tripoli, there are no reported cases of
H1N1. On December 1, the Embassy was informed that a UK
diplomat's two children were also diagnosed with H1N1; the UK
diplomat also later was diagnosed with a H1N1. In response to
the upsurge in H1N1 cases, Post issued a warden message on
November 23 referencing the reported cases and reiterating

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Department guidance on Pandemic Flu precautions.

5. (SBU) In 2005, the Libyan General People's Committee for
Health and Environment (Ministry of Health-equivalent) created
a committee for Avian Flu Preparedness, headed by the Secretary
(Minister-equivalent) of Health and Environment, Mahmoud Mohamed
al-Hijazi. In July 2009, the work of the committee was expanded
to include H1N1 and the name was changed to Pandemic Flu
Preparedness Committee. The goals of the committee are to
ensure the country is prepared to deal with the threat of
pandemic flu, including swine flu (H1N1),and to coordinate the
response of the health establishment, such as clinics, hospitals
and the diagnostic laboratories. An official at the Libyan
National Center for Infectious Disease Prevention and Control
informed Emboff on December 1 that H1N1 vaccines had been
ordered and that an initial stock had been used to vaccinate
Libyans travelling to Saudi Arabia for the Hajj; numbers of
people vaccinated were not available. He reported six million
doses had been ordered (which is also the population of Libya)
but the entire stock had not yet arrived. According to some
private doctors, the Libyan government has stocks of H1N1
vaccine but the strategy for administering the vaccine is
unclear. A rumor is circulating around Tripoli that the
vaccine is available but only for a fee of U.S. 1,000 dollars
and there are no details as to where the vaccine can be
procured.

6. (SBU) Since May, incoming travelers have been screened for
flu symptoms at international ports of entry, including Tripoli
International Airport and the Tunisian border. Travelers on
international flights and at the land borders must fill out a
card that asks if they or family members have been ill with
flu-like symptoms (fever, cough) and the passengers must walk in
front of an infrared camera, which detects unusually-high body
temperatures. Medical personnel are standing by to question any
travelers who indicate a positive response on their cards or
whose temperatures indicate a fever.

7. (SBU) In the past, the Libyan government has been
responsive to offers of technical assistance in responding to
and preventing infectious diseases, including from the U.S.
Government. Through post's scientist engagement program,
various Libyan infectious disease specialists have participated
in U.S. programs to enhance Libya's capacity in safeguarding
public health. The Libyan National Center for Infectious
Disease Prevention and Control has been particularly responsive
to U.S.-sponsored programs. For example, in October, the Center
sent two Libyan laboratory specialists to a training course on
diagnosing Avian Influenza and Newcastle Disease sponsored by
the U.S. Department of Agriculture. The Center has also
participated in similar training courses offered by the U.S.
Navy Medical Research Unit (NAMRU-3) in Cairo, Egypt.

8. (SBU) Comment: Due to the poor state of the Libyan
healthcare network, it is unclear how the state system would
respond to a serious health crisis. Now that Libya has publicly
acknowledged the existence of the H1N1 and a related death, it
must place a priority on procurement of H1N1 vaccines given the
increasing incidence of the virus. Post is seeking further
information from the Libyan equivalent of the ministry of health
(General People's Committee for Health and Environment) for
further details on Libya's pandemic flu strategy, and to assess
if the ministry would be amenable to U.S. assistance to procure
H1N1 vaccines or in offering other healthcare assistance. We
also will hold an expanded Emergency Action Committee meeting on
December 3 to update our tripwires (in response to reftel),and
to tap into the extensive resources within the Embassy
community, including our Libyan colleagues, to ensure post is
ready to respond to pandemic flu in Libya. We will report the
EAC's discussions septel. End comment.
POLASCHIK