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Cablegate: Brazil: Data Collection of Brazilian Government

VZCZCXRO6246
RR RUEHAST RUEHDH RUEHHM RUEHLN RUEHMA RUEHPB RUEHPOD RUEHSL RUEHTM
RUEHTRO
DE RUEHBR #1097/01 2441609
ZNR UUUUU ZZH
R 011609Z SEP 09
FM AMEMBASSY BRASILIA
TO RUEHC/SECSTATE WASHDC 4986
INFO RUEHSO/AMCONSUL SAO PAULO 4474
RUEHRI/AMCONSUL RIO DE JANEIRO 8130
RUEHRG/AMCONSUL RECIFE 9869
RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE

UNCLAS SECTION 01 OF 02 BRASILIA 001097

SENSITIVE

SIPDIS

E.O. 12958: N/A
TAGS: PGOV PREL SOCI TBIO KFLU BR
SUBJECT: BRAZIL: DATA COLLECTION OF BRAZILIAN GOVERNMENT
INTERVENTIONS RE H1N1

REF: STATE 73971

BRASILIA 00001097 001.2 OF 002


(U) THIS CABLE IS SENSITIVE BUT UNCLASSIFIED AND NOT FOR INTERNET
DISTRIBUTION.

1. (SBU) In response to REFTEL post gathered the following
information regarding the Government of Brazil's (GOB) interventions
and actions aimed at dealing with the convergence of the H1N1
outbreak and the Southern Hemisphere's annual flu season.

GOVERNMENT INTERVENTIONS

2. (SBU) H1N1 flu has caused a considerable amount of concern
within the GOB, the state and local authorities, and among the
Brazilian population. The GOB, state, and local authorities have
not/not made any emergency declarations. The GOB has undertaken a
public education campaign focused at keeping the public calm and
reinforcing the idea that, at least in Brazil, the H1N1 flu shows no
signs of being any more severe than the yearly outbreaks of seasonal
flu. The Minister of Health has personally made several televised
appearances reassuring the public that his Ministry is monitoring
the situation closely and taken all prudent actions. This includes
increasing the government's stockpiles of Tamiflu, which is in turn
being dispensed directly by health centers, at reduced or no costs,
if they believe that the patient's situation warrants its use. The
government's increased purchasing of Tamiflu has caused most
pharmacies to run out of the medicine, which may be an intended
side-affect aimed at stopping the public from self-medicating.

3. (SBU) The Ministry of Health has not/not made H1N1 a notifiable
disease. The only quarantine procedures in place are in hospitals
and clinics, in which suspected or confirmed H1N1 cases are kept in
a specific quarantine wing; however in most cases these patients are
then released and asked to stay home for a week. The Embassy is
aware of one situation in which a few AmCits were kept in quarantine
for over a week. Hospitalization occurs in the minority of cases
because the severity of the disease does not warrant it.

4. (SBU) Some schools have closed for short periods of time (1-2
weeks) or delayed their opening after winter break in the hopes that
infected students would realize that they were infected before
returning to school and then decide to stay home rather than infect
their classmates. The American School in Brasilia suspended classes
for one week in the fifth grade only after four students in that
grade became ill with flu-like diseases. The suspension was advised
by the Ministry of Health. There have been no other closures in
theaters or other public venues.

5. (SBU) At this point there have been no/no staggered business
hours, mask ordinances, mandated private funerals, bans on
door-to-door sales, interventions to reduce transmission in the
workplace, or protective sequestration of children.

6. (SBU) While there have not/not been any governmental decisions
to ban public gatherings, there have been several cases in which
event organizers have chosen to postpone or cancel events out of
concern over the spread of H1N1.

7. (SBU) There have not/not been any no-crowding rules or
community-wide business closures.

8. (SBU) Both domestic and international airports are making public
service announcements and distributing flyers describing the primary
symptoms of H1N1 and asking any travelers that believe they have
those symptoms to identify themselves to health officials posted in
the airport. International travelers are required to complete a
written health self-assessment that they present to health officials
while passing through customs and immigration. Those who indicate
they have symptoms are taken aside for additional screening.

9. (SBU) Ministry of Health statistics indicate that the majority
of cases contracted abroad have been linked to Argentina. As such,
the GOB has deployed army units and health officials to help patrol
the southern borders with Argentina, Paraguay, and Uruguay. These
officials are providing information regarding the H1N1 flu and
screening travelers who appear to be ill or who self-identify as
having H1N1-like symptoms.

STATE OF THE HEALTHCARE SYSTEM

10. (SBU) In general, the medical infrastructure in the major
cities of Brazil is comparable with that in the United States. The
number of H1N1 cases in Brazil has not overwhelmed the abilities of
the health care system. Most patients are not being hospitalized
and are being asked to rest at home until they have recovered from
the virus. However, the Minister of Health has expressed some
concern that the public health system in Rio de Janeiro, which is

BRASILIA 00001097 002 OF 002


chronically under strain, could become overwhelmed. This
possibility is increased by the large number of international
travelers going to, or transiting through, Rio.

11. (SBU) Doctors anecdotally report that their patients are coming
in for minor cold and allergy symptoms (which are exceedingly common
during this time of year) fearing that they may have contracted H1N1
flu. In general, doctors are performing an initial clinical
screening which eliminates the majority of suspect cases. Those
that are not eliminated by this screening have an actual flu test
performed to concretely diagnose their case. Generally the hospital
or clinic will keep a patient isolated during the initial screening
and in some cases until the results of the flu test are received.
According to the Ministry of Health, between April 25 and August 22
the results of 30,854 flu tests were reported by state and local
health authorities. Of these tests, 16.9% tested positive for H1N1
while 2.9% tested positive for seasonal flu. The remaining cases
were negative for any type of influenza.

12. (SBU) As of August 22, there have been 557 deaths in Brazil
attributed to H1N1 flu. According to the Ministry of Health the
severity of H1N1 - based on the symptoms it causes, the severity to
which the symptoms are felt, the frequency with which they appear,
and the frequency with which hospitalization is required - in Brazil
is statistically indistinguishable from the severity of the seasonal
flu.

KUBISKE

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