Cablegate: H1n1 Influenza Case Confirmed in Mozambique

VZCZCXRO3243
RR RUEHBZ RUEHDU RUEHJO RUEHMR RUEHRN
DE RUEHTO #1010 2540926
ZNR UUUUU ZZH
R 110926Z SEP 09
FM AMEMBASSY MAPUTO
TO RUEHC/SECSTATE WASHDC 0699
INFO RUCNSAD/SOUTHERN AFRICAN DEVELOPMENT COMMUNITY
RUEHPH/CDC ATLANTA GA
RUEAUSA/DEPT OF HHS WASHDC

UNCLAS MAPUTO 001010

SENSITIVE
SIPDIS

E.O. 12958: N/A
TAGS: TBIO SENV SOCI PGOV PREL MZ
SUBJECT: H1N1 INFLUENZA CASE CONFIRMED IN MOZAMBIQUE

1. (SBU) SUMMARY: The Government of Mozambique (GRM)
confirmed its first case of H1N1 Influenza (Swine Flu) on
August 17. Preparations for the possible arrival of the
influenza began in April, when the GRM began developing a
response plan. The GRM has limited doses of Relenza and
Tamiflu. Post has a Pandemic Influenza Working Group to
monitor the situation. Mozambique's limited health care
infrastructure could potentially be overwhelmed if a large
number of cases were to develop. END SUMMARY.

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FIRST H1N1 CASE CONFIRMED IN AUGUST
-----------------------------------

2. (SBU) On August 17, the GRM confirmed its first case of
H1N1 Influenza A in a 46 year old woman evaluated at Maputo
Central Hospital who had traveled to South Africa and
developed symptoms on August 6. Confirmatory testing was
done at the National Institute for Communicable Diseases
(NICD) in South Africa. To date, Mozambique has had 21
suspected cases but only 1 confirmed; 6 cases have laboratory
results pending.

3. (SBU) Preparations for the possible arrival of H1N1
Influenza began in late April. The Mozambique Ministry of
Health (MISAU) convened a meeting on April 29 to discuss
novel Influenza H1N1. This included MISAU staff, other
ministries (e.g. Agriculture) and other stakeholders,
including NGOs, WHO, CDC, and USAID. MISAU shared the
measures that had already been taken including some
communication to the press, orientation information sent to
provincial staff, consideration of the reactivation of an
Emergency Commission, communication to entry ports (seaports,
airports), and work on a case investigation form. MISAU
previously developed an Avian Influenza Response Plan and
Clinical Manual which is being adapted for H1N1 Influenza.

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GRM TAKING ADDITIONAL MEASURES
------------------------------

4. (SBU) Since the April meeting, additional measures were
taken including: (1) Communication materials were developed
and disseminated through television, radio, newspapers, and
talks in health facilities in Maputo and in the provinces;
(2) Clinical response teams were identified and trained at
Maputo Central Hospital and Emergency Departments of other
hospitals; (3) The National Immunology Reference Lab of the
National Institute of Health procured specimen collection
kits, trained staff in safe specimen packaging, established a
relationship with the National Institute of Communicable
Diseases in Johannesburg for confirmatory testing, and
recently received protocol and reagents to perform
confirmatory testing in-country; (4) MISAU has limited doses
of Relenza that will expire soon and purchased an additional
30,000 doses of Tamiflu and (6) information is now being
provided at airports and other border entry posts advising
passengers with influenza-like illnesses to seek medical
attention.

5. (SBU) Post has a Pandemic Influenza Working Group and
has updated its preparedness plans for Influenza. The working
group is monitoring the situation closely.

---------------------------------------------
COMMENT: HEALTH CARE INFRASTRUCTURE A CONCERN
---------------------------------------------

6. (SBU) While the GRM, and MISAU in particular have put a
response together, the health infrastructure in Mozambique
remains extremely weak, even in Maputo. If a large number of
Influenza cases develop (H1N1 or other), these could
potentially overwhelm the existing health capacity and drug
supply available to the public. It is also likely that the
current surveillance system may fail to detect many cases
that occur, especially those that occur outside of Maputo.
CHAPMAN

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