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Cablegate: Sri Lanka's Preparedness for Pandemic Influenza:

VZCZCXRO3077
PP RUEHBI RUEHCI RUEHLH RUEHPW
DE RUEHLM #0954/01 2920404
ZNR UUUUU ZZH
P 190404Z OCT 09
FM AMEMBASSY COLOMBO
TO RUEHC/SECSTATE WASHDC PRIORITY 0625
INFO RUEHKA/AMEMBASSY DHAKA 1949
RUEHIL/AMEMBASSY ISLAMABAD 8985
RUEHKT/AMEMBASSY KATHMANDU 7223
RUEHNE/AMEMBASSY NEW DELHI 3365
RUEHPF/AMEMBASSY PHNOM PENH 0083
RUEHCG/AMCONSUL CHENNAI 9546
RUEHKP/AMCONSUL KARACHI 2540
RUEHCI/AMCONSUL KOLKATA 0430
RUEHLH/AMCONSUL LAHORE 0084
RUEHBI/AMCONSUL MUMBAI 6846
RUEHPW/AMCONSUL PESHAWAR 0364
RUEKJCS/SECDEF WASHDC
RUEHGV/USMISSION GENEVA 3772
RUCNDT/USMISSION USUN NEW YORK 1310

UNCLAS SECTION 01 OF 02 COLOMBO 000954

SENSITIVE
SIPDIS

STATE FOR SCA/INSB
STATE FOR OES/IHB
STATE FOR AID/GH/HIDN
USDA PASS TO APHIS
HHS PASS TO CDC
HHS FOR OGHA

E.O. 12958: N/A
TAGS: CE ECON PGOV TBIO SOCI CASC KFLU
SUBJECT: SRI LANKA'S PREPAREDNESS FOR PANDEMIC INFLUENZA:
SO FAR SO GOOD

1. (U) SUMMARY: The government of Sri Lanka (GSL) developed a
plan in 2005 to track and respond to pandemic flu (H1N1 and
H5N1) and has updated the plan as needed. Surveillance
systems are in place, hospitals nationwide are prepared with
isolated wards, and ports of entry are closely monitored.
Poultry imports were also banned at the height of the bird
flu scare. To date, there have been no reported cases of
H5N1 (Avian Flu, or AI). The GSL reports 101 H1N1 (Swine
Flu) cases, and no deaths. The World Health Organization
(WHO) gave Sri Lanka's program high marks. The Centers for
Disease Control also recently began funding a cooperative
agreement project worth nearly USD 300,000 with Sri Lanka to
enhance Sri Lanka's capabilities. End summary.

Preparations Look Good on Paper
-------------------------------

2. (U) Econ officer met with Dr. Paba Palihawadana, Chief
Epidemiologist in the Epidemiology Unit of the Sri Lankan
Ministry of Health, on October 7. Palihawadana provided an
overview of Sri Lanka's pandemic flu preparedness program
(www.epid.gov.lk/pdf/Binder4.pdf), which was initially
drafted in October 2005. Many ministries were involved in
the development of the plan -- demonstrating the wide-reach
of Sri Lanka's efforts -- and all remain engaged in frequent
technical committee meetings. These include the ministries
of Health, Education, Communication, Agriculture, Finance,
Environment, and the Department of Animal Production and
Health (DAPH). Currently, the "suspected infected" (those
with flu-like symptoms who seek care) are tested nationwide,
and the Medical Research Institute (MRI) is equipped to test
for H1N1 or H5N1 cases. Across Sri Lanka, and including in
the North and East, twenty hospitals have established
isolated wards should a flu outbreak occur, and medical staff
have received additional training. Sri Lanka monitors all
incoming international airline passengers through data
collection and the use of a thermal scanner at the country's
one international airport. The Department of Health has
stockpiled roughly 350,000 tablets of Tami Flu (mostly from
WHO), enough for 35,000 infected individuals.

3. (U) To date, Sri Lanka has reported 101 cases of H1N1 --
almost all of whom have been visitors or recent returnees
from abroad. The disease has not spread beyond immediate
family members, and no deaths have occurred. When global
outbreaks of H5N1 were more frequent in 2005-2007, Sri Lanka
cut off or severely restricted the import of live poultry
from affected countries. The Sri Lanka Exotic Disease
Emergency Plan was developed in consultation with the poultry
industry and the Food and Agriculture Organization (FAO).
Its aim was to prevent AI transmission to Sri Lanka and
eradicating or controlling the spread of the disease, should
it reach the island. While poultry exports from several U.S.
states were temporarily banned, those restrictions have since
been lifted. The DAPH has identified 14 "hot spots" where
migratory birds may bring AI into Sri Lanka, and the
Veterinary Research Institute carries out tests on birds in
those areas to determine if AI has reached the island.
According to Palihawadana, as a result of the GSL's action,
to date there have been no cases of H5N1.

4. (U) In a follow-up meeting with Dr. Firdosi Mehta at WHO
on October 9, Mehta confirmed the "more than adequate" nature
of Sri Lanka's testing, surveillance, and monitoring systems
for pandemic influenza. However he noted that "more can
always be done" and highlighted the close cooperation between
the GSL and WHO. Mehta emphasized that since the first
confirmed H1N1 case in mid-June, schools have been out of
session. Now that schools have re-opened, case numbers may

COLOMBO 00000954 002 OF 002


rise. Mehta also expressed satisfaction at the GSL's efforts
to monitor the situation at the IDP camps in the East. He
said that WHO is in contact with the more than 30 GSL public
health inspectors who daily collect information in the camps
on a range of diseases.

Additional Support Useful
-------------------------

5. (U) Post has also learned that the Centers for Disease
Control has agreed to provide USD 299,155 to boost Sri
Lanka's surveillance and response to AI and pandemic
influenza. The principal intent of the assistance is
threefold: to support surveillance and response and allow for
containment of highly pathogenic virus transmissible among
humans; to support the development of epidemiologic,
laboratory and related capacity to detect, respond to, and
monitor changes in influenza viruses; and to help strengthen
connections between national institutions in different
countries, especially National Influenza Centers (which Sri
Lanka has) to more fully participate in the WHO Influenza
Program, and to increase the sharing of specimens and
epidemiologic influenza-related data with WHO and CDC.

6. (U) Sri Lanka will also send two government officials to
participated in the Pandemic Senior Leaders Symposium in
Phnom Penh October 12-15. The conference, organized by the
U.S. Department of Defense, will focus on H1N1 current
operations and developments and will review "best practices"
for ports of entry and debarkation should emergencies occur.
Issues related to the care of refugees and displaced persons
will also be reviewed.

7. (SBU) Comment: Sri Lanka has benefitted from its island
status, the relatively low numbers of international visitors,
and the fact that it only has one major port of entry. While
too early to judge Sri Lanka,s preparations, government
officials do share information weekly on reported and
confirmed cases of pandemic flu strains. Cases are broken
down by location, age, and gender; additionally,
epidemiological information is shared, demonstrating a fairly
complex and stringent surveillance and reporting program. At
least on paper, Sri Lanka seems to be well prepared to act
when necessary, with a plan and readiness to follow that
plan. Nonetheless, additional assistance would benefit the
country's efforts -- particularly with additional lab
supplies -- and the CDC project should help fill those gaps.
As is so often the case, we would only fully learn how
prepared Sri Lanka is should an outbreak begin. End comment.
BUTENIS

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