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Cablegate: First H1n1 Death in Estonia Raises Controversy

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RR RUEHAG RUEHAST RUEHDA RUEHDBU RUEHDF RUEHFL RUEHIK RUEHKW RUEHLA
RUEHLN RUEHLZ RUEHNP RUEHPOD RUEHROV RUEHSK RUEHSL RUEHSR RUEHVK
RUEHYG
DE RUEHTL #0380 3291159
ZNR UUUUU ZZH
R 251158Z NOV 09
FM AMEMBASSY TALLINN
TO RUEHC/SECSTATE WASHDC 0243
INFO EUROPEAN POLITICAL COLLECTIVE
RUEAUSA/DEPT OF HHS WASHINGTON DC
RUEHPH/CDC ATLANTA GA

UNCLAS TALLINN 000380

SIPDIS

E.O. 12958: N/A
TAGS: CASC AMED TBIO KFLU EN
SUBJECT: FIRST H1N1 DEATH IN ESTONIA RAISES CONTROVERSY

1. Summary. Estonia reported its first confirmed H1N1-related
death on November 23. The death of the otherwise healthy 13-year
old boy has focused press attention on decisions made by local
health practitioners, and raised questions as to whether the death
was avoidable. The Estonian Social Ministry continues to scramble
to obtain H1N1 vaccine in order to implement a modest campaign
directed at high-risk groups, scheduled to commence in December.
Post is engaging Estonian health authorities to ensure that
resident American citizens will be eligible to obtain the vaccine
in the planned campaign. End Summary.

H1N1 Situation in Estonia

2. 269 persons have been confirmed to have been infected with H1N1
in Estonia, although the Estonian Health Protection Inspectorate
discontinued routine testing for the virus in mid-November. The
Inspectorate has noted that the flu season arrived in Estonia two
months earlier than in previous years, and has suggested that the
actual number of H1N1 cases is likely considerably higher than 269.
Numerous schools (at least 12) have temporarily closed throughout
the country as absentee rates among students have skyrocketed, as
parents decide to keep their children home rather than risk illness
at school.

First H1N1-Related Death Raises Controversy

3. The first confirmed H1N1-related death in Estonia, a 13-year
old boy who died on November 23, is being scrutinized closely by
the local press. The teenager, living in a rural area near
Tallinn, was not known to suffer from any chronic health
conditions. Health authorities continue to investigate the matter,
and the press is speculating why an otherwise athletic teenager
could deteriorate so quickly. Some have pointed to the fact that
the teenager had received routine vaccinations for measles, mumps
and rubella just before falling ill, giving rise to general fears
about the safety of regular vaccination programs, particularly
during the current flu season. Others have questioned treatment by
the nurse at the school the teenager attended, as well as the
family's doctor, neither of whom were reported to have prescribed
anti-viral medication to the boy, despite the widespread
availability of Tamiflu (oseltamivir) in Estonia.

Plans for H1N1 Vaccination Campaign Accelerated

4. The Estonian Social Ministry has announced its intent to
implement a limited vaccination campaign in December, finalizing a
plan to procure surplus vaccine from the Netherlands. Originally
expected to forego a vaccination program during the current flu
season, the Social Ministry accelerated its plans after
considerable public pressure, including an open letter from a local
doctors' association and regular press coverage of an orderly
vaccination campaign underway in neighboring Finland. Meanwhile,
Estonians continue to debate the best way to avoid infection, often
relying on folk remedies such as fresh garlic.

5. Estonian health authorities have stated that eligibility for
the proposed H1N1 vaccination campaign will be determined by the
enrollment register in the country's national health plan
(Haigekassa). In September, Conoff received oral assurance from
the Chairman of the Estonian Health Care Board that American
citizens in Estonia who are members of specified high-risk groups
(e.g., pregnant women) would be included in the H1N1 campaign, even
if they are not enrolled in the national health plan. Post
continues to engage the Estonian health authorities to ensure that
otherwise eligible American citizens are not inadvertently excluded
from the planned vaccination campaign.
DECKER

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