US embassy cable - 05THEHAGUE3033

UNCLAS SECTION 01 OF 02 THE HAGUE 003033 
 
SIPDIS 
 
STATE FOR G, OES, OES/IHA, EUR/WE 
 
E.O. 12958: N/A 
TAGS: EAGR, ECON, KSCA, PREL, SOCI, TBIO, NL, FAO, WHO, OIE 
SUBJECT: AVIAN FLU: DUTCH ASSESS PREPAREDNESS 
 
REF: THE HAGUE O2634 
 
1. SUMMARY: The GONL has initiated a series of steps to 
enhance its ability to deal with a possible outbreak of avian 
influenza.  Measures include a nationwide evaluation of 
regional preparedness, stockpiling anti-viral treatments, 
information campaigns to answer common questions about the 
virus, requirements to isolate poultry from migratory birds, 
and advisories for travelers to regions susceptible to avian 
influenza.  END SUMMARY. 
 
2.  The Ministry of Health has gone on the offensive to 
prepare health care providers for a possible outbreak of 
avian influenza.  The Ministry recently updated its national 
action plan, which outlines the GONL's policy and operational 
strategy to guide local and national responses to isolated 
and large-scale outbreaks.  It has also charged each of the 
nation's 24 health care regions to develop regional action 
plans, and recently commissioned the Dutch Health 
Inspectorate to assess regional preparedness.  In its 
November 2 report, the Inspectorate noted that half of the 
regions were not sufficiently prepared at present for a 
pandemic.  It estimated, however, that 20 of the 24 health 
care regions would be fully prepared to respond to a 
large-scale outbreak by June 2006.  Ministry officials hope 
GONL participation in the EU's avian influenza crisis 
management exercise, scheduled in the Netherlands for 
November 23-24, will speed regional planning.  "Textbook" 
exercises conforming to the EU model will be held in two as 
yet unannounced regions in the Netherlands. 
 
3.  Health Ministry efforts include the stockpiling of 
anti-viral treatments.  The GONL has ordered five million 
treatments -- mostly Tamiflu but some Relenza in case the 
virus develops Tamiflu resistance -- sufficient to treat 30 
percent of the Dutch population.  The order will 
substantially augment the existing stockpile of 220,000 
treatments.  The Ministry expects delivery of 2.5 million 
treatments before the end of the year, and the remainder in 
mid-2007. 
 
4.  The GONL has also taken measures to educate the public on 
avian influenza and the risks to human health.  The Ministry 
of Health has posted basic information on its website with 
links to the WHO and to the Dutch National Institute for 
Public Health and the Environment (RIVM).  RIVM, a major 
research institute for the Ministry, has created a webpage 
similar to the "General Information" section of the USG 
website www.pandemicflu.gov to answer common questions about 
the virus, including risk of transmission, availability of 
treatments and steps the GONL has taken to prevent the 
virus's spread.  The Ministry of Foreign Affairs has also 
taken steps to educate the public, advising travelers to 
Turkey, Indonesia, Thailand and other Asian countries where 
avian influenza has been confirmed or suspected on measures 
to prevent further spread of the virus. 
 
5.  To prevent an outbreak of the virus in the Dutch poultry 
industry, the Ministry of Agriculture imposed measures 
October 31 requiring poultry farms to isolate their poultry 
from other birds by either keeping them indoors or covering 
forage area with netting, and prohibiting the use of surface 
water in areas with a high number of migratory birds. 
Similar restrictions were imposed in late August, following 
the discovery of the avian influenza virus in Russia, but 
were subsequently relaxed.  In addition, new measures require 
transporters carrying poultry or eggs to countries outside 
the EU or to countries where the avian influenza virus has 
been identified to disinfect their cargo containers at 
designated locations on their return to the Netherlands.  To 
comply with European Commission (EC) prohibitions on the 
import of poultry, birds and feathers from designated 
countries and with the EC's temporary import ban on pet 
birds, all Dutch air and sea ports have elevated inspections 
for illegal importation of birds and products. 
 
6.  Despite these recent steps, Ministry of Agriculture 
officials consider the situation in the Netherlands to be 
stable.  Consumption of poultry and eggs has not dropped, 
according to Ministry officials, as has been the case in some 
other countries.  The GONL is focused now on helping 
countries in Eastern Europe prevent the spread of the virus, 
and has sent experts to Romania to assist with emergency 
operations there.  (Note: The Dutch gained valuable expertise 
on containing avian influenza in 2003, when a major outbreak 
of highly pathogenic (H7N7) avian influenza hit its 
commercial poultry flock.  Nearly 26 million birds were 
slaughtered to control the outbreak. END NOTE.)  Health and 
Agriculture Ministry officials plan to attend the Geneva 
conference November 7-9, which they see as crucial for 
preparing an Asian response. 
 
7.  The long-term fear in the Dutch government is that 
migratory birds will take the disease to the Nile delta area 
and to East Africa, where the veterinary infrastructure is 
weak and resources to contain any outbreak limited.  Birds 
from these areas will migrate back to western Europe next 
spring, putting western European countries at risk for 
massive exposure. 
BLAKEMAN