US embassy cable - 05PARAMARIBO764

UNCLAS  PARAMARIBO 000764 
 
SIPDIS 
 
 
SENSITIVE 
 
DEPT FOR WHA/CAR: LLUFTIG; STATE FOR OES 
 
E.O. 12958: N/A 
TAGS: TBIO, SENV, ECON, EAGR, EAID, PREL, NS 
SUBJECT: INFORMATION ON AVIAN AND PANDEMIC FLU - SURINAME 
 
REFS: (A) STATE 209622 (B) PARAMARIBO 692 
 
(U) In response to ref A, the following information is 
provided on avian and pandemic influenza detection, 
prevention and response in Suriname: 
 
PREPAREDNESS/COMMUNICATION 
 
Q. (U) Does the government have a preparedness 
plan/strategy for preventing avian flu from becoming a 
pandemic and containing a pandemic once it occurs?  If the 
country has a strategy, how capable is it of implementing 
it? 
 
A. (U) Plans for avian flu detection and prevention seem to 
be focused initially on efforts by Suriname's Agricultural 
Ministry (LVV) to detect the potential outbreak in poultry 
and export birds.  The heightened concern is due to the 
recent news that a Suriname parrot in quarantine at 
London's Heathrow airport was allegedly infected with the 
deadly H5N1 strain--although it was later determined that 
the bird was infected by Taiwanese birds also in quarantine 
(see ref B). The incident has made government and industry 
acutely aware of the economic consequences which can result 
if the disease is not addressed.  A broader national 
strategy is being developed in cooperation with 
representatives from the Pan American Health Organization 
(PAHO). Suriname is presently preparing a contingency plan 
for the threat of pandemic avian influenza, which will 
include provisions for potential human-to-human 
transmission of the virus.  Planning is still in the early 
stages. Post will forward a copy of the plan as soon as it 
is made available. 
 
Q. (U) How truthful will the government be in reporting the 
scope of any disease outbreak among people?  Among animals? 
What incentives could be offered that would likely result 
in more transparency? 
 
A. (SBU) The Government of Suriname does not have a good 
record of communicating information to its citizens.  The 
Ministry of Public Health would have responsibility for 
reporting human outbreak, but their track record has been 
spotty, based on the recent handling of an increased 
incidence of dengue fever cases this year, for which the 
government has received criticism for lack of an adequate 
response.  Belatedly, the government, in cooperation with 
PAHO, launched a well-publicized awareness campaign 
stressing prevention measures (clearing garbage and 
standing water) and symptoms of dengue fever.  In the case 
of animal outbreak, the LVV would assume reporting 
responsibility.  There is always the possibility that 
reports issued by government officials may be filtered for 
political reasons. 
 
Q. (U) Where does preparing for an avian flu human pandemic 
rank among government priorities?  Who and what would 
influence the country to give the issue a higher priority? 
Who is the key "go-to" person, office or department? 
 
A. (U) Currently, avian flu is fairly low on the list of 
priorities of the Suriname government; however, there is 
heightened awareness, particularly within the Agricultural 
Ministry which has stepped up testing of animals.  The 
government, following PAHO's lead, seems to be taking the 
potential threat more seriously.  The responsibility of 
implementing the plan in the case of a pandemic lies with 
the Director of Public Health, Dr. Martheliese Eersel, 
whose office is in the Ministry of Public Health.  The go- 
to person in the LVV is Dr. Edmund Rozenblad, Director of 
Animal Production and Health. 
 
Q. (U) Have national laws been reviewed to ensure that they 
are consistent with the international health regulations 
and do not pose barriers to avian influenza detection, 
reporting, containment, or response? 
 
A. (U) National laws generally conform to international 
standards.  The largest barrier to avian flu detection, 
reporting, containment and response is a lack of financial 
resources. 
 
Q. (U) Is the host country already working with 
international organizations or other countries on the avian 
flu issue?  Are government leaders likely to ask for 
assistance from the U.S. or other countries?  Would 
government leaders be receptive to messages from U.S. 
leaders through a bilateral approach, at a multilateral 
forum such as the UN (WHO, FAO, etc.) or APEC, or through 
bilateral contacts by a third country? 
 
A. (U) A multi-ministerial and disciplinary task force has 
been established, headed by the Ministry of Public Health. 
World Health Organization (WHO) and PAHO are working 
closely with the Ministry; both organizations are members 
of the task force.  Other UN agencies in Suriname are 
investigating what additional support they can provide to 
Suriname, both in the preparedness phase and in the case of 
a possible pandemic.  In the event of an outbreak, the 
government would likely ask for assistance from the EU, the 
U.S. and international organizations.  The government is 
receptive to messages from U.S. leaders and experts, and 
would be willing to participate in multilateral fora. 
However, communication and coordination between home 
ministries and representatives to International 
Organizations is sometimes problematic. 
 
Q. (U) Does the country currently administer annual flu 
shots?  If not, might it consider doing so?  What is the 
production capability for human influenza vaccines in the 
country?  Does the country produce influenza vaccine for 
poultry? 
 
A. (U) Suriname does not administer flu vaccinations for 
humans, nor do they produce vaccines.  It might consider 
widespread administration if stocks of the vaccine were 
available. Outside of the major metropolitan area of 
Paramaribo the medical infrastructure is underdeveloped and 
a mass vaccination program would tax the country's 
resources. 
 
Q. (U) How well informed is the population about the avian 
flu threat and about measures they should take to mitigate 
the threat?  What mechanisms are available for providing 
additional information to the population, particularly in 
rural areas and how effective are these measures? 
 
A. (U) Avian influenza receives very little press coverage 
in local media, apart from the incident involving the 
Surinamese parrot.  Residents in the country's interior 
would need to be informed through medical missions (semi- 
private health clinics associated with city hospitals). 
There is some experience with earlier efforts to improve 
the public's awareness of HIV/AIDS. 
 
SURVEILLANCE/DETECTION 
 
Q. (U) How capable are the medical and agriculture sectors 
of detecting a new strain of influenza among people or 
animals respectively?  How long might it take for cases to 
be properly diagnosed, given other endemic diseases?  Can 
influenza viruses be subtyped in the country, if so by who, 
and if not, where are they sent?  Does the country send 
samples to a WHO/EU/U.S. reference laboratory? 
 
A. (U) Medical and agricultural staff are currently 
incapable of detecting new strains of the influenza virus. 
In the case of dengue fever, samples are sent to the 
Caribbean Epidemic Center (CAREC) in Trinidad for testing 
to confirm suspected cases, with results returned in two to 
three weeks.  Businesses in the agricultural and trade 
sectors, as well as officials in the LVV, appear willing to 
conduct regular tests in order to detect the virus in 
animals, but equipment and other resources are inadequate. 
Birds for export, because of stricter international 
standards, are tested for avian flu, using testing kits 
received from Canada (see ref B), but the procedure has yet 
to be applied to poultry or other animals. 
 
Q. (U) What are the critical gaps that need to be filled in 
order to enhance the country's disease detection and 
outbreak response capabilities?  What is the country's 
greatest need in this area from the U.S. or international 
organizations? 
 
A. (U) The government is willing to enhance their 
capability for disease detection; however, Suriname is in 
need of the proper equipment.  There is currently one ELISA 
machine in the country, used for HIV/AIDS testing. 
Ideally, in order to accommodate avian flu testing, the 
testing agency would have at least two machines, one to 
serve as a back-up if/when the primary machine is under 
maintenance or repair.  A limited supply of test kits from 
Canada is also currently available in Suriname. 
 
RESPONSE/CONTAINMENT 
 
Q. (U) Does the country have a stockpile of medications, 
particularly of antivirals, and if so how much?  If some 
has been ordered, how much and when is it expected? 
 
A. (U) There is no stockpile of antivirals, and no 
 
medications have been ordered. 
 
Q. (U) Does the country have a stockpile of pre-positioned 
personal protective gear? 
 
A. (U) Some protective gear is available, but the quantity 
and quality are largely inadequate. 
 
Q. (U) What is the rapid response capacity for animal and 
human outbreaks?  Are guidelines in place for the culling 
and vaccination of birds, disinfection of facilities, and 
limitations on animal movement? 
 
A. (U) There is little experience with mass culling and 
vaccination, so response is likely to be very slow 
initially. Suriname would likely seek international 
assistance to engage in a large-scale response. 
 
Q. (U) How willing and capable is the government of 
imposing quarantines and social distancing measures 
(closing schools, public gatherings, mass transit)?  Would 
its military enforce quarantines? 
 
A. (U) It is uncertain whether the government, which has 
not had any experience with an event of this nature, would 
be capable of implementing quarantine or social distancing 
measures.  The military would likely play a role, as the 
National Disaster Coordination Center falls under the 
purview of the Surinamese military. 
 
BARNES 
 
 
NNNN