US embassy cable - 05SANTIAGO2431

UNCLAS SANTIAGO 002431 
 
SIPDIS 
 
SIPDIS 
 
E.O. 12958: N/A 
TAGS: TBIO, SENV, ECON, EAGR, EAID, PREL, CI 
SUBJECT: CHILE: PART II - PUBLIC HEALTH PREPARATIONS FOR 
AVIAN INFLUENZA 
 
REF: A. SECSTATE 209622 
 
     B. SANTIAGO 02393 
 
1.  Summary: This cable outlines preparations in Chile's 
public health sector.  An evaluation of the Chilean 
agricultural sector preparations was reported in reftel B. 
 
2.  Chile has experience with avian influenza (AI) issues due 
to a 2002 outbreak of the disease in poultry.  The 
agricultural sector met the challenge and the outbreak was 
quickly contained.  The GOC demonstrated transparency and 
efficiency throughout that time.  While it is clear that the 
outbreak prompted the poultry industry and the agricultural 
inspectors to upgrade their biosafety measures, the public 
health sector did not benefit from the same level of 
attention and allocation of resources in 2002.  In 2005, 
Chilean health officials have worked with international 
partners to address the latest global AI threats.  The 
Ministry of Health (MOH) has prepared an extensive plan to 
address this issue.  However, the public health sector does 
not enjoy the same levels of resources or manpower as the 
agricultural export sector to fulfill completely its 
emergency plans.  End Summary. 
 
--------------------- 
Historical Statistics 
--------------------- 
 
3.  To raise awareness of the impact of an influenza outbreak 
in humans, the Ministry of Health has cited two previous 
outbreaks in Chile's recent history.  Influenza first 
appeared in Chile in 1918.  In a population of 3.6 million, a 
total of 37,500 people died from the disease between 1918 and 
1920. 
 
4.  There was another influenza outbreak in 1957.  Over 1.4 
million people became ill, although the mortality rate was 
only 0.13 percent among those infected.  This outbreak 
prompted the formation of a National Committee for Influenza 
to coordinate tracking and treatment of the disease.  It 
became the public's authoritative source of information on 
the topic. 
 
--------------------------------- 
Organizing for the Current Threat 
--------------------------------- 
 
5.  The idea of a national committee was revived on November 
30, 2004 when the Chilean Congress passed a resolution to 
create the National Response Commission for Outbreaks and 
Sanitary Emergencies.  The Committee is under the 
jurisdiction of the MOH's Office of Epidemiology.  The 
mandate of this committee is to: 
 
     - propose contingency plans to confront the outbreaks of 
infectious diseases, with a particular emphasis on AI; 
 
     - monitor the implementation of these contingency plans; 
 
     - provide technical advice to the country's decision 
makers. 
 
Most members of this committee are MOH staff, but there are 
also representatives from the Agricultural and Livestock 
Service (SAG) and the Chilean Society for Infectology.  Under 
Secretary of Public Health, Dr. Patricio Bustos, has been 
 
SIPDIS 
identified as the key contact for international coordination 
on this issue. 
 
6.  Other GOC agencies have been included to implement the 
committee's urgent response plans.  These agencies include: 
 
     - Ministry of Interior, Office of National Emergency 
Response (ONEMI) 
     - Chile's Armed Forces and National Police (Carabineros) 
     - Ministry of Education 
     - Treasury Ministry 
     - Labor Ministry 
     - Association of Municipal Governments 
     - Association of Private Health Clinics 
     - Association of Scientists 
     - Executive Office of the President 
 
------------------------------ 
Preparedness and Communication 
 
------------------------------ 
 
7.  The GOC does have a preparedness plan for preventing 
avian flu from becoming pandemic.  A Spanish-language version 
of this document can be found at: 
 
http://www.minsal.gov.cl/ici/pandemiainfluenz a 
 
This plan is extensive.  The GOC has identified key public 
health alert phases: preparatory, pandemic alert, pandemic, 
and post-pandemic.  There are a series of actions outlined to 
be taken at each phase.  The plan emphasizes open 
communication both domestically and internationally. 
 
8.  The GOC has been working with international partners on 
this issue.  The Ministers of Health from the Andean region 
met in Lima, Peru on October 21, 2005.  A declaration was 
signed and regional governments promised to coordinate 
closely with each other on this global health concern.  In 
addition, the GOC's plan repeatedly cites coordination with 
the World Health Organization (WHO). 
 
9.  The MOH has announced it will continue its annual flu 
vaccine program in 2005.  The MOH plans to purchase the H5N1 
vaccine when it becomes available.  Currently, 1.75 million 
Chileans receive a flu shot every year.  The MOH hopes to 
expand the number of recipients in 2005 by also inoculating 
very old and very young citizens. 
 
10.  The GOC has prepared a list of vaccines and 
pharmaceutical companies that currently distribute in Chile: 
 
     - Vaxigrip (Aventis Pasteur) 
     - Fluarix (Glaxo Smith Kline) 
     - Influvac (Solvay) 
     - Agrippal S1 (Chiron) 
     - Inflexal V (Berna) 
 
The MOH estimates that these vaccines cost between USD $9 and 
$16 per patient. 
 
11.  Recent press coverage has raised general awareness in 
Chile of global AI concerns.  Contacts report that most 
Chileans trust their government to handle this issue in a 
proper manner.  The GOC has made communication with the 
public a key part of their response plan in the event of an 
outbreak of AI in humans. 
 
---------------------- 
Surveillance/Detection 
---------------------- 
 
12.  The Institute for Public Health (ISP) will be the main 
point of contact for AI detection in Chile.  It works with a 
network of 16 public hospitals throughout the country to 
identify cases of AI and to isolate infected persons in 
special wards.  A hospital in Santiago (Hospital de Torax) 
will serve as the hub in the case of a widespread outbreak 
among humans.  In order to implement their AI contingency 
plans, the ISP has asked the GOC for an additional USD $3.2 
million for lab personnel.  This request is still pending. 
The ISP states it will turn to the WHO if the crisis produces 
a lack of manpower.  This is an area in which the USG could 
contribute to the GOC's preparations for AI. 
 
----------- 
Containment 
----------- 
 
13. The GOC plans to contain the spread of the disease by 
restricting international points of entry should AI affect 
humans on a large scale.  Internal controls would include the 
cancellation of classes, a restriction on large public 
events, and a restriction on non-essential work functions. 
 
14. The GOC's plan also refers to the widespread distribution 
of protective gear in the event of an outbreak.  Unlike SAG, 
the MOH does not appear to have enough supplies or resources 
on-hand to meet this need.  This is another potential area in 
which the USG could provide support. 
 
YAMAUCHI