This record is a partial extract of the original cable. The full text of the original cable is not available.

UNCLAS SECTION 01 OF 02 VILNIUS 001239 
 
SIPDIS 
 
SENSITIVE 
 
DEPT FOR OES DSINGER AND RDALEY 
 
E.O. 12958: N/A 
TAGS: TBIO SENV ECON EAGR EAID PREL LT
SUBJECT: LITHUANIA READY ON PAPER TO COUNTER AVIAN 
INFLUENZA THREAT 
 
REF: SECSTATE 209622 
 
¶1. (SBU) SUMMARY:  The GOL has plans in place to manage a 
possible outbreak of avian influenza or human pandemic 
influenza.  An outbreak of extremely virulent human pandemic 
influenza would undoubtedly strain Lithuania's capabilities, 
but the GOL likely would report its situation truthfully and 
seek assistance from both its allies and international 
organizations.  Lithuania has the technical means to detect 
any outbreak rapidly, and we expect that it would use both 
police and the military to effectively enforce a quarantine 
if the situation required. 
 
PREPAREDNESS/COMMUNICATION 
 
¶2. (SBU) The GOL's Ministry of Health (MOH) has an "Influenza 
Pandemic Preparedness Plan," and the State Food and 
Veterinary Service (SFVS) has an "Avian Influenza and 
Newcastle Disease Contingency Plan."  Localities and other 
ministries also have plans, but the MOH and SFVS plans are 
the most important.  We will send a copy of these plans via 
e-mail to the POCs listed in reftel.  We have no reason to 
doubt that the GOL will implement these plans if avian or 
pandemic influenza occurs in Lithuania.  An outbreak would 
likely strain Lithuania's resources and the GOL likely would 
seek support from the EU and possibly from the USG. 
 
¶3. (SBU) We expect that the GOL would report truthfully the 
scope of any disease outbreak among people or animals.  The 
GOL has promised to compensate farmers for losses if their 
flocks need to be culled, and we expect that farmers will be 
cooperative if an outbreak occurs in Lithuania. 
 
¶4. (SBU) Preparing for avian or pandemic human influenza is a 
high priority for the MOH and the State Food and Veterinary 
Service, but it is not among the GOL's most pressing issues 
at present.  Foreign Minister Valionis, Prime Minister 
Brazauskas, or President Adamkus would be able to raise the 
profile of this issue in Lithuania, but we would recommend 
working with Lithuania's capable Health Minister, Zilvinas 
Padaiga, first. 
 
¶5. (SBU) The Director of the SFVS told us that he is working 
closely with EU officials and that the GOL has implemented 
all detection, containment, and reporting guidelines 
recommended by the EU. 
 
¶6. (SBU) The MOH's "Influenza Pandemic Preparedness Plan" 
spells out the GOL's intention to cooperate with both the EU 
and WHO.  We would not expect the GOL to ask for assistance 
unless there would be an outbreak in Lithuania large enough 
to strain local resources or if there were an outbreak 
elsewhere that demonstrated clearly that the influenza was 
poised to become a major world catastrophe.  The GOL would 
likely turn first to the EU, but GOL leaders would also 
welcome approaches from the USG in either a bilateral or 
multilateral setting. 
 
¶7. (SBU) Annual flu shot are available in Lithuania, and an 
increasing number of Lithuanians get them, presumably in 
response to the MOH's public encouragements.  Many 
Lithuanians, however, still do not routinely get flu shots. 
Lithuania produces no flu vaccine and is not developing an 
H5N1 vaccine.  In general, foreign makers or donors of 
vaccines would not enjoy a liability shield.  The Director 
General of the MOH's Drug Control Agency told us, however, 
that this is a very complicated issue and is difficult to 
address as a hypothetical situation.  He offered to make his 
agency's lawyers available to us if we wanted to ask more 
detailed questions on liability. 
 
¶8. (SBU) The GOL health and veterinary establishment is very 
well informed about avian influenza.  Among the general 
public, however, awareness is quite low.  The GOL is taking 
steps to raise awareness among farmers, particularly poultry 
farmers.  The MOH updates every two weeks its strategic plan 
for distributing information about avian influenza.  As 
outlined in this plan, the MOH uses mass media, public 
conferences, and networks of healthcare professionals to 
raise public awareness of avian influenza. 
 
SURVEILLANCE/DETECTION 
 
¶9. (SBU) The medical and agricultural sectors are capable of 
rapidly diagnosing a new strain of influenza among people or 
animals.  The SFVS told us that if it positively diagnosed a 
new strain of influenza, it would send the sample to an EU 
reference laboratory in the UK for a final diagnosis. 
Lithuania does not have the capability to subtype viruses. 
 
¶10. (SBU) Lithuania still has not acquired an adequate supply 
of Tamiflu (see para 11).  In addition, the GOL may be unable 
to communicate quickly with outlying regions in the event of 
a rapidly occurring outbreak.  Many residents of these rural 
regions tend to be poor, and may not have televisions or 
radios, the media of choice for communicating the GOL's 
messages. 
 
RESPONSE/CONTAINMENT 
 
¶11. (SBU) Lithuania has a stockpile of most medicines, but it 
does not yet have Tamiflu.  The MOH's Health Emergency 
Situation Center (HECS) told us that it ordered enough 
Tamiflu to service 30 percent of Lithuania's population of 
3.4 million and that it expects these drugs to arrive by 
"early next year." 
 
¶12. (SBU) HECS told us that Lithuania has a stockpile of 
prepositioned personal protective gear. 
 
¶13. (SBU) Lithuania has the capability to respond rapidly to 
either human or animal outbreaks.  The SFVS action plan 
contains the guidelines for culling/vaccination of birds, 
disinfection of facilities, and limitations on animal 
movement. 
 
¶14. (SBU) The GOL has in the past quarantined hospitals where 
outbreaks of infectious diseases occurred, but it has never 
had to deal with an epidemiological situation as complicated 
as pandemic influenza would be.  The SFVS action plan, 
consistent with EU requirements, calls for establishing a 
"protection zone" within a radius of 3 km of an outbreak. 
The GOL, using both the police and the military, would 
restrict or prohibit the movement of people, transport, and 
animals to and from this zone.  Although the GOL has never 
had to employ these kinds of resources in response to a 
health crisis, it has used both the police and military 
successfully to restrict movements to and from areas hit by 
flooding.  In a crisis situation, the GOL's Civil Defense 
Agency would take the lead role in coordinating all of the 
agencies involved. 
 
COMMENT 
 
¶15. (SBU) Lithuania has taken many reasonable steps to 
mitigate the threat posed by avian influenza and a possible 
human influenza pandemic.  While the issue does not yet raise 
tremendous concern among the general public, the GOL takes 
the threat seriously and is responding accordingly. 
KELLY