VZCZCXYZ0007
RR RUEHWEB

DE RUEHDJ #0615/01 1431338
ZNR UUUUU ZZH
R 231338Z MAY 06
FM AMEMBASSY DJIBOUTI
TO RUEHC/SECSTATE WASHDC 7236
INFO RUEHZO/AFRICAN UNION COLLECTIVE
RUEHDS/AMEMBASSY ADDIS ABABA 3307
RUEHAE/AMEMBASSY ASMARA 2082
RUEHEG/AMEMBASSY CAIRO 0114
RUEHKH/AMEMBASSY KHARTOUM 0086
RUEHLO/AMEMBASSY LONDON 0591
RUEHNR/AMEMBASSY NAIROBI 2939
RUEHFR/AMEMBASSY PARIS 0837
RUEHYN/AMEMBASSY SANAA 1518
RHPIGXW/CJTF HOA
RUEHGV/USMISSION GENEVA 0300

UNCLAS DJIBOUTI 000615 
 
SIPDIS 
CORRECTED COPY - CAPTION ADDED 
SENSITIVE 
SIPDIS 
 
LONDON, PARIS FOR AFRICA WATCHER 
 
ADDIS AND ASMARA FOR CONSULAR SECTION 
 
E.O. 12958: N/A 
TAGS: AMED CASC TBIO KFLU EAID EAGR DJ
SUBJECT: UPDATE 2: AVIAN INFLUENZA IN DJIBOUTI 
 
REF: DJIBOUTI 564 
 
DJIBOUTI 578 
 
¶1. (U) Summary.  Since our last update, very little new information 
has been confirmed.  In reftel we referred to a confirmed case in an 
eight-year-old girl.  Since then we have learned that the child in 
question was only two-years-old.  She has since recovered nicely. 
We believe she may be one of the youngest survivors of H5N1 to 
recover without Tamiflu being administered within the first 48 
hours of symptom onset.  Two of her siblings and her health-care 
provider have fallen ill and samples from the three individuals 
were sent to NAMRU-3 in Cairo for testing, as well a sick chicken 
that the family owned.  All returned negative.  It is still not clear 
how the two-year-old girl became infected.  The Government of 
Djibouti (GoD) was offering daily briefings at the Ministry of 
Health.  These briefings have been canceled until further notice 
because of the lack of results in carrying out activities that are 
planned during these meetings, in particular the culling of chickens 
in the capital. End Summary. 
 
What Djibouti is doing: 
---------------------------- 
¶2. (U) When H5N1 was confirmed in a person in Damerjog, the 
GoD announced that all chickens in the Damerjog area should be 
culled and that bird owners would be recompensed for their loss. 
The GoD sent representatives to Damerjog, to initiate the culling, 
but when the birds were presented they announced the 
compensation would be given at a later (undetermined) date.  Most 
bird owners took their chickens and left the area.  The GoD has 
since been trying to cull chickens in Damerjog but no official 
reports have been released with details of results. 
 
¶3. (U) Comment.  This policy has the potential to bring together 
infected and uninfected birds in one area, as upon finding they will 
not be paid, the owners return them to their homes, possibly having 
cross-contaminated previously healthy birds.  However, the 26 
samples that were collected all tested negative in tests performed 
locally in the French Military hospital and official confirmation 
will come from NAMRU-3. 
 
¶4. (U) At the urging of USAID, the World Health Organization 
(WHO) and the French military the Ministry of Agriculture 
announced through a communique, on May 21 that it would soon 
begin culling operations in the capital, but needed full cooperation 
of the population in order to succeed. The communique, did not 
provide details such as date or methodology for carrying out this 
operation. 
 
What the French are doing: 
-------------------------------- 
¶5. (U) The French military hospital has the capability to test to 
identify H5N1 in both birds and people.  The hospital does not 
have a level-3 approved laboratory, so samples with positive 
findings are sent to Cairo to be confirmed by NAMRU-3.    The 
French also provided Tamiflu to Djiboutian health officials to 
administer to the three patients that had been awaiting test results 
as well as the index case of the two year old. 
 
¶6. (SBU) Reportedly the French military got fed up with the daily 
Djiboutian briefing at the Ministry of Health after indications that 
the GoD was doing little and providing no new information.  The 
French announced that they would attend no more meetings until 
the GoD or WHO had something to report.  The meetings have 
therefore been suspended until further notice. 
 
¶7. (U) ConOff also met with representatives from the French 
Consulate to share information about the situation in Djibouti.  The 
French representatives seemed poorly informed, and hungry for 
reliable information.  Comment:  USAID representative has heard 
doubts expressed by the French that Avian Flu really exists in 
Djibouti. End Comment. 
 
What the U.S. is doing: 
--------------------------- 
¶8. (U) USAID and Embassy representatives attended the daily 
briefings until they were suspended.  We continue to communicate 
one on one with our immediate counterparts in the French 
embassy/consulate and with local WHO representatives. Also, 
USAID is working with WHO to develop the communication plan 
which WHO will execute. USAID will provide $50,000 in funding 
to WHO to support this activity which includes production of print 
and television/radio materials as well as dissemination of these 
materials, technical support and general awareness-raising in the 
population. USAID is also providing Personal Protective 
Equipment (PPE) to GoD and US Military, having distributed 50 
sets thus far. Fifty more have arrived and another 2000 are on the 
way as well as two lab specimen kits and one decontamination kit. 
USAID/Washington has said that it could make available up to 
another $100,000 as needed. 
 
¶9. (U) The U.S. military sent several medical personnel to the area 
of Damerjog to look for and sample sick people.  However, they 
expected the Ministry of Agriculture to be sampling chickens. 
When it became clear that the Ministry was not, the U.S. medical 
personnel attempted to locate chickens and test them.  The military 
considered it essential to identify the source or the infected child' 
illness.  If H5N1 cannot be traced to a chicken with which the girl 
had direct contact, new questions are raised.  As yet, all fowl 
samples from that area have tested negative, and the source has not 
been definitively identified. 
 
¶10. (U) On May 14 ConOff held a Warden Meeting. It was well 
attended, with all but one Warden appearing.  USAID rep for 
health issues presented what we know about AI in Djibouti, as well 
as basic information about the virus, and how to protect oneself. 
Information pamphlets were distributed.  On May 17 Ambassador 
held a Town Hall meeting in which CJTF-HOA and USAID 
participated.  This meeting was poorly attended by AmCits, but 
several called ahead of time to inquire as to the content of the 
meeting, so we are confident the message got out through 
Wardens.  Contact with several AmCits after the Town Hall 
confirmed that they were aware, but did not feel sufficient anxiety 
over H5N1 to warrant attending the meeting.  However, the 
meeting was attended by several non-AmCits who wanted to know 
what information we had to share (specifically: the panel 
physician, a CDC representative and the French Consulate.) 
 
¶11. (U) Embassy Djibouti will continue to transmit to Washington 
and the American community information as it becomes available. 
RAGSDALE