VZCZCXRO3545
PP RUEHDBU
DE RUEHKB #0265/01 0611420
ZNY CCCCC ZZH
P 021420Z MAR 07
FM AMEMBASSY BAKU
TO RUEHC/SECSTATE WASHDC PRIORITY 2506
INFO RUCNCIS/CIS COLLECTIVE PRIORITY
RUEHAK/AMEMBASSY ANKARA PRIORITY 2029
RUEHRO/AMEMBASSY ROME PRIORITY 0251
RUEHPH/CDC ATLANTA GA PRIORITY
RHMFISS/CDR USEUCOM VAIHINGEN GE PRIORITY
RUEHGV/USMISSION GENEVA SZ PRIORITY 0257
RUEASWA/DTRA ALEX WASHDC PRIORITY

C O N F I D E N T I A L SECTION 01 OF 02 BAKU 000265 
 
SIPDIS 
 
SIPDIS 
 
USDA FOR OSCE/DAN CAINE, FAS FOR OSTA/MACKE, WRIGHT, LEIER, 
ROSENBLUM; OCRA/THOMAS, FLEMINGS; OA/PATRICK CLERKIN 
 
E.O. 12958: DECL: 01/01/2026 
TAGS: ECON KFLU EAGR USDA PGOV KTIA TBIO CASC AJ
SUBJECT: AZERBAIJAN: THE DEVELOPMENT AND EXERCISING OF 
AVIAN AND PANDEMIC FLU RESPONSE PLANS 
 
REF: STATE 22991 
 
¶1.  (C) SUMMARY: Embassy submits the following Avian 
Influenza (AI) update.  We will ascertain the status of the 
GOAJ's AI/PI response plan with the relevant GOAJ officials 
next week (reftel).  On March 2, Econoff met with Dr. Roberta 
Andraghetti (Medical Officer, Epidemic Preparedness and 
Response),World Health Organization.  Andragehtti, who is 
posted at the WHO offices in Geneva and Copenhagen, was 
visiting Baku this week.  Andragehtti said there has been 
great progress in Azerbaijan on Avian flu testing on the 
human side, and she was complimentary toward to Ministry of 
Health (MoH).  The Azerbaijani State Veterinary Service 
(SVS), however, continues to present perhaps the biggest 
danger to the effective monitoring and combating of AI at its 
early stages. END SUMMARY. 
 
¶2. (U)  In a March 2 conversation with Econoff, World Health 
Organization (WHO) Medical Officer, Epidemic Preparedness and 
Response Dr. Roberta Andraghetti, said that the MoH had made 
"great improvements" in the last year, and that they are 
working hand-in-hand with the WHO and the shipping company 
"Dangerous Goods Management" (DGM) to get human samples out 
for testing in a timely manner.  Andraghetti estimated that 
from the time a sample is taken, the MoH can have it out of 
Azerbaijan "within 48 hours" to the Millhill laboratory in 
England.  Millhill was then able to turn around results in a 
few hours.  The problem continues to lie "on the periphery" 
in which local doctors' assessments and treatments are not 
aggressive enough, and are bogged down in bureaucratic 
paperwork, and local doctors continue to misdiagnose and 
mistreat symptoms.  While the MoH has greatly enhanced its 
capacity to get samples out for testing, they samples they 
are often receiving are frequently not the correct sample 
types for the stage of the disease.  She estimated that that 
this is because diganosis is not taking place quickly enough 
at the local level. 
 
NAFCALA CASE 
------------ 
 
¶3. (SBU)  One example of this problem is a case from early 
2007, a woman from Nafcala, Azerbaijan, who died on February 
¶6.  The woman sought medical attention locally, and then she 
was given out patient-treatment for bursalitis and bacterial 
pneumonia.  After two weeks of not feeling better, the woman, 
on her own initiative, went to the Baku lung hospital, where 
she checked herself in.  At the lung hospital in Baku, the 
woman revealed that she had been, in fact, handling dead 
poultry but that she had not been asked this question by the 
doctors in Neftcala.  The Baku doctors then began treating 
her for possible AI, but she died shortly thereafter. 
Additionally, the area where the woman had lived had 
experienced a bird die-off, through such a die-off had been 
denied by local officials. 
 
¶4. (SBU)  Throat and upper respitory samples were taken 
post-mortem.  Andraghetti estimated that it had been 
approximately three weeks after the woman initially showed 
symptoms, and estimated that to get the most accurate tests 
that samples need to be taken no longer than 7-9 days after 
the virus is acquired.  If a longer time has elapsed, as in 
this case, samples then need to be taken from the lung.  Dr. 
Andragehtti said that most families are not willing to do 
this and that therefore it is usually impossible to get an 
accurate readout from throat/upper respiratory samples 
post-mortem.  The results from Millhill indicated a "weakly 
positive" test, and on the basis of this result, it was not 
possible to determine definitively if the woman had AI. 
 
BUREAUCRATIC HURDLES REMAIN 
--------------------------- 
 
¶5. (C)  Andraghetti said that the MoH engages in surveillance 
in areas where there are suspected outbreaks, however, she 
did not know how this worked in practice, and she had not 
been in the field in Azerbaijan on this trip.  According to 
Andraghetti, the doctor of any flu patient is required to 
fill out three pages of paperwork and send it to Baku for 
review.  The paperwork apparently does not ask specific 
questions which would more quickly identify if an individual 
may have been exposed to Avian Influenza.  For example, there 
 
BAKU 00000265  002 OF 002 
 
 
is no assessment in the questionnaire about handling dead 
birds or if there have been bird dieoffs in the region. 
Therefore the "one real case of AI could be buried in a case 
of 20 regular flu cases."  Andraghetti said that while it was 
nice to have a baseline of flu statistics, this bureaucratic 
process did nothing trigger an "early warning" of AI. 
 
¶6. (C)  Andragehtti said that the MoH has been "fantastic" 
and that both Minister of Health Ogtay Shiraliyev and MoH 
head of Epidimology Viktor Gasimov "get it."  The SVS was 
another story.  They are unable to cooperate with the MoH, 
and they also are unwilling or unable to conduct accurate 
tests and surveillance.  There is very little transparency, 
and Andragehtti was befuddled as to what to do about the SVS. 
 ECONOFF noted that the systemic and personnel problems with 
the SVS are the same as they were in late 2005. 
DERSE