VZCZCXRO7331
OO RUEHMA RUEHPA
DE RUEHAR #1094/01 1361615
ZNR UUUUU ZZH
O 161615Z MAY 07
FM AMEMBASSY ACCRA
TO RUEHC/SECSTATE WASHDC IMMEDIATE 4454
INFO RUEHZK/ECOWAS COLLECTIVE

UNCLAS SECTION 01 OF 02 ACCRA 001094 
 
SIPDIS 
 
STATE FOR G/AIAG SUMMERS 
 
SENSATIVE 
AIDAC 
SIPDIS 
 
E.O. 12958:N/A 
TAGS: GH KFLU MARR MASS CASC
SUBJECT: AVIAN INFLUENZA (H5N1) OUTBREAK IN GHANA 
 
REF: ACCRA 00872 
 
 ACCRA 00986 
 ACCRA 00960 
 
¶1. (U) Summary:  Ghana confirmed its first case of H5N1 on April 28, 
¶2007.  Since then, the GoG has done a significant amount of work to 
manage and contain the epidemic.  To date there are four confirmed 
outbreak locations, all in Tema municipality (approximately 20-25 km 
east of Accra).  No human cases have been reported. The government 
of Ghana veterinary services, with the support of USAID, has been 
carrying out active surveillance to identify infected birds as well 
as carrying out culling and decontamination efforts when infected 
birds have been identified. 
End summary. 
 
Identifying the problem 
----------------------- 
 
¶2. (U) Two adjacent poultry farms in Tema were affected.  Deaths of 
chickens were first noticed o/a April 14, 2007; samples from the 
index farm cluster ("farm 1") tested positive for H5N1 at a U.S. 
Navy supported local lab (Noguchi Research Institute) on April 28 
and were confirmed at NAMRU-3 (Naval Medical Research Unit), a WHO 
world reference lab in Cairo on May 2.  Chickens from two adjacent 
farms ("farms 2 and 3") tested positive for H5N1 on May 3 and May 8. 
 The fourth farm was identified and tested positive for H5N1 on May 
¶10.  The GoG publically announced the outbreak on My 2. 
 
¶3. (U) The manner in which the virus was introduced to Ghana is not 
clear.  Nor has any clear link yet been established between the 
first two farm clusters, which lie more than 9 km apart.  Tema is 
not only a port, but is also the crossroads of several major 
East-West and North-South land routes.  The Tema area is also an 
important landing site for migratory birds from Europe, Asia and 
coastal regions of West Africa.  An initial evaluation of the Ghana 
strain of virus at the NAMRU lab in Cairo suggests that the Ghana 
virus is similar to strains that were found in recent outbreaks in 
the neighboring countries of Cote d'Ivoire, Burkina Faso and 
Nigeria.  The analysis, which is ongoing, also suggests the virus is 
closely linked to strains of H5N1 found in Germany and Siberia. 
 
The Response 
------------ 
 
¶4. (U) The Ghana veterinary service has mounted a vigorous response 
effort, in collaboration with the Ghana Health Service (GHS), 
Ministry of Interior and other government agencies, USAID, NAMRU, 
WHO, and FAO.  The national Avian Influenza Task Force is 
coordinating the response following the framework of the national 
preparedness and response plan that was finalized in 2006 with USAID 
support. 
 
¶5.  (U) Following reports of high numbers of bird deaths on these 
farms, 1,823 birds on farm 1 and approximately 10,300 birds on farms 
2 and 3 were destroyed.  Close to 400 birds were destroyed on farm 
¶4.  To date, 69 other area farms have been evaluated for reports of 
sick and dying birds, and the appropriate clinical and laboratory 
evaluations have been undertaken.  None of these other farms have 
tested positive for avian flu, although about half of these lab 
tests are still being run. 
 
¶6.  (U) The GoG has imposed a ban on the movement and sales of 
poultry in the Tema area, although enforcement capacity is limited. 
On each affected farm, birds are known to have been sold off between 
the time rapid die-off began and the 
time vet services destroyed all remaining birds.  The GHS is 
monitoring workers on the affected farms and has sensitized local 
health care workers.  Tamiflu has been stockpiled by the GoG, and 
other efforts to improve readiness for possible future human cases 
of avian flu are underway. 
 
¶7.  (U) A USG team consisting of USAID, CDC, and NAMRU personnel has 
made numerous direct observations of the veterinary and human 
surveillance and disinfection operations in the field area. 
Technical assistance and commodity support have been provided, and a 
set of recommendations developed.  Based on these recommendations, 
USAID is providing an initial $200,000 in emergency support funds to 
the GoG.  The avian influenza unit at USAID has already provided 
4,450 personal protection equipment (PPE) kits, 45 decontaminate 
sprayer kits and two lab sampling kits, all housed at vet services. 
USAID will also be providing a veterinary/epidemiologist to assist 
in this effort.  CDC and WHO will provide ongoing technical 
assistance to support the human health side. 
 
Comment 
------- 
¶8.  (SBU) The outbreak has tested the past year and a half of 
USG-supported training, capacity building and preparation.  Overall, 
the Government response has been good, with the veterinary services 
 
ACCRA 00001094  002 OF 002 
 
 
clearly ahead of the human health side.  Reports of new bird 
die-offs and positive lab results continue every 2-3 days, with no 
end in sight yet.  Stricter enforcement of restrictions on bird 
movements in/out of affected areas will be crucial for containment. 
There is mounting concern over the lack of transparency regarding 
compensation of farmers for culled birds.  While the Ministry of 
Agriculture states that a compensation plan exists (this plan will 
only cover 60-90% of the costs), no farmers have been paid to date. 
 
¶9.  (U) Since this outbreak is for the time being confined to birds, 
the greatest impact will be economic.  Mass cullings will exact an 
economic toll, but the greatest impact will result if consumers 
refuse to purchase poultry products on a large scale.  The media and 
public were sensitized to AI issues in 2005-06 and have responded 
calmly so far.  USAID is supporting a communications campaign 
targeted at poultry farmers, traders, veterinarians, and health 
workers.  Some messaging for the public has gone out on radio and 
print media and this would be broadened if the outbreak spreads. 
 
¶10.  (SBU) Preparedness for identification of a human case and for 
case management is weak.  An assessment team consisting of 
representatives of the GHS (Institutional Care) and the CDC 
evaluated the local hospitals and found that the only available 
facility with the capacity (after some minor modifications) to 
manage an isolation room is the Military 37 Hospital in Accra. 
Additional help would have to be provided to improve the hospital's 
referral system. 
 
¶11.  (U) USAID and NAMRU will continue to work on the ground to help 
monitor and manage the situation.  With additional resources and 
technical assistance, the response in Ghana on the veterinary side 
may prove to be a model for the rest of Africa. 
 
CHEEMA