VZCZCXRO6102
RR RUEHAG RUEHAST RUEHDF RUEHDH RUEHHM RUEHLN RUEHLZ RUEHMA RUEHPB
RUEHPOD RUEHTM RUEHTRO
DE RUEHRL #0512/01 1250555
ZNR UUUUU ZZH
R 050555Z MAY 09
FM AMEMBASSY BERLIN
TO RUEHC/SECSTATE WASHDC 3992
INFO RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE
RUCNFRG/FRG COLLECTIVE
RUEHME/AMEMBASSY MEXICO 0330
RUEHFT/AMCONSUL FRANKFURT 7970
RUEHRC/DEPT OF AGRICULTURE USD FAS WASHINGTON DC 0102
RUEAUSA/DEPT OF HHS WASHINGTON DC
RUEKJCS/SECDEF WASHINGTON DC
RUCNDT/USMISSION USUN NEW YORK 0720
RUEHGV/USMISSION GENEVA 1454

UNCLAS SECTION 01 OF 02 BERLIN 000512 
 
SENSITIVE 
SIPDIS 
 
STATE FOR EUR/CE PETER SCHROEDER 
STATE FOR OES/IHB 
STATE FOR AID/GH/HIDN 
USDA PASS TO APHIS 
HHS PASS TO CDC 
HHS FOR OGHA 
 
 
E.O. 12958: N/A 
TAGS: TBIO KFLU ECON PREL SOCI CASC EAGR MX GM
SUBJECT: GERMANY H1N1 FLU UPDATE: 8 CONFIRMED, FIRST HUMAN-TO- 
HUMAN INFECTION 
 
REF: A) Berlin 488, B) Berlin 495, C) SECSTATE 44808 
 
¶1. (SBU) SUMMARY: The Robert Koch Institute (RKI) confirmed 
five new cases of A/H1N1 Influenza in Germany over the 
weekend, increasing the total number of confirmed cases to 
eight.  One man from Bavaria and a couple from Brandenburg 
tested positive for H1N1 after returning from Mexico with flu- 
like symptoms.  Local media also reported Germany's first 
human-to-human infection of H1N1.  A nurse and a fellow 
patient from Bavaria (neither of whom had been to Mexico) had 
become infected with the A/H1N1 virus after having contact 
with a patient hospitalized and confirmed to have H1N1 last 
week. The German government added H1N1 to its list of 
mandatory illnesses that doctors must report to health 
authorities if they suspect a patient to be infected.  END 
SUMMARY. 
 
 
New Cases of H1N1 
----------------- 
 
¶2. (SBU) In addition to the three confirmed H1N1 cases 
reported in Ref B, German health authorities have confirmed 
five additional cases of H1N1 -- increasing the country's 
total number to eight.  Health authorities are monitoring 
thirty suspicious cases. 
 
¶3. (SBU) One young man from Bavaria and a couple from 
Brandenburg tested positive for H1N1 after returning from 
Mexico with flu-like symptoms.  No further details were given 
about the man.  The couple from Brandenburg -- a 54 year old 
woman and her 58 year old husband -- was on the same flight as 
a 20 year old female from Hamburg who tested positive for H1N1 
and was hospitalized last week (Ref B).  It is not clear if 
the couple was exposed to the virus in Mexico or if they 
contracted it during the flight, though media report that 
hospital officials suspect that the wife was infected first 
through contact with the female from Hamburg and later 
infected her husband. Health officials said that in the case 
of the couple the course of disease is mild and that patients 
are recovering quickly. 
 
 
Human-to-Human Infection 
------------------------ 
 
¶4. (SBU) German health authorities have confirmed the first 
human-to-human transmission of the virus in Germany.  Bavarian 
Health Ministry officials reported on April 30 that a 42 year 
old nurse had been infected with the virus, but had not been 
in Mexico.  The woman was a nurse treating a 37 year old 
Bavarian patient already known to have the virus (Ref B).  The 
woman has already recovered, according to the Bavarian Health 
Ministry.  The same infected patient also passed the virus on 
to a 38 year old Bavarian fellow patient, whom health 
authorities confirmed had the virus on May 1, despite not 
having traveled to Mexico.  Health officials also suspect that 
Germany's earliest confirmed case, a woman from Hamburg, 
passed the virus on to another woman, who later infected her 
husband, though this has not been confirmed. 
 
 
German Reactions 
---------------- 
 
¶5. (U) Media report that German air carrier Lufthansa, which 
flies to and from Mexico daily, has placed a staff physician 
on every flight there to answer passenger questions and 
identify flu symptoms in flight. 
 
 
Reported Tamiflu Shortage 
------------------------- 
 
 
BERLIN 00000512  002 OF 002 
 
 
¶6. (SBU) German weekly Der Spiegel reported that several 
German states ("Laender") do not hold sufficient stocks of 
Tamiflu (See also Ref C).  Contacts at the Health Ministry 
informed post that the majority of the states had at least 
enough Tamiflu to treat twenty percent of their populations, 
in accordance with guidance from WHO and RKI.  The states not 
holding enough Tamiflu to cover twenty percent of their 
populations have ordered additional stocks of antiviral drugs. 
 
 
Mandatory Reporting to Health Authorities 
----------------------------------------- 
 
¶7. (SBU) On Sunday, Germany added H1N1 to its list of 
illnesses requiring mandatory reporting by doctors to health 
authorities if they suspect a patient to be infected.  Others 
on the list include botulism, cholera, diphtheria, and 
rabies. Before this action, doctors were only required to 
report suspected H1N1 cases to the laboratories; now they must 
report suspicious cases directly to the health authorities. 
 
KOENIG