VZCZCXRO5619
RR RUEHAST RUEHDH RUEHHM RUEHLN RUEHMA RUEHPB RUEHPOD RUEHSL RUEHTM
RUEHTRO
DE RUEHBR #0871/01 1941038
ZNR UUUUU ZZH
R 131038Z JUL 09
FM AMEMBASSY BRASILIA
TO RUEHC/SECSTATE WASHDC 4674
INFO RUEHSO/AMCONSUL SAO PAULO 4303
RUEHRI/AMCONSUL RIO DE JANEIRO 7985
RUEHRG/AMCONSUL RECIFE 9734
RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE
RUEHGV/USMISSION GENEVA 1592
RUEKJCS/SECDEF WASHINGTON DC
RUEHRC/USDA FAS WASHDC
RUEAUSA/DEPT OF HHS WASHDC
RUEAIIA/CIA WASHDC

UNCLAS SECTION 01 OF 02 BRASILIA 000871 
 
DEPT FOR OES/IHB AMBASSADOR LOFTIS 
DEPT FOR WHA/BSC 
USDA PASS TO APHIS 
HHS PASS TO CDC 
HHS FOR OGHA 
 
SENSITIVE 
 
SIPDIS 
 
E.O. 12958: N/A 
TAGS: TBIO KFLU CASC AEMR AMED ASEC KSAF PREL PINR AMGT
KFLO, KPAO, TF, BR 
SUBJECT: H1N1 INFLUENZA OUTBREAK AND BRAZIL:  SITREP #17 
 
BRASILIA 00000871  001.2 OF 002 
 
 
(U) THIS MESSAGE IS SENSITIVE BUT UNCLASSIFIED AND NOT FOR INTERNET 
DISTRIBUTION.  PLEASE HANDLE ACCORDINGLY. 
¶1.  (SBU) This report provides an update on developments in Brazil 
regarding the H1N1 flu outbreak. 
 
NOTEWORTHY DEVELOPMENTS: 
 
- REPORTED CASES: 
 
¶2.  (SBU) As of July 10, 2009 the Brazilian Ministry of Health has 
confirmed 977 cases of the H1N1 virus spread throughout 25 of the 
country's 26 states and the Federal District: Sao Paulo (444 cases), 
Rio de Janeiro (102 cases), Santa Catarina (56 cases), Mato Grosso 
(5 cases), Minas Gerais (90 cases), Tocantins (5 cases), Rio Grande 
do Sul (118 cases), Alagoas (5 cases), Bahia (11 cases), Ceara (6 
cases), Federal District (31 cases), Espirito Santo (11 cases), 
Goias (10 cases), Maranhao (4 cases), Parana (37 cases), Paraiba (5 
cases),Para (2 cases),Amapa (1 case), Acre (1 case) Amazonas (1 
case), Pernambuco (14 cases), Rio Grande do Norte (3 cases), Mato 
Grosso do Sul (4 cases), Piaui (5 cases), Sergipe (5 cases).  Of the 
977 confirmed cases, 563 (or 57.6%) were contracted internationally, 
and 278 (or 28.5%) were contracted within Brazil. Of the cases 
contracted internationally, the Ministry of Health asserts that 
Argentina was the source for 359 of Brazil's cases, the United 
States of America was the source of 97 of the cases, and Chile was 
the source of 61 cases.  Further, 495 (or 50.7%) of the victims are 
women and 49.3% are men.  People younger than 25 years of age 
represented 50% of the cases.  In terms of severity of the disease, 
the Ministry of Health reports that 99.6% of the cases are light to 
moderate, and 0.4% are severe, and of these, only 1 case has 
resulted in death. There are currently 2973 suspected cases. 
 
¶3.  (SBU) Note:  Since July 3, the Ministry of Health has changed 
its procedures for confirming cases of H1N1 flu.  Previously, 
samples of individual biological material were used to confirm the 
presence of the virus in each individual patient.  Under the new 
procedure, when there is a laboratory confirmation of the H1N1 virus 
in one victim, any person with an epidemiological link to that 
person who exhibits symptoms of H1N1 will be considered infected. 
 
- BRAZILIAN GOVERNMENT'S RECENT ACTIONS: 
 
¶4.  (SBU) On July 6, 2009, the Ministry of Health released a report 
reinforcing the World Health Organization's recommendation that all 
health authorities and the whole clinical body maintain the secrecy 
of the suspected and confirmed H1N1 cases, in order to avoid social 
stigma and prevent a breach in doctor-patient confidentiality.  The 
Health Ministry also stresses that the flu transmission in Brazil is 
limited, without evidence of a sustained transmission from person to 
person, considering that all of these cases have an epidemiological 
link to imported cases.  There is an active search and monitoring of 
all the close contacts of this case. 
 
¶5.  (SBU) In schools, workplaces, prisons, and social 
establishments, epidemiological investigation officials may declare 
a suspension of activities if there is a discovery of an aggregation 
of H1N1 cases.  In such occasions, the health officials are supposed 
to take into consideration the number of victims, the 
characteristics of the location, and the number of at-risk citizens 
in the area.  It is also necessary to maintain the secrecy of 
confirmed cases and to avoid discriminatory conduct towards the 
infected.  The Ministry of Health, however, recommends avoiding 
unnecessary closure of these areas, in order to prevent panic within 
the population.  Furthermore, the Ministry of Health maintains that 
the use of protective masks is only effective in hospital locations, 
and does not have a significant impact in reducing the 
transmissibility of the H1N1 virus when used by the general 
community, except when indicated by the local health authority. 
 
¶6.  (SBU) In reference to travelers departing to H1N1 infected 
countries, the Ministry of Health has presented the following 
suggestions: all travelers to countries with H1N1 present should 
rigorously follow the recommendations of local health officials, 
avoid areas with large conglomerations of people, avoid contact with 
the sick, and immediately seek medical attention in case of illness, 
 
BRASILIA 00000871  002.2 OF 002 
 
 
being sure to report the history of their contact with the sick and 
the schedule of their trip to the country. 
 
¶7.  (SBU) In a report developed by Health Minister Jose Gomes 
Temporao on July 3, the Minister warns medical agencies to be wary 
of unnecessary use of antibiotics in patients, in order to reduce 
the potential resistance of the H1N1 virus towards these current 
treatments.  Minister Temporao further commented that the great 
majority of patients with H1N1 recover without any medical 
treatment. 
 
SOBEL