VZCZCXYZ0007
RR RUEHWEB

DE RUEHBU #0778/01 1871141
ZNR UUUUU ZZH
R 061141Z JUL 09
FM AMEMBASSY BUENOS AIRES
TO RUEHC/SECSTATE WASHDC 3991
INFO RUCNMER/MERCOSUR COLLECTIVE
RUEAUSA/DEPT OF HHS WASHINGTON DC

UNCLAS BUENOS AIRES 000778 
 
SIPDIS 
 
DEPT FOR OES/IHB - P. MURPHY AND D. WILUSZ 
 
E.O. 12958: N/A 
TAGS: TBIO SOCI PGOV PREL AMED ELAB AR
 
SUBJECT: H1N1: ARGENTINA DECLINES TO DECLARE H1N1 EMERGENCY--FOR 
NOW 
 
REF: BUENOS AIRES 0752 
 
¶1.  SUMMARY:  The death toll in Argentina attributed to H1N1 
influenza has reached 55.  In the midst of this crisis, the 
Government of Argentina (GOA) has appointed a new Minister with 
extensive public health experience (reftel).  Although the new 
Minister declined to declare a national health emergency, numerous 
provinces have done so, and local governments are looking for local 
solutions.  The GOA has liberalized its policy on influenza 
treatment and offered their stock of oseltamivir to public and 
private health care providers.  Both the Centers for Disease Control 
and the Pan American Health Organization are working with the 
Ministry of Health (MOH) to develop a methodology to provide more 
reliable information.  Indications are that the MOH will take 
additional measures next week.  END SUMMARY. 
 
----------------- 
OFFICIAL NUMBERS 
---------------- 
 
¶2.  As of June 28, Argentina's Ministry of Health (MOH) reported 
1804 confirmed cases of H1N1 out of 3632 samples tested from suspect 
cases (49.7% positive); they reported an additional 967 suspected 
cases with testing still pending, and 55 confirmed deaths.  There 
are 46 additional deaths under investigation.  Of note, of the 
confirmed deaths where information is available, 27 out of 32 had 
underlying high risk conditions.  The median age of the deaths was 
28 years.  The median age of cases was younger.  There have been 
cases reported in most areas of the country, but up until now, most 
of the cases (over 1300) have been concentrated in Buenos Aires 
province and in the Capital District. 
 
----------------------------- 
HEALTH MINISTRY CHANGES HANDS 
----------------------------- 
¶3.  Minister of Health Graciela Ocana resigned the day after the 
legislative elections.  Her resignation came as no surprise.  It was 
in the works for a long time, and can be attributed to exhaustion 
fighting dengue, influenza, and labor leader Moyano (see Buenos 
Aires 0752).  Ocana had been under fire for the government's 
handling of the current influenza pandemic and the outbreak earlier 
this year of mosquito-borne dengue fever. Argentine media had 
reported that Ocana had recommended postponing midterm elections, 
but was overruled.  (Note: The elections took place Sunday, and many 
poll workers donned surgical masks). 
 
¶4.  The national H1N1 Crisis Committee met after Ocana's 
resignation.  President Cristina Fernandez de Kirchner, government 
officials and epidemiology experts decided not to declare a national 
health emergency.  In a press conference, the Chief of Cabinet 
Sergio Massa mentioned that no measures would be taken at that time 
"out of respect" to the incoming Minister of Health, Juan Luis 
Manzur, who was officially appointed on July 1.  (Note:  The 
minister was sworn in at the Casa Rosada, seat of the executive 
branch, in a room where some 500 government officials and guests had 
convened, ironically ignoring prior city and provincial 
proclamations recommending that people avoid public gatherings.) 
Juan Luis Manzur began his medical career as a surgeon, and has a 
Master's degree in Public Health.    Prior to his appointment, he 
had served as the Secretary of Health in the municipality of La 
Matanza and Deputy Minister of Health in the province of San Luis. 
As Minister of Health in the Province of Tucuman, he was credited 
with reducing infant mortality, refurbishing provincial hospitals, 
and creating primary care centers around the province.  He was until 
recently the Lieutenant Governor of Tucuman, and has summoned six 
trusted colleagues from Tucuman to assist him. 
 
----------------------------- 
Health Emergency Declarations 
----------------------------- 
¶5.  The Province of Buenos Aires declared an official health 
emergency on June 30, giving health authorities special powers to 
cut through red tape to buy medical supplies and pay for additional 
personnel.  The provincial Minister of Health, Claudio Zin, approved 
a measure July 2 to summon retired doctors and students of medicine 
in order to increase the number of health care providers.  The 
province also announced both an extension and an advanced start of 
the austral winter school recess.  It will start two weeks early on 
July 6, doubling from two to four weeks. 
 
¶6.  The City of Buenos Aires also declared an official health 
emergency on the same day and similarly changed school vacation 
dates.  Both the province and the city allowed public gathering 
places such as restaurants, shopping centers, public transportation 
and movie theaters to remain open, but advised against large 
gatherings to avoid contagion, particularly in the case of children 
during the extended winter holidays. 
 
¶7.  The new national Minister of Health, Juan Luis Manzur, in his 
first official statement on July 1, announced plans to boost public 
health spending by US$263 million.  He declined to declare a 
national health emergency, but announced that pregnant women and 
other at risk groups would be permitted to stay at home without 
losing pay for 15 days to avoid contracting influenza.  He 
recommended that schools around the country be closed for the next 
four weeks as the city and province of Buenos Aires has done. 
Seventeen provinces had already declared such measures.  (Note: In 
the absence of a declaration of national emergency, the Minister can 
only recommend the closing of schools, as they mostly fall under 
provincial governments.)  Manzur promised that if beds were lacking 
in public hospitals, the government would pay for hospitalization in 
private hospitals for those without insurance.  Although the 
national government has no current plans to shut down public 
buildings or transportation, he added that "we will continue 
monitoring day by day".  As of July 2, each of Argentina's 23 
provinces has moved their school holidays forward, and 12 of the 
provinces have declared a health emergency. 
 
------------------------------------- 
New Emphasis on Oseltamivir Treatment 
------------------------------------- 
 
¶8.  Chief of Cabinet Massa said that the national government would 
provide the public and private health care system antivirals such as 
oseltamivir (Tamiflu).  The medicine will also be provided to 
prophylax health care workers in contact with influenza patients. 
In addition, all patients suspected of being infected with H1N1 will 
be treated with oseltamivir.  Previously, oseltamivir was not 
administered until a patient exhibited serious symptoms.  According 
to the government, two million treatments of oseltamivir are 
available.  Critics claim that this would be insufficient if the 
situation worsens, and that distribution has been a serious problem. 
 The drug is still unavailable in local pharmacies.  Critics have 
suggested that Argentina has restricted prescribing oseltamivir 
because there was not enough available.  (Note: Chile has been 
administering oseltamivir in all suspected cases to contain the 
virus.  This might help to explain why their mortality rate is 
less.) 
 
--------------------------------------- 
Additional Measures by Local Governments 
---------------------------------------- 
 
¶9.  In addition to the limited prevention measures taken by the 
national government, reports are starting to trickle in of various 
local governments and institutions shutting down their 
administrative offices.  The province of Santa Fe has even delayed 
until August 9 local primary elections that had been scheduled for 
July 5.  Some public and private universities have extended their 
winter holidays, the Supreme Court has moved their winter break 
forward, and some theatres have decided to shut down temporarily and 
reschedule their planned shows for the month of August.  President 
Kirchner will present a special program "Learn at Home" for children 
to study during the winter holidays.  Employees from the Province of 
Buenos Aires with children of 14 or less can request special leave 
to take care of their children.  Changes have been implemented in 
local religious services; priests will now put communion in a 
person's hand instead of in the mouth.  The Rugby Association has 
suspended all matches, and the casino in Mar del Plata that boasts 
never to close has finally done so. 
 
----------------------------------- 
Determining the True Extent of H1N1 
----------------------------------- 
 
¶10.  Experts from the Centers for Disease Control (CDC) are 
assisting the Pan American Health Organization (PAHO) and the MOH in 
developing a surveillance program to develop reliable figures for 
the H1N1 virus.  Efforts are underway to enhance surveillance 
throughout the country, and in particular to do additional work in 
three provinces to monitor clinical (to follow the presentation of 
symptoms of patients and/or severity changes), virologic (to monitor 
for changes in the virus and/or its susceptibility to antiviral 
medication), and epidemiologic characteristics (age and gender of 
those affected, risk factors for severe disease, rate of infection 
in the population, etc.) of the outbreak. 
------- 
Comment 
------- 
 
¶11.  The influenza season in Argentina is expected to peak over the 
next two to three weeks.  All levels of government and private 
organizations are starting to take measures to minimize the further 
spread of H1N1.  We expect the announcement of additional measures 
that will be driven by new statistical information currently being 
developed. 
 
 
KELLY