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Viewing cable 09MONTEVIDEO445, URUGUAY: GOU INTERVENTIONS RE H1N1

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Reference ID Created Released Classification Origin
09MONTEVIDEO445 2009-07-30 18:14 2011-08-26 00:00 UNCLASSIFIED Embassy Montevideo
VZCZCXYZ0010
RR RUEHWEB

DE RUEHMN #0445/01 2111814
ZNR UUUUU ZZH
R 301814Z JUL 09
FM AMEMBASSY MONTEVIDEO
TO RUEHC/SECSTATE WASHDC 9257
INFO RUCNMER/MERCOSUR COLLECTIVE
UNCLAS MONTEVIDEO 000445 
 
SIPDIS 
 
E.O. 12958: N/A 
TAGS: KFLU PGOV PREL SOCI TBIO UY
SUBJECT: URUGUAY: GOU INTERVENTIONS RE H1N1 
 
REF: SECSTATE 73971 
 
 1. (U)  Through contacts with local health practitioners and 
the Uruguayan Ministry of Public Health, Post developed the 
following timeline of interventions pertaining to the H1N1 
pendemic, as requested in reftel: 
 
-- First case: The first case of H1N1 in Uruguay was detected 
on May 23, 2009. The patient had just returned from Buenos 
Aires, where he had been infected. 
 
-- Making influenza a notifiable disease: Government 
officials first notified the public of H1N1 on April 27, 
2009, as the epidemic was first starting to spread in the 
United States and Mexico.  The Ministry of Public Health 
established a phone number for Uruguayan citizens to call if 
they had the symptoms of H1N1. 
 
-- Emergency declarations:  The government has not declared 
an emergency due to H1N1 flu. 
 
-- Measures at borders/airports: Following the first 
confirmation of H1N1 in Uruguay on May 23, the Uruguayan 
government implemented a containment and mitigation plan 
placing non-restrictive measures at the country's border 
checkpoints, including Carrasco International Airport. 
Travelers arriving from countries where the outbreak had 
already occurred were requested to fill out a form listing 
any symptoms as well as contact information so that their 
health status could be monitored by the Ministry of Public 
Health. The GOU also began screening incoming pasengers for 
signs of illness due to the flu. This screening included the 
use of thermal scanners, which did not detect fever in any 
arriving passengers, leading the Ministry to conclude that 
the technology was ineffective.  The GOU deactivated all 
border screening measures following the announcement of a 
Phase 6 pandemic, with only sentinel surveillance systems 
remaining operational. 
 
-- Isolation policies:  The Ministry of Public Health 
recommends that those with symptoms stay at home, cover their 
cough, and use disposable tissues instead of handkerchiefs. 
They have also recommended that all Uruguayans regularly wash 
their hands or use alcohol gel due to the spread of the 
disease.  Isolation of hospitalized patients follows WHO/CDC 
recommendations.  The Ministry also has recommended that 
Tamiflu only be provided to patients hospitalized with H1N1, 
as providing it to those who only require rest could 
alleviate symptoms while the virus is still active, thereby 
encouraging patients to return to work and inadvertently 
spread the disease. 
 
-- Quarantine of households where infection is identified: 
Quarantine has not been declared or recommended. 
 
-- School, theater, dance hall, and other closures:  Local 
governments in the departments of Soriano, San Jose, and Rio 
Negro closed theaters and dance halls in response to the H1N1 
outbreak.  However, these closures were criticized as 
unnecessary by the Ministry of Public Health. Local youth 
soccer leagues were also suspended for the last two weeks of 
July, to resume at the beginning of August. 
 
-- Staggered business hours:  Not recommended. 
 
-- Mask ordinances:  Recommended for patients with symptoms 
(common surgical mask) and for health personnel caring for 
H1N1 patients (N95 mask). 
 
-- Rules forbidding crowding on streetcars:  None issued. 
 
-- Private funerals:  No rules issued. 
 
-- Ban on door-to-door sales:  None. 
 
-- Interventions designed to reduce transmissions in the 
workplace:  See "isolation policies" above. 
 
-- Protective sequestration of children:  None. 
 
-- Ban on public gatherings:  None, other than the 
theater/dance hall closures mentioned above.  Some 
institutions (educational, religious, music concerts) have 
voluntarily suspended scheduled events, often due to a low 
expected turnout. 
 
-- No-crowding rules in locations other than transit systems: 
 None. 
 
-- Community-wide business closures:  None. 
 
2. (SBU)  According to our contacts in the local health 
practitioner community, the Uruguayan government has adopted 
a measured and effective policy in response to the H1N1 
epidemic by keeping calm, applying WHO and CDC 
recommendations throughout the country, and coordinating its 
efforts with the private sector.  It has acted firmly to stem 
anxiety, particularly though its response to the closures by 
local governments mentioned above.  Our contacts in the GOU 
also confirmed that the health care system proved effective 
in preparing for and responding to this public health 
emergency.  While the H1N1 outbreak produced a surge of 
patients at both public and private hospitals, bed shortages 
were never a problem. 
 
3. (SBU)  During the outbreak, the greatest strain was put on 
the network of laboratories in Uruguay, which did not have 
the capacity to keep up with testing. Uruguayan labs were 
overwhelmed by the H1N1 crisis despite donations of equipment 
by the CDC, including a PCR detection kit provided on June 
26.  Since the WHO's June 11 declaration of a Phase 6 
pandemic, the government has stopped testing for H1N1 in all 
but those patients hospitalized with severe respiratory 
symptoms, easing the burden on labs.  However, virus samples 
are still sent to the CDC in Atlanta every two weeks for the 
purposes of monitoring possible mutations. 
 
4. (SBU)  To date, the severity and fatality pattern in 
Uruguay has been similar to that in the United States and 
Europe.  According to the Ministry of Public Health, H1N1 flu 
represents 90% of flu cases in the country, with similar 
symptoms and severity.  As of July 28, 31 people have died, 
with most of them already suffering from serious underlying 
health conditions.  Ministry sources report that the local 
epidemic appears to have peaked, but, as in the United 
States, a second wave is expected. 
Schandlbauer