VZCZCXRO6246
RR RUEHAST RUEHDH RUEHHM RUEHLN RUEHMA RUEHPB RUEHPOD RUEHSL RUEHTM
RUEHTRO
DE RUEHBR #1097/01 2441609
ZNR UUUUU ZZH
R 011609Z SEP 09
FM AMEMBASSY BRASILIA
TO RUEHC/SECSTATE WASHDC 4986
INFO RUEHSO/AMCONSUL SAO PAULO 4474
RUEHRI/AMCONSUL RIO DE JANEIRO 8130
RUEHRG/AMCONSUL RECIFE 9869
RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE

UNCLAS SECTION 01 OF 02 BRASILIA 001097 
 
SENSITIVE 
 
SIPDIS 
 
E.O. 12958: N/A 
TAGS: PGOV PREL SOCI TBIO KFLU BR
SUBJECT:  BRAZIL: DATA COLLECTION OF BRAZILIAN GOVERNMENT 
INTERVENTIONS RE H1N1 
 
REF:  STATE 73971 
 
BRASILIA 00001097  001.2 OF 002 
 
 
(U)  THIS CABLE IS SENSITIVE BUT UNCLASSIFIED AND NOT FOR INTERNET 
DISTRIBUTION. 
 
¶1.  (SBU) In response to REFTEL post gathered the following 
information regarding the Government of Brazil's (GOB) interventions 
and actions aimed at dealing with the convergence of the H1N1 
outbreak and the Southern Hemisphere's annual flu season. 
 
GOVERNMENT INTERVENTIONS 
 
¶2.  (SBU) H1N1 flu has caused a considerable amount of concern 
within the GOB, the state and local authorities, and among the 
Brazilian population.  The GOB, state, and local authorities have 
not/not made any emergency declarations.  The GOB has undertaken a 
public education campaign focused at keeping the public calm and 
reinforcing the idea that, at least in Brazil, the H1N1 flu shows no 
signs of being any more severe than the yearly outbreaks of seasonal 
flu.  The Minister of Health has personally made several televised 
appearances reassuring the public that his Ministry is monitoring 
the situation closely and taken all prudent actions.  This includes 
increasing the government's stockpiles of Tamiflu, which is in turn 
being dispensed directly by health centers, at reduced or no costs, 
if they believe that the patient's situation warrants its use.  The 
government's increased purchasing of Tamiflu has caused most 
pharmacies to run out of the medicine, which may be an intended 
side-affect aimed at stopping the public from self-medicating. 
 
¶3.  (SBU) The Ministry of Health has not/not made H1N1 a notifiable 
disease.  The only quarantine procedures in place are in hospitals 
and clinics, in which suspected or confirmed H1N1 cases are kept in 
a specific quarantine wing; however in most cases these patients are 
then released and asked to stay home for a week.  The Embassy is 
aware of one situation in which a few AmCits were kept in quarantine 
for over a week.  Hospitalization occurs in the minority of cases 
because the severity of the disease does not warrant it. 
 
¶4.  (SBU) Some schools have closed for short periods of time (1-2 
weeks) or delayed their opening after winter break in the hopes that 
infected students would realize that they were infected before 
returning to school and then decide to stay home rather than infect 
their classmates. The American School in Brasilia suspended classes 
for one week in the fifth grade only after four students in that 
grade became ill with flu-like diseases.  The suspension was advised 
by the Ministry of Health. There have been no other closures in 
theaters or other public venues. 
 
¶5.  (SBU) At this point there have been no/no staggered business 
hours, mask ordinances, mandated private funerals, bans on 
door-to-door sales, interventions to reduce transmission in the 
workplace, or protective sequestration of children. 
 
¶6.  (SBU) While there have not/not been any governmental decisions 
to ban public gatherings, there have been several cases in which 
event organizers have chosen to postpone or cancel events out of 
concern over the spread of H1N1. 
 
¶7.  (SBU) There have not/not been any no-crowding rules or 
community-wide business closures. 
 
¶8.  (SBU) Both domestic and international airports are making public 
service announcements and distributing flyers describing the primary 
symptoms of H1N1 and asking any travelers that believe they have 
those symptoms to identify themselves to health officials posted in 
the airport.  International travelers are required to complete a 
written health self-assessment that they present to health officials 
while passing through customs and immigration.  Those who indicate 
they have symptoms are taken aside for additional screening. 
 
¶9.  (SBU) Ministry of Health statistics indicate that the majority 
of cases contracted abroad have been linked to Argentina.  As such, 
the GOB has deployed army units and health officials to help patrol 
the southern borders with Argentina, Paraguay, and Uruguay.  These 
officials are providing information regarding the H1N1 flu and 
screening travelers who appear to be ill or who self-identify as 
having H1N1-like symptoms. 
 
STATE OF THE HEALTHCARE SYSTEM 
 
¶10.  (SBU) In general, the medical infrastructure in the major 
cities of Brazil is comparable with that in the United States.  The 
number of H1N1 cases in Brazil has not overwhelmed the abilities of 
the health care system.  Most patients are not being hospitalized 
and are being asked to rest at home until they have recovered from 
the virus.  However, the Minister of Health has expressed some 
concern that the public health system in Rio de Janeiro, which is 
 
BRASILIA 00001097  002 OF 002 
 
 
chronically under strain, could become overwhelmed.  This 
possibility is increased by the large number of international 
travelers going to, or transiting through, Rio. 
 
¶11.  (SBU) Doctors anecdotally report that their patients are coming 
in for minor cold and allergy symptoms (which are exceedingly common 
during this time of year) fearing that they may have contracted H1N1 
flu.  In general, doctors are performing an initial clinical 
screening which eliminates the majority of suspect cases.  Those 
that are not eliminated by this screening have an actual flu test 
performed to concretely diagnose their case.  Generally the hospital 
or clinic will keep a patient isolated during the initial screening 
and in some cases until the results of the flu test are received. 
According to the Ministry of Health, between April 25 and August 22 
the results of 30,854 flu tests were reported by state and local 
health authorities.  Of these tests, 16.9% tested positive for H1N1 
while 2.9% tested positive for seasonal flu.  The remaining cases 
were negative for any type of influenza. 
 
¶12.  (SBU) As of August 22, there have been 557 deaths in Brazil 
attributed to H1N1 flu.  According to the Ministry of Health the 
severity of H1N1 - based on the symptoms it causes, the severity to 
which the symptoms are felt, the frequency with which they appear, 
and the frequency with which hospitalization is required - in Brazil 
is statistically indistinguishable from the severity of the seasonal 
flu. 
 
KUBISKE