VZCZCXRO9051
RR RUEHAST RUEHBI RUEHCI RUEHDBU RUEHLH RUEHLN RUEHNEH RUEHPW RUEHSK
RUEHVK RUEHYG
DE RUEHNT #1507/01 2611218
ZNR UUUUU ZZH
R 181218Z SEP 09
FM AMEMBASSY TASHKENT
TO RUEHC/SECSTATE WASHDC 1341
INFO ALL SOUTH AND CENTRAL ASIA COLLECTIVE
CIS COLLECTIVE
RHEFDIA/DIA WASHINGTON DC
RHEHAAA/NATIONAL SECURITY COUNCIL WASHINGTON DC
RHMFIUU/HQ USCENTCOM MACDILL AFB FL
RUEAIIA/CIA WASHINGTON DC
RUEKJCS/SECDEF WASHINGTON DC
RUMICEA/USCENTCOM INTEL CEN MACDILL AFB FL

UNCLAS SECTION 01 OF 02 TASHKENT 001507 
 
SENSITIVE 
SIPDIS 
DEPARTMENT FOR SCA/CEN 
 
E.O. 12958: N/A 
TAGS: PREL PGOV TBIO TSPL CDC UZ
SUBJECT: Uzbekistan: Suspected Case of Anthrax Puts USG-Funded 
Biological Threat Capabilities to Use 
 
REF: STATE 
 
¶1.  (SBU) Summary:  In the month of August, media in Uzbekistan 
reported a suspected case of Anthrax in the Toytepi region near 
Tashkent, Uzbekistan. The man suspected with Anthrax was believed 
to have been exposed during the slaughtering of his cows. The 
Biological Threat Reduction Program laboratories and personnel 
funded by the United States Government were reportedly used for the 
analyses of Anthrax. The Ministry of Health later reported the 
sample results from the lab as "negative" for anthrax and the cases 
were identified as "an infected ulcer." End summary. 
 
 
 
Background 
 
---------- 
 
¶1.  (U) The Biological Threat Reduction Program (BTRP) currently 
being implemented by the Defense Threat Reduction Agency (DTRA) is 
a United States Government (USG) funded project to assist in the 
enhancement of a Threat Agent Detection and Response (TADR) system 
in Uzbekistan. 
 
 
 
¶2.  (U) The BTRP currently has constructed and trained eight (8) 
out of the twelve (12) planned Regional Diagnostic Laboratories 
(RDLs) throughout Uzbekistan. The RDLs are equipped with the means 
necessary to detect and respond to Especially Dangerous Pathogens 
(EDPs). In the near future, DTRA will construct a limited capacity 
Biological Safety Level Three (BSL-3) Laboratory and thirty-five 
(35) Epidemiological Support Units (ESUs) to further enhance the 
TADR system. 
 
 
 
The Suspected Case 
 
------------------ 
 
¶3.  (SBU) In the Toytepi region, an Uzbekistan citizen became sick 
after slaughtering his cattle to sell the meat at a local market. 
After three to four days, lesions appeared on the man's arms and he 
immediately began treating the lesions with vinegar. The lesions 
continued to appear and grow and he began to incur other symptoms 
such as fever and acute abdominal pain. His wife, a local nurse, 
began intravenous injections after diagnosing him with Acute 
Respiratory Viral Infection (ARVI). The man stayed at home for 
another three days, without seeing a doctor, before his son brought 
him to the Republican Center of Emergency Aid in Tashkent. He was 
then diagnosed as having Hepatomegalia and fever by a Biological 
Threat Reduction Program (BTRP)- trained Chief Infectious Disease 
Doctor of the Tashkent Oblast, Dr. Saidalieva. The case was 
reported to the Ministry of Health by Dr. Saidalieva. 
 
 
 
¶4.  (SBU) The patient was hospitalized in the Isolation ward and 
was examined further by the following BTRP-trained specialists: Dr. 
Mamatkulov (Republican Epidemiologist for the MOH), Dr. Azimov 
(Director of the Research Institute of Epidemiology, Microbiology, 
and Infectious Diseases (REIMID)), Dr. Musabaev (Director of the 
Tashkent Institute of Virology (IoV)). The patient was then 
diagnosed with septic anthrax and samples were sent for analysis to 
the BTRP Regional Diagnostic Laboratory (RDL) at the Republican 
Center for State Sanitary and Epidemiological Surveillance (RSES). 
The patient died six hours after arriving at the hospital. 
 
 
 
¶5.  (SBU) The team then notified the Anti-epidemic committee of a 
suspect case of Anthrax and an investigation commenced of the area 
where the patient's home was located. The investigation revealed 
twelve patients with symptoms for the cutaneous form of Anthrax and 
all samples taken were sent to the RSES for analysis. One of the 
patients who had cutaneous vesications revealed that he had 
recently traveled to the Kashkadaryo region before falling ill, 
 
TASHKENT 00001507  002 OF 002 
 
 
however no other information was given on the investigation. It was 
reported that all patients were treated and cured in the Toytepi 
District Infectious Disease Hospital (IDH). 
 
 
 
¶6.  (SBU) All samples drawn were analyzed at the RSES and the 
Center for Prophylaxis and Quarantine of Most Hazardous Infections 
(CPQMHI), also a BTRP facility. The MOH publically reported that 
all samples were "negative" for Anthrax and all cases were "an 
infected ulcer." 
 
 
 
Comment 
 
------- 
 
¶7.  (SBU) Recent reports to the DTRA from the Infections Disease 
Hospital Directors and Regional Diagnostics Laboratory Directors 
have revealed the use of the fully functional RDLs for response to 
Especially Dangerous Pathogens in the regions of Samarqand and 
Tashkent. During a recent site visit to the Samarqand Oblast Center 
for Sanitary and Epidemiological Surveillance, the director 
informed the DTRA Chief, Ms. Brie Tinsley, of the recent suspected 
cases reported in and around Samarqand. He informed her that his 
RDL was being used for the detection of these three cases in the 
different regions, however he requested that this information not 
be shared. 
 
 
 
¶8.  (SBU) DTRA has been requested by three RDLs, two in Tashkent 
and one in Samarqand, to provide additional Anthrax kits used in 
the Polymerase Chain Reaction (PCR) equipment installed and trained 
by the USG for detection of EDPs. 
 
 
 
¶9.  (SBU) The BTRP Electronic Integrated Disease Surveillance 
System (EIDSS) used for mass reporting via the internet, has been 
installed at all RDLs established by the USG, however EIDSS has not 
yet been accepted by the MOH or the Ministry of Agriculture and 
Water Resources (MAWR) as their reporting system. Reporting of 
infectious diseases is still considered very sensitive with 
possible repercussions for the reporting activity.  If there is an 
EDP reported in an oblast, the Hakim (mayor) might be blamed for 
the outbreak and said to have not been doing his job properly. As a 
result of this pattern of controlling diagnostic information, 
infectious diseases are often covered up by misdiagnosis, as was 
the case in Tashkent.  In reality, however, this USG-provided 
capability is being used to identify and isolate potential 
biological hazards, even if Uzbek authorities are reluctant to 
publicly admit that such episodes occur. 
 
NORLAND 
NORLAND