VZCZCXRO1138
RR RUEHAG RUEHAST RUEHDA RUEHDBU RUEHDF RUEHFL RUEHIK RUEHKW RUEHLA
RUEHLN RUEHLZ RUEHNP RUEHPOD RUEHROV RUEHSK RUEHSL RUEHSR RUEHVK
RUEHYG
DE RUEHBW #1332/01 3161602
ZNR UUUUU ZZH
R 121601Z NOV 09
FM AMEMBASSY BELGRADE
TO RUEAUSA/DEPT OF HHS WASHINGTON DC
RUEHC/SECSTATE WASHDC 0375
RUEHPH/CDC ATLANTA GA
INFO EUROPEAN POLITICAL COLLECTIVE

UNCLAS SECTION 01 OF 02 BELGRADE 001332 
 
SENSITIVE 
SIPDIS 
 
E.O. 12958: N/A 
TAGS: AEMR KFLU AMGT PREL CASC PINR SR
SUBJECT: Serbia Declares H1N1 Epidemic 
 
REF: BELGRADE 579; BELGRADE 703; BELGRADE 1240 
 
BELGRADE 00001332  001.2 OF 002 
 
 
¶1. (U) On November 11 the GOS responded to mounting public and 
media concerns about H1N1 influenza and formally declared an 
epidemic.  H1N1 is widespread in a number of Serbian cities; 
however, the majority of cases are not severe, with nine deaths 
reported thus far out of 258 confirmed cases.  The media and public 
are heavily focused on H1N1.  Schools have extended the autumn 
break period and a vaccination program announced last week did not 
quell public concerns and media hype.  Designating an epidemic 
opens the possibility of event cancellations and travel bans; 
however, no such measures have been taken yet and Health Ministry 
officials stated "life must go on."  End Summary. 
 
 
 
Current Statistics 
 
------------------ 
 
 
 
¶2. (SBU) To date in Serbia, more than 350 persons have been 
hospitalized, with 258 cases confirmed and nine deaths attributed 
to H1N1. (Note:  The number of cases and number of flu-related 
deaths are not out of the ordinary.) Health Minister Tomica 
Milosavljevic told reporters on November 12 he estimated that 
perhaps 20,000 - 30,000 people were currently infected with H1N1. 
The majority of cases, however, are mild, and laboratory testing 
has been limited to hospitalized patients.  Milosavljevic, and 
Predrag Kon, the head of a special working group for pandemic 
influenza, noted at a well attended November 6 press conference the 
flu was "epidemic" in 10 cities (Cacak, Kraljevo, Kragujevac, Nis, 
Paracin, Pozega, Uzice, Ivanjica, Prilike and Leskovac and 
Juznobacki region). 
 
 
 
Readiness 
 
--------- 
 
 
 
¶3. (SBU) The Health Ministry and a special working group began 
preparation and training for a possible flu epidemic two years ago. 
Efforts have been largely focused on H1N1 at the expense of 
ordinary seasonal flu.  Previously, citizens were able to obtain 
seasonal flu vaccinations from government outpatient health 
centers, private medical offices or private pharmacies.  This year, 
supplies of the seasonal flu vaccine are limited due to higher 
demand and respirators are reportedly in short supply.  In recent 
weeks health officials have emphasized the need to treat all cases 
using standard flu treatments and cautioned against waiting for 
test results to begin treatment. 
 
 
 
Procuring Vaccine 
 
----------------- 
 
 
 
¶4. (SBU) On October 3 the GOS ordered three million doses of the 
H1N1 vaccine through a bidding process, with Novartis winning the 
contract on November 9.  The first delivery of 500,000 doses is 
expected by mid-December, and the remainder should arrive in 
January 2010.  In addition, Serbia's Institute of Immunology and 
Virology will begin domestic production of the vaccine in early 
¶2010.  The vaccine will first be available to approximately 900,000 
"priority patients," (i.e., children with chronic diseases, 
pregnant women, and public service employees).  Afterwards the 
vaccine will be made available to the public at large.  The Health 
Ministry has strongly encouraged vaccination against H1N1, and said 
refusal of the vaccine would be noted on patients' health records. 
Milosavljevic said the Health Ministry would request $5 million be 
reallocated for flu monitoring and immunization programs. 
 
 
 
Media Overreacts 
 
-------------- 
 
BELGRADE 00001332  002 OF 002 
 
 
¶5. (SBU) Media reports focus on the sensationalist elements of 
H1N1, such as the decision by a leading grocery chain to purchase 
masks for all of its employees.  The coverage has heightened public 
anxiety.  According to the Health Ministry, the majority of cases 
are mild and, there are sufficient antiviral stockpiles to treat 
patients.  Milosavljevic urged the media "not to spread 
misinformation" about the availability and efficacy of the vaccine. 
 
 
 
 
Declaring an Epidemic, Dispelling Fears and Other Next Steps 
 
--------------------------------------------- --------------- 
 
 
 
¶6. (SBU) Officials first raised the possibility of declaring a 
countrywide H1N1 epidemic on November 8 in light of growing 
concerns that "something must be done", and declared an epidemic on 
November 11 following a three hour Parliamentary debate.  Epidemic 
status provides the authority for officials to close schools and 
cancel public events, and impose quarantines, import and travel 
restrictions.  To date, the only measure the government imposed was 
a ban on prison visits.  The Working Group will prepare a set of 
recommendations to be implemented if the disease continues to 
spread. 
 
 
 
¶7. (SBU) With an epidemic declared, the GOS and Working Group 
members shifted their focus to dispelling fears and assuring the 
public that this step was taken to ensure the GOS has the necessary 
tools to act should it be necessary.  Milosavljevic underscored 
that public events remained open and students should report to 
school next week as scheduled.  Group member and epidemiologist 
Branislav Tiodorovic encouraged citizens to continue with their 
lives by attending holiday events and concerts, and stressed his 
plans to attend an upcoming Tom Jones concert. 
 
 
 
Comment 
 
------- 
 
 
 
¶8. (SBU) Serbia is experiencing an increasing H1N1 outbreak; 
however, most cases are relatively mild.  Sensationalist press 
reports have created considerable mythology around H1N1, escalating 
public anxiety.  The government has done a commendable job of 
attempting to dispel fears and focus efforts on treating patients. 
These reports and resulting public fears encouraged the GOS to 
declare an H1N1 epidemic to mobilize resources, if needed, and 
demonstrate responsiveness.  We continue to believe the government 
is taking prudent actions to address the growing epidemic.  End 
Comment. 
BRUSH