VZCZCXRO6664
PP RUEHAST RUEHBC RUEHDE RUEHDH RUEHHM RUEHKUK RUEHLN RUEHMA RUEHPB
RUEHPOD RUEHROV RUEHSL RUEHTM
DE RUEHTRO #0948/01 3371616
ZNR UUUUU ZZH
P 031616Z DEC 09
FM AMEMBASSY TRIPOLI
TO RUEHC/SECSTATE WASHDC PRIORITY 5521
INFO RUEHEE/ARAB LEAGUE COLLECTIVE
RUEHRO/AMEMBASSY ROME PRIORITY 0659
RUEHVT/AMEMBASSY VALLETTA PRIORITY 0468
RUEHPH/CDC ATLANTA GA
RUEAUSA/DEPT OF HHS WASHINGTON DC
RUEFHLC/DEPT OF HOMELAND SECURITY WASHINGTON DC
RHEHAAA/NSC WASHINGTON DC
RHMFISS/AFRICOM
RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE
RUEHRC/USDA FAS WASHDC
RUEHRC/DEPT OF AGRICULTURE WASHINGTON DC
RUCPDOC/DEPT OF COMMERCE WASHINGTON DC
RHMFISS/DEPT OF ENERGY WASHINGTON DC
RUEATRS/DEPT OF TREASURY WASHINGTON DC
RUEKJCS/OSD WASHINGTON DC
RHEFDIA/DIA WASHINGTON DC
RUEAIIA/CIA WASHDC
RUEHTRO/AMEMBASSY TRIPOLI 6071

UNCLAS SECTION 01 OF 02 TRIPOLI 000948 
 
SENSITIVE 
SIPDIS 
 
STATE FOR NEA/MAG; OES/IHA, OES/IHB, CDC ATLANTA FOR CCID 
 
E.O. 12958: N/A 
TAGS: SOCI CASC LY KFLU AEMR ASEC KFLO TBIO KSAF KPAO
PREL, PINR, AMGT, MG, ECON 
SUBJECT: MGSF01: LIBYA REPORTS FIRST DEATH DUE TO H1N1, WITH 84 
CONFIRMED CASES 
 
REF: STATE   00120578 
 
TRIPOLI 00000948  001.2 OF 002 
 
 
¶1.   (SBU) Summary:  According to Libyan state-run media, a 
pregnant 40-year old Libyan woman recently died in the country's 
first reported H1N1-related death.  The number of H1N1 cases in 
the country reached 84 as of December 1, a jump from the 
official figure of 20 provided by the Libyan National Center for 
Infectious Disease Prevention and Control on November 21. 
International schools in Tripoli, including the American School, 
have reported several H1N1 cases among students.  To prepare for 
the expected outbreak of influenza, , including H1N1, Libya's 
General People's Committee for Health and Environment (Ministry 
of Health-equivalent) expanded the mandate of an existing avian 
flu committee  to cover various types of pandemic  flu, with the 
aim of preparing the Libyan health establishment to deal with a 
probable outbreak of flu, including H1N1.  The H1N1 vaccine is 
not yet publicly available in Libya, although a rumor is 
circulating that the vaccine can be purchased for a fee of USD 
1,000.  Since May, incoming travelers have been screened for flu 
symptoms at international ports of entry, including Tripoli 
International Airport and the Tunisian border.  Due to the poor 
state of the Libyan healthcare network, it is unclear how the 
state system would respond to a serious health crisis.  Post 
will hold an EAC later today to review and update pandemic 
tripwires.  End summary. 
¶2.  (SBU)  On November 29, Libyan national television announced 
the country's first H1N1-related death -- that of a 40-year old 
Libyan woman, who was 25 weeks pregnant.   In press reports on 
November 30, the Secretary of Health (minister-equivalent) 
Mahmoud Mohamed al-Hijazi stated that the deceased's case had 
initially been misdiagnosed and that she had been prescribed 
antibiotics to control her infection, rather than the H1N1 
treatment.  Her symptoms worsened, requiring hospitalization, at 
which point she was diagnosed with the H1N1 virus but was too 
ill to respond to the appropriate treatment.    The website of 
the Libyan National Center for Infectious Disease Prevention and 
Control (nidcc.gov.ly) announced on December 1 there were 84 
confirmed cases of H1N1 in Libya, all of which were being 
treated and controlled.  (Comment: The figure of around 84 cases 
is a marked increase in a short amount of time, given that 20 
cases were reported to be confirmed as of November 21.  It is 
unclear whether surveillance methods are improving or whether 
authorities realized more accurate figures would need to be 
provided to the public.  End comment.) 
¶3.  (SBU)  On December 2, the website of the General People's 
Committee for Health and Environment reported that Secretary 
al-Hijazi convened a meeting of the committee for Pandemic Flu 
Preparedness to discuss the status of the pandemic in Libya.  He 
confirmed that the figures (of 84 cases) that had been published 
by the National Center for Infectious Disease Prevention and 
Control were correct.  He explained that although the current 
situation of the virus is under control, he predicted that the 
number of cases would increase with the start of the winter 
season.  He also provided a hot-line telephone number that 
people could call to report flu symptoms and to be referred to 
treatment centers.  (Note: The Embassy called the number on 
December 2 but the number was out of service.  End note).  He 
also cautioned Libyans against taking unnecessary overseas 
trips, especially to Europe. 
¶4.  (SBU)  Confirmed cases of H1N1 among students at Tripoli's 
international schools - including three cases at the American 
School - have been reported.  Two cases at the French school 
were reported the week of November 22, and there were 
unconfirmed reports of H1N1 cases at the German school during 
the same week.  While there are reports of many cases of 
seasonal flu and colds among students and teachers at the 
International School of Tripoli, there are no reported cases of 
H1N1.   On December 1, the Embassy was informed that a UK 
diplomat's two children were also diagnosed with H1N1; the UK 
diplomat also later was diagnosed with a H1N1.  In response to 
the upsurge in H1N1 cases, Post issued a warden message on 
November 23 referencing the reported cases and reiterating 
 
TRIPOLI 00000948  002.2 OF 002 
 
 
Department guidance on Pandemic Flu precautions. 
¶5.  (SBU)  In 2005, the Libyan General People's Committee for 
Health and Environment (Ministry of Health-equivalent) created 
a committee for Avian  Flu Preparedness, headed by the Secretary 
(Minister-equivalent) of Health and Environment, Mahmoud Mohamed 
al-Hijazi.  In July 2009, the work of the committee was expanded 
to include H1N1 and the name was changed to Pandemic Flu 
Preparedness Committee.  The goals of the committee are to 
ensure the country is prepared to deal with the threat of 
pandemic flu, including swine flu (H1N1), and to coordinate the 
response of the health establishment, such as clinics, hospitals 
and the diagnostic laboratories.  An official at the Libyan 
National Center for Infectious Disease Prevention and Control 
informed Emboff on December 1 that H1N1 vaccines had been 
ordered and that an initial stock had been used to vaccinate 
Libyans travelling to Saudi Arabia for the  Hajj; numbers of 
people vaccinated were not available.  He reported six million 
doses had been ordered (which is also the population of Libya) 
but the entire stock had not yet arrived.  According to some 
private doctors, the Libyan government has stocks of H1N1 
vaccine but the strategy for administering the vaccine is 
unclear.   A rumor is circulating around Tripoli that the 
vaccine is available but only for a fee of U.S. 1,000 dollars 
and there are no details as to where the vaccine can be 
procured. 
¶6.  (SBU) Since May, incoming travelers have been screened for 
flu symptoms at international ports of entry, including Tripoli 
International Airport and the Tunisian border.  Travelers on 
international flights and at the land borders must fill out a 
card that asks if they or family members have been ill with 
flu-like symptoms (fever, cough) and the passengers must walk in 
front of an infrared camera, which detects unusually-high body 
temperatures.  Medical personnel are standing by to question any 
travelers who indicate a positive response on their cards or 
whose temperatures indicate a fever. 
¶7.  (SBU)  In the past, the Libyan government has been 
responsive to offers of technical assistance in responding to 
and preventing infectious diseases, including from the U.S. 
Government.  Through post's scientist engagement program, 
various Libyan infectious disease specialists have participated 
in U.S. programs to enhance Libya's capacity in safeguarding 
public health.  The Libyan National Center for Infectious 
Disease Prevention and Control has been particularly responsive 
to U.S.-sponsored programs.  For example, in October, the Center 
sent two Libyan laboratory specialists to a training course on 
diagnosing Avian Influenza and Newcastle Disease sponsored by 
the U.S. Department of Agriculture.  The Center has also 
participated in similar training courses offered by the U.S. 
Navy Medical Research Unit (NAMRU-3) in Cairo, Egypt. 
¶8.  (SBU)  Comment:   Due to the poor state of the Libyan 
healthcare network, it is unclear how the state system would 
respond to a serious health crisis.  Now that Libya has publicly 
acknowledged the existence of the H1N1 and a related death, it 
must place a priority on procurement of H1N1 vaccines given the 
increasing incidence of the virus. Post is seeking further 
information from the Libyan equivalent of the ministry of health 
(General People's Committee for Health and Environment) for 
further details on Libya's pandemic flu strategy, and to assess 
if the ministry would be amenable to U.S. assistance to procure 
H1N1 vaccines or in offering other healthcare assistance.  We 
also will hold an expanded Emergency Action Committee meeting on 
December 3 to update our tripwires (in response to reftel), and 
to tap into the extensive resources within the Embassy 
community, including our Libyan colleagues, to ensure  post is 
ready to respond to pandemic flu in Libya.  We will report the 
EAC's discussions septel.  End comment. 
POLASCHIK