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### Viewing cable 09TRIPOLI948, MGSF01: LIBYA REPORTS FIRST DEATH DUE TO H1N1, WITH 84 CONFIRMED CASES REF: STATE 00120578 TRIPOLI 00000948 001.2 OF 002

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Reference ID | Created | Released | Classification | Origin
--- | --- | --- | --- | ---
09TRIPOLI948 | 2009-12-03 16:04 | 2011-01-31 21:09 | UNCLASSIFIED//FOR OFFICIAL USE ONLY | Embassy Tripoli

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    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

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    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

    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

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