BURMA: MINISTRY OF HEALTH PREPARES FOR A/H1N1 PHASE 6 PANDEMIC

Identifier: 
09RANGOON370

C O N F I D E N T I A L SECTION 01 OF 03 RANGOON 000370

SIPDIS

STATE FOR EAP/MLS, CA/OCS/ACS/EAP, OES, G/AIAG
PACOM FOR FPA
USDA FOR FAS/PECAD, FAS/CNMP, FAS/AAD, APHIS
BANGKOK FOR USAID:JMACARTHUR, APHIS:RTANAKA, REO:HHOWARD
DEPT PLEASE PASS TO HHS FOR OGHA STEIGER AND HICKEY
PASS TO CDC ATLANTA FOR CCID AND COGH

E.O. 12958: DECL: 06/18/2019
TAGS: KFLU, AEMR, ASEC, CASC, KFLO, TBIO, EAID, KPAO, PREL,
PINR, AMGT, BM
SUBJECT: BURMA: MINISTRY OF HEALTH PREPARES FOR A/H1N1
PHASE 6 PANDEMIC

REF: A. RANGOON 253
B. RANGOON 246
C. RANGOON 241
D. RANGOON 238

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Classified By: Economic Officer Samantha A. Carl-Yoder for Reasons 1.4
(b and d).

Summary
-------

1. (SBU) During a June 16 meeting with the diplomatic
corps, the Burmese Ministry of Health (MOH)reviewed its
A/H1N1 action plan, detailing surveillance procedures. MOH
asserts there are still no confirmed cases of A/H1N1 in
Burma. Since April 28, MOH officials have screened more than
1.3 million incoming travelers at all ports of entry, and
conducted home and hotel surveillance on 3,310 travelers,
ninety percent of whom entered Burma via the Rangoon airport.
GOB officials reiterated requests for donor assistance to
implement its action plan fully, including additional
Tamiflu, masks, personal protective equipment (PPEs), Centers
for Disease Control and Prevention (CDC) rapid test kits and
a Real Time PCR, and thermal scanners. End Summary.

Still No H1N1 in Burma
----------------------

2. (SBU) During a June 16 meeting with diplomats, Ministry
of Health Director of Disease Control Dr. Soe Lwin Nyein
asserted that even though A/H1N1 is present in neighboring
countries, there are still no confirmed cases of A/H1N1 in
Burma. Both MOH and the Ministry of Livestock and Fisheries
(MOLF) continue to work with the UN and international
organizations to monitor for the disease and implement A/H1N1
action plans (Ref A).

MOH Monitoring Travelers
-------------------------

3. (SBU) On April 28, MOH began screening incoming
travelers at the international airports in Rangoon and
Mandalay, the Rangoon international port terminal, and 16
selected border crossings using either thermal scanners or
digital thermometers. All incoming travelers must fill out a
health declaration card, which MOH uses as a basis for
potential surveillance. To date, MOH has screened more than
1.3 million travelers, the majority of whom enter Burma via
land crossing points. Dr. Soe Lwin Nyein noted that since
May 8, MOH officials have conducted either home or hotel
surveillance on 3,310 people who demonstrated potential signs
of A/H1N1. Ninety percent of those people entered Burma at
the Rangoon airport. This involves daily visits by MOH
doctors to individuals to determine whether their symptoms
have worsened and if they require hospital care. None of
these cases were positive for A/H1N1, he noted.

4. (SBU) Dr. Soe Lwin Nyein told diplomats that the MOH
National Reference Laboratory now has the capacity to test
for A/H1N1, using its own Polymerase Chain Reactor (PCR)

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machine and primers and test kits donated by a Japanese
university. Results are available after eight hours, and MOH
sends all samples to the National Institute of Health in
Tokyo for confirmation. Dr. Soe Lwin Nyein could not
confirm how many samples MOH has tested, but emphasized that
all tests came back negative. He acknowledged that the vast
majority of cases surveyed were detected in Rangoon rather
than in other ports of entry.

MOLF Monitoring Animal Movements
--------------------------------

5. (SBU) Dr. Kyaw Sann, Director of Disease Control at the
Livestock Breeding and Veterinary Department, informed
diplomats that MOLF is adapting its H5N1 action plan to
include H1N1. Dr. Murray Mclean, FAO Avian Influenza
specialist, noted that FAO and MOLF are currently surveying
animals for both diseases and are working with farmers to
employ proper biosecurity measures. Using USAID funding, FAO
will begin a study on swine movements across the Thai-Burma
and China-Burma borders.

Needs Still Exist
-----------------

6. (SBU) Both MOH and MOLF are doing what they can with
limited resources to prevent the spread of A/H1N1 into Burma,
officials claimed, but they lack the equipment and resources
necessary to combat the disease should an outbreak occur.
MOH and MOLF reiterated their request for donors to provide
the following:

-- CDC A/H1N1 rapid tests and a Real Time Polymerase Chain
Reaction (RT-PCR) Thermal Cycler to conduct the tests;
-- N95 masks;
-- 100,000 additional courses of Tamiflu;
-- Additional stocks of PPEs;
-- At least three new thermal scanners and additional
temperature gauging equipment;
-- Disinfectants; and
-- Funding for educational outreach.

7. (C) The Singapore Embassy is considering donating a
RT-PRC to MOH, although the Singapore DCM stated a decision
has yet to be made. WHO already provided the MOH with an
additional 50,000 doses of Tamiflu and stands ready to
provide more should an outbreak occur. USAID and AusAID have
authorized both the WHO and FAO to utilize existing H5N1
funding for H1N1 surveillance and training. According to the
Japanese Economic Counselor, the Japanese Government has no
plans at this time to provide any H1N1 assistance. He noted,
however, that private Japanese organizations may provide
additional assistance.

Comment
-------

8. (C) In order to improve surveillance and potential
treatment of an A/H1N1 outbreak, Burma is in need of all of
the products listed above. While the GOB is adamant there

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are no cases of A/H1N1 in the country, we and others in
country are skeptical of MOH's ability to detect the disease,
particularly along the border. Of the 3,310 people surveyed
by MOH officials, more than 3,000 of them were identified at
the Rangoon International Airport, the only port of entry
with a thermal scanner. With more than 30,000 people
entering Burma daily via legal and illegal land crossing
points, most from countries that have confirmed A/H1N1 cases,
there is a strong possibility that someone with A/H1N1 has
already entered Burma undetected.

DINGER