78363 9/14/2006 11:57 06ANKARA5324 Embassy Ankara UNCLASSIFIED VZCZCXRO3059 RR RUEHAST RUEHDA RUEHVK DE RUEHAK #5324/01 2571157 ZNR UUUUU ZZH R 141157Z SEP 06 FM AMEMBASSY ANKARA TO RUEHC/SECSTATE WASHDC 8654 INFO RUEHRC/USDA FAS WASHDC RUEHGB/AMEMBASSY BAGHDAD 0740 RUEHAH/AMEMBASSY ASHGABAT 1911 RUEHKB/AMEMBASSY BAKU 1408 RUEHBM/AMEMBASSY BUCHAREST 0910 RUEHCH/AMEMBASSY CHISINAU 0421 RUEHDM/AMEMBASSY DAMASCUS 1581 RUEHSF/AMEMBASSY SOFIA 1077 RUEHSI/AMEMBASSY TBILISI 3063 RUEHVI/AMEMBASSY VIENNA 1597 RUEHYE/AMEMBASSY YEREVAN 1243 RUEHKU/AMEMBASSY KUWAIT 0860 RUEHRH/AMEMBASSY RIYADH 0615 RUEHMK/AMEMBASSY MANAMA 0200 RUEHMO/AMEMBASSY MOSCOW 5480 RUEHKV/AMEMBASSY KIEV 0733 RUEHTH/AMEMBASSY ATHENS 7431 RUEHNC/AMEMBASSY NICOSIA 6596 RUEHRO/AMEMBASSY ROME 6581 RUEHBS/USEU BRUSSELS RUEHVK/AMCONSUL VLADIVOSTOK 0095 RUEHDA/AMCONSUL ADANA 1091 RUEHIT/AMCONSUL ISTANBUL 1257 RUEHBS/USEU BRUSSELS RHMFIUU/HQ USEUCOM VAIHINGEN GE RHMFIUU/39ABG INCIRLIK AB TU RHMFIUU/39CES INCIRLIK AB TU RHMFIUU/BDP INCIRLIK AB TU RUEHPH/CDC ATLANTA GA RUEAUSA/DEPT OF HHS WASHDC RUEHGV/USMISSION GENEVA 1491 RUEHAST/USOFFICE ASTANA 0108 UNCLAS SECTION 01 OF 02 ANKARA 005324
DEPT PLS PASS EST COLLECTIVE G STAFF FOR JED MELINE USAID FOR TROSTLE, BLANCHET AND CARROLL HHS FOR WSTEIGER/PBUDASHEWITZ CDC FOR DBULL AND TUYEKI FAS FOR ITP/MACKE/THOMAS, CMP/DLP/WETZEL, FAS/JDEVER FAS PASS FSIS AND APHIS VIENNA PASS APHIS BRUSSELS PASS APHIS/FERNANDEZ GENEVA PASS HEALTH ATTACHE ROME FOR US MISSION TO FAO
E.O. 12958:N/A TAGS: TBIO, AMED, EAID, CASC, SENV, EAGR, TU, KFLU SUBJECT: CRIMEAN-CONGO FEVER IN TURKEY
1. Summary: Cases of Crimean-Congo Hemorrhagic Fever in Turkey have increased over prior years to 279, which resulted in 20 deaths over the past summer, causing public concern. Because transmission to humans is mainly via ticks from domesticated animals, the Ministry of Health is coordinating closely with the Ministry of Agriculture, building on cooperation mechanisms established in combating avian influenza. Although the number of human deaths is larger than those for avian influenza, the economic effect has been much smaller, the impact is limited to six provinces east of Ankara, and human-to-human transmission is extremely rare. End Summary.
Tick-borne disease - Animals Show no Symptoms
2. Ministry of Health Doctor Yildirim Bayazit told us that cases of Crimean-Congo Hemorrhagic Fever (CCHF) have grown to 270 for partial year 2006 from 263 in 2005 as a whole, affecting six Anatolia-Black Sea Provinces east of Ankara (Tokat, Gumushane, Amasya, Corum, Yozgat, and Sivas Provinces). Both Bayazit and the European CDC Fact sheet (http://www.ecdc.eu.int/outbreaks/) on the disease suggest the possibility that the increase in cases may reflect greater detection, diagnosis, and notification, rather than increased activity of the virus. A relatively new disease, CCHF was first documented in Turkey in humans in 2002.
3. Bayazit said that the Ministry of Agriculture (MARA) was acting as the lead agency in combating the disease, although they initially denied responsibility for responding to the tick-borne disease. According to Bayazit, MARA now devoted a budget of 50 million YTL ($35 million) for CCHF. Recent tests in cattle revealed that the disease was present in 80% of the cattle in the affected areas. Animals are just carriers for the disease and do not show symptoms (very much unlike avian influenza). The reservoir for CCHF includes hares, birds, cattle, sheep, and goats. The main vector for transmission is hard ticks of the Hayalomma genus. The majority of human cases have been persons working in the livestock sector.
4. Bayazit emphasized the importance of preventing animal movement from infected areas. He noted the particular risk of the sacrifice holiday, when there is normally significant movement of cattle, sheep, and goats.
5. Bayazit said that Turkey was cooperating closely with WHO which had recently sent a team. The Turkey WHO rep said that Turkey's response to the disease had been solid and timely. Turkey was
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seriously considering a proposal from the WHO related Mediterranean Zoonotic Control Program that Turkey organize a three-day regional meeting in Istanbul in November. The CCHF virus has been found in ticks in Africa, Asia, the Middle East, and Eastern Europe. Bayazit said his office was focusing its efforts on public awareness for farmers in the region.
6. Turkey has been broadly recognized for a strong and transparent response to avian influenza in humans earlier this year and it has stepped up its readiness for future potential outbreaks or human pandemic influenza. Like its efforts against avian influenza - much more dangerous for its economic effect on poultry and potential risk for transmission to humans - Turkey has organized a robust and transparent response for Crimean-Congo Hemorrhagic Fever, including good inter-agency coordination. Turkey again could play a role as a regional model, building off its experience. Turkey is interested in cooperation with the CDC, given the importance of tick-borne diseases in the U.S. The twenty deaths this year fueled concern in the press, and despite the "Congo" part of the name, this disease is far removed from an Ebola Fever like scourge given low rates of contagiousness and mortality. Wilson