- "49153","1/5/2006 10:49","06ANKARA55","Embassy Ankara","UNCLASSIFIED","06ANKARA20|06ANKARA55","VZCZCXRO3287
OO RUEHHM RUEHLN RUEHPB
DE RUEHAK #0055/01 0051049
ZNR UUUUU ZZH
O 051049Z JAN 06
FM AMEMBASSY ANKARA
TO RUEHC/SECSTATE WASHDC IMMEDIATE 2384
RUEHRC/USDA FAS WASHDC PRIORITY
INFO RUEHGB/AMEMBASSY BAGHDAD 0503
RUEHAH/AMEMBASSY ASHGABAT 1784
RUEHKB/AMEMBASSY BAKU 1261
RUEHBM/AMEMBASSY BUCHAREST 0757
RUEHCH/AMEMBASSY CHISINAU 0299
RUEHDM/AMEMBASSY DAMASCUS 1434
RUEHSF/AMEMBASSY SOFIA 0924
RUEHSI/AMEMBASSY TBILISI 2910
RUEHVI/AMEMBASSY VIENNA 1448
RUEHYE/AMEMBASSY YEREVAN 1131
RUEHVK/AMCONSUL VLADIVOSTOK 0033
RUEHDA/AMCONSUL ADANA 0187
RUEHPH/CDC ATLANTA GA
RUEAUSA/DEPT OF HHS WASHDC
RUEHGV/USMISSION GENEVA 1384
RUEHAST/USOFFICE ASTANA 0031
RUEHZN/EST COLLECTIVE","UNCLAS SECTION 01 OF 02 ANKARA 000055
USAID FOR TROSTLE, BLANCHET AND CARROLL
HHS FOR WSTEIGER/PBUDASHEWITZ
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
TAGS: TBIO, AMED, EAID, CASC, SENV, EAGR, KPAO, TU
SUBJECT: TURKEY: AVIAN INFLUENZA CAUSES TWO HUMAN DEATHS
Ref: ANKARA 20 AND PREVIOUS ANKARA 00000055 001.2 OF 002
1. Summary. Turkey\'s Ministry of Health has confirmed two human deaths from H5 Avian Influenza. N Sub-type has not been determined, but H5N1 is suspected. It appears that the victims caught AI from handling sick birds. There is no indication of human to human transmission. The GOT continues to implement containment and culling procedures in areas of suspected outbreaks in the east. End Summary.
Two Human Deaths from AI Confirmed
2. The GOT Ministry of Health (MOH) has confirmed three positive H5 test results from humans. Two of these have died (Jan 4 and 5). Four cases are under treatment at a hospital in Van, coming from two separate families from Dogubayazit in eastern Turkey. The victims were reported to have handled and had close contact with sick birds on family farms.
3. The MOH previously reported negative results in the first battery of testing in Ankara (Reftel). The second round of tests included lung tissue from the first death\'s autopsy and broncho-aspirate samples from the others. The positive result was obtained during the day of January 4, but the MOH waited to confirm with a third round of testing in Istanbul - before making a public announcement at 11:00pm local time January 4. The initial false negative was attributed to poor sampling (using nasal swabs). The MOH has sent the total of six samples to the WHO lab in London for confirmation and sub-typing.
4. The Press has reported higher numbers of cases under treatment and/or observation, but these are not confirmed.
5. The EC Mission, like us, is following events closely. The WHO has been keeping the Commission in Brussels informed. The EC expects to send a team today or tomorrow from the European Center for Communicable Diseases. The EC rep gives GOT credit for taking appropriate measures and communicating, but asserted that although Turkey is an observer in the EU \"Network for Communicable Diseases\" alert network, it has not passed any info through this channel (MOH reps told us they had been using appropriate EU reporting channels).
Poultry Outbreaks and Government Actions
6. On December 15, 2005, 1200 poultry died from the H5 virus in the town of Aralik in the province of Igdir, near the Armenian border (Reftel). On December 27, 2005, the Ministry of Agriculture released an official statement announcing this second AI outbreak in the country. (The N subtype has not yet been determined. Samples were sent after the New Year to a laboratory in London and results are pending.) The GOT imposed a strict 10 km. quarantine zone around the city of Aralik, in Igdir. About 700 birds were killed in the first 3 kilometers and entry and exit of poultry and trucks has been forbidden. The next 7 kilometers are under surveillance. (This area is not near any commercial poultry operations. Villagers use the ANKARA 00000055 002.2 OF 002 poultry - turkeys and laying hens - for family consumption.)
7. According to the Ministry of Agriculture, poultry also died in Horasan, in the province of Erzurum, and in Dogubeyazit, Agri Province, during the beginning of the week of January 2, 2006. Samples from the sick and dead poultry from Erzurum and Agri were sent to the laboratory in Izmir for AI testing. Lab results are pending.
8. On January 4, 2006, The Ministry of Agriculture\'s Protection and Control General Directorate released a statement regarding the following 5 cities: Igdir, Kars, Agri, Ardahan and Erzurum, which declared that entrance and exit of all poultry to the above mentioned cities is now banned. Transportation of poultry within the cities is also banned. In Erzurum there are 2 minor, regional commercial establishments and they are allowed to transport poultry but the requirements are very strict (i.e. requirement to use a container, etc). Also, the sale of live poultry is banned in open markets.
9. On January 5, the Governor of Yozgat, a province in Central Anatolia, announced that about 50 poultry died in Akdagmadeni, Yozgat Province, on January 3, 2006. As precautionary measures, 668 additional birds were culled. It is not clear whether the birds died of AI, but the samples were sent to the laboratory in Izmir. The region surrounding Akdagmadeni is under quarantine as a precautionary measure. The head of government in the city of Akdagmadeni confirmed these statements to the Embassy.
10. In addition, the director of the laboratory in Izmir, which tests for AI in poultry, also confirmed to the Embassy that he has received numerous samples from all over Turkey and is in the process of examining them. He is unable to give any results at this time. 11. Comment: The GOT has been generally perceived as reacting quickly to contain at least two separate rounds of outbreaks of AI in poultry (1. In October in the west, confirmed as H5N1, and 2. Current suspected outbreaks in the east, sub-type still not established). The GOT\'s previous - and now disproved - assurances that associated victims did not have AI will feed public anxiety and general mistrust of the government. The GOT may not have adequate capacity to address surveillance, containment, and communication in the event of multiple outbreaks.