- "49353","1/9/2006 9:31","06ANKARA118","Embassy Ankara","UNCLASSIFIED","","VZCZCXRO5720
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DE RUEHAK #0118/01 0090931
ZNR UUUUU ZZH
O 090931Z JAN 06
FM AMEMBASSY ANKARA
TO RUEHC/SECSTATE WASHDC IMMEDIATE 2501
RUEHRC/USDA FAS WASHDC PRIORITY
INFO RUEHGB/AMEMBASSY BAGHDAD 0511
RUEHAH/AMEMBASSY ASHGABAT 1792
RUEHKB/AMEMBASSY BAKU 1271
RUEHBM/AMEMBASSY BUCHAREST 0767
RUEHCH/AMEMBASSY CHISINAU 0308
RUEHDM/AMEMBASSY DAMASCUS 1445
RUEHSF/AMEMBASSY SOFIA 0935
RUEHSI/AMEMBASSY TBILISI 2922
RUEHVI/AMEMBASSY VIENNA 1457
RUEHYE/AMEMBASSY YEREVAN 1142
RUEHVK/AMCONSUL VLADIVOSTOK 0041
RUEHDA/AMCONSUL ADANA 0240
RUEHIT/AMCONSUL ISTANBUL 9536
RHMFISS/CDR USEUCOM VAIHINGEN GE
RUEUITH/ODC ANKARA TU
RUEHPH/CDC ATLANTA GA
RUEAUSA/DEPT OF HHS WASHDC
RUEHGV/USMISSION GENEVA 1394
RUEHAST/USOFFICE ASTANA 0039
RUEHZN/EST COLLECTIVE","UNCLAS SECTION 01 OF 03 ANKARA 000118
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 Update - January 7
Ref: ANKARA 104 AND PREVIOUS
This is an Action Request.
ANKARA 00000118 001.2 OF 003
1. Summary. As of mid-day January 7 there are no new deaths or additional confirmations of human cases. Nine or ten sub- provinces are under animal quarantine. Though there are multiple reports of dead birds in other regions, none have been confirmed as AI, with the possible exception of two wild ducks in Nallihan, west of Ankara. Press reports the GOT has banned bird hunting throughout Turkey. The WHO/ECDC team departed for the affected region in eastern Turkey morning of January 7. The Turkish authorities are fully cooperating with the team, which aims to make a preliminary assessment of critical needs and recommendations by Tuesday, January 10. Personal protective gear, bird incineration equipment, laboratory equipment, surveillance and public information materials seem to be critical needs. Embassy requests Washington agencies assess capacity to respond to Turkey\'s needs, in coordination with international agencies. End Summary.
Cases in Humans
2. There are no new deaths from Avian Flu beyond the deaths confirmed on January 6. Nor are there new confirmations of H5N1. The Istanbul laboratory told us that it had results on 24 samples (representing 12 cases) received from eastern Turkey, all of which came out negative for AI. The Ankara laboratory is processing 26 samples, representing 5 cases in Erzurum and 17 new cases from Van. There are reports of people with flu-like symptoms but none yet confirmed to have AI. Of these, only a group of cases in Yalova (near Istanbul) are outside eastern Turkey and these people recently came from eastern Turkey.
Poultry Outbreaks and Government Actions
3. Press is reporting that 10 sub-provinces are now under animal quarantine (we have not yet been able to confirm the tenth sub-province from official sources.) Outside these sub- provinces, there continue to be new reports of sick birds however they have not been confirmed as AI, with the possible exception of two migratory ducks found dead in Nallihan (in Ankara province about an hour west of Ankara). Press is reporting that the Agriculture Minister has said that the two ducks in Nalihan were confirmed as AI. According to a visiting WHO official, authorities are now actively going around looking for and culling poultry in the affected regions. Press has also reported that the Environment Ministry has banned bird hunting throughout Turkey.
4. We spoke early January 7 with the lead WHO official, ANKARA 00000118 002.2 OF 003 Caroline Brown, just before she and the rest of the team left from the Van region. In addition to ECDC and WHO officials, Brown confirmed the team included a representative FAO/OIE (Office of International Epizootics). Overall, the team was pleased with the cooperation they are receiving, including extensive briefings from government ministries and time spent with the Ankara laboratory. Brown had a generally positive view of the quality of the laboratories and was pleased the GOT had agreed to have a WHO H5 specialist come to Ankara to begin running tests in parallel. The Ankara lab is running RT-PCR (real time polymerase chain reaction) tests and Brown thought the results looked reliable. WHO has offered-and Turkey has accepted-setting up an incident command center in Van.
5. Brown said it was too early for WHO to draw conclusions on case definitions (i.e. criteria used in determining whether a case is AI). She felt strongly that there was room for improvement on surveillance. The small backyard flocks are a particular challenge. Human surveillance has been mostly self-referrals up to this point (sick patients seeking treatment). The MOH has distributed brochures to the affected areas but WHO did not yet have a translation to evaluate the text. (Note: Press is reporting that Turkish students report cards, sent home Friday, included a message on how to prevent AI). Separately, Mr. Gunel Rodier from WHO/Copenhagen is due in Ankara to work on elaborating and mobilizing an emergency assistance budget. Prime Minister Erdogan announced January 6 that the GOT would allocate an additional 7 million New Turkish Lira (about $5.2 million) to address the AI problem. Brown said that, for now, Turkey has adequate Tamiflu supplies having recently ordered additional shipments. Press is reporting that Roche has shipped an additional 100,000 full courses of treatment, of which 10,000 are a donation.
6. Though preliminary, Brown identified a number of areas in which she believed there were critical needs for assistance: --Public Education. Getting the message out to people including remote farm populations on appropriate measures. (Note: Post understands USAID has developed community communication materials which could be available for translation and dissemination at village level. End Note.) --Hospital equipment, particularly ventilators. --Personal protective equipment(PPE), such as gowns masks goggles gloves, for both animal and healthcare workers. --Training for epidemiology. WHO has been working with Turkey on a project to establish improved laboratory epidemiology capacity, but this is not in place yet. From our earlier conversations with Ministry of Agriculture officials, there is a need for portable incinerators for disposable of culled animals. Given the vast numbers now ANKARA 00000118 003.2 OF 003 requiring culling, this need has undoubtedly increased.
7. Embassy requests Washington agencies assess USG capacity to respond to Turkey\'s needs, so that the USG can join the assistance efforts of international organizations. We propose that the Department make a public statement of support for the Turkish authorities\' efforts to address this problem along with a commitment to provide critical assistance.