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Viewing cable 06ANKARA55, TURKEY: AVIAN INFLUENZA CAUSES TWO HUMAN DEATHS

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Reference ID Created Released Classification Origin
06ANKARA55 2006-01-05 10:49 2011-08-24 01:00 UNCLASSIFIED Embassy Ankara
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
RUEHBS/USEU BRUSSELS
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 
 
SIPDIS 
 
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 
 
SIPDIS 
 
E.O. 12958:N/A 
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. 
 
MCELDOWNEY