18 January, 2006
In preparing for a possible pandemic, Greece has taken the following measures: Setting up a National Influenza Pandemic Committee composed of inter-agency representations under the presidency of the Ministry of Health.
Drawing up a National Influenza Pandemic Preparedness Plan to deal with pandemic influenza, posted to the websites of the Center for Infectious Disease Control and Prevention (www.keel.org.gr/en) and of the Ministry of Health (www.mohaw.gr)
The national plan was officially submitted to the Ministry of Health in March 2005 and has been operational ever since, in close coοperation with the National Influenza Pandemic Committee. The pandemic plan incorporates specific actions that are performed both at strategic and operational level according to the phase of the pandemic, as proposed by the WHO.
Guidelines to be followed
The publication of guidelines to be followed by health care agencies, including: definition of a suspect outbreak; notice of an outbreak; instructions for laboratory diagnosis; instructions for treatment of an outbreak in hospitals; instructions for the transportation by ambulance of suspect cases.
Also: the issuance of instructions for all points of entry into the country (by land, sea and air) and for travelers to and from affected regions. These include: instructions as to the health-related measures at airport health care centers, airlines, airport staff, flight and land crews, the cleaning of aircraft, the handling of cargo, preventative guidance for travel by ship, guidance for hotels and lodging places which are susceptible to outbreaks of the bird and/or human disease, instructions to customs posts, tour-guides and tour-bus operators and to border police. All the above instructions have been circulated to health-related agencies and to local authorities.
Further: the issuance of instructions by the Food and Agricultural Development ministries for the shelters of domestic fowl. Stepped-up inspections by the local animal-health authorities to ensure compliance with the above instructions, especially in northern Greece and the Aegean Islands.
And: instructions to the regional authorities for the management of contacts and for the preventive anti-flu vaccination of chicken-producers and other groups at risk. The National Influenza Pandemic Committee includes state agencies not directly related to health, such as the Ministry for Agricultural Development, the Ministry of the Interior, the Ministry of Development etc.
In practice, and on the technical level, the existing inter-agency's strategic plan provides for cooperative action such as the following:
• Cooperation with the Aliens Directorate of the Public Order ministry for posting of informative notices-arid the distribution of leaflets at passport-control posts and every point of entry into the country.
• Cooperation with Regional Police Authorities for the instruction of border-police as to the handling of illegal entry into the country and measures for personal protection.
• Cooperation with the Health Directorate of the Greek Railroad Organization and instruction of its staff on the handling of suspect outbreaks and personal protection, and cooperation with that organization's International Relations Directorate for the distribution of informative material to passengers traveling by train to or from Turkey.
• Cooperation with Regional Health Directorates for the preparation and readiness of hospitals in accordance with instructions issued by the Center for Infectious Disease Control and Prevention.
• Cooperation with the Agricultural Development ministry for the direct exchange of information and for the planning of joint action in the event of a suspicious outbreak in poultry farms .based on the plan already prepared by the ministry to deal with a bird-flu outbreak in poultry-farms.
• On-the-spot instructions to provincial health authorities on the enforcement of prevention and control measures, with priority given to northern Greece and the Aegean islands.
• A close watch on European and worldwide centers and organizations to assess the course of the disease among birds and humans.
• Posting of notices at airports, harbor police and border posts and in Greek Railroad trains traveling to and from Turkey. The same material has been sent also to the regional health authorities.
• Distribution of an informative leaflet giving preventive advice to departing travelers and instructions on early detection of the disease for passengers returning from countries with outbreaks of bird-flu.
• A ban on the importation of food and live birds or their produce from countries with outbreaks of the disease. Customs authorities at all entry points are authorized to seize and destroy all such imports.
• The disinfection of vehicle wheels and the shoes of passengers entering at land border crossings. • Laboratories will be ready to receive and send clinical samples for the detection of flu and suspected outbreaks.
• Preparations for the dispatch of investigative teams in the event of a suspicious outbreak among birds or humans.
• Functioning 24 hours a day seven days a week, of an operational branch of the Center for Infectious Disease Control and Prevention for the immediate declaration of suspect outbreaks, information to the public, instructions to hospitals and provincial health authorities, and to Ministry of Health for the coordination of action by the agencies involved.
• Functioning, 24 hours a day and seven days a week, at the Health Ministry of an operational center for the coordination of action by the agencies involved.
• Creation of a stock of 500,000 doses of Tamiflu, enough for five percent of the population. Half of that amount will be delivered at the end of April 2006. 22,000 doses of Tamiflu which have been generally available commercially have been reserved by the National Pharmaceutical Organization for the treatment of suspected outbreaks until the first deliveries of the drug are received. 400,000 doses of amantadine have already been received, and an order has been given for a further 300,000 doses of Tamiflu.
In the context of world cooperation, Greece actively participates in the international efforts for avian flu preparedness.
At EU level, legislation to control avian influenza is laid down in Directive 92/40/EEC, in accordance to which all member states have avian influenza contingency plans in place to ensure that the most appropriate measures are immediately implemented. On 28 April 2005, the Commission adopted a new Directive, so as to review the measures laid down in Council Directive 92/40/EEC, which is fully implemented by all EU member states including Greece.
At regional level, the Greek Ministry of Health undertook the initiative to organize a Health Minister's Conference on19 November 2005, under the South East European Cooperation Process (SEECP). The results of the Conference were very constructive and the cooperation among the countries of Southeastern Europe continues being systematic.
In addition, representatives of the Ministry of Health participated in the Work Group for Health and Medicines (28 - 29 September 2005), in the framework of the Black Sea Economic Cooperation (BSEC), which discussed issues of preparedness in case of an avian flu pandemic.
In parallel, a Pan-European Avian Flu Pandemic Exercise (23 - 24 November 2005) was actively monitored and followed through by representatives from the Ministry of Health as well as from other Public Institutions.
Source: Press Office of the Embassy of Greece
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