Identifier
Created
Classification
Origin
05COLOMBO1993
2005-11-23 10:42:00
UNCLASSIFIED
Embassy Colombo
Cable title:
SRI LANKA: AVIAN FLU TRIPWIRES
how-toThis record is a partial extract of the original cable. The full text of the original cable is not available.
UNCLAS SECTION 01 OF 04 COLOMBO 001993
SIPDIS
STATE FOR OIE DANIEL SINGER AND REBECCA S DALEY
STATE FOR SA/INS
E.O 12958: N/A
TAGS: AMED AMGT CASC EAGR TBIO ECON CE
SUBJECT: SRI LANKA: AVIAN FLU TRIPWIRES
REF: A) COLOMBO 1592, B) COLOMBO 1992
UNCLAS SECTION 01 OF 04 COLOMBO 001993
SIPDIS
STATE FOR OIE DANIEL SINGER AND REBECCA S DALEY
STATE FOR SA/INS
E.O 12958: N/A
TAGS: AMED AMGT CASC EAGR TBIO ECON CE
SUBJECT: SRI LANKA: AVIAN FLU TRIPWIRES
REF: A) COLOMBO 1592, B) COLOMBO 1992
1. US EMBASSY COLOMBO'S TRIPWIRES AND POSSIBLE ACTIONS
FOR VARIOUS AVIAN INFLUENZA (AI) SCENARIOS WERE PREPARED
BY POST'S AVIAN INFLUENZA WORKING GROUP (AIWG) AND HAVE
BEEN APPROVED BY THE EMERGENCY ACTION COMMITTEE (EAC).
WE INVITE AND WELCOME FEEDBACK FROM RELEVANT OFFICES AND
AGENCIES WITH EXPERTISE IN EMERGENCY PLANNING AND/OR
INFLUENZA.
2. POST'S FOREIGN SERVICE MEDICAL OFFICER, ECONOMIC
OFFICER, CHIEF OF CONSULAR SECTION AND AID HEALTH AND
HUMANITARIAN ASSISTANCE PROGRAM OFFICER ARE MEMBERS OF
THE AIWG. IN ADDITION TO CONSULTING WITH GOVERNMENT
OFFICIALS AND MULTILATERAL REPRESENTATIVES (REFS A AND
B) AND PREPARING THESE TRIPWIRES, POST HAS DISTRIBUTED
AN ADMINISTRATIVE NOTICE TO ALL PERSONNEL REGARDING AI
SYMPTOMS AND PREVENTIVE MEASURES. THE CONSULAR SECTION
HAS ALSO INCLUDED A LINK TO THE STATE DEPARTMENT AVIAN
FLU FACT SHEET WITHIN ITS MEDICAL INFORMATION PAGE FOUND
AT
HTTP://SRILANKA.USEMBASSY.GOV/MEDICAL_INFORMA TION.HTML.
THE AIWG WILL CONTINUE PLANNING FOR A POSSIBLE PANDEMIC,
INCLUDING REFINEMENT OF PROGRAMS AVAILABLE TO EMBASSY
PERSONNEL IN THE EVENT OF A PANDEMIC.
KEY ASSUMPTIONS
--------------
3. THE AIWG HAS MADE THE FOLLOWING ASSUMPTIONS FOR
PLANNING PURPOSES:
THE CURRENT THREAT TO PERSONS IN SRI LANKA, AND USG
PERSONNEL IN PARTICULAR, IS LOW. NO BIRD HAS YET BEEN
DIAGNOSED WITH AI IN SRI LANKA. THE CONTINGENT RISK IS
THAT H5N1 BEGINS TO TRANSMIT ACTIVELY BETWEEN HUMANS.
RISK WOULD BE MANAGEABLE IF HUMAN-TO-HUMAN TRANSMISSION
OCCURRED ONLY IN CASES OF EXTENSIVE INTIMATE CONTACT.
TRANSMISSION BY CASUAL HUMAN-TO-HUMAN CONTACT WOULD
REQUIRE RAPID ACTION TO PROTECT OUR PERSONNEL.
THERE IS A LOW PROBABILITY THAT SRI LANKA WOULD BE AT
THE CENTER OF ANY OUTBREAK OF HUMAN-TO-HUMAN AI
INFECTION. BUT IF CASUAL CONTACT WOULD RESULT IN AI
INFECTION, SRI LANKA IS ONLY A SHORT AIRLINE FLIGHT AWAY
FROM PROBABLE OUTBREAK CENTERS.
SRI LANKAN MEDICAL FACILITIES ARE ALREADY NEAR CAPACITY
EVEN WITHOUT AN EPIDEMIC OF ANY SORT. MEDICAL FACILITIES
WILL BE UNABLE TO HANDLE MORE THAN A FEW CASES. THERE
ARE NO ENTIRELY SUITABLE ISOLATION WARDS SHOULD H5N1
HUMAN-TO-HUMAN TRANSMISSION BECOME HIGHLY EFFICIENT.
DEPENDING ON THE SPEED OF A HUMAN-TO-HUMAN OUTBREAK, U.S.
CITIZENS COULD BE QUICKLY CUT OFF FROM EVACUATION ROUTES.
POST WOULD BE UNABLE TO OBTAIN ESSENTIAL MEDICAL AND
BASIC SUPPLIES IN THE EVENT OF A CRISIS AND SHOULD
STOCKPILE ADEQUATE PROVISIONS.
TRIPWIRES AND RECOMMENDED ACTIONS
--------------
THE AMBASSADOR HAS APPROVED THE FOLLOWING TRIPWIRES AND
POSSIBLE ASSOCIATED ACTIONS:
4. TRIPWIRE ONE: Significant occurrences of AI
transmitted from birds or other animals to other birds
or animals emerge in Sri Lanka; no evidence of sustained
transmission to humans. (Note: "Significant
occurrences" include transmission to a population of non-
migratory birds or animals within a geographically
limited area or transmission in more than one area of
the country. "Sustained transmission to humans" is the
transmission of disease beyond the situation where a
single infected person transmits to another single
person with whom he/she is in extremely close physical
contact, e.g., sick child to mother. End Note.)
POSSIBLE ACTIONS:
- Restrict official and unofficial travel to affected
areas, bird markets and similar facilities.
- Reiterate current Center for Disease Control (CDC)
recommendations regarding AI prevention: reinforce
caution against consuming improperly cooked eggs or
poultry meat as well as advise on proper handling of raw
poultry products; advise people to avoid butcher or wet
markets where poultry is prepared; consider issuing
further recommendations regarding preparation or
consumption of poultry.
- Release a warning announcement to Mission personnel
and a warden message to private US citizens and post the
announcement on the website.
- Hold a town hall meeting with the American community
to discuss AI and other topics of interest.
5. TRIPWIRE TWO: Any case of bird-to-human or animal-
to-human transmission of AI in Sri Lanka
POSSIBLE ACTIONS:
- Restrict travel to affected areas.
- Release a warning announcement to Mission personnel,
a warden message to private US citizens and post the
announcement on the website. Information will include
details of the episode, instructions on watching for
signs and symptoms of avian influenza, triage criteria
and the use of personal protective equipment.
- Begin stockpiling water and canned goods to prepare
for possible need to quarantine individuals returning
from areas where human-to-human transmission may occur
(i.e., prepare for Tripwire 3).
- Instruct Embassy community regarding the medical
response and Emergency Action Committee (EAC) Plan.
- Begin regular communication with Overseas School of
Colombo and/or other international schools used by US
families at the embassy on their AI preparations and
plans.
6. TRIPWIRE THREE: Sustained human-to-human
transmission occurs as evidenced by a cluster of cases
in countries with regularly scheduled direct flights to
Sri Lanka (e.g., China, India, Maldives, Thailand)
POSSIBLE ACTIONS:
- EAC discuss the possibility of requesting authorized
departure of U.S. family members and non-emergency
personnel.
- Personnel who have frequent contact with the public will
use protective gear including masks. Visitors will be
screened by appropriate Mission personnel by taking their
temperatures as well as question them regarding recent
travel history and history of respiratory and flu-like
symptoms.
- Restrict travel to affected countries.
- Do not grant country clearances to non-emergency TDY
personnel from or transiting affected countries.
- Set up open-air facility on compound for medical triage.
- Quarantine USG and Foreign Service National (FSN)
personnel who are returning to Sri Lanka from affected
countries for two weeks or for the predetermined time of
virus incubation.
- Order mandatory sick leave with enforced quarantine at
home for any employee who shows any flu-like symptoms or
has a family member with flu-like symptoms.
- Issue a public announcement to private American citizens.
- Continue communication with Overseas School of Colombo
and/or other international schools used by US families
at the embassy on their AI policies.
- Establish daily briefings on AI status/cases with
Ministry of Health or WHO.
- Close American Center Library to public access until
further notice.
7. TRIPWIRE FOUR: Sustained human-to-human
transmission in Sri Lanka
POSSIBLE ACTIONS:
- Provide emergency consular services only.
- Possibly implement authorized departure. EAC discuss
ordered departure (on the assumption that the airlines
will take passengers from countries where human-to-human
transmission has occurred).
- Consider implementing selective administrative leave
for FSNs and for those Americans who remain at post.
Those on administrative leave are instructed to self-
quarantine to the greatest possible degree. Consider
other options for minimizing workplace exposure (e.g.,
teleconferencing). Prepare a plan for minimal staffing
should Tripwire 5 occur.
- Order mandatory sick leave with enforced quarantine at
home of any employee who shows any flu-like symptom or
has a family member with flu-like symptoms.
- Permit visitors embassy access for emergency purposes
only.
- Consider using designated space to isolate emergency
personnel (those not on leave) to prevent risk of
transmitting to families or to others who are on leave.
- Personnel who have frequent contact with the public
will use protective gear including masks. Visitors will
be screened by appropriate Mission personnel by taking
their temperatures as well as question them regarding
recent travel history and history of respiratory and flu-
like symptoms.
- Cancel local community gatherings until confirming
there are no immediate further occurrences of cases in
Sri Lanka.
- Advise closure of Overseas School of Colombo and/or
other international schools used by US families at the
embassy. Consider ordering American USG families to
keep their children home from school.
- Those personnel who are required to be in direct
contact with potentially infected persons will be
considered as candidates for antiviral prophylaxis.
- Release a warning announcement to Mission personnel,
provide a warden message to private US citizens and post
the information on the website. Information will
include details of the episode(s) and advice on means of
prevention.
8. TRIPWIRE FIVE: One or more Embassy or in-country
personnel sustain human-to-human transmission
POSSIBLE ACTIONS:
- Order mandatory sick leave with enforced quarantine at
home for affected personnel.
- Initiate treatment of affected individuals with
antivirals.
- Those personnel who are required to be in direct
contact with potentially infected persons will be
considered as candidates for antiviral prophylaxis.
- Release a warning announcement to Mission personnel,
provide a warden message to private US citizens and post
the information on the website. Information will
include details of the episode(s) and advice on means of
prevention.
9. POST-TRIPWIRE DETERMINATIONS
The AIWG will continue monitoring the situation and
recommend to the EAC when particular threats are no
longer substantial. Advice from in-country contacts as
well as medical and agricultural contacts worldwide will
be used in forming such recommendations.
LUNSTEAD
SIPDIS
STATE FOR OIE DANIEL SINGER AND REBECCA S DALEY
STATE FOR SA/INS
E.O 12958: N/A
TAGS: AMED AMGT CASC EAGR TBIO ECON CE
SUBJECT: SRI LANKA: AVIAN FLU TRIPWIRES
REF: A) COLOMBO 1592, B) COLOMBO 1992
1. US EMBASSY COLOMBO'S TRIPWIRES AND POSSIBLE ACTIONS
FOR VARIOUS AVIAN INFLUENZA (AI) SCENARIOS WERE PREPARED
BY POST'S AVIAN INFLUENZA WORKING GROUP (AIWG) AND HAVE
BEEN APPROVED BY THE EMERGENCY ACTION COMMITTEE (EAC).
WE INVITE AND WELCOME FEEDBACK FROM RELEVANT OFFICES AND
AGENCIES WITH EXPERTISE IN EMERGENCY PLANNING AND/OR
INFLUENZA.
2. POST'S FOREIGN SERVICE MEDICAL OFFICER, ECONOMIC
OFFICER, CHIEF OF CONSULAR SECTION AND AID HEALTH AND
HUMANITARIAN ASSISTANCE PROGRAM OFFICER ARE MEMBERS OF
THE AIWG. IN ADDITION TO CONSULTING WITH GOVERNMENT
OFFICIALS AND MULTILATERAL REPRESENTATIVES (REFS A AND
B) AND PREPARING THESE TRIPWIRES, POST HAS DISTRIBUTED
AN ADMINISTRATIVE NOTICE TO ALL PERSONNEL REGARDING AI
SYMPTOMS AND PREVENTIVE MEASURES. THE CONSULAR SECTION
HAS ALSO INCLUDED A LINK TO THE STATE DEPARTMENT AVIAN
FLU FACT SHEET WITHIN ITS MEDICAL INFORMATION PAGE FOUND
AT
HTTP://SRILANKA.USEMBASSY.GOV/MEDICAL_INFORMA TION.HTML.
THE AIWG WILL CONTINUE PLANNING FOR A POSSIBLE PANDEMIC,
INCLUDING REFINEMENT OF PROGRAMS AVAILABLE TO EMBASSY
PERSONNEL IN THE EVENT OF A PANDEMIC.
KEY ASSUMPTIONS
--------------
3. THE AIWG HAS MADE THE FOLLOWING ASSUMPTIONS FOR
PLANNING PURPOSES:
THE CURRENT THREAT TO PERSONS IN SRI LANKA, AND USG
PERSONNEL IN PARTICULAR, IS LOW. NO BIRD HAS YET BEEN
DIAGNOSED WITH AI IN SRI LANKA. THE CONTINGENT RISK IS
THAT H5N1 BEGINS TO TRANSMIT ACTIVELY BETWEEN HUMANS.
RISK WOULD BE MANAGEABLE IF HUMAN-TO-HUMAN TRANSMISSION
OCCURRED ONLY IN CASES OF EXTENSIVE INTIMATE CONTACT.
TRANSMISSION BY CASUAL HUMAN-TO-HUMAN CONTACT WOULD
REQUIRE RAPID ACTION TO PROTECT OUR PERSONNEL.
THERE IS A LOW PROBABILITY THAT SRI LANKA WOULD BE AT
THE CENTER OF ANY OUTBREAK OF HUMAN-TO-HUMAN AI
INFECTION. BUT IF CASUAL CONTACT WOULD RESULT IN AI
INFECTION, SRI LANKA IS ONLY A SHORT AIRLINE FLIGHT AWAY
FROM PROBABLE OUTBREAK CENTERS.
SRI LANKAN MEDICAL FACILITIES ARE ALREADY NEAR CAPACITY
EVEN WITHOUT AN EPIDEMIC OF ANY SORT. MEDICAL FACILITIES
WILL BE UNABLE TO HANDLE MORE THAN A FEW CASES. THERE
ARE NO ENTIRELY SUITABLE ISOLATION WARDS SHOULD H5N1
HUMAN-TO-HUMAN TRANSMISSION BECOME HIGHLY EFFICIENT.
DEPENDING ON THE SPEED OF A HUMAN-TO-HUMAN OUTBREAK, U.S.
CITIZENS COULD BE QUICKLY CUT OFF FROM EVACUATION ROUTES.
POST WOULD BE UNABLE TO OBTAIN ESSENTIAL MEDICAL AND
BASIC SUPPLIES IN THE EVENT OF A CRISIS AND SHOULD
STOCKPILE ADEQUATE PROVISIONS.
TRIPWIRES AND RECOMMENDED ACTIONS
--------------
THE AMBASSADOR HAS APPROVED THE FOLLOWING TRIPWIRES AND
POSSIBLE ASSOCIATED ACTIONS:
4. TRIPWIRE ONE: Significant occurrences of AI
transmitted from birds or other animals to other birds
or animals emerge in Sri Lanka; no evidence of sustained
transmission to humans. (Note: "Significant
occurrences" include transmission to a population of non-
migratory birds or animals within a geographically
limited area or transmission in more than one area of
the country. "Sustained transmission to humans" is the
transmission of disease beyond the situation where a
single infected person transmits to another single
person with whom he/she is in extremely close physical
contact, e.g., sick child to mother. End Note.)
POSSIBLE ACTIONS:
- Restrict official and unofficial travel to affected
areas, bird markets and similar facilities.
- Reiterate current Center for Disease Control (CDC)
recommendations regarding AI prevention: reinforce
caution against consuming improperly cooked eggs or
poultry meat as well as advise on proper handling of raw
poultry products; advise people to avoid butcher or wet
markets where poultry is prepared; consider issuing
further recommendations regarding preparation or
consumption of poultry.
- Release a warning announcement to Mission personnel
and a warden message to private US citizens and post the
announcement on the website.
- Hold a town hall meeting with the American community
to discuss AI and other topics of interest.
5. TRIPWIRE TWO: Any case of bird-to-human or animal-
to-human transmission of AI in Sri Lanka
POSSIBLE ACTIONS:
- Restrict travel to affected areas.
- Release a warning announcement to Mission personnel,
a warden message to private US citizens and post the
announcement on the website. Information will include
details of the episode, instructions on watching for
signs and symptoms of avian influenza, triage criteria
and the use of personal protective equipment.
- Begin stockpiling water and canned goods to prepare
for possible need to quarantine individuals returning
from areas where human-to-human transmission may occur
(i.e., prepare for Tripwire 3).
- Instruct Embassy community regarding the medical
response and Emergency Action Committee (EAC) Plan.
- Begin regular communication with Overseas School of
Colombo and/or other international schools used by US
families at the embassy on their AI preparations and
plans.
6. TRIPWIRE THREE: Sustained human-to-human
transmission occurs as evidenced by a cluster of cases
in countries with regularly scheduled direct flights to
Sri Lanka (e.g., China, India, Maldives, Thailand)
POSSIBLE ACTIONS:
- EAC discuss the possibility of requesting authorized
departure of U.S. family members and non-emergency
personnel.
- Personnel who have frequent contact with the public will
use protective gear including masks. Visitors will be
screened by appropriate Mission personnel by taking their
temperatures as well as question them regarding recent
travel history and history of respiratory and flu-like
symptoms.
- Restrict travel to affected countries.
- Do not grant country clearances to non-emergency TDY
personnel from or transiting affected countries.
- Set up open-air facility on compound for medical triage.
- Quarantine USG and Foreign Service National (FSN)
personnel who are returning to Sri Lanka from affected
countries for two weeks or for the predetermined time of
virus incubation.
- Order mandatory sick leave with enforced quarantine at
home for any employee who shows any flu-like symptoms or
has a family member with flu-like symptoms.
- Issue a public announcement to private American citizens.
- Continue communication with Overseas School of Colombo
and/or other international schools used by US families
at the embassy on their AI policies.
- Establish daily briefings on AI status/cases with
Ministry of Health or WHO.
- Close American Center Library to public access until
further notice.
7. TRIPWIRE FOUR: Sustained human-to-human
transmission in Sri Lanka
POSSIBLE ACTIONS:
- Provide emergency consular services only.
- Possibly implement authorized departure. EAC discuss
ordered departure (on the assumption that the airlines
will take passengers from countries where human-to-human
transmission has occurred).
- Consider implementing selective administrative leave
for FSNs and for those Americans who remain at post.
Those on administrative leave are instructed to self-
quarantine to the greatest possible degree. Consider
other options for minimizing workplace exposure (e.g.,
teleconferencing). Prepare a plan for minimal staffing
should Tripwire 5 occur.
- Order mandatory sick leave with enforced quarantine at
home of any employee who shows any flu-like symptom or
has a family member with flu-like symptoms.
- Permit visitors embassy access for emergency purposes
only.
- Consider using designated space to isolate emergency
personnel (those not on leave) to prevent risk of
transmitting to families or to others who are on leave.
- Personnel who have frequent contact with the public
will use protective gear including masks. Visitors will
be screened by appropriate Mission personnel by taking
their temperatures as well as question them regarding
recent travel history and history of respiratory and flu-
like symptoms.
- Cancel local community gatherings until confirming
there are no immediate further occurrences of cases in
Sri Lanka.
- Advise closure of Overseas School of Colombo and/or
other international schools used by US families at the
embassy. Consider ordering American USG families to
keep their children home from school.
- Those personnel who are required to be in direct
contact with potentially infected persons will be
considered as candidates for antiviral prophylaxis.
- Release a warning announcement to Mission personnel,
provide a warden message to private US citizens and post
the information on the website. Information will
include details of the episode(s) and advice on means of
prevention.
8. TRIPWIRE FIVE: One or more Embassy or in-country
personnel sustain human-to-human transmission
POSSIBLE ACTIONS:
- Order mandatory sick leave with enforced quarantine at
home for affected personnel.
- Initiate treatment of affected individuals with
antivirals.
- Those personnel who are required to be in direct
contact with potentially infected persons will be
considered as candidates for antiviral prophylaxis.
- Release a warning announcement to Mission personnel,
provide a warden message to private US citizens and post
the information on the website. Information will
include details of the episode(s) and advice on means of
prevention.
9. POST-TRIPWIRE DETERMINATIONS
The AIWG will continue monitoring the situation and
recommend to the EAC when particular threats are no
longer substantial. Advice from in-country contacts as
well as medical and agricultural contacts worldwide will
be used in forming such recommendations.
LUNSTEAD