AVIAN INFLUENZA PREPAREDNESS IN SINGAPORE

UNCLAS SECTION 01 OF 02 SINGAPORE 001311

SIPDIS

STATE FOR EAP/PMBS
STATE FOR OES/IHA
HHS FOR AMAR BHAT

SENSITIVE

E.O. 12356: N/A
TAGS: TBIO AMED EAGR ETRD SN
SUBJECT: AVIAN INFLUENZA PREPAREDNESS IN SINGAPORE

REF: A) 04 Singapore 231

B) 04 Singapore 445


1. (SBU) Summary. Although Singapore has not detected
avian influenza infections in either poultry or human
beings, it is preparing to address this growing regional
threat. After its successful control of the 2003 SARS
outbreak, the GOS is confident it can respond adequately to
a bird flu epidemic should one occur within its borders.
The GOS will release a Pandemic Influenza Preparedness Plan
in June. Ministry of Health officials have told us
privately that they do not intend to restrict travel into or
out of Singapore if bird flu erupts. End summary.

Multiple GOS Agencies Working on Bird Flu
--------------


2. Several Singapore Government agencies are monitoring
avian influenza and preparing response plans:

-- the Agri-Veterinary Authority (AVA) has the lead on
monitoring bird flu and regulating Singapore's small, modern
poultry sector.

-- Singapore General Hospital's National Influenza Center
performs surveillance for influenza and acute respiratory
illness.

-- the Ministry of Health (MOH) will become the lead
response agency if the virus demonstrates efficient human-to-
human transmission (defined as transmission past the first
generation of contact from infected poultry to humans).

-- the interagency "Home Team" leads Singapore's crisis
response management and will play that role in any bird flu
epidemic. Home Team member agencies are Singapore's Police
Force, Internal Security Department, Civil Defense Force,
Prisons Department, Immigration and Checkpoints Authority,
Central Narcotics Bureau, Commercial and Industrial Security
Cooperation, and Corporation of Rehabilitative Enterprises.

Planning Well Advanced
--------------


3. (SBU) Singapore has developed detailed plans for bird
flu management and will release a comprehensive Pandemic
Influenza Preparedness Plan by the end of June:

-- the AVA now requires poultry workers to wear protective
masks at all times while handling chicken and chicken
products, to follow strict hygiene practices, and to undergo
daily temperature checks. Workers are also vaccinated
against common human influenza to decrease the risk of
individuals who are immuno-compromised that will contract
bird flu and potentially serve as vectors for mutation of
the virus into strains transmissible between human beings.
If it detects avian influenza in imported poultry or
products, AVA will ban further imports from that location
and destroy and dispose of all birds imported that day. If
the disease strikes any of Singapore's seven poultry farms
or if clinical signs of avian influenza appear in poultry,
AVA will cull and safely dispose of every bird on all seven
of them.

-- the MOH continues to stockpile the anti-viral drug
Tamiflu (ref B) and aims at acquiring enough for 25 percent
of the population. MOH is discussing with vaccine
manufacturers the possibility of obtaining an early stock of
an experimental H5N1 vaccine once the testing trials and
approval process are completed. It has on hand an ample
supply of personal protective equipment left over from the
SARS epidemic.

-- Singapore will take a step-by-step approach. It
currently imposes no travel restrictions related to avian
influenza. At present, Singapore will not quarantine
individuals entering into Singapore on the basis that they
have spent any amount of time in countries with known cases
of avian influenza, either in poultry or in humans.

-- if a limited number of human cases emerges, the MOH will
employ quarantine/containment measures and possibly
institute temperature monitoring at airports (not because
this will necessarily help contain the spread, but because
it might be politically expedient). If bird flu spreads,
then there could be school closures and discouragement of
public gatherings. The GOS most likely will not impose
travel restrictions.


Unfulfilled Outreach
--------------


4. (SBU) Singapore is attempting to engage in regional
outreach to halt this potential epidemic by offering high-
end technical assistance, but to date these offers have not
been accepted. Singapore's outreach efforts have been
stymied by a lack of communication and coordination with
other nations in the region. GOS officials have told us
privately that their biggest challenge is obtaining reliable
information concerning regional outbreaks and responses to
avian influenza.


U.S. Concerns
--------------


5. (U) The experience with SARS told the U.S. business
community that Singapore's effective response did not
prevent a significant drop in business travel. This
reluctance to travel to the region affects companies'
ability to recruit staff and conduct normal business.
Although avian influenza is qualitatively different from
SARS, U.S. business representatives are concerned it will
have the same dampening effect on commerce.


6. (SBU) The RMO continues to work closely with the MOH to
ensure adequate access to Singapore's advanced medical
facilities for U.S. personnel. Officially, Singapore
immigration and health regulations do not permit entry to
people with contagious diseases. Nonetheless, MOH
representatives have unofficially told the RMO that they
will take a case-by-case approach to any USG bird flu
medevacs.

FERGIN