AI: AVIATION EXERCISE IN HONG KONG

UNCLAS SECTION 01 OF 02 HONG KONG 001231

SIPDIS

SIPDIS

STATE FOR EAP/ANP AND INR/EAP
STATE FOR EAP/EX, EAP/BCLTV, EAP/EP TWANG, EAP/CM KBENNETT,
GWARD
STATE FOR G VTUREKIAN
STATE FOR M/MED AND M/MEDEX PETER WOOD
STATE FOR OES ANTHONY ROCK, OES/STC MGOLDBERG, OES/IRA
DSINGER AND RDALEY
HHS FOR OGRA - STEIGER, ELVANDER, BHAT BANGKOK FOR RMO, CDC
USDA FOR DU/US - LAMBERT
BEIJING FOR DSELIGSOHN, CSHAPIRO

E.O. 12958: NA
TAGS: ECON TBIO SENV EAGR AMED KFLU HK CH
SUBJECT: AI: AVIATION EXERCISE IN HONG KONG


1. (U) Summary: The Hong Kong Department of Health (DOH),
the Civil Aviation Department (CAD),and the Airport
Authority (AA) jointly organized a Seminar on Avian
Influenza Preparedness for the Aviation Sector on March 16,

2006. Topics discussed included aviation preparedness,
health screening of travelers and the epidemiology of avian
influenza (AI). The following morning, an exercise named
"Laurentian Spring" was staged at the airport to demonstrate
the Hong Kong Airport Authority's current working plan for
responding to a report of a passenger with AI symptoms. End
Summary.


2. (U) Conoffs attended a Hong Kong Government (HKG) hosted
seminar on aviation preparedness for a possible AI outbreak.
Presenters included Dr. Anthony D.B. Evans, Chief of the
Aviation Medicine Section of the International Civil
Aviation Organization (ICAO); Dr. Henry Kong, Chief Port
Health Officer of the HKG; and Dr. Edwin Tsui, Senior
Medical and Health Officer, Surveillance Section, Centre for
Health Protection of the HKG's Department of Health. U.S.
Department of Homeland Security (DHS) representatives Jim
Hawkins, David McAdam, Ted Wentz and Center for Disease
Control (CDC) representative Dr. Michael Doney also
attended.

Seminar Presentations
--------------


3. (U) Dr. Evans briefly described the current threat posed
by H5N1, including information on bird infections world-wide
spread by migrating wild birds. He reiterated that while
human infections continue to occur, there have been no
proven cases of efficient human-to-human transmission. Dr.
Evans discussed the importance of recommended precautionary
measures such as hand washing, use of protective wear, and
proper disposal of contaminated materials and also talked
about the WHO phases of AI pandemic progression. Evans then
discussed the efficacy of screening and travel restrictions
and ICAO actions to counter a possible AI pandemic. ICAO
has proposed AI pandemic guidelines on creating links and
networks, recommendations on screening, and detailed advice
on implementation.


4. (U) Dr. Henry Tong outlined key features of the
International Health Regulations published in 2005, which
required "core capacity to implement surveillance,
notification, investigation, control and prevention at the
community and national levels as well as points of entry."
Underscoring Hong Kong's experience in dealing with
communicable disease emergencies, Dr. Tong shared
information from the 2003 SARS outbreak including duration
characteristics, frequency of symptoms, infection linkages,
and how cases were identified and referred for care.
Interestingly, of the 125 patients referred for SARS-related
hospitalization, 72 (57% of the patients) were identified
through the health declaration forms travelers were required
to complete upon entering Hong Kong. The remaining 53 were
detected through temperature screening. According to Dr.
Tong, the key lesson learned from the SARS outbreak was the
need for close cooperation among government departments, the
health care sector and the community.


5. (U) Dr. Edwin Tsui outlined the epidemiological aspects
of H5N1 including age and sex distribution, disease
characteristics such as incubation period, symptoms and
survivability of the virus in the open environment. He
described the various surveillance mechanisms in place in
Hong Kong as well as investigation and control measures to
deal with reported infections. Tsui also reviewed the world-
wide H5N1 human infection totals and distribution and the
current status of suspected human cases in Hong Kong, all of
which had proven negative for H5N1.

Laurentian Spring
--------------


HONG KONG 00001231 002 OF 002



6. (U) The following morning, an exercise named "Laurentian
Spring" was staged at the airport. The exercise
demonstrated the Hong Kong Airport Authority's current
working plan for responding to a report of a passenger with
symptoms of Avian Influenza (AI) on a Cathay Pacific flight.
Exercise observers included representatives from the Hong
Kong Department of Health, the Hong Kong Port Health, the
Hong Kong Hospital Authority, Hong Kong Disneyland and
various international airlines. Radio Television Hong Kong
(RTHK) filmed the entire exercise.


7. (U) In the exercise scenario, a passenger suffering
symptoms of AI was a member of a tour group seated in
business class. The flight crew reported the case to Cathay
Flight Operations, who then relayed the message to Hong Kong
Port Health. Hong Kong Port Health then convened the Public
Health Emergencies Incident Group (PHIAG),comprised of Hong
Kong Port Health, Hong Kong Police, the Hong Kong Hospital
Authority and the Airport Authority Mobile Command Unit.


8. (U) During the exercise, Hong Kong Airport Authority and
Cathay Pacific had a plane parked on an emergency runaway.
Using live camera transmission, observers were able to watch
and hear the flight crew report the case. Hong Kong Port
Health then sent two medics in full protection (mask,
clothing protection, eye protection and gloves) to remove
the symptomatic passenger from the flight and assist him in
boarding an ambulance. Following his removal, the flight
crew passed out masks and health report forms to all other
passengers on board. After labeling the passengers based on
their physical proximity to the case, the remaining
passengers disembarked the plane and were filed into four
different buses (based on their label color) to be screened
in the terminal area. In the screening areas, the
passengers' temperatures were taken and their contact
information confirmed. At the conclusion of the exercise,
the Hong Kong Airport Authority also simulated a press
conference, which would occur concurrently with the
quarantining process.


9. (U) Overall, the exercise demonstrated the Hong Kong
Airport Authority's ability to develop a strategy for
dealing with reports of AI on flights. In conversations
with observers, several key questions arose. First,
procedures for masking and containment seemed irregular, as
the symptomatic passenger and flight crew were never masked
while all others were. Additionally, no one on board
disinfected their hands. CDC representative Dr. Doney said
that the U.S. would plan to quarantine all passengers
without any division because it is difficult to ascertain
with whom the symptomatic passenger may have come into
contact during or prior to the flight. A United Airlines
manager questioned the ability of flight crews to control
passengers should they be kept on the plane for a lengthy
period following landing. A Hong Kong Port Health official
noted that this exercise was a first, and that further
exercises are planned.

CUNNINGHAM