HONG KONG AVIAN INFLUENZA UPDATE

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SUBJECT: HONG KONG AVIAN INFLUENZA UPDATE


1. (SBU) Summary: In late December, the Hong Kong
government (HKG) will submit a revised paper on Hong Kong,s
Avian Influenza (AI) preparations to the Hong Kong
Legislative Council (Legco). Bonnie Yau, Assistant Secretary
responsible for AI at the Health, Welfare and Food Bureau
(HWFB),provided Econoff an advance overview of the paper in
which she stated that Hong Kong has a four-pronged strategy
to respond to the AI threat during the upcoming migratory
bird season: 1) limiting contact between humans and poultry,
and between poultry and wild birds, 2) early detection in
animal and human populations, 3) improved preparedness and
response to a regional or global pandemic, and 4) increased
collaboration with mainland China, Macau and international
health agencies.


2. (SBU) Bonnie Yau, Assistant Secretary (Health),at the
Health, Welfare and Food Department, told Econoff that the
HKG is preparing for the annual rise in migratory bird
arrivals that usually occurs in January/February and
increases the risk of an AI outbreak in Southern China. Yau
said that Hong Kong, Macau and mainland China have stepped up
monitoring and collaboration efforts to respond to a possible
outbreak.

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Limited Contact of Poultry with Humans and Migratory Birds
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3. (SBU) Yau stated that Hong Kong has achieved significant
results in reducing the AI threat. The Hong Kong
government,s (HKG) &voluntary surrender scheme8 for
poultry farmers, wholesalers, and retailers has successfully
reduced both the farm poultry population and the number of
live chicken sellers in Hong Kong. Under this program, 146
farmers have surrendered operating licenses for cash.
Subsequently, Hong Kong,s farm poultry population dropped
from approximately 4 million to 1.7 million birds. The
number of live poultry wholesalers has also dropped from 86
to 70, while 348 out of 814 live poultry retailers have
ceased operations. These reductions allow the HKG to
reallocate resources to increase monitoring and hygiene
inspection at remaining farms and sales outlets.


4. (U) The HKG increased biosecurity measures. It requires
farms to &bird proof8 poultry areas to prevent interaction
and infection between farm stocks and wild birds. It also
mandates full vaccination of all poultry stocks in Hong Kong,
implements strong import controls for chickens from mainland
China, and increases inspections of mainland farms by HKG
officials. In addition, wholesale and retail markets have
strict measures to mitigate the AI threat. All market
vehicles, cages, and sales areas undergo daily disinfection;
the number of chickens allowed in each cage has been limited
to prevent overcrowding; all markets also must cease
operations twice each month for thorough cleaning and
inspection.


5. (U) In February 2006, the HKG banned the keeping of
backyard poultry with hefty fines of up to HK$100,000
(approx. US$13,000). However, Hong Kong has allowed a
limited number of exemptions (31) for people who owned pet
chickens, geese, ducks or pigeons before the ban.

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Early Detection and Prevention
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6. (U) As part of its ongoing surveillance and testing
program, the HKG regularly tests bird samples from wholesale
markets, pet bird shops, and imported bird suppliers with
approximately 600 birds tested randomly per month. Imported
chickens are tested both for the H5N1 virus as well as for
the effectiveness of vaccines. Since implementing this
program in 2004, 130,000 live poultry have been tested. All
tests have been negative for H5N1. The HKG also opened a
hotline for the general public to report sick or dead wild
birds. Through this program, Agriculture, Fisheries and

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Conservation Department (AFCD) workers collected and tested
approximately 11,000 birds, of which only 17 were found to
contain an AI virus. To limit the potential for human
infection, the HKG also has drawn up plans to close local
nature reserves if a bird is found to be infected within a
three-kilometer radius of the reserve.


7. (U) Three entities (Center for Health Protection and two
hospitals) have been identified as testing laboratories for
all suspected AI cases. Three additional hospitals are
capable of conducting rapid tests. Due to Hong Kong,s role
as a WHO testing center, the Center for Health Protection
(CHP) collaborates with other laboratories around the world
to monitor avian influenza outside of the region.

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AI Preparedness and Response
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8. (SBU) Hong Kong is stockpiling anti-virals (Tamiflu) as
part of its preparedness plan. Hong Kong ) through the
Department of Health and Hospital Authority ) currently has
14 million doses and expects to reach its target of 20
million doses in 2007. The HKG is also looking into building
commercial vaccine production facilities in Hong Kong. These
facilities would produce normal influenza vaccines, but could
be converted to produce anti-virals and other drugs necessary
during an AI outbreak.


9. (U) Hong Kong regularly conducts interdepartmental
preparedness and response drills. The Department of Health
conducted an AI drill in September 2006 that involved the
Health, Welfare and Food Bureau (HWFB),the Hospital
Authority, and Fire Services Department. AFCD and the
Department of Health had a poultry culling drill in October
2006, while the Food and Environmental Hygiene Department
(FEHD) organized another culling exercise in December 2006.
Yau stated that these drills are essential to remind
emergency response workers of proper infection control
techniques during a possible human or animal outbreak. The
Hong Kong Airport Authority and ferry terminal operators have
also held joint AI exercises with the government and industry
stakeholders.


10. (U) Hong Kong also conducts regular public awareness
programs on AI through television, press and street
advertising. It has published AI preparation guidelines in
Chinese (both traditional and simplified) and English. The
HKG,s AI factsheet is available online on the HWFB website
(www.hwfb.gov.hk) in 22 languages, including those of Hong
Kong,s minority populations (Urdu, Nepali, Vietnamese,
Hindi, Thai, Tagalog, Indonesian, and a variety of others).


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Collaboration with mainland China, Macau and others
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10. (SBU) Hong Kong signed agreements with the Mainland and
Macau to promote intelligence sharing prior to and in the
event of an outbreak. The HKG also conducts joint exercises
with Macau and mainland China to test the communication and
response systems among the three jurisdictions. Yau stated
that coordination with the mainland has improved,
particularly on the local level with Guangdong province.
Collaboration with Macau is also very good, although Yau
informed Econoff that she remains concerned that there were
only two hospitals in Macau to deal with a potential human
outbreak. The Macau Special Administrative Region
government, with its much smaller infrastructure, also
appears to lack the same level of human resources as the HKG
in managing the AI threat. Nevertheless, Yau predicted that
Macau &is in fine shape, so long as neighboring Zhuhai does
not have a major outbreak.8 (NOTE: Post plans further AI
outreach with the Macau and a separate report on Macau AI
preparations in the new year.)


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11. (SBU) Hong Kong also sends infectious disease experts to
places that have experienced AI outbreaks to study local
responses and provide assistance. In the region, the HKG
remains concerned about the ability of some of its neighbors
to respond to a pandemic. Yau cited Indonesia as a country
of particular concern.
Cunningham