AI: PRC PRESSURE ON HONG KONG; HHS A/S SIMONSON'S

C O N F I D E N T I A L SECTION 01 OF 03 HONG KONG 000777 SIPDIS SIPDIS STATE FOR EAP/ANP AND INR/EAP STATE FOR 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/IHA DSINGER AND RDALEY HHS FOR U/S SIMONSON HHS FOR OGHA - STEIGER, ELVANDER, BHAT BANGKOK FOR RMO, CDC STATE PLEASE PASS TO USDA FOR DU/US LAMBERT BEIJING FOR DSELIGSOHN, CSHAPIRO E.O. 12958: DECL: 02/24/2016 TAGS: AMED ECON PREL KSTH TBIO EAGR HK CH SUBJECT: AI: PRC PRESSURE ON HONG KONG; HHS A/S SIMONSON'S VISIT TO HONG KONG REF: HONG KONG 3520 Classified By: E/P Chief Simon Schuchat. Reasons 1.4 (B,D). ¶1. (C) Summary: During a meeting with between Department of Health and Human Services (HHS) Assistant Secretary Stewart Simonson and Hong Kong University's (HKU) Microbiology Department, renowned influenza expert Dr. Robert Webster (strictly protect) alleged that pressure from the PRC's Ministry of Agriculture on Hong Kong's (HKG) Food and Environmental Hygiene Department (FEHD) had prevented HKU from acquiring samples of China's AI poultry vaccine. This appears to be the first time that PRC pressure on the HKG has interfered with local AI research efforts. Webster also said that HKU is planning to release a study that will show that the distribution of AI among poultry in China is much more extensive the Chinese government has reported and will "prove" that the lineage of AI strains in Vietnam can be directly traced back to specific provinces in China. He predicted the study would greatly displease the Mainland government, and he expressed concern that this could result in efforts to "get rid of" of him and fellow flu researcher Guan Yi. End Summary VISIT DETAILS ¶2. (U) HHS Assistant Secretary Stewart Simonson visited Hong Kong between December 28, 2005, and January 1, 2006, to observe the state of Hong Kong's avian influenza (AI) preparedness. He held meetings with the HKG Centre for Health Protection (CHP),the Agriculture, Fisheries an Conservation Department (AFCD),and the ChineseUniversity of Hong Kong's (CUHK) Centre for Emering Infectious Diseases, and HKU's Microbiology Department. Meeting With HKU Department of Microbology -------------- ¶3. (C) HKU Department of Microbiology Profesors Robert Webster, Malik Peiris, and Guan Yi tod A/S Simonson that Mainland Chinese poultry vaccines have not been effective to date and may have actually driven the evolution of the AI virus. Corruption in China is in general hampering the overall production of effective vaccines. Webster emphasized the need for China to standardize its poultry vaccines, pointing out that a failure to do so could negatively impact countries such as Vietnam that purchase poultry vaccines from China. Webster further alleged that pressure from the PRC's Ministry of Agriculture had forced the FEHD to interfere with HKU efforts to acquire samples of China's AI poultry vaccine. ¶4. (C) Webster also said that HKU is planning to release a study that will show that the distribution of AI among poultry in China is much more extensive the Chinese government has reported and will "prove" that the lineage of AI strains in Vietnam can be directly traced back specific provinces in China. Webster warned that this action will likely greatly displease the Mainland government and expressed concern that there may be efforts to "get rid of" of him and Guan Yi. ¶5. (U) Professor Peiris said that although AI remains a real threat, it was "highly unlikely" that a pandemic deriving from H5N1 would strike in the next year or two. As AI goes off of the public radar screen, governments have to manage public expectations and avoid backlash against the use of large amounts of government funds. Peiris concluded that public health officials, doctors, and researchers should work hard to avoid the "Chicken Little" syndrome. ¶6. (U) HKU professors expressed concern about the growing stability of the AI virus, noting that it could now survive for up to one week at a temperature of 27 degrees Celsius. They noted, however, that some new data suggested a low rate of AI infection among poultry workers despite likely high levels of exposure to the virus. This indicates that a genetic pre-disposition may be necessary for people to be HONG KONG 00000777 002 OF 003 severely affected by the virus. As for research on anti-viral drugs, Webster said that laboratory tests show that the H5N1 virus isolated from China is susceptible to combinations of Tamiflu and amantadine or rimantidine and therefore amantadine or rimantidine may be treatment options for persons with avian influenza. Meeting With CHP -------------- ¶7. (U) CHP officials briefed A/S Simonson on the structure of Hong Kong's Department of Health and provided a quick overview of Hong Kong's Pandemic Influenza Preparedness Plan (covered in detail in reftel, also available at http://www.chp.gov.hk/files/pdf/ flu plan framework en 20050222.pdf). The CHP discussed the planned March 2006 completion of their Communicable Disease Information System (CDIS),which is designed to pull together various sources of communicable disease data and merge them into a central "data warehouse." This data would be used to organize emergency response and planning efforts for any prospective pandemic disease situation. CHP Controller Dr. P.Y. Leung pointed out that Mainland China already has a similar system in place and said that CDIS may be able to connect to the Mainland system. The CHP hopes to deploy CDIS by the end of 2007 and start full operation of the system by ¶2008. ¶8. (U) Leung agreed with A/S Simonson's view that non-pharmaceutical intervention measures (hand washing, social distancing, etc.) were vitally important in the fight against AI. In the event of a full blown pandemic, he continued, the HKG will try to encourage people to use social distancing measures and otherwise try to live as normally as possible. Towards that aim, the CHP has met with various public utilities, businesses, and other private sector entities to help them set up business continuity plans. As for possible border closures, Leung said that the HKG would be very reluctant to restrict travel; even if the borders closed, he explained, the HKG would not be able to deny Hong Kong residents the right to return home. ¶9. (C) When asked about the HKG's contributions towards international efforts against AI, Leung said that Hong Kong's first priority was cooperating with Mainland China, especially Guangdong Province, against the spread of AI in the country. Leung said that the CHP enjoyed good working relations with the PRC government, engaging frequently in exchanges of information with the Ministry of Health and health officials in Guangdong. He added that doctors and researchers in Hong Kong also have extensive informal networks through which they can obtain information. Visit To CUHK Centre for Emerging Infectious Diseases -------------- -------------- ¶10. (U) Flu Researchers at CUHK's Centre for Emerging Infectious Diseases focus more on directly applicable clinical research as opposed to the molecular level laboratory-focused research being done by their colleagues at HKU. Some of the research projects that CUHK is currently working on include ventilation in hospital rooms, oxygen flow rates through different types of masks, duration of viral shedding, and syndromic surveillance. ¶11. (U) CUHK Microbiology Professor Paul Chan emphasized the importance of providing more training on the importance of infection control. (Note: HKU professors criticized the CUHK-affiliated Prince of Wales Hospital for poor infection control practices during SARS which led to high infection rates among hospital staff there. End note.) Chan said that key factors in infection control included setting safe distances between beds, preventing symptomatic health care workers from reporting to duty, and making sure that there were exhaust fans in every ward to provide adequate ventilation. CUHK professors also lamented the lack of foreign AI or pandemic flu "investments" in Hong Kong and hoped for improvements in the situation. HONG KONG 00000777 003 OF 003 Meeting With AFCD -------------- ¶12. (U) AFCD officials gave A/S Simonson an overview of the animal control measures that the HKG has implemented to combat the threat of AI (measures detailed in Hong Kong's Pandemic Influenza Preparedness Plan, also see reftel). AFCD Assistant Director Thomas Sit said that the H5N1 virus evolves quite slowly in birds and appears to have reached a fairly stable stage in its evolutionary progression. Sit concluded that AI situation in the region is currently quiet and stable. ¶13. (U) This cable has been cleared with HHS A/S Simonson. Sakaue