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IdentifierCreatedClassificationOrigin
08SHANGHAI36 2008-01-29 07:14:00 UNCLASSIFIED Consulate Shanghai
Cable title:  

SHANGHAI AVIAN INFLUENZA PREVENTION CONTINUES

Tags:   TBIO ECON PGOV CH 
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1. (SBU) Summary: In discussions with Conoff on January 25,
Shanghai Health Bureau and Center for Disease Control (CDC)
officials stressed that the city's Avian Influenza (AI)
prevention and reaction plans are on track. Shanghai CDC has
recorded only one case of AI infection, which occurred in 2006
and is considered to be an isolated case. Shanghai has
increased its efforts to monitor migratory birds and closed down
many live chicken sellers at local markets. Because of the lack
of cases, Shanghai CDC has also scaled down services at a
hospital dedicated to infectious diseases located 53 kilometers
from Shanghai's city center. The rarely used hospital no longer
provides transportation for relatives of patients and scraped
its plans for a helicopter. Coordination among Shanghai's
district hospitals is good and Shanghai has tried to reach out
to neighboring provinces when outbreaks occur. End Summary.

Get with the Program


--------------------------





2. (SBU) On January 25 Conoff and Environment, Population and
Health Assistant met with Shanghai Municipal Center for Disease
Prevention and Control Deputy Director General Lu Wei. Lu
asserted that AI has not been a problem for Shanghai. There has
only been one death in the Shanghai CDC's jurisdiction and this
occurred early in 2006 when a young woman, still in her
twenties, died. She was a migrant worker from Guangdong
province who was working as a cook. According to Lu, this was
an isolated case and no one else was infected. Since 2004,
there have been few changes to the original Shanghai AI
prevention and response protocol plans. (See reftel A for more
details on the protocols.) He believed that a major factor in
the success of the Shanghai AI prevention program is strict CDC
oversight to enforce program compliance.

Fever or Deadly Disease


--------------------------





3. (SBU) Thirty nine hospitals in Shanghai are tasked with
carrying out routine surveillance of all influenza like
symptoms. If symptoms meet defined criteria, samples must be
taken and tested at the Shanghai CDC. One of the reasons for
this is to examine and positively identify the type of virus.
The other reason is to track virus mutations. If it is
discovered that a virus is mutating, samples are then forwarded
to Beijing CDC for further testing. All hospitals must
identify, quarantine and treat AI cases according to the
protocol spelled out by the Shanghai Public Health and Clinic
center. Each district must also identify beds that would be
used as isolation beds if a pandemic occurs.

Bird Watching


--------------------------





4. (SBU) Lu says that since 2005, the most important addition
to the Shanghai AI prevention plan is Shanghai's bird monitoring
program. There are now 37 designated monitoring sites. The two
sites considered most important are located near the
Shanghai-Zhejiang and the Shanghai-Jiangsu border areas. The
third most important site is on the island of Chongming, which
is the third largest island in China and a resting site for many
migratory birds.



5. (SBU) Aside from keeping an eye on the wild birds, Shanghai
officials remain vigilant about domestic poultry health issues.
Almost all chicken farms that were once located inside the city
are now shut down and new laws limit the selling of live
chickens at wet markets. Lu said that the few markets that do
sell live chickens must have a special license and follow
guidelines. Lu explained that the purpose for the closures was
two-fold: 1) to decrease the odds of an AI outbreak, and 2) to
better use Shanghai's expensive real estate. According to Lu,
these are the most noticeable proactive step that Shanghai has
taken to prevent AI.

If they build it, hopefully, they will not come


--------------------------

--



6. (SBU) According to the AI treatment protocol, those infected
with AI would be moved to a special infectious disease hospital

SHANGHAI 00000036 002 OF 002


located 53 kilometers from the city center. That hospital, the
Shanghai Public Health Clinical Center of Fudan University is
located in Jin Shan and was completed in 2004, following the
2003 SARS outbreak. (See reftel A for more details on the
hospital.) The hospital continues to function but in a reduced
capacity. Although the state of the art facility is equipped
with 500 beds and is prepared to provide care for a maximum of
1100 beds in the event of a pandemic, it currently uses only a
small fraction of its facilities. A hospital administrator said
that the hospital currently cares for approximately 200
patients. When Conoff toured the facility, employees and
medical students appeared to outnumber the patients. Patients
diagnosed with infectious diseases, most of them infected with
AIDs, can elect to use the facility or stay in a Shanghai
hospital. The administrator said that most people choose to
remain in Shanghai because of Jin Shan's inconvenient location.
There were less than 20 cars parked on the hospital compound yet
hospital bus service for relatives was recently canceled and is
no longer offered. Local bus services are not convenient and a
taxi from the hospital to Shanghai city center costs
approximately 250 RMB - more than USD 35. (Comment: For many
less affluent Chinese, repeated visits to patients in Jin Shan
via taxi would rapidly consume a month's pay. End Comment.) In
another hospital cost saving measure, a plan announced in 2005
to purchase a helicopter dedicated for emergency use has been
scrapped due to its high expense.



7. (SBU) Medical students from Fudan University appeared to
make up the majority of the hospital's population. Students are
offered the option of living on the compound in dormitory
housing or commuting on one of the seven hospital shuttle buses
(not available to patient family members). The medical students
use the hospital labs, classrooms and library located in the
research building to carry out their studies.

Provincial Cooperation


--------------------------





8. (SBU) Lu said that cooperation between the Shanghai CDC and
the Shanghai district hospitals is excellent. Once a year
representatives from the different districts in Shanghai get
together at the CDC to discuss infectious diseases and
coordinate future policy changes. In regards to provincial
cooperation, Shanghai appears to be the first to initiate
contact with other provinces. Lu said that this past December
when Nanjing was dealing with the two confirmed cases of AI
(reftel B), Shanghai CDC initiated contact with Nanjing to ask
about their progress. Moreover, when Anhui province discovered
cases of AI, Shanghai CDC sent people there to observe.
JARRETT