SHANGHAI AVIAN INFLUENZA PREVENTION CONTINUES

UNCLAS SECTION 01 OF 02 SHANGHAI 000036 SIPDIS SIPDIS STATE FOR EAP/CM HHS FOR ELVANDER/BHAT E.O. 12958: N/A TAGS: TBIO ECON PGOV CH SUBJECT: SHANGHAI AVIAN INFLUENZA PREVENTION CONTINUES REF: A) 2005 SHANGHAI 3660; B) SHANGHAI 35 (U) This cable is sensitive but unclassified and for official use only. Not for distribution outside of USG channels or via the internet. ¶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