MGSF01: Good Initial A/H1N1 Response in Thailand

UNCLAS SECTION 01 OF 02 BANGKOK 001060 SIPDIS SENSITIVE DEPARTMENT FOR OES/IHB:JJONES,CPATTERSON; EAP FOR DHANNEMAN DEPT FOR USAID/GBH USDA FOR FAS AND APHIS HHS FOR CDC USCINCPACLO FOR AFRIMS E.O. 12958: N/A TAGS: KFLU AEMR ASEC CASC TBIO KSAF KPAO PREL PINR AMGT MG, ECON, EAID, WHO, TH SUBJECT: MGSF01: Good Initial A/H1N1 Response in Thailand REF: A) State 41745 (B) State 41768 (C)State 42349 (D) Bangkok 611 BANGKOK 00001060 001.2 OF 002 SENSITIVE BUT UNCLASSIFIED ¶1. (SBU) SUMMARY: The Royal Thai Government (RTG) has cautioned its public to avoid travel to parts of the U.S. and Mexico. In Thailand there have been no reported cases of A/H1N1 in humans or swine, but Ministry of Public Health officials, with CDC advice, are meeting daily as part of a robust preparatory response. Airport security has employed thermal scanners for all arriving (but not transit) international passengers in Bangkok, Chiang Mai and Phuket. The RTG has temporarily banned pork products from the U.S., and is advising pig farmers to take precautions. Mission health agencies CDC, AFRIMS and USAID, with current investigations and diagnostics, are contributing strongly to the regional response. END SUMMARY ROYAL THAI GOVERNMENT RESPONSE -------------- ¶2. (U) The RTG Ministry of Public Health (MoPH) has formally advised the public to use caution in travel to affected areas in the U.S. and Mexico. The Tourism Authority of Thailand told ESTHoff that it does not expect U.S. or other tourism to Thailand to be negatively affected; on the contrary Thailand should be seen as a more desirable tourism destination to the extent that flu-affected competing locations are avoided. ¶3. (U) While to date no confirmed case of A/H1N1 influenza has been reported in Thailand or Southeast Asia, the MoPH has initiated a strong response to prepare for an outbreak here. On April 28, MoPH announced a suspected case of H1N1 from a Thai lecturer who just returned from Mexico; the case was confirmed April 29 as only seasonal influenza. ¶4. (U) The MoPH is the lead RTG agency on H1N1 influenza and has set up a "war room" in its Disease Control Department. U.S. Centers for Disease Control (CDC) doctors attend its daily meetings to consider global, regional and local H1N1 updates. The current Avian/Pandemic Influenza preparedness and response plan is MoPH's template for its approach. CDC notes that at this point other Thai agencies do not attend the daily MoPH meetings. The MoPH and WHO delivered a joint briefing on the H1N1 outbreak to the diplomatic community on April 29, at which the MoPH point person for H1N1 Response, Dr. Pasakorn Akarasewi, announced that MoPH was the lead agency but that an interagency task force had been formed to include the Ministries of Education, Agriculture, Tourism and Foreign Affairs. ¶5. (U) Airport security in Thailand has employed thermal scanners at its airports in Bangkok, Chiang Mai, and Phuket. The scanners are being used to screen all passengers arriving on international flights but not on passengers who transit to other countries; the Bangkok Airport communications director told ESTH officer that the scanners have detected several febrile patients but none with influenza. Passengers are also receiving on arrival information cards detailing influenza signs. Thai Airways reported it is instituting check-in questioning of travelers; on flights it is distributing information, performing deep-clean fumigation on flights to and from high-risk countries, providing face masks to passengers on demand and requesting that symptomatic passengers notify crew before landing. ¶6. (U) While the MoPH claims to have Tamiflu for 300,000 individual courses of treatment, CDC notes that most of this is contained in concentrate with an uncertain time frame for converting the concentrate into pill form for patient use. Dr. Pasakorn briefed today that the MoPH planned to convert 100,000 treatment courses by next week. ¶7. (U) The RTG is not calling the outbreak "swine flu" out of concern that its pork industry would be affected; Dr. Pasakorn announced today that the RTG is officially calling it A/H1N1 but also commonly "Mexican flu." (Note: at today's diplomatic briefing the Mexican Ambassador protested this common name. End Note.) An Agriculture Ministry contact told ESTHoff that the ministry has an active program in process, extending throughout the provinces, informing pig farmers to avoid unnecessary contact with their livestock and to report signs of sickness. The Ministry's BANGKOK 00001060 002.2 OF 002 Department of Livestock Development has temporarily banned all imports of pork products from the U.S., Mexico and any country announcing an A/H1N1 outbreak. The ban was made effective Monday, April 27, but will not affect product currently in transit so long as the product was loaded in the US prior to April 27. (Note: In 2008, U.S. pork exports were valued at $69,121 in meat products and $179,154 in breeding swine. End Note.) AFRIMS AND USAID DOING REGIONAL DIAGNOSTIC WORK -------------- ¶8. (U) The Armed Forces Research Institute for Medical Sciences (AFRIMS) regional office in Bangkok is running diagnostics for Embassies and other entities in the region. It is expecting 21 suspected influenza samples from Embassy Beijing and one sample from Embassy Hanoi to be sent shortly. AFRIMS can currently diagnose influenza A but cannot confirm the swine H1N1 until new diagnostic reagents are received from CDC, which are expected by 3 May. USAID continues to work with implementing partners to refine pandemic influenza preparedness. ONGOING INFLUENZA STUDY HOLDS PROMISE -------------- ¶9. (U) AFRIMS and CDC are in the second year of a joint study of influenza precautions such as hand washing and face mask use. This study could be a key component in the global response to the H1N1 outbreak; CDC noted that public response to the outbreak, however, could confound the study if some of the study subjects begin hand washing, using face masks and seeking influenza vaccination. (Note: While Bangkok media have reported that three local hospitals are developing a H1N1 vaccine, they are actually engaging in basic virology research that may contribute to H1N1 vaccine development. Thailand is not in possession of H1N1 samples. End Note.) EMBASSY BANGKOK PREPARATIONS -------------- ¶10. (U) The mission held a meeting of its Pandemic Working Group on April 28. The Embassy sent an ADMIN notice to mission personnel and will send a brief consular warden message. CDC experts noted that surveillance for this outbreak will continue for a long time. Working Group members noted that as the summer R&R season approaches, the Mission will need to monitor if employees and families should be advised against travel to the U.S. Bangkok regional medical officer advises that while Bangkok has one of the largest stocks of Tamiflu, it also has one of the largest missions and its supply would not go far if a suspected case led to treatment courses for office mates and family members of the affected. The Embassy will continue to review its pandemic tripwire procedures (recently updated); for the moment the triggering event would be second generation cases in New Zealand or other patients in the region who contract H1N1 from Mexico. ¶11. (SBU) COMMENT: In the past Thailand has been hit hard with Avian Influenza and SARS outbreaks in the region. We note a fairly robust response by the MoPH. CDC queries of its MoPH contacts who attended these meetings have indicated, however, that there has been a conspicuous lack of adequate participation by other RTG agencies that would have to deal with an outbreak on Thai soil: police, military and the education ministry, for example. We have yet to see a coordinated interagency plan that would be critical for an effective outbreak response. However, Dr. Pasakorn told ESTHoff today that a meeting in process, chaired by the Deputy Prime Minister, was the first true interagency response, and would include police and military; his agency was only recently authorized to work with other agencies. ¶12. (U) POC is ESTH officer Hal Howard, howardhh@state.gov. ENWISTLE