UNCLAS SECTION 01 OF 04 BEIJING 001171

HHS FOR OGHA
CDC ATLANTA FOR CCID, AND PASS TO FLU COX AND MOUNTS AND COGH BLOUNT
AND KELLY

SENSITIVE
SIPDIS

E.O. 12958: N/A
TAGS: KFLU AEMR ASEC CASC KFLO TBIO KSAF KPAO PREL PINR
AMGT, MG, EAGR, HHS, CH
SUBJECT: MGSF01 H1N1 INFLUENZA OUTBREAK - CHINA SITREP # 2

REF: A) BEIJING 1135 B) BEIJING 1132
C) STATE 42349 D) STATE 41768

(SBU) SUMMARY: On April 28, both President HU Jintao and Premier
WEN Jiabao made highly-publicized statements, ordering "stepped up"
quarantine and inspection measures and "enhanced prevention and
control" procedures, as well as emphasizing the need for
transparency at all levels of government. The World Health
Organization (WHO) raised the pandemic alert status to Phase five on
April 29. The Government of China will observe a national holiday
on Friday (May 1). As of the time of this report, there are no
confirmed cases of infection by the H1N1 influenza A virus in humans
or livestock. Throughout the country, however, entry processing and
screening procedures at airports and other large facilities continue
to be strengthened, and Beijing and other cities have designated
specific hospitals to deal with suspected H1N1 infections. Media
reporting has been fairly straightforward with a focus on government
actions and positive cooperation with other countries. Articles on
front page of Chinese dailies however, also indicated official
Chinese concern over reports that the virus had originated in China.
On April 29, Embassy Beijing convened an influenza outbreak
sub-group of the Emergency Action Committee (EAC) and hosted a
planning digital video conference (DVC) with Consulates in
Guangzhou, Shanghai, Chengdu, and Shenyang participating. A warden
message was sent to the American citizens community on April 29 and
the mission websites were revised to reflect updated guidance and

official USG resources. END SUMMARY.


1. (U) The World Health Organization (WHO) China Representative
Hans Troedsson reported on April 28 that while an "unspecified
number" of suspected H1N1 are cases currently being investigated in
China, to date, there still are no confirmed cases of infection by
the virus in humans or livestock. The Ministry of Health said on
April 29 that the previously-reported case (REF A) of over 100
primary school children in Shaanxi Province falling ill had been
"contained," and that authorities have now ruled out any connection
with the H1N1 virus outbreak.


2. (SBU) In what appears to be a drastic departure from the central
government's handling of the SARS epidemic in 2003, President Hu
Jintao on April 28 called for "stepped up" efforts by all levels of
government in response to outbreak. Specifically, Hu cited the need
to maintain a "people-first" policy, to "monitor closely" the
situation, and to "take prompt and comprehensive measures." Premier
WEN Jiabao later that same day issued similar guidance to the State
Council and authorized an eight-point plan for responding to the
H1N1 outbreak as follows:

-------------- Relevant government departments should follow latest
developments on the disease around the world, and step up
cooperation with foreign countries, as well as Taiwan, Hong Kong,
and Macao;

-- A joint prevention and control mechanism, including the Ministry
of Health (MOH), Ministry of Agriculture (MOA), and General
Administration of Quality Supervision, Inspection and Quarantine
(AQSIQ), should be established to make emergency plans and monitor
the entire disease prevention process;

-- Local entry-exit inspection and quarantine authorities should
enhance practices for examination and disinfection of people and
vehicles coming back from disease-plagued countries, to prevent the
entry of the illness;

-- The government should promptly issue travel notices for citizens
going abroad, according to the disease's newest information
worldwide;

-- Health authorities should enhance monitoring on unknown pneumonia
and influenza cases, set up an instant-reporting system, and treat
people promptly using early detection;

-- Supervision should be tightened on farms, slaughterhouses, and
agricultural and sideline products markets, and on pork-related

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products;

-- Anti-disease medicine and clinical treatment apparatus should be
well-prepared, and research on the disease-infection model, and the
vaccine and clinical treatment should be enhanced;

-- The government should report to the public the latest news
promptly, and better-publicize disease facts.



3. (SBU) The Civil Aviation Administration of China (CAAC) issued
updated its guidance regarding increased surveillance to nationwide
airports on April 29. The guidance sets procedures to direct all
international flights from affected areas to designated gates at
each airport for inspection and quarantine practices to be employed
for suspected H1N1 cases, and to screen other passengers from
flights arriving with one or more suspected cases. The guidance
also requires airlines to train crew and staff on safety practices,
and local civil aviation officials to devise a localized emergency
communications system for reporting suspected cases. According to
contacts at Beijing offices of U.S. airline carriers, this guidance
is being applied as follows:

--parking the arriving aircraft from affected areas separately, and
establish separate passenger flow channels;

-- sterilizing aircraft and waste products from the aircraft;

-- advising crew members to observe passengers, contact the Ministry
of Health and the Health and Quarantine Bureau (H&Q) of the
Exit-Entry Administration to notify them of sick passengers prior to
arrival at the airport, and separating and treating ill passengers
immediately;

--Upon arrival at the gate, H&Q officials board the aircraft to
survey the situation;

-- check all passengers seated within three rows in front and three
rows behind the individual suspected to be infected will have their
temperature checked by H&Q; (NOTE: U.S. CDC China Director
indicates that this designation is arbitrary and unlikely to be
effective in containing the infection, especially given the
movements of passengers while the flight is in progress, and the air
circulation systems in use onboard. END NOTE).

--The individual suspected to be infected will then be escorted off
the aircraft, and after all required CIQ formalities are
accomplished, will be transported to a designated hospital for
evaluation and any necessary treatment up to and including
possibility of quarantine, should infection by H1N1 influenza virus
be confirmed;

--All remaining passengers and crew will be required to fill out a
"Contact Card," to be distributed by H&Q (similar to H&Q cards that
used to be required from passengers), and upon confirmation that all
necessary required information is included, all passengers will be
allowed to deplane as usual;

--Should two or more passengers present symptoms of infection by
H1N1, the entire plane will be checked, quarantined, and then
possibly transported to a designated hospital.

As of April 30, the affected carriers operating international
flights arriving in Beijing are American Airlines, Continental
Airlines, Delta Airlines, Northwest Airlines, United Airlines,
Cathay Pacific Airlines, Air France, Asiana Airlines, Air China, Air
Nippon Airlines, and Scandanavian Airlines. However, in Shanghai,
for example, these procedures have only been applied to AeroMexico
flights. These procedures do not apply to flights both originating
and terminating domestically.


4. (U) Shanghai was the only city receiving direct flights arriving
from Mexico this week. Aeromexico operates two flights each week to
Shanghai Pudong Airport, arriving on Thursdays and Sundays at 6:00

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AM. The flights (both Aeromexico Flight 98) start in Mexico City,
transfer in Tijuana, and then fly direct to Shanghai. Shanghai
ESTHOFF reports that Mexican Consulate officials were on hand for
the arrival today (April 30) and according to Mexican officials,
procedures went smoothly. The enhanced airport measures were in
place, the plane taxied to a remote gate, all passengers were
screened using a body temperature scanners and cargo was inspected.
No passengers were quarantined or found to exhibit flu-like
symptoms. Passengers were briefed about the enhanced arrival
procedures during the flight. Shanghai airport authorities have
been working directly with Aeromexico to ensure that procedures
continue to run smoothly. Additionally, the arrival garnered
considerable media attention, with local press resources reporting
that 17 "3G" wireless global eyes were installed so that the
temperature and other checks could be conducted.


5. (SBU) The Beijing Municipal Government has designated three
local hospitals as suitable to handle suspected H1N1 infections.
The three hospitals are You'an, Ditan, and Peking Union Hospitals,
which are in geographically-disperse locations around the city. The
Post Medical Unit has toured one facility and is scheduled to tour
the other two next week. In addition, local expat-oriented Beijing
United Hospital is in discussions with local health authorities on
whether it may be listed as an additional designated hospital. To
date, no Chinese facility is equipped yet to confirm the current
strain of H1N1 in-country; however, this might change next week as
laboratory test kits from U.S. Centers for Disease Control (U.S.
CDC) arrive. The physical presence at U.S. CDC in Atlanta of a
leading Chinese CDC epidemiologist Dr. Zijian FENG, who has been
designated the primary liaison for information sharing, has already
enhanced the communications process between the two counterpart
agencies. Additionally, U.S. CDC China Director Dr. Jeff McFarland
maintains daily contact with MOH and Chinese CDC officials in
Beijing, providing them with the latest information available to
U.S. CDC.


6. (SBU) Chinese media reaction has been generally straightforward
and factual. Many national media publications such as Global Times
published articles refuting reports that the H1N1 virus had origins
from pigs in Fujian province. Reports also were quick to show the
Chinese government's response to the H1N1 outbreak by reporting on
the monitoring of the flow of people and goods from the Americas,
such as, the increased airport checks and denying travelers
exhibiting flu-like symptoms to enter.


7. (SBU) Mission China continues to receive, evaluate, and share
information among the Embassy and Consulates. A warden message was
sent out to all registered American citizens early on April 29, and
the front pages of mission websites were revised to reflect updated
guidance and official USG resources. Also on April 29, CDA Piccuta
met with the Influenza Outbreak Working Sub-Group of the Emergency
Action Committee (EAC) to review Tripwire 2, adjust operations
mission-wide, and conduct preliminary planning for changes that may
occur in the medium- and long-term. Later the same day, Embassy
Beijing and Consulates in Shanghai, Guangzhou, Chengdu, and
Shenyang, held a digital video conference (DVC) to coordinate
actions, exchange information, and establish a reporting mechanism
for providing information on conditions in all consular districts.
Post's response to the H1N1 influenza outbreak will be an agenda
item at a monthly "open" Country Team meeting on May 4, which will
be open to all interested Embassy personnel and American family
members.


8. Post has received detailed reporting from Shanghai, Guangzhou,
Shenyang, and Chengdu and will consolidate the information received
into the next situational report.


9. U) COMMENT: One week into the current H1N1 influenza outbreak
and as China heads into a three-day weekend, Chinese authorities by
and large have put out the "right" signals on how officials at all
levels of government should be viewing the crisis. It appears that
since the international criticism levied at China during and after
the SARS crisis of 2003, concrete lessons have been learned on how
to respond to potential outbreaks, and on the importance of

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maintaining transparency in the process. The U.S. CDC China
Director has been in daily contact with counterparts at the Chinese
CDC, and has expressed confidence that national authorities, for the
time being, are doing all within their power to contain the
situation. However, as the outbreak progresses through the weekend
and perhaps in the weeks to come, the Chinese Government may
reassess its posture. END COMMENT.

PICCUTA