H1N1 INFLUENZA OUTBREAK - CHINA SITREP # 20

UNCLAS SECTION 01 OF 03 BEIJING 001636 HHS FOR OGHA CDC ATLANTA FOR CCID, AND PASS TO FLU COX AND MOUNTS AND COGH BLOUNT AND KELLEY SENSITIVE SIPDIS E.O. 12958: N/A TAGS: KFLU AEMR ASEC CASC KFLO TBIO KSAF KPAO PREL PINR AMGT, MG, EAGR, HHS, CH SUBJECT: H1N1 INFLUENZA OUTBREAK - CHINA SITREP # 20 REF: A) BEIJING 1596 B) BEIJING 1548 C) BEIJING 1466 D) BEIJING 1396 E) BEIJING 1377 227 CASES OF 2009 A/H1N1 CONFIRMED, 70 AMCIT CASES -------------- -------------- ¶1. (U) As of COB June 16, China's Ministry of Health (MOH) has officially communicated information about 227 confirmed cases of infection by the novel 2009 influenza A/H1N1. Of the confirmed cases, 70 are American citizens. Confirmed cases have been detected in 15 provinces and the municipalities of Beijing, Shanghai and Tianjin, with the greatest number of cases occurring in Guangdong (46),Fujian (30),Sichuan (26),Beijing (47),and Shanghai (21). Of the 227 confirmed cases, MOH reported that as of June 15, 86 infected patients had recovered and been released from treatment. The remaining 141 are being treated in isolation at local designated hospitals. ¶2. (SBU) American citizen cases have been reported in the municipalities of Beijing, Shanghai, and Tianjin, and the provinces of Guangdong, Fujian, Sichuan, Hubei, Henan, Shandong, and Hainan. Consular officers in Beijing, Guangzhou, Chengdu, and Shanghai have established and maintained contact with Amcits being treated in local hospitals. ¶3. (SBU) ACS sections in all consular districts also are tracking hundreds of cases of Americans being moved in and out of officially-imposed quarantine, including several high school student exchange groups who have had members quarantined in hotels or the hospital. These developments have generated a flurry of anxious inquiries from parents and congressional offices. The rise in cases in the last week has slowed the notifications process for new quarantine cases. In recent days, ACS sent a third diplomatic note, again requesting timely notification and more attention to customer service issues, such as cleanliness of quarantine facilities and poor communication procedures(both lack of information regarding case status and insufficient English-speaking staff). ¶4. (SBU) ConGen Shanghai is watching particularly closely the case of a 5-year old American child, who was confirmed with H1N1 and moved to a treatment hospital designated for children. Her parents remain in quarantine in a separate observation hospital and at home. �0A; The parents previously were not permitted to communicate freely with the child, and had little or no input on treatment decisions for the child. However, the parents now have a more established channel for communicating with the child's doctors on her condition. ¶5. (SBU) In addition to the 70 confirmed American citizen cases, 23 Canadian nationals have been confirmed as having been infected by the novel 2009 influenza A/H1N1 virus, as well as one Australian national, one French national, one Philippine national, one Japanese national, and one Venezuelan national. ¶6. (U) The Program for Monitoring Emergency Diseases (PROMED) operated by the International Society for Infectious Diseases released an epidemiological analysis on June 16 of China's first 120 cases, based on press reports. The first domestic case of "unknown source" was reported on June 12. While all 120 cases have exhibited influenza-like symptoms, none of the cases have shown severe symptoms. Only 15 of the 120 cases were detected through airport temperature screening procedures. Other confirmed cases were detected some time after arrival in country, or were domestic transmission cases. SPECIAL QUARANTINE AND RELEASE ARRANGEMENTS -------------- -------------- BEIJING 00001636 002 OF 003 ¶7. (SBU) Through consultations with Shanghai Foreign Affairs Office (FAO),Shanghai ACS negotiated the early release from quarantine and departure from China of New Orleans Mayor C. Ray Nagin, who had been detained and quarantined on June 7 (REF B). Mayor Nagin departed Shanghai the evening of June 10 on a Qantus flight bound for Sydney. ¶8. (SBU) In Nanjing, a U.S. Department of Agriculture (USDA) official traveling in China on an official passport was placed into quarantine when H1N1 cases were confirmed on her international Washington Dulles to Beijing flight arriving on June 9. Through official requests from Embassy Beijing to the Ministry of Foreign Affairs (MFA) and Ministry of Health (MOH),the official was moved to a location separate from the designated quarantine hotel on June 11 and eventually released on June 15 (a day earlier than anticipated). Beijing Agoff confirmed that the USDA official departed from Shanghai on June 16. The official showed no influenza-like symptoms during her period in quarantine, and local health officials tested her twice for influenza A/H1N1, with both tests coming back negative. RESPONSE TO WHO PHASE 6 PANDEMIC ANNOUNCEMENT -------------- -------------- ¶9. (SBU) On a national level, the Chinese government has not noticeably modified novel 2009 influenza A/H1N1 procedures since the June 11 announcement by the World Health Organization (WHO) of the move to Phase 6. However, according to press reports, the Guangdong Health Department convened a leadership taskforce meeting on June 12 with pandemic experts, which resulted in some adjustments in its novel 2009 influenza A/H1N1 prevention and control measures. While the measures focus broadly on improving general awareness, detection and preparedness toward reducing infection and transmission, two items of note include strengthened surveillance of people who have come in close contact with infected cases and prevention and control focused on schools and kindergartens. A Ministry of Health source indicated to Post on June 12 that quarantine procedures likely would continue into July (REF A). ¶10. (U) While not explicitly in response to the WHO increasing the influenza pandemic alert level to Phase 6, Beijing media sources have reported that five more hospitals have been designated as H1N1 hospitals in Beijing. In addition to the current two, You'an Hospital and Ditan Hospital, three others have been designated as H1N1 treatment hospitals and two more have been designated as hospitals for medical observation of suspected novel 2009 influenza A/H1N1 cases. Nationwide, the central government has plans to increase the lab network from 84 to 203, and the identified hospitals from 197 to 354 in the near future. After that, they will add an additional 202 labs and 198 hospitals. UNITED COMPLAINS OF INCONSTITENCIES IN AIRPORT PROCEDURES -------------- -------------- -------------- ¶11. (SBU) United Airlines has registered complaints with Embassy Beijing of inconsistent applications of quarantine procedures at the airports in Beijing versus in Shanghai. According to United, these problems have caused long delays in Shanghai due to slow processing and transporting of quarantined passengers, and have made it difficult to turn planes around for return flights. Based on conversations Beijing Econoff had with United station managers in Beijing and Shanghai, and with representatives from other U.S. carriers, guidance governing quarantine procedures in the two cities do not/not appear to differ. However, in executing these measures, there appear to be inadequate resource planning, coordination, and communication by the Shanghai municipal government, whereas this has been less of a problem in Beijing. ConGen Shanghai and Embassy Beijing will continue to work with airline contacts to identify ways BEIJING 00001636 003 OF 003 to raise this issue with relevant entities. PICCUTA