HK H1N1 UPDATE - LOCAL TRANSMISSION TAKES ROOT,

UNCLAS HONG KONG 001109 SIPDIS DEPT FOR OES/IHB AMBASSADOR LOFTIS, DEPT FOR EAP/CM, DEPT FOR CA/OCS/EAP, DEPT FOR M/PRI, DEPT FOR SES-O, HHS FOR OGHA, CDC ATLANTA FOR CCID AND COGH E.O. 12958: N/A TAGS: AMED AEMR AMGT ASEC CASC KFLO KFLU KPA KSAF MG, PINR, PREL, TBIO, HK, CH SUBJECT: HK H1N1 UPDATE - LOCAL TRANSMISSION TAKES ROOT, MACAU HOSTS AIR TRAVEL AND INFECTIOUS DISEASE CONFERENCE REF: HONG KONG 1065 ¶1. Summary: H1N1 cases in Hong Kong continue to increase, including new community transmissions, despite school closures. Four secondary schools have now been closed, joining all nursery, kindergarten and primary schools in Hong Kong. Additional secondary schools will be closed as outbreaks occur. The shift to additional community transmission is forcing the Hong Kong Government (HKG) to abandon efforts to contain the virus and move toward a mitigation strategy. Macau authorities released four AmCits from quarantine after they arrived in Hong Kong on a plane with an infected passenger. None tested positive for H1N1. Macau hosted the third Asian Steering Committee for the Cooperative Arrangement for Preventing the Spread of Communicable Diseases Through Air Travel (CAPSCA),June 12-13, where World Health Organization (WHO) representatives defended WHO's decision not to mandate H1N1 border screening. End Summary. ¶2. The number of confirmed H1N1 cases in Hong Kong continues to increase, with the HKG announcing a total of 118 infections on June 16. The community transmission rate continues to increase as well, with 9 of 14 newly identified cases resulting from local contact rather than international travel. ¶3. School closures (Reftel) have not been completely effective at stopping the community spread of H1N1 in Hong Kong. Three additional secondary schools, including the Australian International School, were ordered closed June 16-17 due to outbreaks. 27 of the H1N1 cases in Hong Kong occurred among student populations of the now-closed schools, including 22 cases at St. Paul's Convent School, the site of the original school outbreak. The HKG continues to monitor the situation and can be expected to continue closing secondary schools on a case-by-case basis as outbreaks occur. ¶4. The Hospital Authority announced June 16 that they will no longer admit all suspected H1N1 cases to hospitals for testing and observation. Instead, suspected cases will be identified and tested at one of the HKG-operated flu clinics, provided with Tamiflu and sent home. Those individuals who test positive for H1N1 will be contacted and asked to report to a hospital for treatment and isolation. This new policy is a result of the HKG decision to move from a "containment" strategy to embracing a "mitigation" strategy for handling the outbreak. Macau Quarantines AmCits, Hosts CAPSCA -------------- ¶5. Macau health authorities released four AmCits on June 16 who had been quarantined in Macau since June 8-9. The four arrived in Macau from Hong Kong and had been identified as sitting near H1N1-infected passengers on their flights to Hong Kong. None developed symptoms of H1N1. Four other AmCits are currently quarantined in Macau. ¶6. Macau hosted the third Asian Steering Committee for CAPSCA, June 12-13. Attendees included participating member and observer country delegations, international organizations, non-governmental organizations and aviation industry representatives. Initiated by the International Civil Aviation Organization (ICAO) in 2006, CAPSCA's goal is to reduce the spread of disease by air travelers through efforts by member states, air operators and airports. This conference was held only hours after the WHO's announcement of the H1N1 Phase 6 Pandemic Alert. Although H1N1 dominated the CAPSCA agenda, participants were reminded that H5N1 (Avian Influenza) is still "the deadliest viral threat to the region that requires everyone's commitment and vigilance." ¶7. Local attendees questioned WHO's decision not to recommend border screening for H1N1. The WHO representative defended WHO's decision, particularly regarding the utility of thermal scanning. According to WHO, these measures are not effective in preventing H1N1's global spread because some infected travelers are asymptomatic, yet still contagious. The WHO representative cited "less than 2% of the 27,737 H1N1 cases, as of June 11" as having been detected by border screening measures. MARUT