UNCLAS SECTION 01 OF 02 KUALA LUMPUR 000663

SENSITIVE
SIPDIS

STATE FOR CA/OCS/EAP
STATE FOR M/PRI FOR RMORRITZ
STATE FOR S/ES-O/CMS FOR EPARRA
STATE FOR EAP/MTS FOR DBISCHOF
STATE FOR OES/AIAG FOR AMBASSSADOR LOFTIS, DWINN AND
CPATTERSON
STATE FOR REO/BKK FOR HHOWARD
STATE FOR OES/IHB, AAIT, MED
HHS FOR OGHA STEIGER AND HICKEY
CDC ATLANTA FOR CCID AND COGH
USDA FOR APHIS

E.O. 12958: N/A
TAGS: KFLU AEMR ASEC AMED CASC KFLO TBIO KSAF KPAO PREL
PINR, AMGT, TF, MY
SUBJECT: MALAYSIA H1N1 UPDATE - August 11, 2009


1. (SBU) SUMMARY: The Ministry of Health (MOH) has reported 14
H1N1-related deaths in the last 48 hours bringing the total to 32
deaths. The Embassy community has experienced its first suspected
cases, both involving non-school age children of employees who have
been treated and are now recovering. In consultation with RMO
Singapore, the Mission reviewed its H1N1 procedures and issued
updated influenza guidance to the Mission community. END SUMMARY.

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MOH Response
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2. (SBU) MOH has reported 32 total H1N1 related deaths, with 14 in
the last two days. The confirmed caseload continues to grow with
1780 total cases since the onset of the pandemic. However, MOH is
now in a mitigation mode, which means the confirmed caseload
understates the actual situation; MOH is not testing or subtyping
those who report to private hospitals and clinics or those who are
at low risk and choose to treat themselves. The region has also
been severely impacted by haze from fires in Indonesia and Malaysia
(will be reported septel). The haze has created unhealthy air
quality, which can further complicate influenza illness.


3. (SBU) PM Najib has expressed his concern with the spread of the
disease and the uptick in flu-related fatalities, and stated on
August 10 that he "will ask the Health Minister for tighter measures
and more drastic steps that the Government should take on this

matter." It remains unclear what those steps might entail, but are
likely to include social distancing measures. Najib has asked that
unnecessary public gatherings be canceled. Penang chief minister Lim
Guan Eng stated that the state-level National Day (August 31)
celebrations in Penang may be postponed. The Deputy Prime Minister
Muhyiddin Yassin (who is also the Education Minister) said that
Education Ministry has contingency plans, including adjusting the
dates for public examinations, if the Influenza situation forces
school closures. The State education directors would decide on the
possibility of school closures on the advice of health authorities.



4. (SBU) The International School of Kuala Lumpur (ISKL) where most
of the children of Mission staff attend school, welcomed students
back to school last week, which required them to quickly organize a
screening and self-reporting operation at the entrances to both ISKL
campuses on the first day of school. ISKL also has an H1N1 action
plan in place, which includes plans for "virtual schooling" in the
event that a decision is made to close the school for any length of
time. ISKL's School Nurse has experience working in Asia during the
SARS epidemic, and has been instrumental in compiling the school's
action plan.

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H1N1 within the Embassy Community
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5. (SBU) On August 7, the infant child of an American Mission
employee began showing influenza-like symptoms and was taken to the
ER of a local hospital over the weekend for evaluation. The rapid
test confirmed Influenza A. As such, the case was treated as H1N1
but was not subtyped for confirmation, which is in accordance with
MOH protocol. The infant was given oseltamivir (Tamiflu) and
released, and is recovering well at home.


6. (SBU) On August 10, a local Mission employee reported that her
child exhibited flu like symptoms, who was later confirmed to have
Influenza A via the rapid test at a local hospital. The child was
treated and is recovering at home.

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Post's Actions
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7. (SBU) Country team discussed the H1N1 situation on August 10 and

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decided to issue an updated management notice. The notice was
prepared in consultation with the RMO in Singapore and provided
Mission staff and family members with guidance on steps to be taken
in the event flu like symptoms are experienced or observed. The
notice also describes the support that can be provided by the Post
medical unit and RMO Singapore and reemphasizes observing good
personal hygiene habits and staying home if sick.

KEITH