MGSF01: H1N1 FLU - INDIA'S RESPONSE

UNCLAS SECTION 01 OF 05 NEW DELHI 000860

SENSITIVE
SIPDIS

HHS FOR OGHA AND PASS TO ANNE CUMMINGS AND DANIEL MILLER
CDC ATLANTA FOR CCID AND PASS TO NANCY COX, STEPHEN BLOUNT, ANN MOE
AND STEVE REDD
PASS TO NIH FOR ROGER GLASS, THOMAS MAMPILLY, JAMES HEDDINTON AND
GRAY HANDLEY
PASS TO FDA FOR MAC LUMPKIN AND MARY LOU VALEX
PASS TO AIAG FOR AMBASSADOR ROBERT LOFTIS, HELEN REED ROWE, AND
CRAIG SHAPIRO
USDA PASS APHIS AND FAS
DOT PASS SHATLEY
FAA PASS TNASKOVIAK

E.O. 12958: N/A
TAGS: KFLU AEMR ASEC CASC KFLO TBIO KSAF KPAO PREL PINR
AMGT, MG, EAGR, EAIR, ECON, PREL, SOCI, IN
SUBJECT: MGSF01: H1N1 FLU - INDIA'S RESPONSE

REF: STATE 042349


1. (SBU) SUMMARY: At the close of business on April 29 in India, no
cases of H1N1 infection in humans or livestock have been reported by
the local press or government authorities. We expect India to
achieve independent diagnostic capability within the next few days;
CDC is providing technical assistance to the Indian Ministry of
Health (MOH). As a precaution, the MOH has begun a screening
program which is not yet uniformly in place at all international
airports in India. Moreover, an anticipated airport strike on May 1
is not expected to significantly impact airport operations and
flights to and from India will continue as normal. Agricultural
trade activities have not been impacted. Mission India has
instituted an interagency working group to coordinate activities,
actions and responses. END SUMMARY

NO H1N1 CASES IN DELHI, DEVELOPING A DIAGNOSTIC CAPABILITY


2. (SBU) No cases of H1N1 infection in humans or livestock have been
reported by Embassy New Delhi contacts at the MOH, Ministry of
Agriculture (MOA),or by Indian media outlets. India is in the
process of developing a capability to detect H1N1 and expects to be
able to conduct diagnostics on its own within the next three to four
days. Embassy New Delhi's Health Attache provided the MOH with
information on the virus sequence and instructions for ordering
CDC's real-time PCR diagnostic kits on April 29. Embassy Health
Officers remain in close contact with the MOH and other Government
of India (GOI) contacts to provide any requested technical
assistance. Within India, diagnostic tests will be conducted at two
labs - the internationally recognized National Institute of Virology
in Pune and the National Institute of Communicable Diseases in New
Delhi. Disease surveillance is conducted by the MOH based on
reporting from hospitals and state government boards of health.

SCREENING PROCEDURES IMPLEMENTED FOR ALL INBOUND PASSENGERS


3. (SBU) The MOH and Airport Public Health Organization (APHO) have
issued guidelines for screening of passengers to both Indian
airports and airlines operating in India. The Ministry of External
Affairs (MEA) America's Desk confirmed to Emboff today that all
international passengers, including those holding official and
diplomatic passports, will be required to fill out a questionnaire
and be subjected to health screening before they reach immigration.
Where passengers reveal symptoms of H1N1 flu, they will be
quarantined by the MOH. Airport health officials will also rely on
airlines to identify passengers that are not feeling well. Those
passengers, along with any passengers seated in the same row or
within three rows ahead or behind, will be taken to secondary
facilities for further observation. Based on a copy of the
guidelines provided by an airline contact, and conversations with
the MOH and Delhi Airport Health Officers, Mission India believes
screening procedures will be implemented at most airports by this

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evening Delhi time.


4. (SBU) The draft questionnaire shared by MOH with the Health
Attache includes the following questions: (1) Have you
visited/transited above mentioned countries (i.e. US, Canada and
Mexico) Yes/No; (2) If yes, kindly answer the following questions,
(a) Do you have fever or experienced fever in the past 10 days
Yes/No, (b) Is fever accompanied by any of the following symptoms;
cough, shortness of breath, difficulty in breathing Yes/No, (c) Have
you cared for or lived with or have had face to face contact with a
case of flu or visited or worked in a hospital where cases of flu
are being treated, or whether your family member has been a suspect
or probable case of Swine Flu. The questionnaire also requires
personal information such as name, passport number, flight number,
seat number, date of arrival, port of embarkation, port of
disembarkation, contact address, and telephone number in India.


5. (SBU) A survey of airports and airlines by MissionOffs suggests
that screening implementation may not be uniform. Following is a
summary of reported activities at airports across India:

-- NEW DELHI: APHO officer Dr. Sujeet K. Singh told EmbOffs on April
29 that immigration staff informally screened some passengers flying
into India from the U.S., Canada, and Mexico starting on April 28
evening. From 2000 hours local time onwards, all incoming
passengers into India will be screened. The MOH, in coordination
with airport officials, has put in place eight counters at which
passengers will be required to submit a questionnaire and be
screened by a medical doctor and paramedic. Passengers are expected
to self-report any flu-like symptoms. Passengers who report they
are healthy and pass a visual inspection will, upon review of the
form by medical officials, receive a medical officer's signature and
stamp to proceed to immigration. If further inquiry is required
based on the passenger's responses or physical appearance, he/she
will be sent to one of two screening rooms to undergo an examination
involving a check on vital signs like temperature and pulse, as well
as listening to the lungs with a stethoscope. At this time, more
intrusive tests like blood sampling or urine specimens will not be
conducted. A passenger who is still of concern will be transferred
by ambulance to Ram Manohar Lohia hospital for additional
observation and treatment. No airport disruptions are expected as a
result of the anticipated May 1 strike by Airport Authorities of
India (AAI) workers.

-- MUMBAI: Airport contacts suggested that procedures will be very
similar to those at New Delhi's airport and will be implemented
starting at midnight tonight local time in accordance with the MOH
directive. Passengers suspected of infection will be transported by
ambulance to Kasturba Hospital and kept in quarantine. No
disruptions are anticipated as a result of the May 1 airport
strike.


NEW DELHI 00000860 003.2 OF 005


-- HYDERABAD: Airline contacts indicated that they expect the GOI
to promulgate information on procedures this evening, and that until
then Rajiv Gandhi International Airport staff (employed by the
private developer, the GMR group) are closely holding all
information. The anticipated screening procedures closely follow
those at New Delhi's airport, although in this case the APHO is
expected to actually meet all international flights and direct those
passengers needing additional attention to the medical screening
stations for further evaluation. Since the airport has no onsite
quarantine facility, arrangements have been made with the Sir Ronald
Ross Institute for Tropical and Communicable Diseases (Fever
Hospital) in Nallakunta to conduct further observation of passengers
of concern if warranted. No disruptions are anticipated as a result
of the May 1 airport strike.

-- CHENNAI: Airport officials in Chennai's consular district -
including Bangalore, Cochin and Chennai - are confused at what the
Central Government expects. As of this evening, these airports have
not established screening procedures or identified which medical
facilities will be used for quarantine or treatment. Post expects
these airports to follow procedures spelled out by the central
government, with perhaps a slight delay in implementation as
procedures are clarified. Bangalore and Cochin are not expected to
be impacted by the May 1 airport strike, and it is not clear whether
staff at Chennai airport will participate. (Note: Both Bangalore
and Cochin are privatized airports while Chennai is being modernized
as a public private partnership by AAI and a private developer. END
NOTE)

-- KOLKATA: Airport personnel in Kolkata are not sure what is going
on and have been moving slowly to implement any screening policy.
Some airlines - including Druk Air (Bhutan),GMG (Bangladesh),and
Biman Bangladesh Airlines - were not even aware of any screening
requirements. Air India is talking to the health inspectors, and
Emirates, Thai, Singapore and Lufthansa are aware of screening
requirements and making arrangements to screen incoming passengers
arriving later this evening/overnight. There are no direct flights
from North America landing in Kolkata International Airport.
Kolkata consulate staff anticipates that the May 1 strike will cause
delays in baggage screening and handling services, but expects
flights will continue.

POSSIBLE AIRPORT STRIKE NOT LIKELY TO DISRUPT OPERATIONS


6. (SBU) A strike by AAI workers is anticipated to take place on May
1 across Indian airports. Based on conversations with airport and
airline contacts, MissionOffs expect that the impact of the strike,
if it takes place at all, will be rather minimal for most airports
and that neither incoming nor outgoing flights will be effected. A
Continental Airlines representative did express concern to EmbOff
about possible "serious" impact on airport services and flights
operations if the air traffic controllers decide to join the strike;

NEW DELHI 00000860 004.2 OF 005


though he said that "seems pretty unlikely." Most importantly,
MissionOffs do not see an impact on airport security and screening
operations by agitating and on strike employees.

NO IMPACT ON AGRICULTURE TRADE


7. (SBU) On April 28, the Chief Animal Health Officer told EmbOff
that India does not have H1N1 flu in animals. Further, he expressed
irritation at the use of the term "swine flu" in the media, saying
that the World Animal Health Organization had it correct when they
announced that this was not a swine disease. The Animal Health
Officer also noted that they had received the Food and Agriculture
Organization alert and the MOA was participating in GOI meetings on
the subject. Finally, he said that contrary to media reports, the
MOA was not conducting extra-ordinary surveillance of pig farms in
India. India has taken no trade actions against countries reporting
H1N1 human flu outbreaks. India imports only small amounts of pork
meat - mainly from the EU - totaling less than $400,000 in value in

2008. The MOA has not made an official announcement on H1N1 nor
posted any notice on their official web site.

MISSION INDIA PREPARED AND PROACTIVELY RESPONDING


8. (SBU) Relying on our Avian Influenza action plan, Mission India
has instituted a core interagency working group across the Embassy
and Consulates to discuss worldwide developments and their impact on
India and the Mission, and formulate and coordinate Mission
activities, actions and responses. Officers at all posts are
engaged with appropriate government and commercial contacts to stay
apprised of H1N1-related activities on the ground.


9. (SBU) Embassy New Delhi's Medical Unit advises that Tamiflu,
Relenza, and personal protective equipment are fully stocked at the
Embassy, and that adequate influenza medications and supplies are
also accounted for in all Consulate medical units. The Medical Unit
will continue to monitor the situation in country and provide
updated guidance to the Mission community as needed. On April 27,
the Management Section provided Mission personnel with basic health
and hygiene instructions to reduce the spread of germs like H1N1.



10. (SBU) Excepting press inquiries, Mission India has seen no
significant increase in calls regarding H1N1 flu and no increase in
American Citizen Services requests due to H1N1, but has received a
few inquiries via email. The Embassy Consular Section disseminated
two warden messages based on the new airport screening procedures
and will continue to provide timely updates to the American Citizen
community in India. The Public Affairs Office has created a direct
link to the H1N1 warden messages from Embassy New Delhi's public
webpage (newdelhi.embassy.gov).


11. (SBU) Several diplomatic missions in New Delhi contacted the

NEW DELHI 00000860 005.2 OF 005


Embassy about our H1N1 activities, and the GOI's response, screening
methods, and travel advisories; they are awaiting official GOI
announcements and the US course of action before issuing their own
guidance. The H1N1 point of contact at the Mexican Embassy said
that they were providing information to their government about the
Indian reaction but not notifying their citizens already in India.
The Embassy's consular section has taken the lead in communicating
with our diplomatic counterparts, and will continue to coordinate
with them as needed.


12. (U) Post will continue to report relevant developments as they
occur.

BURLEIGH