MGSF01: PUBLIC OUTREACH AND SURVEILLANCE RESULT IN

UNCLAS SECTION 01 OF 02 SEOUL 000729

SIPDIS

DEPT FOR AIAG (DAVID WINN),DEPT PASS TO AID (DENNIS
CARROLL)

E.O. 12958: N/A
TAGS: KFLU AEMR ASEC CASC KFLO TBIO KSAF KPAO PREL
PINR, AMGT, MG, KS
SUBJECT: MGSF01: PUBLIC OUTREACH AND SURVEILLANCE RESULT IN
THREE H1N1 INFLUENZA CASES DETECTED IN KOREA


1. Summary: South Korea has confirmed three cases of H1N1
influenza during the recent outbreaks. The first case was a
nun who had recently returned from a visit to Mexico. The
second case was a nun at the same convent who had close
contact with the first. The third case was a woman who was
on the same airline flight as the first. None of the
individuals developed serious illness. All were treated with
Tamiflu and subsequently discharged from in-patient medical
facilities. A National Swine Flu Task Force established
under the Ministry of Health, Welfare and Family Affairs
(MHWFA) deployed 38 infrared thermal detectors to screen
arrivals and bolstered quarantine staffing at the country,s
international airports and seaports. Approximately 400
people who either had contact with the three infected persons
or who themselves exhibited fever or other flu-like symptoms
after traveling abroad have tested negative for the H1N1
virus. The Ministry of Food, Agriculture, Forestry and
Fisheries (MIFAFF) temporarily banned the import of live
swine from North America and is testing all imported pork for
the presence of the H1N1 virus. Signs posted at the airport
and enhanced surveillance were instrumental in the detection
of Korea's three H1N1 influenza cases. End summary.

Three Persons Test Positive, Treated, and Released
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2. Korea,s first case of H1N1 influenza was a 51-year-old
nun who spent a week in Mexico from April 18 to 25. On
arrival at Incheon Airport April 26 on a flight from Los
Angeles she saw signs informing recent visitors to Mexico
experiencing flu-like symptoms to report to health
authorities. With a cough, runny nose and a fever of 37.7 C
(99.9 F),she voluntarily went to a public health clinic the
following day where rapid antigen screening tests detected
influenza type A infection. The patient began a course of
oseltamivir (Tamiflu) and was advised to remain at home under
appropriate quarantine precautions. After H1N1 influenza was
confirmed on May 2 using MDCK cell culture laboratory method,
the patient was moved to an isolation ward at the ROK Armed
Forces Medical Command (AFMC) Capital Hospital. After
completing the Tamiflu treatment and full recovery from the
minor symptoms, she was discharged from the hospital on May 4.


3. ROK health officials tested the other 39 nuns who resided
in the convent with the first case and advised them to
quarantine themselves. In addition, health officials began
tracking down and testing the passengers who arrived in Korea
on the same airline flight as the infected nun. These
proactive surveillance measures detected the other two cases:
One was a 44-year-old nun who had driven the original
H1N1-infected nun home from the airport on April 26 and who
developed mild flu-like symptoms; the other was a 62-year-old
woman who sat six rows behind the infected nun on the
airplane and who displayed neither fever nor any other
flu-like symptom (she had spent the previous six months
visiting relatives in Arizona). Both of these additional
cases were confirmed H1N1 by cell culture, placed in
isolation at ROK AFMC Capital Hospital, treated with Tamiflu,
and discharged on May 6 and May 7, respectively.

Government Response: Stepped Up Surveillance and Control
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4. On April 26, the ROKG established a National Swine Flu
Task Force under the Korean Centers for Disease Control,
which was subsequently moved on April 30 to the central MHWHA
under the direct supervision of the Minister of Health.
Through the Task Force, the ROKG implemented several response
and control measures, including dispatching 45 staff to
reinforce the 69 quarantine officials already in place at the
country,s ports of entry.


5. The MHWFA stepped up surveillance of international
arrivals by deploying 38 infrared temperature scanners at
international airports and seaports. The scanners are set to
detect individuals with a body temperature of 38 degrees C
(100.4 degrees F). Anyone found to have an elevated
temperature is re-checked by quarantine officials using a
more precise ear thermometer. Individuals with a fever are
not placed in quarantine; instead, they are instructed to
report to a health facility for testing.


6. The Task Force also initiated screening of all persons
who may have had contact with the three confirmed H1N1 cases
by rapid antigen testing. Those tested included the 39 nuns
who lived in the same convent as the first confirmed case, 5
healthcare providers at the hospital where she was treated,
and 185 people who were on the same airline flight from Los

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Angeles. (Note: Of the 337 people on that flight, 140 people
were excluded from testing because they were either transit
passengers or short-term visitors. The MHWFA was unable to
track down the remaining 12 passengers.)


7. The healthcare system has also tested approximately 200
other persons who recently traveled abroad and who had a
fever or other flu-like systems. None of these have tested
positive.


8. The Task Force put five hospitals on alert to prepare 197
isolation beds in case of a more widespread outbreak. The
hospitals are the National Medical Center in Seoul (68
isolation beds),ROK AFMC Capital Hospital (28 beds),
National Mokpo Medical Center in southern Cholla Province (50
beds),Incheon Medical Center in Incheon (25 beds),and
Cheonbuk University Hospital in Jeonju, northern Cholla
Province (26 beds).


9. The ROKG has allocated 83.3 billion won (USD 64 million)
to procure 2 million additional courses of Tamiflu and
500,000 courses of the anti-viral drug Relenza ) these are
in addition to the country,s existing supply of 2.5 million
courses of Tamiflu. The ROKG will also provide support to a
team at Chungnam National University to research and develop
a vaccine for this strain of H1N1 virus.


10. The ROKG posted signs throughout the country,s airports
and other public places advising anyone who develops flu-like
symptoms to be checked by a health-care provider. It also
initiated education and outreach activities such as directing
teachers to instruct school children on influenza
precautions. The ROKG also sent information on flu symptoms
and prevention to every government employee, and has begun
implementing a hand-washing poster campaign, with other basic
information on proper hygiene to reduce the risk of
contracting influenza.


11. The Ministry of Food, Agriculture, Forestry, and
Fisheries (MIFAFF) announced that the virus could not be
transferred from eating pork, but that it would nonetheless
commence testing of all imported pork from North America to
relieve concerns among consumers; MIFAFF later extended the
testing to all imported pork regardless of origin. On May 6,
MIFAFF issued a press release that it had tested a total of
255 metric tons of pork from North America (10MT from Mexico,
42 MT from the United States, and 112 MT from Canada) that
had all tested negative for the H1N1 virus. On April 28,
MIFAFF placed a ban on all imported live swine from North
America as a temporary measure in an attempt to prohibit the
introduction of the H1N1 virus entering with live swine
imports. The ROKG has not yet provided a response to the
U.S. request for Korea to lift its ban on imported live swine.

Embassy Response: EAC Meeting, Info Sharing, Monitoring
-------------- --------------

12. The Embassy Emergency Action Committee (EAC) convened on
April 30, reviewed the Embassy Pandemic Tripwires and
Response Plan, and decided to take several actions. As a
result, a Pandemic Working Group was created to monitor the
situation and report back to the EAC as necessary. An
information message was sent via e-mail to the Embassy
community, and a warden message was transmitted to U.S.
citizens in Korea to keep them fully informed. RSO
coordinated with local schools on their response, and ESTH
has been participating in conference calls with U.S. Forces
Korea. Management reviewed the Embassy,s supplies of
anti-viral medications and personal protective equipment and
decided to procure additional hand sanitizers for various
offices and rapid influenza test kits for use by the Health
Unit.


13. Comment: Korea is generally viewed as having a strong
healthcare infrastructure, as well as valuable experience in
prevention, containment and control of SARS and avian
influenza. If not for the public information signs posted at
the airport, the country's first case may have gone
undetected. And if not for MHWFA's enhanced surveillance
following the first infection, the other two cases might also
have gone undetected. Post will continue to maintain close
contact with the MHWFA and will report on any further
developments.
STANTON