TAIWAN CONFIRMS 61 CASES BUT DOWNGRADES

UNCLAS SECTION 01 OF 02 TAIPEI 000756 SENSITIVE SIPDIS STATE PASS OES/IHA, OES/IHB FOR AMB LOFTIS, HHS FOR MARK ABDOO, CDC ATLANTA FOR CCID, BANGKOK FOR CDC BAGGETT, USDA/FAS FOR OFSO/WAINIO OSTA/HAMILTON, OCRA/BEILLARD E.O. 12958: N/A TAGS: AEMR AMGT ASEC CASC KFLU KFLO TBIO TW CH SUBJECT: TAIWAN CONFIRMS 61 CASES BUT DOWNGRADES SERIOUSNESS OF H1N1, WILL PRODUCE VACCINE REF: TAIPEI 660 AND PREVIOUS ¶1. (U) SUMMARY. On June 19, the Taiwan Centers for Disease Control (TCDC) confirmed Taiwan's 61st case of H1N1 and also downgraded the virus from a Category I Notifiable Infectious Disease to Category IV, meaning that medical doctors and hospitals are only required to report "severe" H1N1 cases to the TCDC, and H1N1 patients are no longer quarantined. Incoming travelers to Taiwan exhibiting flu-like symptoms will be allowed to enter the island without medical examination or quarantine. Taiwan still plans to stockpile at least 10 million doses of H1N1 vaccine through a combination of international procurement and domestic production, and a Taiwan biotechnology company announced plans to mass-produce a vaccine by the end of October. END SUMMARY. TAIWAN CONFIRMS 61 CASES OF H1N1 -------------- ¶2. (U) Taiwan confirmed its 61st case of H1N1 on June 19. Two instances of local transmission are reported, most recently in case 56 (a 25 year-old female, daughter of case 53). Nearly all of the 59 non-locally transmitted cases entered Taiwan from Thailand and the US, in roughly equal measure. Two of the 61 reported cases are Amcits, and 20 of the 61 individuals who contracted H1N1 were still receiving hospital treatment as of June 19. Following TCDC action to downgrade H1N1 through reclassification (see para 3),Taiwan will only publicly report severe cases of H1N1. AIT will continue to monitor H1N1 developments and report primarily through the on-line S/ES-O/CMS H1N1 Flu Matrix. H1N1 DOWNGRADED BY TCDC BUT MONITORING CONTINUES -------------- -------------- ¶3. (SBU) On June 19, following a TCDC determination that "the overall severity of the H1N1 pandemic appears to be moderate and similar to local seasonal flu," TCDC reclassified H1N1 from a Category I Notifiable Infectious Disease to Category IV. These categories are defined under Taiwan's Communicable Diseases Prevention Law. Category I diseases include, for example, SARS, smallpox, and avian influenza. Class IV disease other than H1N1 include chicken pox and Lyme disease. TCDC Division 1 Deputy Director Shih Chin-shui told ESTH officer that Taiwan is the first regional entity to downgrade H1N1 in this fashion, and he claims Taiwan took this action following the lead of US CDC. Shih noted that Taiwan still receives H1N1 case notifications from Singapore and Japan, including names of individuals seated close to the H1N1 infected airline passengers, but in recent weeks the US CDC has told Taiwan it no longer wants this information. This development, along with epidemiological data showing that H1N1 is a flu of moderate severity, prompted Taiwan to reclassify the virus. In conjunction with downgrading H1N1, Taiwan also canceled all H1N1-related travel advisories and will no longer report new H1N1 cases to the World Health Organization. ¶4. (U) As a Category IV infectious disease, doctors and hospitals in Taiwan are not required to report H1N1 cases to the TCDC unless they are "severe" (as is the case with all Category IV infectious diseases),and H1N1 patients are no longer quarantined. The reclassification to Category IV has implications for visitors to Taiwan. For incoming airline passengers, for instance, while temperature monitoring stations will continue to function as they have since the 2003 SARS outbreak, passengers with flu-like symptoms will simply be notified at the monitoring station that they exhibit symptoms that may indicate H1N1, they will be asked to self-monitor and seek medical attention if symptoms become severe, they will be asked to wear a face mask and then allowed to leave the airport. No swabs or samples will be taken. ¶5. (U) The TCDC notes that it will reinforce monitoring of H1N1 by integrating Taiwan's National Health Insurance database into the existing H1N1 surveillance system. As a TAIPEI 00000756 002 OF 002 result, hospital records indicating a patient with H1N1 symptoms was seen by a doctor will be available to TCDC authorities through the linkage of the National Health Insurance database to the H1N1 surveillance system. TAIWAN PLANS TO PURCHASE, PRODUCE VACCINE -------------- ¶6. (SBU) The Taiwan Department of Health (DOH) still plans to procure 10 million does of the H1N1 flu vaccine and 5 million doses of seasonal flu vaccine by the end of this year. The DOH originally hoped to procure 2.5 million doses of H1N1 vaccine through an international bid process that closes on June 28. However, TCDC Deputy Director General Shih Wen-yi told ESTH officer that Taiwan's international procurement efforts are unlikely to obtain more than 1 million doses of H1N1 vaccine due to shortages. There are currently four bidders on the contract: Aventis, Baxter, GlaxoSmithKline, and Novartis. ¶7. (SBU) On June 18, President Ma Ying-jeou attended the inauguration of a plant owned by Taiwan's Adimmune Corporation (Chinese name: Guoguang Biological Technology Company),which expects to begin human clinical trials of an H1N1 vaccine by late-August and mass-production by late-October. Adimmune is reportedly the 12th facility globally that can produce an H1N1 vaccine and has stated it will be able to manufacture 30 million doses per year when operating at capacity. Taiwan health authorities have expressed concern that even if Adimmune can deliver on its production timeline and targets, public willingness to inoculate with an H1N1 vaccine will depend on the whether there exists widespread trust in the quality of the vaccine. REQUESTS US FDA CERTIFICATION ASSISTANCE -------------- ¶8. (SBU) To this end, Taiwan DOH Minister Yeh Chin-chuan has requested US FDA assistance with vaccine certification efforts related to H1N1, saying that if the Taiwan produced vaccine can reach international standards it will not only be used in Taiwan but can also be donated or sold to "friendly countries." Dr. Kang Jaw-jou, Director of the Drug Research Center and Professor at the Institute of Toxicology at Taiwan National University, who is slated to serve as Taiwan's first FDA director, is currently in the US, where he plans to meet with the FDA's Center for Biologics, Evaluation and Research. YOUNG