MGSF01 H1N1 OUTBREAK CONFIRMED IN JAPAN

UNCLAS SECTION 01 OF 02 TOKYO 001125 DEPT FOR OES/IHB AMBASSADOR LOFTIS DEPT FOR EAP/J, EAP/EX, CA USDA PASS TO APHIS, FAS FOR BURDETT HHS PASS TO CDC HHS FOR OGHA DEPT PASS TO AID/GH/HIDN SENSITIVE SIPDIS E.O. 12958: N/A TAGS: KFLU AEMR AESC CASC KFLO TBIO KSAF KPAO PREL PINR AMGT, MG, EAGR, JA SUBJECT: MGSF01 H1N1 OUTBREAK CONFIRMED IN JAPAN REF: TOKYO 1086 and previous TOKYO 00001125 001.2 OF 002 Sensitive but Unclassified. Please handle accordingly. ¶1. (SBU) Summary: Japan has reported as many as 130 confirmed cases of H1N1 influenza. With the exception of four patients in quarantine near Narita Airport, all cases were reported to be in the Osaka and Kobe areas. There are no reports of H1N1 infection among Americans in Japan. While the majority of confirmed cases involve students, cases have also been reported outside of schools and universities. Local governments are encouraging patients without severe symptoms to remain at home during treatment and recovery. The GOJ raised its pandemic alert level to Stage Two in response to the confirmed domestic outbreak May 16, but has no plans to raise the level to Stage Three. Although local officials have closed many schools and universities in Hyogo and Osaka prefectures, the GOJ is not requesting local governments to cancel public gatherings or limit business activities. The Embassy and U.S. Forces Japan continue to coordinate with the GOJ and local governments are taking appropriate actions. Airline officials note continuing declines in passenger air travel to/from Japan, despite travel returning to normal in many other countries. End Summary. ¶2. (U) As of May 18, 2009 1600 local time, media report 130 confirmed human cases of the novel Type A H1N1 influenza in Japan. ¶3. (SBU) The GOJ confirmed its first domestic H1N1 case May 16 in a male high school student in Kobe in Hyogo Prefecture. Two other students at the same high school and five students at another Kobe High School were later confirmed to have been infected. None of the eight students reported recent foreign travel, according to press reports. (Note: Prior to May 16, the four confirmed H1N1 cases in Japan were among members of a Japanese student group who arrived and were subsequently quarantined at Narita Airport May 8. End Note). Hyogo and Osaka prefectures reported to the press a number of additional confirmed H1N1 cases May 17 and 18. There are no reports of H1N1 infection among Americans in Japan. While junior high, high school, and university students comprise the majority of confirmed cases, the H1N1 virus has also been confirmed among employees at a bank and rail station convenience store, as well as among family members of infected students. Local officials said Prefectural governments in Osaka and Hyogo have closed of nearly all local schools, in some cases for at least one week. A number of universities in the two prefectures have also been closed. Hyogo and Osaka prefectural governors met with Health Minister Masuzoe May 18 to request GOJ assistance in preparing local medical facilities to deal with the outbreak. ¶4. (SBU) Following confirmation May 16 of the first domestic H1N1 case, the GOJ raised its pandemic alert level to Stage Two. Meeting May 18, the Prime Minister's Task Force announced the GOJ is not planning to raise its pandemic alert to Stage Three based on the current spread of H1N1 in Hyogo and Osaka prefectures. Although Japanese Government officials announced support for school closures in the affected prefectures, officials told reporters the GOJ will not request local governments to cancel public gatherings or limit social and business activities. In a May 16 announcement, the GOJ stated it will maintain current border measures, but it may scale down screening procedures gradually in order to shift resources to containing the domestic outbreak. Officials at Kansai International Airport near Osaka said medical personnel who have been conducting airport health screening may be pulled back to assist local governments with the domestic outbreak. The GOJ is also attempting TOKYO 00001125 002 OF 002 to determine the route of infection for the domestic H1N1 cases, according to press reports. ¶5. (SBU) In accordance with GOJ guidelines, local governments throughout Japan have set up telephone hotlines to take calls from individuals with flu symptoms. In order to minimize contact with other hospital patients, individuals reporting H1N1 flu symptoms are referred to specialized fever clinics at local hospitals, where they receive a preliminary test for Type A influenza. Positive results are sent to local health research institutes for confirmation of the H1N1 virus. Local officials told emboffs they are encouraging patients who do not have severe symptoms to remain at home for treatment with antiviral medications. (Note: While Tamiflu is the antiviral most commonly prescribed in Japan for flu symptoms, Japanese doctors often prescribe Relenza to teenage flu patients, as some studies link Tamiflu to serious side effects in young adults. End Note). ¶6. (SBU) The Embassy and U.S. Forces Japan continue to coordinate with the GOJ and local governments and are considering appropriate actions in response to the confirmation of domestic transmission of the H1N1 virus in Japan. The Embassy issued a warden message May 18 alerting Americans to current information on the H1N1 outbreak in Japan. The warden message is posted at: http://japan.usembassy.gov. ¶7. (SBU) Officials at international airlines report continuing declines in passenger air travel to/from Japan, even while business has returned to normal in other countries. One airline official said Japan is the only country in which cancellations continue to exceed new bookings and added he was "surprised by the degree to which Japan is over-reacting" to the H1N1 outbreak. ¶8. (SBU) There are numerous reports that Japanese universities are asking staff who returned from H1N1-affected countries to remain at home for seven to ten days before returning to work. ZUMWALT