MGSF01 December 3 UPDATE ON H1N1 OUTBREAK IN JAPAN

UNCLAS SECTION 01 OF 02 TOKYO 002762 UNCLAS TOKYO 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 SIPDIS E.O. 12958: N/A TAGS: KFLU AEMR AESC CASC KFLO TBIO KSAF KPAO PREL PINR AMGT, MG, EAGR, JA SUBJECT: MGSF01 December 3 UPDATE ON H1N1 OUTBREAK IN JAPAN REF: TOKYO 2445 and previous TOKYO 00002762 001.2 OF 002 ¶1. Summary: H1N1 continues to spread throughout Japan on the cusp of the winter flu season. The National Institute of Infectious Diseases (NIID) announced that an estimated 1.73 million people with flu-like symptoms visited medical institutions across Japan from November 16 to November 22, the latest reporting period. To date, 73 people in Japan have died from H1N1-related complications. NIID estimates that 10.75 million Japanese have visited doctors for flu-like symptoms since July, and most of these are assumed to have been infected with H1N1. Inoculations of priority groups are underway, with 4.5 million people vaccinated as of November 19, but there have been confusing policy changes regarding foreign vaccine and the number of shots needed. End Summary. LATEST INFECTION FIGURES AND THEIR CONSEQUENCES -------------- --- ¶2. During the weeklong reporting period that ended on November 22, the number of flu cases reported by a network of 5000 medical institutions increased to 186,117 from 169,095 from the previous reporting period. That translates to about 1.73 million new flu patients nationwide. The total number of people estimated to have been infected with H1N1 since July totals 10.75 million, lower than some early expert predictions but still quite high as a percentage of the total population. Approximately seventy percent of these infections were children under 14 years of age. Seventy-three people have died in Japan from H1N1 to date. ¶3. Based on data from a reporting network of 5000 hospitals and clinics, Oita prefecture had the highest infection rate at nearly 77 patients per institution, followed by Fukui with 71 and Ishikawa with 65. About 17,000 schools (about 25 percent) were closed throughout Japan in mid-November, including nearly 900 schools in Tokyo. An officer at the U.S. Consulate in Fukuoka reports that one-third of his daughter's class at a Japanese school is currently out with flu-like symptoms. VACCINATIONS UNDERWAY -------------- ¶4. Vaccinations of priority groups (Tokyo 2293) are underway throughout Japan, although the pace, availability, and wait times for vaccinations appear to vary significantly by municipality. To date, 4.5 million people out of a total of 54 million at-risk individuals have been vaccinated. Many prefectures have moved up the start date for inoculations of children based on recommendations from public health officials. Tokyo and Osaka prefectures started inoculating healthy children in mid-November, and Fukuoka prefecture will start this week. However, anecdotal evidence indicates that wait times for appointment can be as long as two weeks. CONFUSION IN VACCINATION POLICY -------------- ¶5. The Government of Japan's (GOJ) plans to buy foreign vaccine to make up for shortfalls in domestic production were thrown into confusion last week when a higher than normal rate of side effects for people receiving vaccine produced by GlaxoSmithKline (GSK) was announced in Canada. The GOJ had signed a contract to buy vaccine for 37 million people from GSK. Responding to widespread public TOKYO 00002762 002.2 OF 002 concerns about foreign vaccine reported in reftel, Health Minister Akira Nagatsuma on November 29 sent a fact-finding team to Canada to investigate, and plans to send another team to Switzerland, where the other foreign-produced vaccine Japan plans to import is undergoing clinical trials. Press reports indicate that a ruling-party legislator introduced a bill to make the GOJ liable for any lawsuits by patients suffering side effects from foreign vaccine. This action was criticized by domestic producers, who do not enjoy the same level of protection. ¶6. The GOJ has reversed itself twice on the issue of whether one or two shots are necessary for proper vaccination. After results of clinical studies showed that one shot would be sufficient, a Health Ministry panel announced in mid-October that only one shot would be given to adults. However, in the face of opposition from some lawmakers fearing liability issues, the panel scrapped this plan and opted to continue giving two shots to each adult. Then, on November 11, the GOJ reverted to the original plan of giving just one shot to healthy adults after another clinical trial showed that the second shot was largely ineffective. This "flip-flopping," as one newspaper editorial dubbed it, has left local governments, medical institutions, and the general public confused. OTHER COUNTER-MEASURES -------------- ¶7. Media reported the health ministers of Japan, China, and South Korea announced the three countries will cooperate on pandemic flu and share data on H1N1 infections. Media also reported major Japanese companies will begin drawing up contingency plans to deal with mass employee absenteeism and thus limit the adverse economic impact of new influenza. ROOS