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Cablegate: H1n1 Preparedness Deemed Sufficient by Guangdong Health

VZCZCXRO9478
RR RUEHCN RUEHGH
DE RUEHGZ #0585/01 2870906
ZNR UUUUU ZZH
R 140906Z OCT 09
FM AMCONSUL GUANGZHOU
TO RUEHC/SECSTATE WASHDC 0980
INFO RUEHGZ/CHINA POSTS COLLECTIVE 0281
RUEHBJ/AMEMBASSY BEIJING 0768
RUEHGH/AMCONSUL SHANGHAI 0216
RUEHCN/AMCONSUL CHENGDU 0217
RUEHSH/AMCONSUL SHENYANG 0226
RUEAUSA/DEPT OF HHS WASHINGTON DC 0026
RUEAIIA/CIA WASHDC 0265
RUEKJCS/DIA WASHDC 0261
RHHMUNA/HQ USPACOM HONOLULU HI

UNCLAS SECTION 01 OF 02 GUANGZHOU 000585

SENSITIVE
SIPDIS

STATE FOR EAP/CM, OES/IHA, MED, CA/OCS/ACS/EAP
STATE PASS TO ENVIRONMENTAL SCIENCE & TECHNOLOGY COLLECTIVE
STATE PASS TO USAID FOR ANE AND GH
HHS PASS TO OGHA, NIH/FIC, CDC/COGH AND FLU DIV TMOUNTS AND NCOX
BANGKOK FOR RMO, CDC, USAID
BEIJING FOR HHS HEALTH ATTACHE AND RMO

E.O. 12958: N/A
TAGS: TBIO KFLU CASC SOCI PREL HK CH
SUBJECT: H1N1 PREPAREDNESS DEEMED SUFFICIENT BY GUANGDONG HEALTH
OFFICIALS

1. (SBU) Summary: Health officials in Guangdong Province,
birthplace of SARS and the H5N1 virus in Asia, are confident that
they are well prepared to deal with the threat of influenza
outbreaks this flu season. Officials expressed confidence that
existing H1N1 prevention and control measures --including expanded
flu surveillance activities, national plans to produce and
distribute H1N1 vaccines, and strict quarantine measures-- would
succeed in preventing a serious outbreak. They also believe an H5N1
outbreak is highly unlikely. End Summary.


---------------------------------------------
H1N1 PREVENTION AND CONTROL MEASURES IN PLACE
---------------------------------------------

2. (SBU) Since September 1, at least 2,026 new cases of confirmed
H1N1 have been reported, bringing the total number of confirmed
cases in Guangdong to 2,851. Of this total, only nine remain
hospitalized and 37 are currently under home quarantine according to
data available on the Guangdong CDC website. He Jianfeng, Director
of the Guangdong's CDC's Epidemic Disease Prevention Institute, told
us that no fatalities in Guangdong province had been linked to H1N1
infection. He also noted that hospitalization of H1N1 patients did
not necessarily indicate the patient was in serious condition.
According to He, it is common practice to hospitalize the first
patient in a city or locality with confirmed H1N1 for observation.

3. (SBU) Health officials acknowledged in recent meetings that
isolated outbreaks at schools were likely to continue through the
current flu season. At the same time, officials expressed a high
degree of confidence that existing measures would be effective in
preventing any serious outbreak. According to Feng Shaomin, Head of
the Foreign Affairs Office at the Guangdong Health Department, these
measures include the establishment of a joint prevention and control
mechanism composed of 33 government agencies under the direction of
the Health Department, continued reliance on strict border control
measures including quarantine, and the expansion of the flu
surveillance network to incorporate all municipalities, Hong Kong
and Macao.

4. (SBU) Both He and Feng pointed to the strengthening of flu
surveillance capacity as a critical element to the province's flu
prevention efforts. Since June 2009, according to Feng, the
Influenza-like Illness (ILI) surveillance system has expanded from
14 cities to include all 21 cities in the province. The total
number of ILI surveillance stations --located in schools, community
clinics, and municipal and county-level hospitals --has increased
from 52 to 65, according to He, who also noted that the data
collected from this network is reflected in weekly and monthly
reports available on the CDC website. After noting the success
these measures have achieved in controlling the spread of H1N1, Feng
added, "The U.S. does not need to worry about us."

--------------------------------------------- -
VACCINES ON THEIR WAY, ANTIVIRALS IN STOCKPILE
--------------------------------------------- -

5. (SBU) The Central Government announced in early September that an
H1N1 vaccine developed by a domestic biotechnology company, Sinovac,
had passed clinical trials. News reports indicate that inoculations
with the vaccine have already commenced in Beijing. Lin Jinyan,
Deputy Director General of the Guangdong CDC, told us at a September
17 meeting that the Ministry of Health (MOH) had already identified
Beijing, Shanghai, and Guangzhou as "key areas" under its
inoculation plan. According to a contact familiar with the MOH
plan, Guangzhou should soon receive a first batch of five million
doses. Once the vaccines have been received, Lin stated that the
initial batch will be given free of charge to priority groups.

6. (SBU) The determination of priority groups will be based on WHO
and MOH recommendations, according to Lin, but will definitely
include public health and other service workers, e.g. police, border
control, and bus drivers. When asked if pregnant women would be
considered a priority group, Lin stated that the MOH was still
studying the safety issues surrounding inoculation of pregnant

GUANGZHOU 00000585 002 OF 002


women. He also noted that Chinese Health Minister Chen Zhu had
instructed the MOH to monitor the progress of studies on this issue
in other countries and had also asked that caution be exercised when
recommending the vaccine to this group.

7. (SBU) Guangdong has a total of 200,000 doses of Tamiflu in its
stockpile, the majority of which are kept in a central warehouse,
according to Wang Jing of the Guangdong Health Department's
Emergency Response Office. Wang noted that some doses of Tamiflu
are kept at the 109 designated hospitals for treatment of H1N1
cases, and that other hospitals could apply to obtain Tamiflu
through an emergency review and approval procedure. According to
Feng of the Health Department's Foreign Affairs Office, the Central
Government has entered into an agreement with Tamiflu suppliers that
would in the event of a national emergency permit local generic
production of the vaccine "without having intellectual property
issues get in the way." In addition to Tamiflu, Wang noted that
several local manufacturers of traditional Chinese medicine (TCM)
were currently producing antiviral TCMs that could be used to treat
H1N1.

----------------------------------
NO CHANGE IN QUARANTINE PROCEDURES
----------------------------------

8. (SBU) The quarantine procedure for Guangdong province has remain
unchanged since the first case was discovered in May, according to
Zhang Wen, Division Chief of the Guangdong Inspection and Quarantine
Bureau. Zhang stated that according to the procedure, which is
identical for foreigners and nationals, all travelers are required
to fill in health declaration cards and pass through a body
temperature screener at the point of entry. Any traveler with an
elevated temperature and severe flu-like symptoms will be sent to a
hospital immediately for H1N1 screenings. Travelers with elevated
temperatures who display mild flu-like symptoms will be sent to a
designated hotel for quarantine until lab tests are completed. If
the traveler tests positive for H1N1, he/she will be sent to a
designated hospital, at which point a doctor will decide if the
patient should remain hospitalized or be placed into home
quarantine. (Note: In the Consulate's experience, quarantine
measures initially put into place in May were much stricter than
current procedures, affecting hundreds, if not thousands of visitors
who displayed no symptoms but had arrived on the same flight or
train as a suspected H1N1 case. End Note.)

------------------------------
LITTLE CHANCE OF H5N1 OUTBREAK
------------------------------

9. (SBU) According to World Health Organization (WHO) surveillance
data, the H5N1 virus was last discovered in Guangdong's poultry in
June 2008; human infection with H5N1 has not been reported in
Guangdong since February 2008. Regarding the possibility of H5N1
resurgence, Feng from the Guangdong Health Department predicted an
extremely low likelihood that a human case of H5N1 would be
discovered in the province in the next few months. Feng's
assessment was affirmed by officials at the Guangdong CDC and the
Guangdong Provincial People's Hospital.

10. (U) This cable was coordinated with Embassy Beijing.

GOLDBECK

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