VZCZCXRO1825
OO RUEHAST RUEHCHI RUEHDH RUEHDT RUEHHM RUEHLN RUEHMA RUEHNH RUEHPB
RUEHPOD RUEHTM RUEHTRO
DE RUEHBK #1060/01 1191042
ZNR UUUUU ZZH
O 291042Z APR 09
FM AMEMBASSY BANGKOK
TO RUEHC/SECSTATE WASHDC IMMEDIATE 6858
INFO RUEHCHI/AMCONSUL CHIANG MAI 6512
RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE
RUCNASE/ASEAN MEMBER COLLECTIVE
RUEHKT/AMEMBASSY KATHMANDU 7486
RUEHSV/AMEMBASSY SUVA 0453
RUEAUSA/DEPT OF HHS WASHINGTON DC
RUEKJCS/USCINCPACLO WASHDC
RUEHPH/CDC ATLANTA GA
RUEHRC/USDA FAS WASHDC

UNCLAS SECTION 01 OF 02 BANGKOK 001060 
 
SIPDIS 
SENSITIVE 
 
DEPARTMENT FOR OES/IHB:JJONES,CPATTERSON; EAP FOR DHANNEMAN 
DEPT FOR USAID/GBH 
USDA FOR FAS AND APHIS 
HHS FOR CDC 
USCINCPACLO FOR AFRIMS 
 
E.O. 12958: N/A 
TAGS: KFLU AEMR ASEC CASC TBIO KSAF KPAO PREL PINR AMGT
MG, ECON, EAID, WHO, TH 
SUBJECT:  MGSF01: Good Initial A/H1N1 Response in Thailand 
 
REF: A) State 41745 (B) State 41768 (C)State 42349 (D) Bangkok 611 
 
BANGKOK 00001060  001.2 OF 002 
 
 
SENSITIVE BUT UNCLASSIFIED 
 
¶1. (SBU) SUMMARY: The Royal Thai Government (RTG) has cautioned its 
public to avoid travel to parts of the U.S. and Mexico.  In Thailand 
there have been no reported cases of A/H1N1 in humans or swine, but 
Ministry of Public Health officials, with CDC advice, are meeting 
daily as part of a robust preparatory response. Airport security has 
employed thermal scanners for all arriving (but not transit) 
international passengers in Bangkok, Chiang Mai and Phuket.  The RTG 
has temporarily banned pork products from the U.S., and is advising 
pig farmers to take precautions. Mission health agencies CDC, AFRIMS 
and USAID, with current investigations and diagnostics, are 
contributing strongly to the regional response.  END SUMMARY 
 
ROYAL THAI GOVERNMENT RESPONSE 
------------------------------ 
¶2. (U) The RTG Ministry of Public Health (MoPH) has formally advised 
the public to use caution in travel to affected areas in the U.S. 
and Mexico.  The Tourism Authority of Thailand told ESTHoff that it 
does not expect U.S. or other tourism to Thailand to be negatively 
affected; on the contrary Thailand should be seen as a more 
desirable tourism destination to the extent that flu-affected 
competing locations are avoided. 
 
¶3. (U) While to date no confirmed case of A/H1N1 influenza has been 
reported in Thailand or Southeast Asia, the MoPH has initiated a 
strong response to prepare for an outbreak here.  On April 28, MoPH 
announced a suspected case of H1N1 from a Thai lecturer who just 
returned from Mexico; the case was confirmed April 29 as only 
seasonal influenza. 
 
¶4. (U) The MoPH is the lead RTG agency on H1N1 influenza and has set 
up a "war room" in its Disease Control Department.  U.S. Centers for 
Disease Control (CDC) doctors attend its daily meetings to consider 
global, regional and local H1N1 updates.  The current Avian/Pandemic 
Influenza preparedness and response plan is MoPH's template for its 
approach.   CDC notes that at this point other Thai agencies do not 
attend the daily MoPH meetings. The MoPH and WHO delivered a joint 
briefing on the H1N1 outbreak to the diplomatic community on April 
29, at which the MoPH point person for H1N1 Response, Dr. Pasakorn 
Akarasewi, announced that MoPH was the lead agency but that an 
interagency task force had been formed to include the Ministries of 
Education, Agriculture, Tourism and Foreign Affairs. 
 
¶5. (U) Airport security in Thailand has employed thermal scanners at 
its airports in Bangkok, Chiang Mai, and Phuket.  The scanners are 
being used to screen all passengers arriving on international 
flights but not on passengers who transit to other countries; the 
Bangkok Airport communications director told ESTH officer that the 
scanners have detected several febrile patients but none with 
influenza.  Passengers are also receiving on arrival information 
cards detailing influenza signs.  Thai Airways reported it is 
instituting check-in questioning of travelers; on flights it is 
distributing information, performing deep-clean fumigation on 
flights to and from high-risk countries, providing face masks to 
passengers on demand and requesting that symptomatic passengers 
notify crew before landing. 
 
¶6.  (U) While the MoPH claims to have Tamiflu for 300,000 individual 
courses of treatment, CDC notes that most of this is contained in 
concentrate with an uncertain time frame for converting the 
concentrate into pill form for patient use.  Dr. Pasakorn briefed 
today that the MoPH planned to convert 100,000 treatment courses by 
next week. 
 
¶7. (U) The RTG is not calling the outbreak "swine flu" out of 
concern that its pork industry would be affected; Dr. Pasakorn 
announced today that the RTG is officially calling it A/H1N1 but 
also commonly "Mexican flu." (Note: at today's diplomatic briefing 
the Mexican Ambassador protested this common name.  End Note.)  An 
Agriculture Ministry contact told ESTHoff that the ministry has an 
active program in process, extending throughout the provinces, 
informing pig farmers to avoid unnecessary contact with their 
livestock and to report signs of sickness.  The Ministry's 
 
BANGKOK 00001060  002.2 OF 002 
 
 
Department of Livestock Development has temporarily banned all 
imports of pork products from the U.S., Mexico and any country 
announcing an A/H1N1 outbreak.  The ban was made effective Monday, 
April 27, but will not affect product currently in transit so long 
as the product was loaded in the US prior to April 27.  (Note: In 
2008, U.S. pork exports were valued at $69,121 in meat products and 
$179,154 in breeding swine.  End Note.) 
 
AFRIMS AND USAID DOING REGIONAL DIAGNOSTIC WORK 
-------------------------------------- 
¶8. (U) The Armed Forces Research Institute for Medical Sciences 
(AFRIMS) regional office in Bangkok is running diagnostics for 
Embassies and other entities in the region.  It is expecting 21 
suspected influenza samples from Embassy Beijing and one sample from 
Embassy Hanoi to be sent shortly.  AFRIMS can currently diagnose 
influenza A but cannot confirm the swine H1N1 until new diagnostic 
reagents are received from CDC, which are expected by 3 May.  USAID 
continues to work with implementing partners to refine pandemic 
influenza preparedness. 
 
ONGOING INFLUENZA STUDY HOLDS PROMISE 
------------------------------------- 
¶9. (U) AFRIMS and CDC are in the second year of a joint study of 
influenza precautions such as hand washing and face mask use.  This 
study could be a key component in the global response to the H1N1 
outbreak; CDC noted that public response to the outbreak, however, 
could confound the study if some of the study subjects begin hand 
washing, using face masks and seeking influenza vaccination.  (Note: 
While Bangkok media have reported that three local hospitals are 
developing a H1N1 vaccine, they are actually engaging in basic 
virology research that may contribute to H1N1 vaccine development. 
Thailand is not in possession of H1N1 samples.  End Note.) 
 
EMBASSY BANGKOK PREPARATIONS 
---------------------------- 
¶10. (U) The mission held a meeting of its Pandemic Working Group on 
April 28.  The Embassy sent an ADMIN notice to mission personnel and 
will send a brief consular warden message.  CDC experts noted that 
surveillance for this outbreak will continue for a long time. 
Working Group members noted that as the summer R&R season 
approaches, the Mission will need to monitor if employees and 
families should be advised against travel to the U.S.   Bangkok 
regional medical officer advises that while Bangkok has one of the 
largest stocks of Tamiflu, it also has one of the largest missions 
and its supply would not go far if a suspected case led to treatment 
courses for office mates and family members of the affected.  The 
Embassy will continue to review its pandemic tripwire procedures 
(recently updated); for the moment the triggering event would be 
second generation cases in New Zealand or other patients in the 
region who contract H1N1 from Mexico. 
 
¶11. (SBU) COMMENT: In the past Thailand has been hit hard with Avian 
Influenza and SARS outbreaks in the region.  We note a fairly robust 
response by the MoPH.  CDC queries of its MoPH contacts who attended 
these meetings have indicated, however, that there has been a 
conspicuous lack of adequate participation by other RTG agencies 
that would have to deal with an outbreak on Thai soil: police, 
military and the education ministry, for example.  We have yet to 
see a coordinated interagency plan that would be critical for an 
effective outbreak response.  However, Dr. Pasakorn told ESTHoff 
today that a meeting in process, chaired by the Deputy Prime 
Minister, was the first true interagency response, and would include 
police and military; his agency was only recently authorized to work 
with other agencies. 
 
¶12. (U) POC is ESTH officer Hal Howard, howardhh@state.gov. 
 
ENWISTLE