VZCZCXRO0783
RR RUEHCN RUEHDT RUEHGH RUEHPB RUEHVC
DE RUEHBJ #1636/01 1680700
ZNR UUUUU ZZH
R 170700Z JUN 09
FM AMEMBASSY BEIJING
TO RUEHC/SECSTATE WASHDC 4588
INFO RUEHOO/CHINA POSTS COLLECTIVE
RUEHBY/AMEMBASSY CANBERRA 9703
RUEHDN/AMCONSUL SYDNEY 0588
RUEAUSA/DEPT OF HHS WASHINGTON DC
RUEHRC/DEPT OF AGRICULTURE WASHDC
RUCPDOC/DEPT OF COMMERCE WASHDC
RUEATRS/DEPT OF TREASURY WASHINGTON DC
RHMFIUU/DEPT OF HOMELAND SECURITY WASHINGTON DC
RUEKJCS/SECDEF WASHDC//USDP/ISA/AP//
RHEHNSC/NSC WASHDC
RUCNARF/ASEAN REGIONAL FORUM COLLECTIVE
RUEHPH/CDC ATLANTA GA
RUEAIIA/CIA WASHDC
RHEFDIA/DIA WASHINGTON DC
RHMFISS/CJCS WASHINGTON DC//J2/J3/J5//
RHMFIUU/CDR USPACOM HONOLULU HI//J00/J2/J3/J5//

UNCLAS SECTION 01 OF 03 BEIJING 001636 
 
HHS FOR OGHA 
CDC ATLANTA FOR CCID, AND PASS TO FLU COX AND MOUNTS AND 
COGH BLOUNT AND KELLEY 
 
SENSITIVE 
SIPDIS 
 
E.O. 12958: N/A 
TAGS: KFLU AEMR ASEC CASC KFLO TBIO KSAF KPAO PREL PINR
AMGT, MG, EAGR, HHS, CH 
SUBJECT:  H1N1 INFLUENZA OUTBREAK - CHINA SITREP # 20 
 
REF: A) BEIJING 1596 B) BEIJING 1548 C) BEIJING 1466 
D) BEIJING 1396 E) BEIJING 1377 
 
 
227 CASES OF 2009 A/H1N1 CONFIRMED, 70 AMCIT CASES 
----------------------------- -------------------- 
 
¶1.  (U) As of COB June 16, China's Ministry of Health (MOH) has 
officially communicated information about 227 confirmed cases of 
infection by the novel 2009 influenza A/H1N1.  Of the confirmed 
cases, 70 are American citizens.  Confirmed cases have been detected 
in 15 provinces and the municipalities of Beijing, Shanghai and 
Tianjin, with the greatest number of cases occurring in Guangdong 
(46), Fujian (30), Sichuan (26), Beijing (47), and Shanghai (21). 
Of the 227 confirmed cases, MOH reported that as of June 15, 86 
infected patients had recovered and been released from treatment. 
The remaining 141 are being treated in isolation at local designated 
hospitals. 
 
¶2. (SBU) American citizen cases have been reported in the 
municipalities of Beijing, Shanghai, and Tianjin, and the provinces 
of Guangdong, Fujian, Sichuan, Hubei, Henan, Shandong, and Hainan. 
Consular officers in Beijing, Guangzhou, Chengdu, and Shanghai have 
established and maintained contact with Amcits being treated in 
local hospitals. 
 
¶3. (SBU) ACS sections in all consular districts also are tracking 
hundreds of cases of Americans being moved in and out of 
officially-imposed quarantine, including several high school student 
exchange groups who have had members quarantined in hotels or the 
hospital.  These developments have generated a flurry of anxious 
inquiries from parents and congressional offices.  The rise in cases 
in the last week has slowed the notifications process for new 
quarantine cases.  In recent days, ACS sent a third diplomatic note, 
again requesting timely notification and more attention to customer 
service issues, such as cleanliness of quarantine facilities and 
poor communication procedures(both lack of information regarding 
case status and insufficient English-speaking staff). 
 
¶4. (SBU) ConGen Shanghai is watching particularly closely the case 
of a 5-year old American child, who was confirmed with H1N1 and 
moved to a treatment hospital designated for children.  Her parents 
remain in quarantine in a separate observation hospital and at home. 
 The parents previously were not permitted to communicate freely 
with the child, and had little or no input on treatment decisions 
for the child.  However, the parents now have a more established 
channel for communicating with the child's doctors on her condition. 
 
 
¶5. (SBU) In addition to the 70 confirmed American citizen cases, 23 
Canadian nationals have been confirmed as having been infected by 
the novel 2009 influenza A/H1N1 virus, as well as one Australian 
national, one French national, one Philippine national, one Japanese 
national, and one Venezuelan national. 
 
¶6. (U)  The Program for Monitoring Emergency Diseases (PROMED) 
operated by the International Society for Infectious Diseases 
released an epidemiological analysis on June 16 of China's first 120 
cases, based on press reports.  The first domestic case of "unknown 
source" was reported on June 12.  While all 120 cases have exhibited 
influenza-like symptoms, none of the cases have shown severe 
symptoms.  Only 15 of the 120 cases were detected through airport 
temperature screening procedures.  Other confirmed cases were 
detected some time after arrival in country, or were domestic 
transmission cases. 
 
 
SPECIAL QUARANTINE AND RELEASE ARRANGEMENTS 
-------------- ---------------------------- 
 
 
BEIJING 00001636  002 OF 003 
 
 
¶7.  (SBU) Through consultations with Shanghai Foreign Affairs Office 
(FAO), Shanghai ACS negotiated the early release from quarantine and 
departure from China of New Orleans Mayor C. Ray Nagin, who had been 
detained and quarantined on June 7 (REF B). Mayor Nagin departed 
Shanghai the evening of June 10 on a Qantus flight bound for 
Sydney. 
 
¶8. (SBU) In Nanjing, a U.S. Department of Agriculture (USDA) 
official traveling in China on an official passport was placed into 
quarantine when H1N1 cases were confirmed on her international 
Washington Dulles to Beijing flight arriving on June 9.  Through 
official requests from Embassy Beijing to the Ministry of Foreign 
Affairs (MFA) and Ministry of Health (MOH), the official was moved 
to a location separate from the designated quarantine hotel on June 
11 and eventually released on June 15 (a day earlier than 
anticipated).  Beijing Agoff confirmed that the USDA official 
departed from Shanghai on June 16.  The official showed no 
influenza-like symptoms during her period in quarantine, and local 
health officials tested her twice for influenza A/H1N1, with both 
tests coming back negative. 
 
 
RESPONSE TO WHO PHASE 6 PANDEMIC ANNOUNCEMENT 
------------------ -------------------------- 
 
¶9.  (SBU) On a national level, the Chinese government has not 
noticeably modified novel 2009 influenza A/H1N1 procedures since the 
June 11 announcement by the World Health Organization (WHO) of the 
move to Phase 6.  However, according to press reports, the Guangdong 
Health Department convened a leadership taskforce meeting on June 12 
with pandemic experts, which resulted in some adjustments in its 
novel 2009 influenza A/H1N1 prevention and control measures. While 
the measures focus broadly on improving general awareness, detection 
and preparedness toward reducing infection and transmission, two 
items of note include strengthened surveillance of people who have 
come in close contact with infected cases and prevention and control 
focused on schools and kindergartens.  A Ministry of Health source 
indicated to Post on June 12 that quarantine procedures likely would 
continue into July (REF A). 
 
¶10. (U) While not explicitly in response to the WHO increasing the 
influenza pandemic alert level to Phase 6, Beijing media sources 
have reported that five more hospitals have been designated as H1N1 
hospitals in Beijing.  In addition to the current two, You'an 
Hospital and Ditan Hospital, three others have been designated as 
H1N1 treatment hospitals and two more have been designated as 
hospitals for medical observation of suspected novel 2009 influenza 
A/H1N1 cases.  Nationwide, the central government has plans to 
increase the lab network from 84 to 203, and the identified 
hospitals from 197 to 354 in the near future.  After that, they will 
add an additional 202 labs and 198 hospitals. 
 
 
UNITED COMPLAINS OF INCONSTITENCIES IN AIRPORT PROCEDURES 
-------------- ---------------------------- ------------ 
 
¶11.  (SBU) United Airlines has registered complaints with Embassy 
Beijing of inconsistent applications of quarantine procedures at the 
airports in Beijing versus in Shanghai.  According to United, these 
problems have caused long delays in Shanghai due to slow processing 
and transporting of quarantined passengers, and have made it 
difficult to turn planes around for return flights.  Based on 
conversations Beijing Econoff had with United station managers in 
Beijing and Shanghai, and with representatives from other U.S. 
carriers, guidance governing quarantine procedures in the two cities 
do not/not appear to differ.  However, in executing these measures, 
there appear to be inadequate resource planning, coordination, and 
communication by the Shanghai municipal government, whereas this has 
been less of a problem in Beijing.  ConGen Shanghai and Embassy 
Beijing will continue to work with airline contacts to identify ways 
 
BEIJING 00001636  003 OF 003 
 
 
to raise this issue with relevant entities. 
 
PICCUTA