VZCZCXRO8602
RR RUEHAST RUEHCHI RUEHDH RUEHDT RUEHHM RUEHLN RUEHMA RUEHNH RUEHPB
RUEHPOD RUEHSL RUEHTM RUEHTRO
DE RUEHKL #0513/01 1760927
ZNR UUUUU ZZH
R 250927Z JUN 09
FM AMEMBASSY KUALA LUMPUR
TO RUEHC/SECSTATE WASHDC 2894
INFO RUEHPH/CDC ATLANTA GA
RUEAUSA/DEPT OF HHS WASHINGTON DC
RUEHGV/USMISSION GENEVA 1743
RUEKJCS/SECDEF WASHINGTON DC
RUEHRC/DEPT OF AGRICULTURE WASHINGTON DC
RUCNASE/ASEAN MEMBER COLLECTIVE
RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE

UNCLAS SECTION 01 OF 03 KUALA LUMPUR 000513 
 
SENSITIVE 
SIPDIS 
 
STATE FOR CA/OCS/EAP 
STATE FOR M/PRI FOR RMORRITZ 
STATE FOR S/ES-O/CMS FOR EPARRA 
STATE FOR EAP/MTS FOR DBISCHOF 
STATE FOR OES/AIAG FOR AMBASSSADOR LOFTIS, DWINN AND 
CPATTERSON 
STATE FOR REO/BKK FOR HHOWARD 
STATE FOR OES/IHB, AAIT, MED 
HHS FOR OGHA STEIGER AND HICKEY 
CDC ATLANTA FOR CCID AND COGH 
USDA FOR APHIS 
 
E.O. 12958: N/A 
TAGS: KFLU AEMR ASEC AMED CASC KFLO TBIO KSAF KPAO PREL
PINR, AMGT, TF, MY 
SUBJECT: MALAYSIA H1N1 UPDATE - June 25, 2009 
 
REF:  Taipei 756 
 
¶1. (SBU) SUMMARY:  Malaysia is currently committed to containing 
local transmission of H1N1, although pressures to shift to a 
mitigation strategy appear to be mounting.  The Ministry of Health 
(MOH) and Ministry of Education (MOE) have jointly asked all 
students returning from the U.S., London, Melbourne, and Manila for 
any reason to home quarantine for seven days before returning to 
school.  MOH and MOE closed four local schools in the Kuala Lumpur 
area due to infection among their respective student bodies.  PM 
Najib has stated that a complete school closure might be considered 
but only if other measures prove ineffective.  MOH has also asked 
all employers to grant additional leave to employees who are placed 
under quarantine.  No official travel warnings have been issued but 
several public statements from GOM officials have discouraged travel 
to the U.S.  Malaysia has confirmed 91 cases of H1N1 since the start 
of the virus, 56 of which have been in the last week. 
 
¶2. (SBU) COMMENT:  Singling out of the U.S. and a few other 
countries like Australia, UK, and the Philippines has become 
noticeable both in government statements and media reports on H1N1. 
It is unclear what basis is being used to publicly identify these 
countries and not others (including those in the region) where the 
number of H1N1 cases is rising quickly.  Post requests any guidance 
from Washington that we could usefully and appropriately share with 
the MOH and GOM to help them formulate a transparent and 
scientifically/medically sound H1N1 policy.  END SUMMARY AND 
COMMENT. 
 
----------- 
Containment 
----------- 
 
¶3. (SBU) Dr. Devan Kurup, MOH Principal Assistant Director for 
Infectious Disease Surveillance, informed ESTHoff on June 25 that 
Malaysia is still pursuing a containment policy with an emphasis on 
stopping local transmission.  However, the policy is changing daily. 
 He admitted that MOH was "running out of ideas."  ESTHoff asked Dr. 
Devan to comment on Taiwan's decision to downgrade the virus 
(reftel);  Dr. Devan did not want to predict what course the 
situation would take, but he did volunteer that MOH might move into 
a mitigation strategy, like Taiwan, if the disease continues to 
spread while maintaining its current lack of severity.  The ministry 
is admittedly over-stretched already as it is also focused on Dengue 
prevention and surveillance.  Health Minister Liow stated that MOH 
personnel from other states have been deployed to the Klang Valley 
and all annual leave has been frozen. 
 
------------------------------ 
Quarantine and School Closures 
------------------------------ 
 
¶4. (SBU) In conjunction with the Ministry of Education (MOE), Health 
Minister LIOW Tiong Lai announced on June 23 that all students, 
Malaysian and foreign, returning from the U.S., London, Melbourne, 
and Manila for any reason must undergo a seven day home quarantine 
period before returning to school.  While strictly worded in public 
announcements and news reports, the quarantine requirement is 
actually voluntary at this stage.  Dr. Devan told ESTHoff that there 
is no enforcement mechanism at this time.  He also added that these 
locations were selected because most of the imported confirmed cases 
in Malaysia traveled through or from one of these places.  More 
locations might be added over the coming days according to Dr. 
Devan.  MOH and MOE have also instructed schools to allow any 
student with flu-like symptoms to remain home for 3 days without a 
note from a physician.  MOH is considering giving teachers and other 
school faculty members the authority to screen students for high 
temperatures each day.  (Note: Most Malaysian schools are currently 
in session; some schools, including the International School of 
Kuala Lumpur (ISKL) where many American students attend, are 
currently in summer recess through the first week of August. End 
note.) 
 
KUALA LUMP 00000513  002 OF 003 
 
 
 
¶5. (SBU) Current MOH and MOE protocol requires the complete closure 
of a school for seven days when more than one case is confirmed 
among the student body.  When only one case is confirmed, just that 
student's class is closed.  The students and faculty are expected to 
undergo home quarantine during this 7 day period while the school is 
thoroughly cleaned.  MOH and MOE have completely closed four schools 
as of June 25, while three other schools have closed only one class 
of students.  The editorial board of Nanyang Siang Pao, a local 
paper, has called for the closure of all schools in the Klang Valley 
to prevent the spread of the disease.  PM Najib responded that a 
complete school closure might be considered but only if other 
measures prove ineffective. 
 
¶6. (SBU) On June 25, Health Minister Liow urged all employers in 
Malaysia to grant their employees seven days of administrative leave 
if they are placed under quarantine upon returning from abroad. 
Media coverage of the announcement again highlighted the U.S., 
Australia, UK, and the Philippines as the high risk locations.  Liow 
stated that he will propose this policy to the cabinet next week to 
make it mandatory.  MOH had previously arranged to have a taxi 
driver receive welfare payments for time lost while in quarantine. 
These measures are intended to remove the economic disincentive that 
individuals face when they are asked to self quarantine. 
 
--------------- 
Travel Warnings 
--------------- 
 
¶7. (SBU) While there are no current official travel warnings or 
bans, GOM has issued several statements discouraging travel to the 
U.S.  State Tourism, Domestic Trade and Consumer Affairs Committee 
chairman Hoo Seong Chang advised the public against traveling to 
countries affected by the virus.  He recommended that those who had 
already taken leave consider traveling domestically instead of going 
abroad.  PM Najib has also recommended against travel to "high risk" 
countries, without specifically naming any locations.  The 
abovementioned home quarantine policy also acts as a de facto travel 
warning.  Dr. Devan told ESTHoff that the official policy remains to 
not discourage travel but they cannot control what other ministries 
say.  In our recent interactions with officials at MOH and the 
Foreign Ministry on H1N1, we have requested that GOM policy 
statements regarding travel to and from the U.S. be consistent and 
based on sound scientific/medical justification. 
 
------------ 
Surveillance 
------------ 
 
¶8. (SBU) MOH has confirmed 14 cases of local transmission with a 
total of 91 confirmed cases since the beginning of the outbreak.  35 
of the total cases have been released from quarantine with no 
further symptoms, while the other 56 cases have occurred in the last 
week and are currently in quarantine.  All cases have reportedly 
responded well to Tamiflu treatment.  There have been no deaths. 
MOH continues to ask contacts and fellow passengers of confirmed 
cases to self quarantine for seven days but the ministry has put 
fewer resources than before into tracking down these passengers. 
 
¶9. (SBU) All travelers continue to be screened at ports of entry by 
both thermal scanning and mandatory health questionnaires.  Any 
passenger with a fever, other flu-like symptoms, or deemed to be 
high risk will be given a throat swab.  Those who test negative for 
influenza A will be given a two day dose of Tamiflu and sent home 
for self-quarantine.  Previously, individuals with flu-like symptoms 
from H1N1-affected countries, like the U.S., would be immediately 
sent to a MOH hospital for further testing.  Now, only those who 
test positive for influenza A at the port of entry will be 
hospitalized for H1N1 subtyping, regardless of country of origin. 
This change should decrease the number of people being sent to 
hospital for testing.  However, MOH has designated ten more 
hospitals for H1N1 testing, bringing the total to 38 hospitals 
 
KUALA LUMP 00000513  003 OF 003 
 
 
throughout Malaysia.  MOH is considering expanding testing to 
private hospitals as well.  Individuals who test positive for H1N1 
are now required to quarantine in hospital for three days with a 
subsequent four days of home quarantine assuming no complications; 
this is a change from the previous requirement of seven days in 
hospital regardless of condition. 
 
--------------- 
Mission Actions 
--------------- 
 
¶10. (SBU) Post is preparing a mission-wide message to Embassy staff 
and American dependents and another warden message regarding the 
current situation.  Dr. Devan of MOH told ESTHoff that AmCit 
students should plan on returning to Malaysia at least seven days 
before school starts in order to avoid missing the beginning of 
classes.  Post has also reached out to other missions, including the 
UK, Australia, New Zealand, Japan, and Canada, to gauge their 
response to GOM H1N1 policy.  Post is continuing to seek clarity 
with the GOM on its policies.  Additional guidance from Washington 
on how to possibly encourage appropriate GOM surveillance and 
quarantining policies is requested. 
 
RAPSON