VZCZCXRO3582
RR RUEHDA RUEHDF RUEHFL RUEHKW RUEHLA RUEHLN RUEHLZ RUEHROV RUEHSR
RUEHVK RUEHYG
DE RUEHVB #1985/01 3561039
ZNR UUUUU ZZH
R 221039Z DEC 05
FM AMEMBASSY ZAGREB
TO RUEHC/SECSTATE WASHDC 5464
INFO RUEHZL/EUROPEAN POLITICAL COLLECTIVE
RUEHPH/CDC ATLANTA GA
RUEAUSA/DEPT OF HHS WASHDC
RUERAFX/DIR AFMIC FORT DETRICK MD
RUEKJCS/SECDEF WASHDC
RUCPDOC/USDOC WASHDC
RUEHRC/USDA WASHDC

UNCLAS SECTION 01 OF 03 ZAGREB 001985 
 
SIPDIS 
 
SIPDIS 
 
DEPT PLEASE PASS TO DS/DSS, DS/IP, M/MED/JCTRIPLETT 
S/ES-O/CMS - OFFICE OF CRISIS MANAGEMENT SUPPORT 
FAS/CMP/DLP WETZEL AND MAGGINNIS 
FAS/ITP/EAMED POMEROY AND FLEMING 
CA/OCS/ACS RICK DOWELL 
USAID FOR E&E/ECA/B/ANNE CONVERY 
 
E.O. 12958: N/A 
TAGS: TBIO PREL AMGT ASEC AMED AEMR HR
SUBJECT: CROATIA: AVIAN INFLUENZA POST CONTINGENCEY 
PLANNING, TRIPWIRES AND WEEKLY UPDATE: DECEMBER 22 
 
REF: A) STATE 219189 
 
B) ZAGREB 1946 AND PREVIOUS 
 
1) SUMMARY: As of December 22, no additional cases 
of H5N1 have been confirmed in Croatia.  In response 
to Ref A, Croatia has a developed, but strained 
public health care system with limited resources. 
There are fourteen specialized hospitals, including 
an infectious disease hospital, located in Zagreb. 
It is unlikely that the Croatian public health 
system could handle a full-scale influenza pandemic. 
Depending on circumstances, post believes it could 
maintain a shelter in place posture for a period of 
four to six weeks.  In addition to existing 
emergency radio systems, post recognizes that new 
technologies such as the OpenNet Everywhere (ONE) 
program and wireless email (Blackberry) could 
facilitate continuity of operations and distribution 
of essential information during a pandemic.  END 
SUMMARY 
 
------------------ 
PREPAREDNESS STEPS 
------------------ 
¶2. Post is providing the following status 
information on our preparedness steps per request in 
Ref A: 
a) RMO Vienna held a briefing on avian and pandemic 
influenza for all employees and dependents on 
October 27, 2005. 
b) Management and MED identified 5 employees with 
medical backgrounds and will offer training to non- 
medical personnel in caring for those suffering from 
influenza as needed. 
c) Post currently has 800 doses of Tamiflu, 10 boxes 
of hand sanitizer wipes, 147 N95 masks, 200 surgical 
masks, 56 goggles, 100 head and foot covers, and 50 
gowns. 
d) Tamiflu stockpiles are securely stored in the 
Health Unit. 
e) Post has stockpiles of emergency supplies at the 
embassy and Chief of Mission Residence (CMR).  We 
distributed a health unit notice advising all 
employees to stockpile emergency supplies. 
f) Post's Emergency Action Plan (EAP) includes a 
plan for an alternate command post and the 
continuation of operations in the case of reduced 
staff.  We have the ability to disseminate warden 
messages from an alternative location. 
g) Post's existing EAP Drawndown list of emergency 
personnel will be used in the case of possible 
authorized or ordered departure. 
h) MED has identified staff with medical issues or 
risk of severe disease to depart when authorized. 
i) Management has prepared pre-planned departure 
packets for potential Mission evacuees. 
j) The EAC discussed strategies, such as sheltering 
in place, for responding to border and airport 
closures. 
k) We plan to hold Town Hall meetings in early 2006. 
Pandemic influenza information will be provided to 
American citizens at these meetings. 
l) Post continues to engage Croatian officials on 
the GOC's response strategy and health care 
capabilities. 
 
--------------------------------------------- 
Embassy Zagreb's Pandemic Influenza Tripwires 
--------------------------------------------- 
¶3. Tripwire One:  Confirmed case(s) of animal to 
human transmission in Croatia or neighboring 
countries or sustained human-to-human transmission 
in any country. 
 
Tripwire One Responses: 
a) EAC meets to confirm tripwire has been crossed 
and decide on further action. 
b) Provide Mission briefings for American and LES 
 
ZAGREB 00001985  002 OF 003 
 
 
employees and dependents.  Confirm and update 
personal email addresses of employees to facilitate 
dissemination of information. 
c) Ensure that any public announcements or travel 
warnings issued relating to other countries are 
disseminated to American citizens in Croatia. 
d) In coordination with the Department, issue public 
announcement, warden message, or travel warning 
cautioning American citizens against nonessential 
travel to the affected region and to suspected areas 
within Croatia. 
e) In coordination with the Department, prepare 
press guidance. 
f) Prepare guidance for American citizen community 
on treatment options. 
g) EAC considers limiting consular services with CA 
consultation prior to taking such steps. 
h) EAC restricts official and unofficial travel to 
suspected areas. 
i) EAC reviews drawdown section of EAP and considers 
requesting authorized departure of non-essential 
staff and family members.  Note: Under certain 
scenarios, drawdown of personnel may not be 
possible, safe, or medically advisable due to 
factors such as: closure of borders and other travel 
restrictions; establishment of quarantines at ports 
of entry; rapid curtailment of commercial travel; 
and surge in demand for medicine and related 
services. 
j) EAC accounts for and considers recalling all 
persons falling under Chief of Mission authority who 
are currently in remote areas. 
k) EAC considers instituting mandatory sick leave 
for employees who exhibit flu-like symptoms or have 
a family member exhibiting flu-like symptoms. 
l) EAC considers implementing use of protective 
equipment (gloves, masks, etc.) according to MED 
guidance. 
m) EAC reviews and revises tripwires, as necessary. 
 
 
¶4. Tripwire Two: A spike in the number and/or 
broadening geographic spread of animal to human 
cases or sustained human-to-human transmission in 
neighboring countries or within Croatia. 
 
Tripwire Two Responses: 
a) EAC meets to confirm tripwire has been crossed 
and decide on further actions. 
b) Provide Mission briefings (perhaps by phone or 
email) for American and LES staff and dependents. 
c) EAC reviews EAP section for evacuation. 
d) Cancel incoming official travel to host country, 
except for personnel involved in 
investigative/containment efforts, or as otherwise 
deemed necessary by COM. 
e) Coordinate with CA/OCS on issuance of guidance 
(public announcement or travel warning, as 
appropriate) urging American citizens to defer all 
non-emergency travel to Croatia and particularly the 
affected regions. 
f) Depending on level of public inquiries, Embassy 
staffs and equips a situation room.  Consular 
officers should establish a database tracking 
American citizens who have been quarantined, 
hospitalized, or are ill at home.  Distribute 
guidance for American citizen community on treatment 
options. 
g) Limit consular services as necessary with CA 
approval prior to taking such steps. 
h) In coordination with the Department, prepare 
press guidance. 
i) Institute mandatory sick leave for employees who 
exhibit flu-like symptoms or have a family member 
exhibiting flu-like symptoms. 
j) Implement use of protective equipment (gloves, 
masks, etc.) according to MED guidance. 
k) Implement home quarantine of any staff or 
 
ZAGREB 00001985  003 OF 003 
 
 
dependents who have been in contact with a person 
confirmed to have an AI infection and implement at 
home monitoring procedure. 
l) If authorized departure/ordered departure is not 
permissible, instruct all non-emergency American and 
LES staff to remain home on administrative leave. 
Children should remain home from school. 
m) Implement social distancing (limit movements of 
all personnel and dependents in the city). 
n) Plan for home visits to sick individuals who 
receive care under the Embassy health unit. 
o) Consider relocation of Embassy personnel to 
designated residences. 
p) Consider delivery service of groceries and other 
essential items to residences. 
q) Consider dividing the Marine Security Guard 
detachment into two separate and independent 
entities to decrease the risk of the spread of the 
disease and ensure proper coverage of classified 
materials. 
r) Restrict visitor access to Mission. 
s) Consider prophylactic Tamiflu treatment only for 
staff who are required to be in direct contact with 
potentially infected persons. 
 
 
¶5. Parallel Tripwire: Mission employee or eligible 
family member develops AI infection. 
 
Parallel Tripwire Response: 
 
a) Employee or eligible family member begins Tamiflu 
treatment. 
b) Medevac if possible. 
 
 
FRANK