VZCZCXRO5522
PP RUEHGR
DE RUEHWN #0338/01 0531819
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P 221819Z FEB 06
FM AMEMBASSY BRIDGETOWN
TO RUEHC/SECSTATE WASHDC PRIORITY 1950
INFO RUCNCOM/EC CARICOM COLLECTIVE PRIORITY

UNCLAS SECTION 01 OF 04 BRIDGETOWN 000338 
 
SIPDIS 
 
SIPDIS 
 
DEPT PASS TO USAID/GH/RCS/KELLY WOLFE AND LAC/PEG MARSHALL 
 
E.O. 12958: N/A 
TAGS: AEMR AMED AMGT ASEC CASC EAGR EAID ETRD KFLO
KSCA, SENV, SOCI, TBIO, BB, GJ, XL 
SUBJECT: CORRECTED COPY:  AI REPORT #7:  POST'S AI-SPECIFIC 
CONTINGENCY PLANNING AND TRIPWIRES 
 
REF: STATE 219189 
 
¶1.  This is a corrected cable in response to reftel.  See 
additional information in para 2 about Embassy's activities 
and constituent Post in Grenada, changes in para 3 on Post's 
geographic areas of responsibility and concern, and 
tripwire-related changes in para 5. 
 
¶2.  Summary: Post's Avian Influenza Working Group (AIWG) met 
on November 23 and January 27 to develop preparedness 
measures to meet the threat of a avian influenza (AI) human 
pandemic.  Consequent to these meetings, AIWG members 
inventoried medical supplies and identified medically trained 
and medically at-risk staff in a pandemic scenario.  AIWG 
members also began making plans for mission briefings, social 
distancing, warden messaging, and continued operations in a 
drawdown situation.  AIWG members formulated and refined 
AI-specific tripwires and tripwire responses.  Post's AI 
preparations and plans also apply to constituent-post Embassy 
Grenada.  Because Post's geographic area of concern is 
diverse, extensive, and consists of many small-island states, 
Post prefers to maintain its AI-specific tripwires and 
tripwire responses as general guidelines rather than trying 
to outline a particular Post response for every possible 
scenario. End Summary. 
 
¶3.  Post's AIWG met on November 23 and January 27 to develop 
preparedness measures against the threat of a AI human 
pandemic.  The AIWG formulated AI-specific preparations, 
contingencies, and tripwires, and followed up with 
AI-specific preparatory activities.  (Note: Because of the 
high level of human interaction in the Caribbean, the AIWG is 
taking the whole region as its area of concern.  Post covers 
the seven Eastern Caribbean islands of Antigua and Barbuda, 
Barbados, Dominica, Grenada, St. Kitts and Nevis, St. Lucia, 
and St. Vincent and the Grenadines.  Post's consular 
district, however, extends beyond these seven countries to 
the islands of Martinique, (French) St. Martin, St. 
Barthelemy, Montserrat, Guadeloupe, the British Virgin 
Islands, and Anguilla.  There are also several Dutch island 
countries in the Lesser Antilles.  Because the small U.S. 
State Department mission in Grenada is a constituent Post, 
all tripwires and tripwire responses enumerated in this cable 
apply to that mission as well.  End Note. 
 
------------------------------ 
Early AI-Specific Preparations 
------------------------------ 
 
¶4.  Concerning AI-specific preparations, AIWG members have 
inventoried and ordered medical supplies, including 
medications and protective gear; identified staff who would 
be medically at-risk during a pandemic; and identified staff 
with medical skills who can assist Post's nurse in a 
pandemic.  AIWG members also continue to plan for smooth 
AI-related information flow to American staff, LES, and 
Americans in the consular district through mission briefings 
and warden messaging respectively.  Post has begun to 
inventory and stockpile fuel, food, water, and other 
emergency supplies.  The AIWG members are also weighing 
options for Mission drawdown and social distancing. 
 
-------------------------------------------- 
AI-Specific Tripwires and Tripwire Responses 
-------------------------------------------- 
 
¶5.  AIWG discussions have generated the following list of 
AI-specific tripwires and post responses: 
 
Tripwire One:  Pathogenic virus strain H5N1 infects an animal 
in a Caribbean country; or there is human infection with 
pathogenic H5N1 in the non-Caribbean Western Hemisphere, but 
without sustained human-to-human (H-2-H) transmission 
anywhere in the world. 
 
Tripwire Responses: 
 
a. Convene Emergency Action Committee (EAC) to confirm 
tripwire has been crossed. AIWG makes report to EAC 
concerning contingency plans and AI-related activities in 
host countries.  EAC issues recommendations. 
 
b. Provide town hall and other briefings to American and LES 
employees and dependents. 
 
c. If applicable, bar travel into areas suspected to have 
H-2-H transmission. 
 
d. If applicable, disseminate public announcements and travel 
 
BRIDGETOWN 00000338  002 OF 004 
 
 
warnings about H-2-H regions among American citizens in 
Post's Consular District. 
 
e. Continue convening AIWG to review contingency plans, 
survey medical supplies, and monitor AI-related activities in 
host countries. 
 
Tripwire Two:  Pathogenic H5N1 infects a human in a Caribbean 
country, but without H-2-H transmission; or there is 
sustained H-2-H transmission anywhere in the world. 
 
Tripwire Responses: 
 
a. Convene EAC to confirm tripwire has been crossed.  The 
AIWG makes its report to EAC concerning AI-contingency 
preparations and AI-related activities in host countries. 
The EAC issues recommendations. 
 
b. Provide town hall and other briefings to American and LES 
employees and dependents. 
 
c. Disseminate public announcements and travel warnings about 
H-2-H regions among American citizens in Post's Consular 
District. 
 
d. Bar USG travel into H-2-H suspected areas. 
 
e. Consider recalling all employees from remote areas. 
 
f. In the case of human AI illness in a Caribbean country, 
consider requesting authorized departure of non-essential 
staff and family members, and begin implementation planning. 
 
g. Continue convening AIWG to refine contingency plans and to 
monitor AI-related activities in host countries. 
 
Tripwire Three:  There is sustained H-2-H pathogenic H5N1 
transmission in a Caribbean country, but not yet in the 
Lesser Antilles; or someone in the Lessor Antilles becomes 
infected with pathogenic AI, but without H-2-H transmission. 
Tripwire Responses: 
 
a. Convene EAC to confirm that tripwire has been crossed. 
The AIWG makes its report to the EAC concerning 
AI-contingency plans and AI-related activities in host 
countries.  The EAC issues recommendations. 
 
b. Provide town hall and other briefings to American and LES 
employees and dependents. 
 
c. Bar USG travel into H-2-H suspected areas. 
 
d. If medically advisable, request authorized departure of 
all non-essential staff and family members.  Begin planning 
to implement medically advisable authorized departures. 
 
e. Consider canceling incoming official travel to host 
country, except for personnel involved in investigative or 
containment efforts, or as otherwise deemed necessary by the 
Chief of Mission (COM). 
 
f. In coordination with the Department, issue public 
announcements, warden messages, and travel warnings 
cautioning American citizens against nonessential travel to 
suspected areas. 
 
g. In coordination with the Department, prepare press 
guidance. 
 
h. Institute mandatory sick leave for employees who exhibit 
flu-like symptoms, or who have a family member exhibiting 
flu-like symptoms. 
 
i. In consultation with CA, limit consular services as 
necessary. 
 
j. Implement use of personal protective equipment (PPE - 
gloves, masks, etc.) according to MED guidance. 
 
k. Plan for home visits to sick individuals who would receive 
care and medications under Post,s health unit. 
 
l. Plan for the delivery of food, water, medical supplies, 
and other essential items to residences. 
 
m. Plan for the implementation of social distancing measures 
 
n. Provide, in consultation with medical staff, prophylactic 
Tamiflu or other antiviral treatment for staff who are 
 
BRIDGETOWN 00000338  003 OF 004 
 
 
required to be in direct contact with potentially infected 
persons. 
 
o. Convene AIWG to refine contingency plans, including plans 
for social distancing, quarantines, emergency delivery of 
food and supplies.  AIWG continues to monitor AI-related 
activities in host countries. 
 
Tripwire Four:  Sustained pathogenic H5N1 H-2-H cases occur 
on any Lesser Antilles island or a USG employee becomes ill 
with pathogenic AI.  (Note:  Besides U.S. Embassy personnel 
in Barbados and its constituent post in Grenada, there are 
115 Peace Corps volunteers and administrative staff 
distributed among the islands of Antigua, Dominica, Grenada, 
St. Kitts and Nevis, St. Lucia, and St. Vincent.  There is 
also a seven-person U.S. Air Force tracking station and a 
Consular Agent in Antigua, as well as a Consular agent in 
Martinique.  End Note.) 
 
Tripwire Responses: 
 
a. Convene EAC to confirm that tripwire has been crossed. 
The AIWG makes its report to the EAC concerning 
AI-contingency plans and AI-related activities in host 
countries.  The EAC issues recommendations. 
 
b. Provide Mission briefings, some perhaps by phone or 
e-mail, for American and LES staff and dependents. 
 
c. Cancel incoming official travel to host country, except 
for personnel involved in investigative or containment 
efforts, or as otherwise deemed necessary by the Chief of 
Mission (COM). 
 
d. Coordinate with CA/OCS on issuance of guidance (public 
announcement or travel warning) urging Americans to defer all 
non-emergency travel to host countries and particularly the 
affected regions. 
 
e. In coordination with the Department, prepare press 
guidance. 
 
f. Implement home quarantine of any staff or dependents who 
have been in contact with a person confirmed to have an AI 
infection and implement at-home monitoring procedures as 
needed. 
 
g. Instruct all non-emergency American and LES staff to 
remain home on administrative leave. 
 
h. Implement social distancing measures:  Children should 
remain home from school, and all personnel should avoid 
crowds and social gatherings.  Consider moving well people 
out of AI-endemic areas to safehavens. 
 
i. Implement home visits to sick individuals receiving 
medications or care under Post,s health unit. 
 
j. Relocate Embassy personnel to designated residences. 
 
k. Deliver food, water, medical supplies, and other essential 
items to residences as needed. 
 
l. Depending on level of public enquiries, Embassy staffs and 
equips a situation room.  Consular officers establish a 
database tracking quarantined, hospitalized, or ill-at-home 
American citizens.  Post issues guidance for American 
community on treatment options. 
 
m. Reduce consular operations to emergency consular services 
only. 
 
n. Divide Marine Security Guard detachment and local guard 
squad into two separate and independent entities respectively 
to decrease the risk of spread of the disease and ensure 
proper coverage to Mission. 
 
o. Restrict visitor access into Embassy buildings. 
 
p. Provide, in consultation with medical staff, prophylactic 
Tamiflu or other antiviral treatment for staff who are 
required to be in direct contact with potentially infected 
persons. 
 
q. Continue convening the AIWG on an ad hoc basis to monitor 
AI-related activities in host countries.  The AIWG, in 
coordination with Post's EAC, continues to monitor and guide 
Post,s AI-related activities. 
 
 
BRIDGETOWN 00000338  004 OF 004 
 
 
¶6. Comment:  Post's area of concern (the Caribbean) is 
diverse and geographically extensive.  Although the countries 
of Lesser Antilles are coordinating their AI preparations 
with the Pan American Health Association (PAHO) and the 
Trinidad-based Caribbean Epidemiology Center (CAREC), Post 
anticipates that, beyond protocols for tissue sampling, the 
countries in the region may respond to an AI pandemic in 
various and unpredictable ways.  To assure maximum 
flexibility of action, Post therefore believes it is best to 
use the above tripwires and tripwire responses as general 
guidelines, instead of trying to outline a list of particular 
Post responses for every possible scenario.  End Comment 
KRAMER