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UNCLAS SECTION 01 OF 05 STATE 115971 
 
SIPDIS 
 
SIPDIS - INFORM CONSULS 
 
E.O. 12958: N/A 
TAGS: CASC KFLU AMED AMGT
SUBJECT: AVIAN INFLUENZA FACT SHEET AND FREQUENTLY ASKED 
QUESTIONS 
 
STATE 00115971  001.2 OF 005 
 
 
¶1. The Department has completely revised and updated the 
Avian Influenza Fact Sheet and FAQs below.  Posts are 
instructed to: 
 
a. Issue a warden message to the American citizen 
community drawing attention to the new information; 
 
b. Engage in active outreach activities at all levels to 
disseminate this information; 
 
c. Keep the Department informed of all outreach activities 
and report any feedback from the American citizen 
community in your host country. 
 
¶2. In order to make sure that all American citizens 
receive the same information about avian influenza, this 
fact sheet must not be altered.  Posts wishing to submit 
additional Frequently Asked Questions should forward them 
to CA/OCS/ACS Attn: Elizabeth Ryan and Michelle Bernier- 
Toth. 
 
¶3.  The Fact Sheet and FAQs are posted at 
www.travel.state.gov and on the CA Intranet site at 
http://intranet.ca.state.gov/ .  The Fact Sheet and FAQs 
may be used in conjunction with the PowerPoint 
presentation also located on the CA Intranet site. 
 
4) FACT SHEET: AVIAN INFLUENZA A (H5N1) and PANDEMIC 
INFLUENZA 
 
This fact sheet alerts Americans to the Department of 
State's preparedness efforts with respect to a possible 
influenza pandemic.  The Department of State emphasizes 
that, in the event of a pandemic, its ability to assist 
Americans traveling and residing abroad may be severely 
limited by restrictions on local and international 
movement imposed for public health reasons, either by 
foreign governments and/or the United States. 
Furthermore, American citizens should take note that the 
Department of State cannot provide Americans traveling or 
living abroad with medications or supplies even in the 
event of a pandemic. 
 
Background - H5N1 Avian Influenza A 
 
Countries continue to report cases of avian influenza A 
(H5N1), commonly referred to as "bird flu" in their 
domestic and wild bird populations.  In addition, 
countries are reporting H5N1 in other wild and domestic 
animal populations.  A small number of confirmed cases of 
H5N1 among humans have been reported, some of which have 
resulted in death.  More information is available on the 
World Health Organization (WHO) website, 
http://www.who.int/csr/disease/avian_influenz a/country/en/ 
.  Please refer to this website for the most up to date 
information on the countries affected by H5N1 and the 
number of deaths. 
 
The vast majority of the reported human cases have 
resulted from direct contact with H5N1-infected poultry. 
Although there is evidence to suggest very limited, human- 
to-human transmission in family groups involving close 
exposure to a critically ill member, there is no evidence 
that the virus can be easily or sustainably transmitted 
from human-to-human.  The U.S. Department of Health and 
Human Services, Centers for Disease Control and Prevention 
(DHHS/CDC), the WHO, and the Department of State are 
nonetheless concerned about the potential for the virus to 
adapt or mutate into a strain that can be easily 
transmitted in a sustained manner among humans, a 
characteristic that could result in a human influenza 
 
STATE 00115971  002.2 OF 005 
 
 
pandemic, and are working closely with other partners to 
prepare for the possibility of pandemic influenza. 
Information on the U.S. Government's overall response and 
efforts is available at http://www.pandemicflu.gov. 
 
Travel and Avian Influenza A 
 
The Department of State, the DHHS/CDC and the WHO have not 
issued any health precautions, travel alerts or warnings 
for H5N1 infected areas.  However, the DHHS/CDC advises 
travelers to H5N1 affected countries to avoid poultry 
farms, contact with animals in live food markets, and any 
surfaces that appear to be contaminated with feces or 
fluids from poultry or other animals, and to eat only 
thoroughly cooked poultry products.  American citizens 
traveling to or living in H5N1 affected countries should 
consider the potential risks and keep informed of the 
latest medical guidance and information in order to make 
appropriate plans.  Specific DHHS/CDC travel information 
relating to H5N1, including preventive measures, is 
available at http://www.cdc.gov/flu/avian/index.htm and 
http://www.cdc.gov/travel. WHO guidance related to avian 
influenza is available at 
http://www.who.int/csr/disease/avian_influenz a/en/. 
 
Additional general country information can be obtained 
from the Department of State's Consular Information Sheets 
at http://travel.state.gov and embassy and consulate 
websites at 
http://www.travel.state.gov/travel/tips/embas sies/embassie 
s_1214.html. You may also call the Department of State's 
toll-free number, 1-888-407-4747, or if calling from 
overseas, 202-501-4444. 
 
Prevention, Response and Treatment - Take Charge of Your 
Plans 
 
A vaccine for humans that is effective in preventing 
infection with the avian influenza A (H5N1) virus is not 
yet available. Based upon limited data, the DHHS/CDC has 
suggested that the anti-viral medication Oseltamivir 
(brand name- Tamiflu) may be effective in treating avian 
influenza A.  U.S. embassies and consulates do not have 
supplies of this drug for use by private American citizens 
abroad.  The Department of State has pre-positioned 
supplies of the drug Tamiflu at its embassies and 
consulates worldwide, for eligible U.S. Government 
employees and their families serving abroad.  Americans 
should also be aware of the potential health risk posed by 
counterfeit drugs, including those represented as Tamiflu, 
by scam artists who sell products on the internet or in 
countries with lax regulations governing the production 
and distribution of pharmaceuticals. For more information 
on counterfeit drugs please visit the Food and Drug 
Administrations (FDA) questions and answers for 
counterfeit drugs at 
http://www.fda.gov/oc/initiatives/counterfeit /qa.html 
 
In addition, the Department of State has asked its 
embassies and consulates to consider preparedness measures 
that take into consideration the fact that travel into or 
out of a country may not be possible, safe, or medically 
advisable during a pandemic.  Guidance on how private 
citizens can prepare to shelter in place, including 
stocking food, water, and medical supplies, is available 
at the www.pandemicflu.gov website.  Embassy stocks cannot 
be made available to private American citizens abroad and 
we encourage people living in an area with outbreaks of 
H5N1 to prepare appropriately. 
 
It is also likely that governments will respond to a 
pandemic by imposing public health measures that restrict 
domestic and international movement, further limiting the 
U.S. government's ability to assist Americans in these 
countries.  These measures can be implemented very 
quickly.  Areas of known H5N1 outbreaks in poultry have 
 
STATE 00115971  003.2 OF 005 
 
 
been quarantined by governments within 24 hours, 
restricting (if not preventing) movement into and out of 
the affected area. 
 
Americans who are planning travel to a country that has 
reported the virus or who are concerned about avian 
influenza are advised to monitor the DHHS/CDC and the WHO 
websites for the latest information. 
 
CDC Contact Information 
 
Public Inquiries: 
English (888) 246-2675 
Spanish (888) 246-2857 
TTY (866) 874-2646 
Mon-Fri 8am-11pm EST 
Sat-Sun 10am-8pm EST 
 
Address: 
Centers for Disease Control and Prevention 
1600 Clifton Rd. 
Atlanta, GA 30333 
USA (404) 639-3311 
 
Traveler's Website 
 
http://www.cdc.gov/travel 
 
WHO Liaison Office in Washington, DC 
 
Contact Information: 
Telephone: (202) 974-3787 
Facsimile: (202) 974-3789 
 
Address: 
WHO Liaison Office 
1889 F Street, N.W., Suite 369 
Washington, D.C. 20006 USA 
 
July 2006 
 
Frequently Asked Questions about Avian Influenza A (H5N1) 
and Pandemic Influenza 
 
Where can I find up-to-date medical and planning 
information on avian influenza A (H5N1) and pandemic 
influenza? 
 
Why is the U.S. government not providing Tamiflu) to 
private Americans overseas? 
 
What if I get sick when I am in another country?  I have a 
pre-existing medical condition, is there anything 
different I should do?  How do I locate a doctor in the 
country I am traveling to? 
 
Will the U.S. government evacuate Americans in a foreign 
country in the event of a pandemic? 
 
As a private American citizen living overseas, what can I 
do today to help prepare myself and my family for possible 
bird flu pandemic? 
 
What precautions should I take if I live in or visit an 
area affected by H5N1 "bird flu"? 
 
Can my domestic animals get H5N1 "bird flu"? 
 
Where can I find up-to-date medical and planning 
information on avian influenza A (H5N1) and pandemic 
influenza? 
 
Current information about avian influenza A (H5N1) and 
pandemic influenza can be found at: 
http://www.cdc.gov/flu/avian/gen-info/qa.htm 
 
 
STATE 00115971  004.2 OF 005 
 
 
http://www.cdc.gov/travel 
 
http://www.who.int 
 
http://www.pandemicflu.gov 
 
http://www.travel.state.gov 
 
Why isn't the U. S. Government providing Tamiflu) to 
private Americans overseas? 
 
The Department of State lacks the legal authority to 
provide any type of medication, including Tamiflu, to 
private American citizens. State Department physicians and 
medical staff have authorization to treat only those 
official employees, and their families, who are under 
Chief of Mission (the principal officer in charge of a 
diplomatic facility of the United States) authority. 
 
What if I get sick when I am outside the U.S.?  If I have 
a pre existing medical condition, is there anything 
different I should do?  How do I locate a local doctor 
when I am in another country? 
 
Please see the Department's travel tips brochure on health 
issues, including the importance of obtaining adequate 
medical insurance to cover overseas medical emergencies: 
http://www.travel.state.gov/travel/tips/healt h/health_1185 
.html 
 
If you have preexisting medical problems you should carry 
a letter from your physician, describing the medical 
condition and any prescription medications, including the 
generic name of prescribed drugs. 
 
For a current list of doctors/hospitals in the country to 
which you are traveling, please visit the embassy or 
consulate website, which can be accessed through 
http://usembassy.state.gov/.  The list is generally found 
under the Embassy or Consulate's link for Consular 
Services or American citizen services. 
 
Will the U. S. government evacuate Americans from a 
foreign country in the event of a pandemic? 
 
Current medical thinking suggests that sheltering in place 
may be the appropriate response to the start of an 
influenza pandemic in certain countries or regions. In 
this scenario, people would be advised to exercise "social 
distancing" and avoid any form of public gathering where 
transmission of the disease could occur. Mass transit, 
including air travel, is a common venue for human-to-human 
transmission of viral infections due to the proximity of 
travelers to each other. 
 
Whether the U.S. government evacuates anyone will depend 
on a variety of country-specific factors.  Each U.S. 
embassy and consulate has been asked to develop a 
contingency plan in the event of a pandemic, and to 
identify events that might prompt them to send employees 
and/or their dependents out of the country, assuming such 
travel is possible. Should this decision be made, the 
Department of State will communicate this to the private 
American community so that people can plan accordingly. As 
in any other crisis, the Department of State will assess 
the availability of commercial transportation, the ability 
of people to travel to the United States or a third 
country, and other related factors in deciding on 
appropriate actions to assist official and private 
Americans. 
 
As a private American citizen living overseas, what can I 
do today to help prepare myself and my family for a 
possible influenza pandemic? 
 
Several simple measures can be taken now that will put you 
 
STATE 00115971  005.2 OF 005 
 
 
and your family in a better state of readiness should such 
a pandemic occur.  These measures are outlined at 
http://www.pandemicflu.gov/planguide/.  If you are living 
overseas for work or education, contact your sponsors and 
find out what plans they have regarding repatriation or 
evacuation; they may also have advice for you about 
obtaining an influenza vaccination (if and when a vaccine 
becomes available), anti-viral medication, and employing 
other suggested preventive measures as the need arises. 
 
What precautions should I take if I live in or visit an 
area affected by H5N1 "bird flu"? 
Avoid contact with live birds, chickens, ducks, turkeys 
and geese and their feces, feathers and pens if at all 
possible. Children, in particular, should be taught these 
precautions, and small children may need to be supervised 
for their protection. Do not purchase or agree to adopt 
new pet birds from an area in which H5N1 influenza has 
been reported. Avoid poultry products from areas with 
H5N1-infected birds. Do not transport live or dead poultry 
even if it appears to be healthy. 
 
All foods from poultry, including eggs and poultry blood 
should be cooked thoroughly. Egg yolks should not be runny 
or liquid.  Because influenza viruses are destroyed by 
heat, the cooking temperature for poultry meat should be 
74 C (165 F). 
 
Avoid cross contamination of other foods by use of 
separate kitchen utensils and surfaces exposed to raw 
poultry. Wash hands with soap and water after any poultry 
contact.  For more information on food handling and safety 
please visit the United States Department of Agriculture 
(USDA) website at 
http://www.fsis.usda.gov/Fact_Sheets/index.as p 
 
Sanitary professionals, health-care workers and others who 
must travel to H5N1-infected areas and work directly with 
infected birds, poultry and humans should follow approved 
precautions for reducing the risk for infection with H5N1 
virus.  See DHHS/CDC guidance at 
http://cdc.gov/flu/avian/professional. 
 
Can my domestic animals get bird flu? 
 
There have been reports of H5N1 infection in domestic 
cats, pigs, tigers, leopards, ferrets, and stone martens. 
The domestic cats are believed to have been infected by 
eating raw, H5N1-infected birds.  Although no human cases 
of avian influenza A have been associated with contact 
with infected cats, you should keep your cats inside if 
there has been a verified outbreak of H5N1 in your area. 
In addition, avoid contact with stray cats, and inform 
your local veterinarian if your cat becomes sick after 
having had contact with birds.  You should always follow 
strict hygiene rules when disposing of animal waste or 
caring for your pets. 
 
At this time, there is not enough information to determine 
if dogs can become infected with H5N1 virus.  For more 
information about H5N1 infection in domestic animals, see 
the DHHS/CDC website at http://www.cdc.gov/flu/avian/gen- 
info/qa.htm 
 
¶5.  Minimized Considered. 
RICE