VZCZCXRO8940
PP RUEHCHI RUEHCN RUEHDT RUEHHM
DE RUEHJA #0578/01 0790832
ZNR UUUUU ZZH
P 190832Z MAR 08
FM AMEMBASSY JAKARTA
TO RUEHC/SECSTATE WASHDC PRIORITY 8423
RUEHPH/CDC ATLANTA GA PRIORITY
INFO RUEAUSA/DEPT OF HHS WASHINGTON DC
RUEHZS/ASSOCIATION OF SOUTHEAST ASIAN NATIONS
RUEHRC/USDA FAS WASHDC
RHHMUNA/HQ USPACOM HONOLULU HI
RHHMUNA/CDR USPACOM HONOLULU HI//J07/CATMED/CATT//
RUEHFR/AMEMBASSY PARIS 1097
RUEHRO/AMEMBASSY ROME 2037
RUEHIN/AIT TAIPEI 2021
RUEHHK/AMCONSUL HONG KONG 2509
RUEHBJ/AMEMBASSY BEIJING 4836
RUEHBK/AMEMBASSY BANGKOK 8370
RUEHHM/AMCONSUL HO CHI MINH CITY 0230
RUEHGZ/AMCONSUL GUANGZHOU 0304

UNCLAS SECTION 01 OF 02 JAKARTA 000578 
 
SIPDIS 
 
SENSITIVE 
SIPDIS 
 
DEPT FOR EAP/MTS, OES, DS/IP/EAP, A/MED AND S/ES-O 
DEPT PASS TO USDA/FAS/OSTA/ROSENBLUM, USDA/APHIS/ANNELLI, 
USDA/DU/S LAMBERT 
DEPT ALSO PASS TO HHS/STEIGER/MSTLOUIS AND HHS/NIH 
DEPT ALSO PASS TO USAID/ANE/CLEMENTS AND GH/CARROLL 
BANGKOK FOR RMO, CDC, USAID/RDM/A, APHIS 
 
 
E.O. 12958: N/A 
TAGS: TBIO KFLU AMED CASC AMGT PGOV SOCI ID ASEC
SUBJECT: Indonesia - Post Contingency Planning and Updated 
Tripwires 
 
REF: A) 2005 Jakarta 9024 B) 2005 State 202824 
 
JAKARTA 00000578  001.2 OF 002 
 
 
¶1. (SBU) Summary: Our Emergency Action Committee reviewed and 
reaffirmed our Avian Influenza (AI) tripwires on March 13.  This 
cable provides minor updates to the original tripwires. End 
Summary. 
 
¶2. (SBU) Following a review of Ref A, the Mission's Avian Influenza 
Working Group (AIWG) updated Embassy Jakarta's tripwires to reflect 
better the actual trajectory of the disease and ensure an accurate 
and speedy response to the threat posed to humans.  The revision 
reflects the unexpected distribution of H5N1 AI human cases in urban 
rather than rural areas as envisioned in the original tripwire 
scenario.  The Ambassador has approved the following updated 
tripwires and possible associated actions.  The AIWG has determined 
that post has reached Tripwire 1 and taken the actions listed in 
para 6. 
 
¶3. (SBU) Indonesia has 105 confirmed human fatalities from avian 
influenza (AI), a number of them in family clusters in the greater 
Jakarta metropolitan area.  The Ministry of Health has instructed 
all health care providers in the city to refer suspected cases of AI 
to three AI referral hospitals for Jakarta:  Sulianti Saroso 
Infectious Diseases Hospital, Persahbatan, and Gatot Subroto Army 
Hospital. Although each hospital is equipped with limited number of 
respirators and isolation rooms, they would quickly become 
overwhelmed in the event of a pandemic. 
 
¶4. (SBU) One U.S. commercial carrier, Continental Micronesia, flies 
twice weekly from Denpasar, Bali to Honolulu via Guam.  All other 
commercial flights via Singapore or Bangkok require an overnight 
stop.  There is a Cathay Pacific flight from Jakarta to Hong Kong 
that does not require a stopover in Asia.  Individuals flying on 
Cathay Pacific can connect on US Airlines directly to U.S. cities. 
If traveling from Jakarta directly to Tokyo on Garuda or Japan 
Airlines, they can connect with any U.S. carrier directly to the 
U.S. the same day of arrival.  During the SARS epidemic in 2003, 
Singapore refused entry to any traveler with a fever.  Countries 
that serve as transportation hubs in Asia would impose border 
control measures and restrict entry to travelers originating in 
Indonesia.  To the extent possible, U.S. staff and dependents should 
depart Indonesia at the beginning of a pandemic. 
 
¶5.  (SBU) The Regional Security Office (RSO) will input tripwire 
data into the TRIPS system. 
 
¶6.  (SBU) Begin Mission Jakarta AI tripwires: 
 
Tripwire 1: Spike in number and broadening geographic 
spread of animal-to-human transmission cases in Indonesia. 
 
Actions: 
a) Restrict official and unofficial travel to wet markets. 
b) Release warning announcement to Mission personnel and warden 
message to American citizens.  Prepare talking points for domestic 
and international press. 
c) Provide detailed briefing to Embassy/Consulate staff. 
d) Communicate pertinent information to the embassy community by way 
of venues such as town hall meetings, the embassy web site and 
newsletter articles. 
e) Review and update Mission contingency plans. 
 
Tripwire 2: Confirmed, sustained human-to-human transmission in one 
or more of the other at-risk countries in the region (but not in 
Indonesia), indicating an increase in transmissibility of the virus. 
This is particularly significant if there are multiple, 
geographically diverse clusters. 
 
 
JAKARTA 00000578  002.2 OF 002 
 
 
     Actions: 
a) Consider authorized departure for U.S. family members and 
non-emergency personnel. 
b) Institute screening practices for all visitors to USG 
facilities. 
c) Mandatory sick leave for any employee who shows any flu symptoms 
or has a family member with flu symptoms.  Monitoring by MED Unit. 
d) Public announcement to the American community. Prepare press 
guidance/talking points for domestic and international press. 
e) Department of State makes public announcement regarding travel to 
the region. 
  f) Assess availability of commercial flights. 
  g) Recommend stockpiling of food and water supplies for 
90 days, in the event post personnel would not be able to depart in 
a pandemic (Tripwire 3). 
 
 
Tripwire 3:  Sustained human-to-human transmission in Indonesia. 
 
     Actions: 
a) Reduction to emergency consular services only. 
b) The Chief of Mission recommends implementation of authorized or 
ordered departure, at his discretion, if departure is still 
possible. 
c) Implement administrative leave for non-emergency FSNs. 
d) Mandatory sick leave for any employee who shows any flu symptoms 
or has a family member with flu symptoms. Monitoring by MED Unit. 
e) Consider social distancing measures, such as home quarantine and 
limiting venues of human to human contact, such as community 
gatherings. Consider restricting children from school. 
f) Screening of all visitors and use of protective gear (masks, 
gloves, clothing). 
g) Public announcement to the American community.  Prepare press 
guidance/talking points for domestic and international press. 
h) Department of State makes public announcement regarding travel to 
the region. 
i) Advise and request assistance from DoD as needed. 
 
Alternative Tripwire:  A Mission employee develops Avian Influenza, 
in the absence of a broader outbreak per tripwires 1, 2, or 3 
above. 
 
     Actions: 
a) Treat the victim.  Medevac if possible. 
b) Disinfect office. 
c) Administer Tamiflu to close contacts. 
d) Prepare press guidance/talking points. 
 
 
HUME