VZCZCXRO3993
RR RUEHLH RUEHPW
DE RUEHKP #0151/01 1210248
ZNR UUUUU ZZH
R 010248Z MAY 09
FM AMCONSUL KARACHI
TO RUEHC/SECSTATE WASHDC 1056
INFO RUEHIL/AMEMBASSY ISLAMABAD 0514
RUEHLO/AMEMBASSY LONDON 0323
RUEHBUL/AMEMBASSY KABUL 0281
RUEHNE/AMEMBASSY NEW DELHI 1871
RUEHLH/AMCONSUL LAHORE 2730
RUEHPW/AMCONSUL PESHAWAR 4613
RUEAIIA/CIA WASHDC
RUMICEA/USCENTCOM INTEL CEN MACDILL AFB FL
RHMFISS/JOINT STAFF WASHINGTON DC
RHEHAAA/NSC WASHINGTON DC
RUEKJCS/SECDEF WASHINGTON DC
RUEHPH/CDC ATLANTA GA
RUEAUSA/DEPT OF HHS WASHINGTON DC

UNCLAS SECTION 01 OF 02 KARACHI 000151 
 
SENSITIVE 
SIPDIS 
 
E.O. 12958:  N/A 
TAGS: EAGR TBIO SOCI EAID PK
SUBJECT:  KARACHI - AIRLINES ALERTED TO CHECK FOR H1N1 AT KARACHI 
JINNAH INTERNATIONAL AIRPORT 
 
Summary 
----------- 
¶1.  (SBU)  While there are currently no reported cases of H1N1 
"swine flu" in Pakistan, the government is beginning preparations in 
case the virus arrives via international travelers.  The Pakistan 
Civil Aviation Authority (CAA) has increased monitoring of inbound 
passengers to check for those with exposure to or showing symptoms 
of the deadly virus.  Health experts warn, however, that if the 
virus reaches Pakistan, the country is ill prepared to identify the 
virus and treat infected patients.  End Summary. 
 
 
Monitoring at Karachi Airport 
------------------------------ 
¶2.  (SBU)  Karachi Jinnah International Airport, Pakistan's busiest 
airport, receives 25 international flights per day, mainly from the 
transit hubs of Bangkok, Dubai, and Qatar.  The CAA announced that 
all inbound international passengers will be monitored for symptoms 
of H1N1, particularly those arriving from infected destinations and 
the transit hubs.  The Authority further instructed airline crews to 
be vigilant, and to report passengers exhibiting symptoms, such as 
incessant coughing and fever, to airport officials.  The CAA, in 
conjunction with the Director General of Health, is making 
arrangements to meet any arriving passenger suspected of carrying 
the virus.  News reports, however, quote CAA officials as saying 
nothing is being done, and passengers who did not notice any 
screening.  (Note:  The Director General of Health was quoted in the 
press as saying Pakistan was at low risk because the disease is 
spread mostly from pigs and there are no pig farms in the country. 
End Note.)  Health experts also warned of the need to contain the 
virus to the airport, due to the lack of adequate treatment 
facilities in Karachi. 
 
¶3.  (SBU)  Airport Manager Ashfaq Ahmad confirmed that airports in 
Pakistan have made emergency arrangements to monitor the H1N1, and 
that the Ministry of Health is making arrangements in the 
eventuality of the disease arriving at an airport.  Sindh Health 
Department Secretary Mohmad Hussain Syed told Post the provincial 
department is working with the federal Ministry of Health in 
devising a strategy for a possible outbreak.  The provincial 
ministry has set up an isolation ward at Karachi Civil Hospital, 
and, if needed, will create two more at Liaquat Medical Hospital and 
Dr. Ziauddin Hospital.  However, Mr. Syed raised concerns, 
especially regarding ability to test for and identify the virus, and 
also how to treat patients. 
 
 
Health Experts Express Concern 
------------------------------- 
¶4.  (SBU)  Mr. Syed said that he fears that if the virus arrives in 
Karachi, it will spread quickly on the streets, and turn into an 
outbreak.  Unfortunately, he continued, Pakistan lacks basic 
facilities to distinguish between normal flu and H1N1.  Other health 
officials expressed similar fears.  Dr. Afia Zafar, a member of 
Infection Control Committee at Aga Khan Hospital, said the health 
infrastructure is not sufficient to deal with any eventuality 
arising from the spread of the virus.  The ability to collect, 
transport, and test samples is non-existent.  Many government health 
facilities lack not just isolation wards, but also preventative 
equipment such as gloves and masks.  Dr. Shahana UrooJ Kazmi, Dean 
Faculty of Microbiology at the University of Karachi, said that 
preparedness is almost zero.  She expressed an urgent need for H1N1 
antigen, antibody vaccine, N95 Masks and lab equipment for testing. 
She fears that if the virus reaches the Middle East or India, it 
will likely come to Pakistan. 
 
 
Comment 
-------- 
¶5.  (SBU)  If H1N1 migrates to Pakistan, it will likely arrive in 
Karachi first.  Government officials are taking action to identify 
passengers with the virus and prevent its spread into the general 
population.  However, Pakistan health facilities are lacking, and 
public health experts are in short supply.  If the virus arrives, it 
may be difficult to treat and control without foreign assistance. 
That being said, the GOP can use similar surveillance and tripwires 
that it has developed for H5N1 avian influenza.  The GOP is much 
better prepared for this type of outbreak than it was several years 
 
KARACHI 00000151  002 OF 002 
 
 
ago before avian influenza spread to Pakistan. 
FAKAN