VZCZCXRO6241
OO RUEHCHI RUEHDT RUEHHM RUEHNH
DE RUEHGO #0253/01 1250639
ZNR UUUUU ZZH
O 050639Z MAY 09
FM AMEMBASSY RANGOON
TO RUEHC/SECSTATE WASHDC IMMEDIATE 8918
INFO RUCNASE/ASEAN MEMBER COLLECTIVE
RUEHBJ/AMEMBASSY BEIJING 2265
RUEHBY/AMEMBASSY CANBERRA 1929
RUEHKA/AMEMBASSY DHAKA 5190
RUEHNE/AMEMBASSY NEW DELHI 5407
RUEHUL/AMEMBASSY SEOUL 9000
RUEHKO/AMEMBASSY TOKYO 6576
RUEHCN/AMCONSUL CHENGDU 1780
RUEHCHI/AMCONSUL CHIANG MAI 2151
RUEHCI/AMCONSUL KOLKATA 0628
RUEAUSA/DEPT OF HHS WASHDC
RUEHRC/DEPT OF AGRICULTURE WASHINGTON DC
RUEHPH/CDC ATLANTA GA
RUEHRC/USDA FAS WASHDC
RHHMUNA/CDR USPACOM HONOLULU HI
RHEHNSC/NSC WASHDC
RUEKJCS/SECDEF WASHDC
RUEKJCS/JOINT STAFF WASHDC

UNCLAS SECTION 01 OF 03 RANGOON 000253 
 
SENSITIVE 
SIPDIS 
 
STATE FOR EAP/MLS, CA/OCS/ACS/EAP, OES, G/AIAG 
PACOM FOR FPA 
USDA FOR FAS/PECAD, FAS/CNMP, FAS/AAD, APHIS 
BANGKOK FOR USAID:JMACARTHUR, APHIS:RTANAKA, REO:HHOWARD 
DEPT PLEASE PASS TO HHS FOR OGHA STEIGER AND HICKEY 
PASS TO CDC ATLANTA FOR CCID AND COGH 
 
E.O. 12958: N/A 
TAGS: KFLU AEMR ASEC CASC KFLO TBIO EAID KPAO PREL
PINR, AMGT, BM 
SUBJECT: TFFLU01: BURMA HEALTH MINISTRY DETAILS A/H1N1 
ACTION PLAN 
 
REF: A. RANGOON 246 
     ¶B. RANGOON 241 
     ¶C. RANGOON 238 
 
RANGOON 00000253  001.2 OF 003 
 
 
Summary 
------- 
 
¶1.  (SBU)  During a May 4 meeting with the diplomatic corps, 
the Burmese Ministry of Health (MOH) detailed its A/H1N1 
action plan, including surveillance and quarantine 
procedures.  Since April 28, MOH officials have screened 
incoming travelers at all ports of entry, including two 
international airports, one seaport, and 16 border crossings. 
 The MOH designated two hospitals for A/H1N1 quarantine and 
treatment, although it has yet to quarantine anyone.  The MOH 
has 50,000 tamiflu doses available, and expects to receive 
another 50,000 from the World Health Organization in upcoming 
weeks.  The Ministry has requested donor assistance to 
implement fully its action plan, including additional 
tamiflu, masks, personal protective equipment (PPEs), Centers 
for Disease Control and Prevention (CDC) rapid test kits and 
a Polymerase Chain Reactor (PCR) thermal cycler, and thermal 
scanners.  Please see action request in paragraph 10.  End 
Summary. 
 
Still no Cases; MOH Details Action Plan 
--------------------------------------- 
 
¶2.  (SBU)  During a May 4 meeting with diplomats, Ministry of 
Health Director of Disease Control Dr. Soe Lwin Nyein 
emphasized that there are still no reported cases of swine 
flu in Burma.  Both the Ministry of Health (MOH) and Ministry 
of Livestock and Fisheries (MOLF) continue to work with the 
UN and international organizations to monitor the disease. 
Dr. Soe Lwin Nyein explained that the MOH and MOLF 
established and implemented A/H1N1 action plans, based on 
existing avian influenza action plans.  The Burmese 
Government also set up two new committees -- the Central 
Committee for Prevention and Control headed by the Minister 
of Health and the State/Division Committee for Prevention and 
Control led by the State/Division Health Directors; members 
include representatives from MOH, MOLF, Customs, Ministry of 
Information, and Ministry of Immigration. 
 
¶3.  (SBU)  Since A/H1N1 is not currently present in Burma, 
the GOB's response is focused on improving and increasing 
surveillance of both humans and animals.  On April 28, the 
MOH began screening incoming travelers at the international 
airports in Rangoon and Mandalay, the Rangoon international 
port terminal, and 16 selected border crossings, surveying 
more than 30,000 people daily.  Both the MOH and MOLF have 
deployed 17 State/Division-level and 65 district-level rapid 
response surveillance teams to potential hotspots throughout 
Burma, Dr. Kyaw Hsan, Deputy Director of the Livestock 
Breeding Veterinary Department, explained.  The MOLF met with 
the Myanmar Livestock Federation on April 28 to discuss ways 
to improve biosecurity measures on farms (Ref B). 
 
¶4.  (SBU)  According to MOH officials, the Burmese Government 
has a strict quarantine procedure to prevent the spread of 
A/H1N1 in Burma.  The MOH set up a thermal scanner at the 
Rangoon International Airport and is using infrared 
temperature gauges to screen passengers in Mandalay, at the 
port, and at border crossings.  Dr. Soe Lwin Nyein noted that 
 
RANGOON 00000253  002.2 OF 003 
 
 
all visitors must fill out an influenza surveillance form 
detailing health symptoms and travel history.  Should 
visitors show signs of influenza, the MOH will quickly 
transport them for quarantine at one of two infectious 
disease hospitals, Wei Bagi Hospital in Rangoon or Kandaw 
Nagi outside of Mandalay.  The MOH will take smear samples of 
suspected A/H1N1 cases and will send them to Tokyo or Center 
for Disease Control (CDC) Atlanta for testing, as the MOH 
does not have diagnostic capacity to test for the disease 
(Ref A).  Dr. Kyaw Nyunt Sein, Deputy Director of Health, 
acknowledged that the MOH has limited quarantine plans for 
those entering along the border, although he highlighted that 
the MOH and WHO recently upgraded 17 border hospitals to 
include isolation wards. 
 
¶5.  (SBU)  The MOH has yet to quarantine any visitors, 
although it continues to monitor the health of two persons 
who arrived in Rangoon with a fever.  The GOB's A/H1N1 action 
plan was tested on May 5, with the arrival of a cruise ship 
with 391 passengers, including 262 American citizens, at the 
Port of Rangoon.  (Note:  Embassy consular personnel were 
present at the port to assist Amcits as needed during health 
screening procedures.  None of the passengers had the flu and 
none were quarantined.) 
 
¶6.  (SBU)  The MOH and MOLF recently began educational 
outreach to explain the dangers of A/H1N1.  UNICEF is 
translating A/H1N1 documents into Burmese for dissemination 
and is looking into printing awareness posters, WHO Country 
Representative Adik Wibowo told us.  Burma's borders are 
extremely porous, so GOB awareness efforts will target both 
legal and illegal border crossings, Dr. Kyaw Nyunt Sein 
explained. 
 
Should an Outbreak Occur 
------------------------ 
 
¶7.  (SBU)  The Ministry of Health announced it has a 
stockpile of personal protective equipment (PPEs) and 50,000 
tamiflu doses available for treatment, should an outbreak 
occur.  (Note: approximately 10,000 of these doses expired in 
October 2008 and MOH is seeking guidance on whether they can 
still be used.)  WHO expects delivery of an additional 50,000 
tamiflu doses in the next two weeks.  Tamiflu stocks are 
currently stored in Rangoon, and the MOH will begin to 
disburse medicines to Mandalay and border hospitals within 
the next week.  Dr. Kyaw Nyunt Sein, Deputy Director of 
Health, told us that the two infectious disease hospitals can 
treat up to 35 patients each, and that tamiflu will be made 
available to patients, regardless of nationality.  The MOH 
will designate additional hospitals for A/H1N1 treatment, 
should it become necessary. 
 
Limited Supplies and Resources 
------------------------------ 
 
¶8.  (SBU)  MOH officials emphasized that while the GOB is 
actively responding to the A/H1N1 situation, it lacks the 
equipment and resources necessary to combat the disease, 
should an outbreak occur in Burma.  The MOH and MOLF have 
requested donors to provide the following: 
 
--  CDC A/H1N1 rapid tests and a Polymerase Chain Reaction 
(PCR) Thermal Cycler (cost USD 50,000) to conduct the tests; 
 
RANGOON 00000253  003.2 OF 003 
 
 
--  N95 masks; 
--  100,000 additional courses of tamiflu; 
--  Additional stocks of PPEs; 
--  At least three new thermal scanners and any additional 
temperature gauging equipment; 
--  Disinfectants; and 
--  Funding for educational outreach. 
 
¶9.  (SBU)  The MOH and MOLF both inquired whether existing 
funding and equipment for avian influenza (AI) programs (from 
USAID, AusAID, and the European Commission) could be used to 
respond to A/H1N1.  AusAID agreed, but noted that because AI 
is endemic to Burma and A/H1N1 is not, the majority of funds 
should be used for AI programs. 
 
Action Request 
-------------- 
 
¶10.  (SBU)  Embassy Rangoon encourages the Department and 
USAID to assist the World Health Organization, the Food and 
Agricultural Organization, and the Burmese Government to 
prepare for A/H1N1, modeling our response after our 
successful AI program in Burma.  We urge the Department and 
USAID to consider providing WHO with CDC rapid test kits and 
a PCR thermal cycler, as well as additional PPEs and tamiflu. 
 Additionally, Embassy Rangoon seeks clarification about 
whether USAID AI funds can be used to address pandemic flu 
preparedness. 
 
DINGER