VZCZCXRO6664
OO RUEHAST RUEHDH RUEHHM RUEHLN RUEHMA RUEHPB RUEHPOD RUEHTM RUEHTRO
DE RUEHKO #1125/01 1380849
ZNR UUUUU ZZH
O 180849Z MAY 09
FM AMEMBASSY TOKYO
TO RUEHC/SECSTATE WASHDC IMMEDIATE 3033
INFO RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE
RUEHME/AMEMBASSY MEXICO CITY 0629
RUEHUL/AMEMBASSY SEOUL 5331
RUEHBJ/AMEMBASSY BEIJING 9313
RUEHFK/AMCONSUL FUKUOKA 4041
RUEHNAG/AMCONSUL NAGOYA 1661
RUEHNH/AMCONSUL NAHA 6371
RUEHOK/AMCONSUL OSAKA KOBE 7843
RUEHKSO/AMCONSUL SAPPORO 4572
RUEHGV/USMISSION GENEVA 3529
RUCNDT/USMISSION USUN NEW YORK 5097
RHHMUNA/HQ USPACOM HONOLULU HI
RUEKJCS/SECDEF WASHINGTON DC
RUEHRC/USDA FAS WASHDC 8630
RUEAUSA/DEPT OF HHS WASHINGTON DC
RHMFIUU/DEPT OF HOMELAND SECURITY IA WASHINGTON DC
RUEAIIA/CIA WASHDC
RHMFIUU/USFJ

UNCLAS SECTION 01 OF 02 TOKYO 001125 
 
DEPT FOR OES/IHB AMBASSADOR LOFTIS 
DEPT FOR EAP/J, EAP/EX, CA 
USDA PASS TO APHIS, FAS FOR BURDETT 
HHS PASS TO CDC 
HHS FOR OGHA 
DEPT PASS TO AID/GH/HIDN 
 
SENSITIVE 
SIPDIS 
 
E.O. 12958: N/A 
TAGS: KFLU AEMR AESC CASC KFLO TBIO KSAF KPAO PREL PINR
AMGT, MG, EAGR, JA 
SUBJECT: MGSF01 H1N1 OUTBREAK CONFIRMED IN JAPAN 
 
REF: TOKYO 1086 and previous 
 
TOKYO 00001125  001.2 OF 002 
 
 
Sensitive but Unclassified.  Please handle accordingly. 
 
¶1.  (SBU) Summary: Japan has reported as many as 130 confirmed cases 
of H1N1 influenza.  With the exception of four patients in 
quarantine near Narita Airport, all cases were reported to be in the 
Osaka and Kobe areas.  There are no reports of H1N1 infection among 
Americans in Japan.  While the majority of confirmed cases involve 
students, cases have also been reported outside of schools and 
universities.  Local governments are encouraging patients without 
severe symptoms to remain at home during treatment and recovery. 
The GOJ raised its pandemic alert level to Stage Two in response to 
the confirmed domestic outbreak May 16, but has no plans to raise 
the level to Stage Three.  Although local officials have closed many 
schools and universities in Hyogo and Osaka prefectures, the GOJ is 
not requesting local governments to cancel public gatherings or 
limit business activities.  The Embassy and U.S. Forces Japan 
continue to coordinate with the GOJ and local governments are taking 
appropriate actions.  Airline officials note continuing declines in 
passenger air travel to/from Japan, despite travel returning to 
normal in many other countries. 
End Summary. 
 
¶2.  (U) As of May 18, 2009 1600 local time, media report 130 
confirmed human cases of the novel Type A H1N1 influenza in Japan. 
 
 
¶3.  (SBU) The GOJ confirmed its first domestic H1N1 case May 16 in a 
male high school student in Kobe in Hyogo Prefecture.  Two other 
students at the same high school and five students at another Kobe 
High School were later confirmed to have been infected.  None of the 
eight students reported recent foreign travel, according to press 
reports.  (Note: Prior to May 16, the four confirmed H1N1 cases in 
Japan were among members of a Japanese student group who arrived and 
were subsequently quarantined at Narita Airport May 8.  End Note). 
Hyogo and Osaka prefectures reported to the press a number of 
additional confirmed H1N1 cases May 17 and 18.  There are no reports 
of H1N1 infection among Americans in Japan.  While junior high, high 
school, and university students comprise the majority of confirmed 
cases, the H1N1 virus has also been confirmed among employees at a 
bank and rail station convenience store, as well as among family 
members of infected students.  Local officials said Prefectural 
governments in Osaka and Hyogo have closed of nearly all local 
schools, in some cases for at least one week.  A number of 
universities in the two prefectures have also been closed.  Hyogo 
and Osaka prefectural governors met with Health Minister Masuzoe May 
18 to request GOJ assistance in preparing local medical facilities 
to deal with the outbreak. 
 
¶4.  (SBU) Following confirmation May 16 of the first domestic H1N1 
case, the GOJ raised its pandemic alert level to Stage Two.  Meeting 
May 18, the Prime Minister's Task Force announced the GOJ is not 
planning to raise its pandemic alert to Stage Three based on the 
current spread of H1N1 in Hyogo and Osaka prefectures.  Although 
Japanese Government officials announced support for school closures 
in the affected prefectures, officials told reporters the GOJ will 
not request local governments to cancel public gatherings or limit 
social and business activities.  In a May 16 announcement, the GOJ 
stated it will maintain current border measures, but it may scale 
down screening procedures gradually in order to shift resources to 
containing the domestic outbreak.  Officials at Kansai International 
Airport near Osaka said medical personnel who have been conducting 
airport health screening may be pulled back to assist local 
governments with the domestic outbreak.  The GOJ is also attempting 
 
TOKYO 00001125  002 OF 002 
 
 
to determine the route of infection for the domestic H1N1 cases, 
according to press reports. 
 
¶5.  (SBU) In accordance with GOJ guidelines, local governments 
throughout Japan have set up telephone hotlines to take calls from 
individuals with flu symptoms.  In order to minimize contact with 
other hospital patients, individuals reporting H1N1 flu symptoms are 
referred to specialized fever clinics at local hospitals, where they 
receive a preliminary test for Type A influenza.  Positive results 
are sent to local health research institutes for confirmation of the 
H1N1 virus.  Local officials told emboffs they are encouraging 
patients who do not have severe symptoms to remain at home for 
treatment with antiviral medications.  (Note:  While Tamiflu is the 
antiviral most commonly prescribed in Japan for flu symptoms, 
Japanese doctors often prescribe Relenza to teenage flu patients, as 
some studies link Tamiflu to serious side effects in young adults. 
End Note). 
 
¶6.  (SBU) The Embassy and U.S. Forces Japan continue to coordinate 
with the GOJ and local governments and are considering appropriate 
actions in response to the confirmation of domestic transmission of 
the H1N1 virus in Japan.  The Embassy issued a warden message May 18 
alerting Americans to current information on the H1N1 outbreak in 
Japan. The warden message is posted at: http://japan.usembassy.gov. 
 
¶7.  (SBU) Officials at international airlines report continuing 
declines in passenger air travel to/from Japan, even while business 
has returned to normal in other countries.  One airline official 
said Japan is the only country in which cancellations continue to 
exceed new bookings and added he was "surprised by the degree to 
which Japan is over-reacting" to the H1N1 outbreak. 
 
¶8.  (SBU) There are numerous reports that Japanese universities are 
asking staff who returned from H1N1-affected countries to remain at 
home for seven to ten days before returning to work. 
 
ZUMWALT