VZCZCXRO1228
OO RUEHPT
DE RUEHBY #0531/01 1560724
ZNR UUUUU ZZH
O 050724Z JUN 09
FM AMEMBASSY CANBERRA
TO RUEHC/SECSTATE WASHDC IMMEDIATE 1580
INFO RUEHBJ/AMEMBASSY BEIJING 9496
RUEHJA/AMEMBASSY JAKARTA 5458
RUEHKO/AMEMBASSY TOKYO 3568
RUEHWL/AMEMBASSY WELLINGTON 5810
RUEHBN/AMCONSUL MELBOURNE 6398
RUEHPT/AMCONSUL PERTH 4662
RUEHDN/AMCONSUL SYDNEY 4624
RUEAUSA/DEPT OF HHS WASHINGTON DC

UNCLAS SECTION 01 OF 02 CANBERRA 000531 
 
SENSITIVE 
SIPDIS 
 
STATE FOR OES/IHB, AIAG FOR WINN 
 
E.O. 12958: N/A 
TAGS: TBIO KFLU AS
SUBJECT: AUSTRALIA H1N1 CASES CONTINUE TO RAMP UP 
 
REF: CANBERRA 518 AND PREVIOUS 
 
¶1. (U) This is an action request, see para 5. 
 
¶2. (SBU) Summary:  In per capita terms, Australia surpassed 
the U.S. for confirmed H1N1 infections on June 4-5.  The 
rapid internal spread of the disease following a lengthy 
period with only a few, foreign-connected cases highlights 
the difficulty any country -  even an island like Australia - 
 faces in preventing an infectious disease from entering the 
country.  The H1N1 outbreak has tested Australia's emerging 
infectious disease and pandemic response plans, and 
coordination between federal and state authorities has 
functioned but not prevented inter-state friction. 
Preparations to assess border measures and other steps taken 
initially to prevent transmission into Australia are 
underway, and a process identifying key gaps in federal and 
state capabilities is being set up.   End Summary. 
 
CASE NUMBERS TAKE OFF 
--------------------- 
 
¶3. (SBU) Confirmed cases of H1N1 in Australia exploded 
between May 19 and June 5, going from one case in May to 
nearly 900 as of the latest reports.  Australia's per capita 
infection rate now surpasses that of the U.S.  The government 
of Victoria, which has 85% of Australia's confirmed cases so 
far, moved its response phase from "contain" to "modified 
sustain" on June 3, an admission that containing infections 
through quarantine and social distancing was no longer 
effective.   Morbidity of the H1N1 strain in Australia has 
been mild, with no deaths reported to date and only five 
hospitalizations required.  Australia is in the midst of the 
normal seasonal flu season, has expanded its testing and 
confirmation capacity, and has lost containment of flu 
clusters in several locations, all of which are contributing 
to the rapid growth in case numbers.  A major vector in 
Victoria has been schools, where despite closing more than a 
dozen schools following detection of cases there, 62 percent 
of confirmed cases have emerged among school age children. 
Under their new modified sustain posture, all Victoria 
schools are reopening on June 5. 
 
¶4. (SBU) According to Gary Lum, head of the Health Emergency 
Management and Biosecurity Branch at the Department of Health 
and Ageing (DOHA), and one of the leaders of DOHA's National 
Incident Room for H1N1, the government response to H1N1 is 
being modified as several jurisdictions currently at moderate 
levels of response move to a "sustain" level over the next 
several days.  The massive expansion in case numbers, along 
with the low severity of the infections in Australia, means 
that quarantines, surveillance, and social distancing 
measures were being reassessed.  The activation of border 
measures, detailed reporting, and surveillance had been 
largely successful in detecting the disease but voluntary and 
home quarantine measures undertaken by various states and 
territory health officials has not prevented the virus from 
breaking out.  The federal and state governments have 
maintained a relatively soft touch throughout, with home 
quarantining and voluntary social distancing, which would 
change if the disease had proved to be more dangerous. 
 
COORDINATING A ROLLERCOASTER 
---------------------------- 
 
¶5. (SBU) Lum said that the Federal Government, which has a 
coordinating role but few direct health assets,, has worked 
Qcoordinating role but few direct health assets,, has worked 
generally well with the state authorities who have the 
medical capacity to respond to an outbreak.  Medicines and 
supplies to bolster state stockpiles were in place early on 
in the outbreak, and the national health coordinating bodies 
meet daily to coordinate actions.  The imposition of 
quarantine and distancing measures has varied widely over 
different states and territories as they have experienced 
very different attack rates.  Lum said that Australia's 
response is struggling around three different response levels 
simultaneously, which has complicated coordination efforts. 
In Victoria, schools are being reopened and quarantine 
measures lifted.  At the same time, the Australian Capital 
Territory government ordered on June 5 that any school child 
returning from Victoria wait seven days before returning to 
school; now all Australian jurisdictions states have adopted 
 
CANBERRA 00000531  002 OF 002 
 
 
that requirement.  Federal authorities are currently 
examining whether to maintain existing border surveillance 
practices, Lum said, and there will be a face-to-face after 
action review process between federal and state authorities 
in the near future.  DOHA's ongoing response posture remains 
unchanged, as there are considerations that "go beyond 
epidemiology" in maintaining a federal role in confronting 
the disease, Lum said.  He expressed concern that there would 
likely be a next wave of outbreaks in the region, as new 
cases were still turning up in places like Singapore. 
 
NEED INFO ON U.S. TESTING GUIDANCE 
---------------------------------- 
 
¶6. (SBU) Action Request:  Lum asked for detailed information 
on current USG guidance and policy on surveillance and 
testing for Novel H1N1 Influenza A.  He said the perception 
in Australia was that HHS, CDC and states were rolling back 
their efforts on testing and surveillance as the specter of a 
very dangerous outbreak recedes.  U.S. thinking on those 
issues would be very valuable, Lum said.  We ask that OES/IHB 
pass on any information or details on changes to HHS/CDC 
domestic testing and surveillance recommendations over the 
past seven days. 
 
¶7. (SBU) Comment:  Australia failed to prevent the 
establishment of H1N1 on its shores, but has been spared 
fatalities and expensive hospitalizations so far.  The value 
of many of the elements of the GOA's pandemic planning will 
be examined as the country adjusts to having H1N1 in its 
population and prepares for follow-on or new emerging disease 
outbreaks.  End Comment. 
 
CLUNE