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OO RUEHAST RUEHDH RUEHHM RUEHLN RUEHMA RUEHPB RUEHPOD RUEHSL RUEHTM
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DE RUEHKO #1449/01 1770522
ZNR UUUUU ZZH
O 260522Z JUN 09
FM AMEMBASSY TOKYO
TO RUEHC/SECSTATE WASHDC IMMEDIATE 4103
INFO RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE
RUEHME/AMEMBASSY MEXICO CITY 0638
RUEHUL/AMEMBASSY SEOUL 6152
RUEHBJ/AMEMBASSY BEIJING 0121
RUEHFK/AMCONSUL FUKUOKA 4883
RUEHNAG/AMCONSUL NAGOYA 2426
RUEHNH/AMCONSUL NAHA 7214
RUEHOK/AMCONSUL OSAKA KOBE 8686
RUEHKSO/AMCONSUL SAPPORO 5408
RUEHGV/USMISSION GENEVA 3556
RUCNDT/USMISSION USUN NEW YORK 5841
RHHMUNA/HQ USPACOM HONOLULU HI
RUEKJCS/SECDEF WASHINGTON DC
RUEHRC/USDA FAS WASHDC 8643
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 001449 
 
DEPT FOR OES/IHB AMB 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 
 
SIPDIS 
 
E.O. 12958: N/A 
TAGS: KFLU AEMR AESC CASC TBIO PREL MG EAGR JA
SUBJECT: JAPAN'S GOVERNMENT REVISES H1N1 INFLUENZA GUIDANCE 
 
REF: TOKYO 1171 and previous 
 
TOKYO 00001449  001.2 OF 002 
 
 
¶1.  (U) Summary: The Japanese Government revised its guidelines for 
responding to H1N1 influenza outbreaks June 19.  Acknowledging the 
difficulty in using border controls to keep the H1N1 virus from 
entering Japan, the GOJ will, in many cases, allow arriving 
passengers with flu symptoms to enter the country without a 
quarantine period and to recover and await test results at home or 
at their hotels.  Local governments will follow up regarding medical 
care and self-isolation measures with patients who test positive for 
H1N1.  To prepare for a possible second wave of H1N1 this fall, the 
GOJ designed its guidance to focus on finding patients swiftly and 
treating those with severe symptoms.  While hospitalization will 
likely only be required for serious cases, the GOJ has stipulated 
all medical institutions should be willing to accept flu patients 
unless the facility determines patients the facility is already 
caring for would be put at risk.  End Summary. 
 
---------------- 
Basic Guidelines 
---------------- 
 
¶2.  (U) Japan's government issued revised guidelines June 19 
updating and consolidating earlier guidance for responding to H1N1. 
The GOJ's revised guidance emphasizes four basic principles: 1) 
Giving patients with severe symptoms priority for hospital beds and 
treatment; 2) Preventing in-hospital transmission of the virus; 3) 
Closely monitoring for any virus mutations and outbreak trends of 
both seasonal and novel influenza strains; and 4) Implementing 
public health measures to limit the spread of the infection.  The 
GOJ intends to review these guidelines if the virus exhibits 
significant changes or mutations. 
 
----------------- 
Border Procedures 
----------------- 
 
¶3.  (U) The GOJ plans to raise awareness of H1N1 influenza among 
individuals entering Japan by distributing information at the ports 
of entry quarantine areas.  Authorities will continue to request 
passengers report any symptoms and will conduct on-board quarantine 
checks in cases where passengers exhibiting possible symptoms are 
present.  However, border officials will not require a Polymer Chain 
Reaction (PCR) exam for arriving passengers with flu symptoms, but 
rather will allow them to enter the country and recover and await 
test results at home or at their hotels.  Those exhibiting flu 
symptoms may be requested to use non-public transportation and wear 
a mask en route from the port of entry to their residence.  Should 
several people in a group of travelers exhibit symptoms, quarantine 
authorities will conduct a preliminary test and a PCR exam.  During 
testing, however, patients will be allowed to go home or to their 
hotels.  Local governments will follow up with patients who test 
positive for H1N1 regarding medical care and self-isolation 
measures. 
 
------------------------------------- 
Local Government and Medical Response 
------------------------------------- 
 
¶4.  (U) The GOJ's revised guidance calls on local governments to 
request infected patients and those having close contact with 
patients to self-monitor and recover at home.  Local government 
health authorities should provide a PCR test and anti-viral drugs at 
an early stage to patients with underlying health conditions. 
Hospitalization will be available if necessary.  Call centers will 
provide information on hospitals accepting patients and consult 
those recovering at home. 
 
TOKYO 00001449  002.2 OF 002 
 
 
 
¶5.  (U) The revised guidance notes all medical institutions should 
admit people with flu symptoms, but are advised to create a separate 
waiting area or separate service hours.  While hospitalization is 
seen to be unnecessary for the majority of H1N1 flu patients, those 
with severe symptoms should be able to seek care at any medical 
institution, not just designated hospitals. However, local 
governments can direct certain medical institutions, such as cancer 
institutes or obstetrical institutes, to refuse flu patients if 
their current patients would be put at risk.  Local governments will 
continue to request schools in which students are infected to close 
if necessary. 
 
ZUMWALT