VZCZCXRO4662
OO RUEHIK
DE RUEHC #4542/01 2801740
ZNR UUUUU ZZH
O 071720Z OCT 09
FM SECSTATE WASHDC
TO ALL DIPLOMATIC AND CONSULAR POSTS COLLECTIVE IMMEDIATE
RUEHTRO/AMEMBASSY TRIPOLI IMMEDIATE 0155
RUEHRY/AMEMBASSY CONAKRY IMMEDIATE 1890
RUEHFSI/DIR FSINFATC IMMEDIATE
RHEHNSC/WHITE HOUSE NATIONAL SECURITY COUNCIL WASHINGTON DC IMMEDIATE
RUEATRS/DEPT OF TREASURY WASHINGTON DC IMMEDIATE
RUEHPH/CDC ATLANTA IMMEDIATE 7905
RUCPDOC/ALL USDOC DISTDIR COLLECTIVE WASHINGTON DC IMMEDIATE
RHMCSUU/CDRAMC FT BELVOIR VA//AMCMI-SS// IMMEDIATE
RUEAHQA/HQ USAF WASHINGTON DC//XOXXI// IMMEDIATE
RHMCSUU/HQ AFOSI DOQ ANDREWS AFB MD//IVOA// IMMEDIATE
RHMCSUU/FAA NATIONAL HQ WASHINGTON DC//ACI-400// IMMEDIATE
RHMCSUU/COMNAVAIRSYSCOM PATUXENT RIVER MD//AIR1031B// IMMEDIATE
RHMFIUU/NRC WASHINGTON DC//INFOSEC// IMMEDIATE
RHMFISS/CDR USCENTCOM MACDILL AFB FL//CCJ2-JIT// IMMEDIATE
RUCPCIM/CIM NTDB WASHINGTON DC IMMEDIATE
RHMCSUU/COGARD INTELCOORDCEN WASHINGTON DC IMMEDIATE
RHMFIUU/CDR USPACOM HONOLULU HI IMMEDIATE
RHMFISS/CDR USSOUTHCOM MIAMI FL IMMEDIATE
INFO RUESBKC/ATO ASIA IMMEDIATE 1958

UNCLAS SECTION 01 OF 03 STATE 104542 
 
SIPDIS 
 
E.O. 12958: N/A 
TAGS: AMED AMGT CASC CMGT TBIO KFLU
SUBJECT: 2009-H1N1: CONSULAR SERVICES FOR U.S. CITIZENS 
ABROAD DURING A PANDEMIC 
 
STATE 00104542  001.2 OF 003 
 
 
REF.:  (A) 09 STATE 043249 (B) 09 STATE 099088 
 
¶1. SUMMARY:  In June 2009, the World Health Organization 
(WHO) declared that a global pandemic was underway due to 
2009-H1N1 influenza, also known as novel H1N1.  Unlike 
avian influenza (H5N1), the disease caused by this strain 
of the influenza virus is far less severe, with a mortality 
rate similar to that of seasonal influenza.  As a result, 
the Department's pandemic planning guidance has been 
updated to take severity into account.  This cable provides 
guidance to Consular Section Chiefs and American Citizens 
Services (ACS) officers for the provision of services to 
U.S. citizens who remain abroad during a pandemic, 
regardless of severity.  A warden message template for 
2009-H1N1 pandemic influenza is provided at the end of the 
cable.  END SUMMARY. 
 
¶2. On June 11, 2009, the WHO declared that a global 
pandemic of novel influenza A (2009-H1N1) was underway by 
raising the worldwide pandemic alert level to Phase 6. 
Since the WHO pandemic declaration, the new 2009-H1N1 virus 
has continued to spread.  Though the current strain of 
2009-H1N1 influenza has a low mortality rate, and most 
people who become ill have recovered without requiring 
medical treatment, the U.S. Government (USG) remains 
concerned about the possibility of a severe influenza 
pandemic resulting from changes in the 2009-H1N1 virus or 
the emergence of an even newer influenza virus. 
 
¶3. Though the Department's primary planning guidance 
continues to be that all overseas Americans should be 
prepared to remain abroad during a pandemic, severity, 
which has a close correlation to fatality rate, is now an 
important factor in applying this guidance.  A document 
titled "Options During a Pandemic," which takes the new 
severity guidance into account, was recently published on 
CA's Internet website at 
http://www.travel.state.gov/travel/tips/healt h/health_3096. 
html 
 
----------------------------------- 
General Policy for Americans Abroad 
----------------------------------- 
 
¶4. Any U.S. citizen who chooses not to return to the United 
States via commercial means at the onset of a severe 
pandemic may have to remain abroad for the duration of the 
pandemic due to transportation disruptions and border 
closures.  Those who choose to wait out a severe pandemic 
abroad are therefore urged to maintain adequate provisions 
for an infection wave or waves that could last from two to 
twelve weeks.  Americans who travel abroad during the 
current 2009-H1N1 pandemic may face screening measures, 
isolation, or quarantine as local public health authorities 
seek to contain the spread of the virus and treat sick 
travelers. 
 
¶5. Due to legal restrictions and a lack of sufficient 
resources, the Department is not/not in a position to 
provide private U.S. citizens residing or traveling abroad 
with pandemic-related supplies, medications or medical 
treatment, including vaccines.  The Fact Sheet found at 
http://travel.state.gov/travel/tips/health/he alth_1181.html 
provides guidance to private citizens on the advisability 
of obtaining an advance supply of antiviral medication for 
their period of stay overseas, along with other measures 
they can take to stay healthy.  Posts may wish to further 
publicize this information by means of virtual town hall 
meetings, newsletters, and warden messages. 
 
STATE 00104542  002.2 OF 003 
 
 
¶6. In the event that the current pandemic becomes more 
severe, consular sections may have to temporarily suspend 
or limit non-emergency services.  Consular Section Chiefs 
must coordinate any proposed drawdown or suspension of 
service with CA/EX.  If authorized departure is implemented 
for a particular post, the Department will call the 
public's attention to the authorized departure by issuing a 
Travel Warning (TW).  Once published, the TW must also be 
transmitted to the American community within post's 
consular district by means of a warden message. 
 
---------------------------------------- 
Consular Contact with Influenza Patients 
---------------------------------------- 
 
¶7. Though consular assistance to private citizens is likely 
to be limited during a pandemic, it should include 
communicating with family and friends on a sick or 
quarantined individual's behalf, monitoring 
quarantine/isolation conditions as permitted by local 
health authorities, arranging for transfers of funds or 
granting temporary subsistence loans, and providing 
information regarding the availability of medical care (to 
be paid for by the individual).  Please note that public 
health officials are likely to prohibit direct contact with 
persons who are sick or quarantined; in such instances, 
consular access will be restricted to telephone calls, 
paper or electronic correspondence.  The Department does 
not expect consular officers to personally visit influenza 
patients. 
 
--------------------------------------------- ---------- 
Warden Messages--Information on Screening, Isolation and 
Quarantine 
--------------------------------------------- ---------- 
 
¶8. It is extremely important that posts get the word out 
regarding host country entry/exit screening and quarantine 
procedures by means of warden messages, which should be 
posted to the Embassy/Consulate website and linked to the 
Country Specific Information site on www.travel.state.gov. 
In conjunction with these efforts, private citizens should 
be informed that the USG cannot demand their release if 
they have been detained or quarantined abroad in accordance 
with public health and legal authorities.  (Consular 
officers should be prepared to raise inadequate 
quarantine/isolation conditions, but should not try to 
intervene with the host government to shorten the period of 
time that someone is held.)  Information on country 
entry/exit screening and quarantine procedures should also 
be entered into the "H1N1 10/09 Matrix" located at: 
http://poems.ses.state.sbu/sites/portal/seso/ cms/WebPages/P 
andemic%20Flu.aspx. 
 
¶9. Posts must clear all health-related warden messages with 
the Regional Medical Officer or post's direct-hire Foreign 
Service Health Practitioner before sending them to 
CA/OCS/ACS for Department clearances.  Warden messages 
should attribute medical guidance to the Centers for 
Disease Control and Prevention (HHS/CDC), the WHO, or local 
health authorities, as the Department is prohibited from 
providing specific medical advice or medical services to 
the public. 
 
¶10. The following template is included to aid posts in 
formatting their warden messages.  BEGIN TEMPLATE. 
 
Warden Message 
(Insert Post Name) 
(Insert Date) 
 
This Warden Message alerts U.S. citizens to the latest 
information regarding human cases of 2009-H1N1 influenza, 
 
STATE 00104542  003.2 OF 003 
 
 
sometimes referred to as novel H1N1 or swine flu.  The 
(fill in the reporting authority) has reported (fill in 
outbreak information, pandemic declaration, etc.).  (Insert 
adjective for host country) authorities have (fill in local 
actions being taken, particularly those that limit travel 
and involve entry/exit screening, quarantine, or isolation 
procedures; avoid commentary and speculation.) 
 
If you are quarantined or placed in isolation due to 2009- 
H1N1 influenza, please contact the (Embassy/Consulate 
General/Consulate) at the number below and let us know, so 
we can monitor your situation.  However, please be aware 
that the (Embassy/Consulate General/Consulate) cannot 
demand your immediate release if you have been detained or 
quarantined in accordance with local public health and 
legal authorities. 
 
Due to legal restrictions and a lack of sufficient 
resources, the (Embassy/Consulate General/Consulate) is not 
in a position to provide private citizens with pandemic- 
related supplies, medications or medical treatment, 
including vaccines, and cannot provide specific medical 
advice.  Questions and concerns about influenza or other 
illnesses should be directed to a medical professional.  A 
list of local hospitals and doctors can be found on our 
website at (insert link to post's website). 
 
For more information on how to prepare for a severe 
pandemic, please see the State Department "Pandemic 
Influenza Fact Sheet" and "Options During a Pandemic" flyer 
located on www.travel.state.gov.  Detailed information 
about 2009-H1N1 influenza can be found on the U.S. Centers 
for Disease Control and Prevention website at 
http://www.cdc.gov/h1n1flu/, the U.S. Government's federal 
influenza website at http://www.flu.gov, and the World 
Health Organization website at 
http://www.who.int/csr/disease/swineflu/en/in dex.html. 
 
U.S. citizens residing or traveling in (insert name of 
country) are encouraged to register with the 
(Embassy/Consulate General/Consulate) through the State 
Department's travel registration website, 
https://travelregistration.state.gov/ibrs/ui/ , to obtain 
updated travel and security information.  U.S. citizens 
without Internet access may register directly with the 
(Embassy/Consulate General/Consulate).  Registration is 
important; it allows the (Embassy/Consulate 
General/Consulate) and the State Department to assist you 
in an emergency. 
 
The (Embassy/Consulate General/Consulate) is located at 
(insert street address, and also mailing address if this is 
different from street address.)  The (Embassy/Consulate 
General/Consulate) telephone number is (insert telephone 
number); the (Embassy/Consulate General/Consulate) fax 
number is (insert ACS fax number).  For after-hours 
emergencies, please call (insert after-hours emergency 
number). 
 
END TEMPLATE. 
 
¶11. Minimize considered. 
CLINTON