VZCZCXRO8940
PP RUEHCHI RUEHCN RUEHDT RUEHHM
DE RUEHJA #0578/01 0790832
ZNR UUUUU ZZH
P 190832Z MAR 08
FM AMEMBASSY JAKARTA
TO RUEHC/SECSTATE WASHDC PRIORITY 8423
RUEHPH/CDC ATLANTA GA PRIORITY
INFO RUEAUSA/DEPT OF HHS WASHINGTON DC
RUEHZS/ASSOCIATION OF SOUTHEAST ASIAN NATIONS
RUEHRC/USDA FAS WASHDC
RHHMUNA/HQ USPACOM HONOLULU HI
RHHMUNA/CDR USPACOM HONOLULU HI//J07/CATMED/CATT//
RUEHFR/AMEMBASSY PARIS 1097
RUEHRO/AMEMBASSY ROME 2037
RUEHIN/AIT TAIPEI 2021
RUEHHK/AMCONSUL HONG KONG 2509
RUEHBJ/AMEMBASSY BEIJING 4836
RUEHBK/AMEMBASSY BANGKOK 8370
RUEHHM/AMCONSUL HO CHI MINH CITY 0230
RUEHGZ/AMCONSUL GUANGZHOU 0304
UNCLAS SECTION 01 OF 02 JAKARTA 000578
SIPDIS
SENSITIVE
SIPDIS
DEPT FOR EAP/MTS, OES, DS/IP/EAP, A/MED AND S/ES-O
DEPT PASS TO USDA/FAS/OSTA/ROSENBLUM, USDA/APHIS/ANNELLI,
USDA/DU/S LAMBERT
DEPT ALSO PASS TO HHS/STEIGER/MSTLOUIS AND HHS/NIH
DEPT ALSO PASS TO USAID/ANE/CLEMENTS AND GH/CARROLL
BANGKOK FOR RMO, CDC, USAID/RDM/A, APHIS
E.O. 12958: N/A
TAGS: TBIO KFLU AMED CASC AMGT PGOV SOCI ID ASEC
SUBJECT: Indonesia - Post Contingency Planning and Updated
Tripwires
REF: A) 2005 Jakarta 9024 B) 2005 State 202824
JAKARTA 00000578 001.2 OF 002
1. (SBU) Summary: Our Emergency Action Committee reviewed and
reaffirmed our Avian Influenza (AI) tripwires on March 13. This
cable provides minor updates to the original tripwires. End
Summary.
2. (SBU) Following a review of Ref A, the Mission's Avian Influenza
Working Group (AIWG) updated Embassy Jakarta's tripwires to reflect
better the actual trajectory of the disease and ensure an accurate
and speedy response to the threat posed to humans. The revision
reflects the unexpected distribution of H5N1 AI human cases in urban
rather than rural areas as envisioned in the original tripwire
scenario. The Ambassador has approved the following updated
tripwires and possible associated actions. The AIWG has determined
that post has reached Tripwire 1 and taken the actions listed in
para 6.
3. (SBU) Indonesia has 105 confirmed human fatalities from avian
influenza (AI), a number of them in family clusters in the greater
Jakarta metropolitan area. The Ministry of Health has instructed
all health care providers in the city to refer suspected cases of AI
to three AI referral hospitals for Jakarta: Sulianti Saroso
Infectious Diseases Hospital, Persahbatan, and Gatot Subroto Army
Hospital. Although each hospital is equipped with limited number of
respirators and isolation rooms, they would quickly become
overwhelmed in the event of a pandemic.
4. (SBU) One U.S. commercial carrier, Continental Micronesia, flies
twice weekly from Denpasar, Bali to Honolulu via Guam. All other
commercial flights via Singapore or Bangkok require an overnight
stop. There is a Cathay Pacific flight from Jakarta to Hong Kong
that does not require a stopover in Asia. Individuals flying on
Cathay Pacific can connect on US Airlines directly to U.S. cities.
If traveling from Jakarta directly to Tokyo on Garuda or Japan
Airlines, they can connect with any U.S. carrier directly to the
U.S. the same day of arrival. During the SARS epidemic in 2003,
Singapore refused entry to any traveler with a fever. Countries
that serve as transportation hubs in Asia would impose border
control measures and restrict entry to travelers originating in
Indonesia. To the extent possible, U.S. staff and dependents should
depart Indonesia at the beginning of a pandemic.
5. (SBU) The Regional Security Office (RSO) will input tripwire
data into the TRIPS system.
6. (SBU) Begin Mission Jakarta AI tripwires:
Tripwire 1: Spike in number and broadening geographic
spread of animal-to-human transmission cases in Indonesia.
Actions:
a) Restrict official and unofficial travel to wet markets.
b) Release warning announcement to Mission personnel and warden
message to American citizens. Prepare talking points for domestic
and international press.
c) Provide detailed briefing to Embassy/Consulate staff.
d) Communicate pertinent information to the embassy community by way
of venues such as town hall meetings, the embassy web site and
newsletter articles.
e) Review and update Mission contingency plans.
Tripwire 2: Confirmed, sustained human-to-human transmission in one
or more of the other at-risk countries in the region (but not in
Indonesia), indicating an increase in transmissibility of the virus.
This is particularly significant if there are multiple,
geographically diverse clusters.
JAKARTA 00000578 002.2 OF 002
Actions:
a) Consider authorized departure for U.S. family members and
non-emergency personnel.
b) Institute screening practices for all visitors to USG
facilities.
c) Mandatory sick leave for any employee who shows any flu symptoms
or has a family member with flu symptoms. Monitoring by MED Unit.
d) Public announcement to the American community. Prepare press
guidance/talking points for domestic and international press.
e) Department of State makes public announcement regarding travel to
the region.
f) Assess availability of commercial flights.
g) Recommend stockpiling of food and water supplies for
90 days, in the event post personnel would not be able to depart in
a pandemic (Tripwire 3).
Tripwire 3: Sustained human-to-human transmission in Indonesia.
Actions:
a) Reduction to emergency consular services only.
b) The Chief of Mission recommends implementation of authorized or
ordered departure, at his discretion, if departure is still
possible.
c) Implement administrative leave for non-emergency FSNs.
d) Mandatory sick leave for any employee who shows any flu symptoms
or has a family member with flu symptoms. Monitoring by MED Unit.
e) Consider social distancing measures, such as home quarantine and
limiting venues of human to human contact, such as community
gatherings. Consider restricting children from school.
f) Screening of all visitors and use of protective gear (masks,
gloves, clothing).
g) Public announcement to the American community. Prepare press
guidance/talking points for domestic and international press.
h) Department of State makes public announcement regarding travel to
the region.
i) Advise and request assistance from DoD as needed.
Alternative Tripwire: A Mission employee develops Avian Influenza,
in the absence of a broader outbreak per tripwires 1, 2, or 3
above.
Actions:
a) Treat the victim. Medevac if possible.
b) Disinfect office.
c) Administer Tamiflu to close contacts.
d) Prepare press guidance/talking points.
HUME