US embassy cable - 05SINGAPORE1311

UNCLAS SECTION 01 OF 02 SINGAPORE 001311 
 
SIPDIS 
 
STATE FOR EAP/PMBS 
STATE FOR OES/IHA 
HHS FOR AMAR BHAT 
 
SENSITIVE 
 
E.O. 12356: N/A 
TAGS: TBIO, AMED, EAGR, ETRD, SN 
SUBJECT:  AVIAN INFLUENZA PREPAREDNESS IN SINGAPORE 
 
REF: A) 04 Singapore 231 
 
     B) 04 Singapore 445 
 
1.  (SBU)  Summary.  Although Singapore has not detected 
avian influenza infections in either poultry or human 
beings, it is preparing to address this growing regional 
threat.  After its successful control of the 2003 SARS 
outbreak, the GOS is confident it can respond adequately to 
a bird flu epidemic should one occur within its borders. 
The GOS will release a Pandemic Influenza Preparedness Plan 
in June.  Ministry of Health officials have told us 
privately that they do not intend to restrict travel into or 
out of Singapore if bird flu erupts.  End summary. 
 
Multiple GOS Agencies Working on Bird Flu 
----------------------------------------- 
 
2. Several Singapore Government agencies are monitoring 
avian influenza and preparing response plans: 
 
-- the Agri-Veterinary Authority (AVA) has the lead on 
monitoring bird flu and regulating Singapore's small, modern 
poultry sector. 
 
-- Singapore General Hospital's National Influenza Center 
performs surveillance for influenza and acute respiratory 
illness. 
 
-- the Ministry of Health (MOH) will become the lead 
response agency if the virus demonstrates efficient human-to- 
human transmission (defined as transmission past the first 
generation of contact from infected poultry to humans). 
 
-- the interagency "Home Team" leads Singapore's crisis 
response management and will play that role in any bird flu 
epidemic.  Home Team member agencies are Singapore's Police 
Force, Internal Security Department, Civil Defense Force, 
Prisons Department, Immigration and Checkpoints Authority, 
Central Narcotics Bureau, Commercial and Industrial Security 
Cooperation, and Corporation of Rehabilitative Enterprises. 
 
Planning Well Advanced 
---------------------- 
 
3.  (SBU)  Singapore has developed detailed plans for bird 
flu management and will release a comprehensive Pandemic 
Influenza Preparedness Plan by the end of June: 
 
-- the AVA now requires poultry workers to wear protective 
masks at all times while handling chicken and chicken 
products, to follow strict hygiene practices, and to undergo 
daily temperature checks.  Workers are also vaccinated 
against common human influenza to decrease the risk of 
individuals who are immuno-compromised that will contract 
bird flu and potentially serve as vectors for mutation of 
the virus into strains transmissible between human beings. 
If it detects avian influenza in imported poultry or 
products, AVA will ban further imports from that location 
and destroy and dispose of all birds imported that day.  If 
the disease strikes any of Singapore's seven poultry farms 
or if clinical signs of avian influenza appear in poultry, 
AVA will cull and safely dispose of every bird on all seven 
of them. 
 
-- the MOH continues to stockpile the anti-viral drug 
Tamiflu (ref B) and aims at acquiring enough for 25 percent 
of the population.  MOH is discussing with vaccine 
manufacturers the possibility of obtaining an early stock of 
an experimental H5N1 vaccine once the testing trials and 
approval process are completed.  It has on hand an ample 
supply of personal protective equipment left over from the 
SARS epidemic. 
 
-- Singapore will take a step-by-step approach.  It 
currently imposes no travel restrictions related to avian 
influenza.  At present, Singapore will not quarantine 
individuals entering into Singapore on the basis that they 
have spent any amount of time in countries with known cases 
of avian influenza, either in poultry or in humans. 
 
-- if a limited number of human cases emerges, the MOH will 
employ quarantine/containment measures and possibly 
institute temperature monitoring at airports (not because 
this will necessarily help contain the spread, but because 
it might be politically expedient).  If bird flu spreads, 
then there could be school closures and discouragement of 
public gatherings.  The GOS most likely will not impose 
travel restrictions. 
 
 
Unfulfilled Outreach 
-------------------- 
 
4.  (SBU) Singapore is attempting to engage in regional 
outreach to halt this potential epidemic by offering high- 
end technical assistance, but to date these offers have not 
been accepted. Singapore's outreach efforts have been 
stymied by a lack of communication and coordination with 
other nations in the region.  GOS officials have told us 
privately that their biggest challenge is obtaining reliable 
information concerning regional outbreaks and responses to 
avian influenza. 
 
 
U.S. Concerns 
------------- 
 
5.  (U) The experience with SARS told the U.S. business 
community that Singapore's effective response did not 
prevent a significant drop in business travel.  This 
reluctance to travel to the region affects companies' 
ability to recruit staff and conduct normal business. 
Although avian influenza is qualitatively different from 
SARS, U.S. business representatives are concerned it will 
have the same dampening effect on commerce. 
 
6.  (SBU) The RMO continues to work closely with the MOH to 
ensure adequate access to Singapore's advanced medical 
facilities for U.S. personnel.  Officially, Singapore 
immigration and health regulations do not permit entry to 
people with contagious diseases.  Nonetheless, MOH 
representatives have unofficially told the RMO that they 
will take a case-by-case approach to any USG bird flu 
medevacs. 
 
FERGIN