Warden Notice 07/06 (13 June 2006)

You are probably aware of international concern about outbreaks of avian influenza, and fears that this might trigger a global human flu pandemic. The FCO has been planning for this possibility for some time.

British nationals living overseas may find it difficult to obtain information about the virus and a possible future pandemic. This letter should aims to give you the basic information you may need, point s you in the direction of other sources of information , and set s out what the Embassy will and will not be able to do in the event of a pandemic.

I attach a copy of the FCO fact - sheet: Avian and Pandemic Influenza (available on the FCO's website at www.fco.gov.uk ). This makes clear that the risk to human being s from the H5N1 avian flu virus is low, notwithstanding the publicity about reported cases. Medical experts believe, however, that the virus could develop into one which that could be passed between human beings. If that were to happen, it could trigger a global flu pandemic.

In the event of a pandemic, the virus would spread rapidly, almost certainly affecting all countries within a matter of weeks. Given the likely disruption to transport, healthcare (including the NHS in the UK ) and other local services , the level of consular help and the visa service that we can provide might be significantly reduced, not least because some of our own staff m ight ay be ill. In certain circumstances we may even have to close the Embassy temporarily to prevent the spread of infection.

We have put a flu contingency plan for the Embassy Commission so that we can try to maintain a t least a basic consular service during any the crisis. However But , in order to minimise the risk s of infection , we might be forced to this w ill mean limit ing public access or ev en to clos e ing the Embassy to the public. In t hat his case, w W e w ould send you ill though be offer ing regular updates, and p ost these on the Embassy website. We would also try to increase our capacity to offer help and advice through a dedicated offer personal advice and help by tele phone number and or e-mail address ( which we would advertise ). by a dedicated team who could advi s e on such matters as local healthcare providers We would also welcome your help in maintaining a database of British citizens who had been affected.

We would also set up a drop-off box to deal with applications for services such as passport renewals or visa requests , although, as the pandemic progresse d , s, we might only be able to accept handle only the most urgent requests for passports and visas.

I would especially draw your attention to the section of the factsheet headed "British nationals living overseas". You will note that that, in the event of a pandemic, we have concluded that given the potential number of British nationals involved would mean that we w ould ill be unable to offer repatriation.

Nor would we ill be able to offer diagnosis or medical treatment. That, rightly, should be the duty of your usual healthcare provider. It would therefore be sensible for you to consider whether you would have access to anti-viral drugs and medical facilities should a pandemic occur. The Saudi Ministry of Health has told us that they are assembling stocks of ant i -viral drugs, which would be available on the basis of need regardless of nationality.

I also suggest you visit the Department of Health website at: www.dh.gov.uk/pandemicflu , to view their pamphlet: Pandemic flu: Important information for you and your family. This has been made available in GP surgeries in the UK and contains information about the implications of a pandemic. You should read this together with the FCO factsheet. Both give important information to help you consider your options and make any necessary preparations before a human flu pandemic occurred. They also give advice on sensible precautions you might take to reduce the risk of infection.

Further information can be found on the World Health Organisation, Department of Health and Health Protection Agency websites. .

You should also monitor the FCO and Embassy websites for updates. We will also disseminate further information through the Wardens' network.

Please contact me Brian Hefford at the Embassy should you have any further queries about pandemic flu planning.

I should be grateful if you would arrange for a copy of this letter and the enclosed factsheet to be sent given to all members of your flock.

Brian Hefford

HM Consul

AVIAN AND PANDEMIC INFLUENZA: FACTSHEET FOR BRITISH NATIONALS TRAVELLING OR RESIDENT OVERSEAS

Summary

The risks to humans from avian influenza are low, but it is possible that current outbreaks in birds could at some point develop into a human flu pandemic which would be much more serious.

The risk of avian flu to British nationals visiting countries affected by avian flu is believed to be very low. There is no reason not to travel to these countries.

The risk of avian flu to British nationals living overseas in countries affected by avian flu is also currently very low; but they should take personal responsibility for their own safety in the event of a future pandemic, including considering their access to adequate healthcare

All those visiting or living in countries affected by avian flu should follow sensible precautions.

Introduction

The World Health Organisation (WHO) has warned that recent outbreaks of bird flu, also known as avian influenza, could trigger a future human flu pandemic. This fact-sheet explains why there is international concern about this. It describes sensible precautions for travellers and residents in affected areas, both in respect of avian influenza, and in respect of a possible future human flu pandemic. And it sets out the measures taken by the Foreign & Commonwealth Office and its diplomatic posts abroad (Embassies, Consulates and High Commissions) in response to these concerns.

Current situation

Experts began monitoring a form of avian influenza - known as the highly-pathogenic H5N1 (or A/H5N1) strain - eight years ago. Since the end of 2003, there have been a series of outbreaks amongst poultry and wild birds, starting in South-East Asia . Afghanistan, Albania, Austria, Bosnia & Herzegovina, Bulgaria, Burkina Faso, Cameroon, Cote d'Ivoire, Croatia, Cyprus, Czech Republic, Denmark, France, Georgia, Germany, Greece, Hong Kong, Hungary, India, Iran, Israel, Italy, Japan, Jordan, Kazakhstan, Laos, Malaysia, Mongolia, Myanmar, Niger, Nigeria, North Korea, Pakistan, Palestine National Authority, Poland, Romania, Russia, Serbia & Montenegro, Slovakia, Slovenia, South Korea, Sudan, Sweden, Switzerland, Ukraine and the United Kingdom have all suffered confirmed outbreaks in poultry or wild birds. (In rare instances, cases have also been reported in cats and Stonemartens.) Other countries are investigating suspected cases.

The WHO have issued an alert phase three, which means that there have been human infections of the virus, but very rare instances of human to human spread. Avian influenza is largely a disease of birds. As of 11 May, 208 people have caught the disease and of these 115 have died. Human cases have been confirmed in Azerbaijan , Cambodia , China , Egypt , Indonesia , Iraq , Thailand , Turkey and Vietnam . Almost all are thought to have caught the disease directly from infected poultry. Despite the spread of avian influenza to Eastern Europe and Africa , the perceived threat of a human flu pandemic remains the same, as the virus has not shown an ability to pass easily between people.

Medical experts warn that the avian influenza virus could combine with influenza viruses already circulating in the human population or adapt into a form which could be transmitted readily between people. It is impossible to predict when this might happen. But if it did, it could trigger a global human flu pandemic.

It is important to distinguish between avian influenza, the current disease affecting mainly birds, and pandemic flu, which would affect mainly humans and is at this stage only a possibility.

Precautions against avian influenza

There are no specific restrictions for travellers to any of the countries affected by avian influenza, as the risk is believed to be very low. But if you plan on travelling to areas where outbreaks have been reported, you may wish to take the following precautions:

• Avoid visiting live animal markets, poultry farms and other places where you might come into contact with wild, domestic or caged birds
• Avoid contact with surfaces contaminated with animal faeces or fluids
• Avoid eating or handling poultry, egg or duck dishes, if any of these are undercooked or raw
• Wash hands regularly
• Do not attempt to bring any live poultry products back to the UK

Most human cases are thought to have acquired their infection following exposure to dead or diseased birds. Evidence suggest that particularly risky exposure occurs during the slaughter, plucking and preparation of poultry for cooking.

You should not eat dishes made with fresh duck blood or any other raw or inadequately cooked poultry or egg products. Normal cooking destroys the avian influenza virus. No cases of avian influenza have been linked to the consumption of properly cooked poultry and egg products.

The Department of Health issued guidance to all UK healthcare providers in March. This information gives advice to those who may be travelling to, or returning from, areas affected by avian influenza (see Department of Health website at www.dh.gov.uk/pandemicflu ).

Medical interventions for avian influenza and pandemic flu

There is at present no vaccine against any future pandemic flu strain. The normal seasonal flu vaccination protects against currently circulating human flu strains, but is unlikely to offer any protection against avian influenza strains or against a new pandemic flu strain. The use of seasonal flu vaccination, by minimising numbers of cases of seasonal flu, would reduce opportunities for avian strains to mix with human strains, and may allow people with avian influenza or pandemic flu to be more easily identified.

Anti-viral drugs, such as oseltamivir (Tamiflu ®), may be effective in reducing the severity and duration of an influenza illness, but this has not been proven in a pandemic situation and their effect may be limited if the virus develops resistance to the drugs. Further medical information is provided on the Department of Health website.

FCO precautions

The FCO and its posts overseas are working to prepare for a possible pandemic in line with Department of Health guidelines. You can read the British Government's national contingency plan on the DH website at: www.dh.gov.uk/Pandemicflu. As a precaution, the FCO has obtained courses of the anti-viral drug oseltamivir (Tamiflu ®) for treatment of our staff working overseas should they fall ill in the event of a pandemic. This should enable FCO staff at posts overseas to continue to work and provide consular assistance to British nationals overseas. It also fulfils the FCO's duty of care to its staff, in line with the actions of many other organisations and companies with operations overseas.

Depending on the scale, impact and severity of the pandemic, it is possible that staff may be evacuated from some diplomatic missions. However, as far as possible, the FCO will work to continue to deliver a consular service for British Nationals, although the level of assistance we offer may be limited; our staff might contract the virus.

British nationals living overseas

British nationals resident overseas should be prepared to take personal responsibility for their own health in a pandemic situation, including access to adequate healthcare. Availability of anti-viral drugs is currently limited in many countries, including the UK . Should a pandemic occur, transport and healthcare systems - including the NHS - would be severely disrupted.

As a precautionary measure, those living in or near an avian influenza-affected country for an extended period might consider, with their healthcare adviser, whether they would have access to anti-virals for treatment in case of a pandemic. In a pandemic you should seek medical advice before using anti-viral drugs. British diplomatic missions overseas cannot provide medicine or medical treatment to British nationals, but may be able to advise on local availability of medicines, and provide details of healthcare providers. Where appropriate British nationals are advised to seek guidance from employers, who may also have a pandemic contingency plan in place.

A flu pandemic could spread extremely quickly and with little warning. Some countries might close their borders, international transport could be severely disrupted or halted, and travel could become medically inadvisable. In these circumstances, and because of the likely numbers involved, the FCO will not be in the position to offer repatriation to British nationals. British nationals should consider in advance the potential risks, monitor medical guidance and travel advice (on the FCO website), and make appropriate preparations. Should they plan to return to the UK, they should ensure that travel documents such as passports and visas for family members are up to date and in order.

British nationals travelling overseas

Travellers to areas affected by avian influenza with specific health concerns should consult their usual healthcare provider for travel medical advice and further guidance. As the risks from avian influenza are considered small, the UK 's Health Protection Agency does not at present advise tourists visiting affected areas to carry anti-viral drugs. There have been no cases of avian influenza in travellers.

Should the WHO change the level of their global pandemic alert, the FCO will update travel advice accordingly.

International co-ordination

The British Government will continue to work with the international community to try to prevent a pandemic from arising and to provide technical assistance to those countries most vulnerable to the effects of a pandemic. At the International Pledging Conference held in Beijing in January, the UK announced £20m ($35m) of new, untied finance to support this work.

Further information

The latest information on avian influenza and pandemic flu, including prevention and treatment measures and other Frequently Asked Questions, can be found on the following websites:

• Department of Health
• Health Protection Agency
• National Travel Health Network and Centre
• World Health Organisation

Travel advice on specific countries can be found on the FCO website at www.fco.gov.uk .

***********************************************************************************

Visit http://www.fco.gov.uk for British foreign policy news and travel advice; and http://www.i-uk.com - the essential guide to the UK.

***********************************************************************************