February 28, 2007

Kuwait City, Kuwait


MEMORANDUM

To:  All American Wardens

From:  Consular Section

Subject:  Warden Notice 2007 – 2

Please circulate the following message without additions or omissions immediately to all American citizens within your area of responsibility:

As of February 28, the Government of Kuwait has confirmed 39 cases of the H5N1 virus in wild and domesticated birds in Kuwait.  Thus far, there are no reports of the virus in commercial poultry and no reports of transmission to humans.   The Government of Kuwait is taking appropriate steps to isolate affected poultry and conduct screening around the country.  The U.S. Embassy is in frequent contact with the Kuwait government and is ready to help the Kuwaiti government contain the spread of the virus and help ensure it does not spread to other animals or humans.

The following information was prepared by the Department of State’s Medical Services, and may be of interest to Americans in Kuwait.

Precautionary steps regarding birds and poultry:

•  Avoid all contact with birds, including live domestic poultry (such as chickens and ducks) or any wild birds. 

•  Avoid touching surfaces contaminated with poultry feces or secretions.

•  Avoid settings where H5N1 virus-infected poultry may be present, such as commercial or backyard poultry farms and live poultry markets.

•  Children should be taught not to touch sick or dead birds. If there has been a verified H5N1 virus infection in birds within the region, make sure that small children are supervised by an adult when they go outside.

•  If possible, allow trained workers to dispose of bird carcasses and bird droppings. Contact local health authorities or government officials to determine if trained workers are available.

•  If contact with a bird carcass is unavoidable (for example, a cat brings a dead bird into the house), follow the interim guidance below: 

•  Under no circumstances should the bird be touched with bare hands. Appropriate personal protective equipment (PPE), as described below, should be worn to avoid direct contact with skin, mucous membranes, and eyes.

•Use an inverted double-plastic bag technique to protect the hands while picking up the carcass. This technique involves taking two plastic bags, placing one inside the other; put hands inside the bags; pick up the carcass, using the bags as a protective barrier; pull the bag up and around the carcass; and tie the bag. Alternatively, use a shovel or other disposable or cleanable utensil and wear disposable impermeable gloves, if possible. Gloves should be changed if torn or otherwise damaged. CDC does not generally recommend latex gloves because a significant proportion of people have latex allergies.  

•  For additional protection, safety goggles or glasses and a surgical mask may be worn to protect the mucous membranes of the nose, mouth and eyes against splashes.

•  If disposing of the carcass in the absence of other instructions from health or government authorities, place it in a double-plastic bag and bury it or place it in an appropriate trash receptacle in a location where it is unlikely to be disturbed by animals.

•  Discard or disinfect* any PPE used. Immediately clean hands with soap and water (or an alcohol-based hand gel with at least 60% alcohol when soap and water are not available).

Avoid touching face, rubbing eyes, eating, drinking, or smoking before washing hands with soap and water.

*Recommendations for PPE Disinfection:
For machine-washable, reusable PPE: Disinfect PPE in a washing machine with detergent in a normal wash cycle. Adding bleach will increase the speed of viral inactivation as will hot water, but detergent alone in cold water will be effective. Follow manufacturer recommendations for drying the PPE. Non machine-washable, reusable PPE should be cleaned following the manufacturer’s recommendations for cleaning.
(The above paragraph was quoted from the CDC website: http://www.cdc.gov/travel/other/avian_flu_ig_americans_abroad_032405.htm )

House Cats

A few domestic cats, in addition to pigs, tigers, leopards, ferrets, and stone martens (a weasel-like mammal), have been infected with AI.  The cats are believed to have been infected by eating uncooked diseased birds.  Although no human cases of AI have been associated with contact with AI-infected cats, the following measures are recommended if there has been a verified AI infection in birds within the region:

-- keep domestic cats inside the house to avoid exposure to potentially infected birds;
-- avoid all contact with stray cats and keep them outside the house;
-- inform local veterinary authorities if your cat is sick and has possibly been in contact with birds;
-- strictly follow normal cat care hygiene rules.  When cleaning cat litter boxes, wear gloves and thoroughly wash your hands with soap and water immediately afterward.

Useful Links

For further information, consult the following websites:
http://www.avma.org/public_health/influenza/avian_faq.asp
http://www.fao.org/ag/againfo/subjects/en/health/diseases-cards/avian_cats.html
http://www.nwhc.usgs.gov/publications/wildlife_health_bulletins/WHB_05_03.jsp
http://www.oie.int/eng/en_index.htm
www.pandemicflu.gov
www.travel.state.gov./travel/tips/health/health_1181.html

American citizens with any questions or concerns may telephone the Embassy at
259-1581 or 259-1583.  In case of an emergency outside business hours, American citizens may reach the Embassy duty officer by calling 259-1001.
This message may be accessed on the Embassy website, http://kuwait.usembassy.gov

American citizens in Kuwait who would like to receive future Warden Messages from the Embassy directly by e-mail may sign up for this service by sending an e-mail to the following address: join-wardenmessagekuwait@mh.databack.com

American citizens resident and visiting in Kuwait who are not registered with the Embassy, or whose registration information has changed, are urged to register as soon as possible.  They may now do so on-line at the Department of State, Bureau of Consular Affairs’ website at https://travelregistration.state.gov/ibrs/home.asp

American citizens also may register in person by coming with their passport to the American Citizen Services Unit, Consular Section, from 9 AM to 11 AM and from 1 PM to 3 PM on Saturdays, Sundays, Tuesdays, and Wednesdays; on Mondays from 1 PM to 3 PM; and on the first Sunday of each month from 5 PM to 7 PM.