Asia and Oceania

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Health

In August 2009 the state media agency Xinhua reported the death of three people, and the infection of nine others, of pneumonic plague in Qinghai Province (north-western China). Ziketan town (population about 10,000), near Xinghai, where the outbreak occurred was quarantined on 2 August although this quarantine was lifted on 8 August.

Pneumonic plague is a virulent form of plague that attacks the lungs.

There are confirmed cases of the H1N1 virus (Swine Flu) in Mainland China, including British nationals.

The Chinese government continues to place great emphasis on screening and surveillance, rapid detection, quarantine and treatment and stringent measures for detection are in place at ports of entry across China. China’s strategy for dealing with A(H1N1) differs from that of other countries in that it centres on ‘containment’.  The effect of this is that quarantine measures are particularly rigorous in both Beijing and Shanghai, and these measures may be replicated at other airports if the situation deteriorates – by way of example, large numbers of British nationals entering Beijing from the UK were quarantined in July 2009. If your flight is subjected to these measures you may experience lengthy delays between landing and the transition from the airport to a designated hotel or hospital (this process regularly takes around five hours or so). Very little information is provided, and rarely anything in English, until arrival at the designated hotel/hospital.  Reports indicate that some passengers find the process confusing and upsetting.  In these circumstances, Consular staff can assist by liaising with health professionals.        

You should be aware that, if any passenger on, for example, an aircraft, has flu-like symptoms this may lead to all passengers being quarantined for up to seven days, until health officials are satisfied all are free of the A(H1N1) virus.  Any passenger having come into direct/indirect contact with anyone suspected of having the virus may also be quarantined.  Levels of quarantine differ; all suspected victims are hospitalised, others are confined to hotel rooms, still others are asked to self-monitor and stay at home.  You should be aware that the quarantine conditions across Mainland China vary and food and drink choices are limited, as are entertainment options (for example TV may not be available in hospitals and, if it is, may only show Chinese channels). If you intend to travel to China for any reason, please be aware that you may be quarantined for up to seven days if there is a suspected victim on your flight (i.e. not necessarily you).  These measures could impact significantly on your overall travel plans. 

Any British national affected should report the details to the Embassy's Consular Section on (010) 8529 6600 where staff will be able to offer consular assistance, though access will be limited to telephone contact due to Chinese quarantine restrictions.  As far as possible we will continue to deliver a consular service for British nationals in China, although there may be a limited service depending on the scale and severity of the swine flu outbreak. Many countries may have limited availability of anti-viral drugs. Consular staff will be able to provide advice on the availability of healthcare in China but we cannot provide medical treatment (including anti-viral medication). Given the WHO’s declaration of a phase 6 pandemic alert, stringency measures may be increased further by the Chinese authorities. Baggage and freight are also under inspection.

The World Health Organisation (WHO) has raised its Pandemic Threat Alert Phase to Level 6. The WHO website at has additional details. There is a dedicated Swine Flu page on the FCO website. Guidance on Pandemic Flu can be obtained on the UK Department of Health website.

The WHO does not currently consider Severe Acute Respiratory Syndrome (SARS) to be a significant threat to public health in China. See the WHO website for more details.

Rabies is common in China, which has the second highest incidence in the world.  Rabies has been the most prevalent cause of death from reportable infectious disease in China since 2006. The number of fatalities from the disease rose to 3,293 in 2006, an increase of 27% over 2005. (Source: NaTHNaC website)

Hand, foot and mouth (HFMD) disease is a regularly occurring illness in China (and elsewhere).  An intestinal virus, a variant of HFMD, also occurs annually in China. Both diseases are usually more severe in children and babies, and generally peak in the summer months.  The disease is again affecting China, mainly in Shandong and Anhui provinces. By 2 April 2009, estimates of incidence varied from between 1,700 and 18,000, and up to nine deaths of young babies have been reported.

In the 2008 Report on the Global AIDS Epidemic the UNAIDS/WHO Working Group estimated that around 690,000 adults aged 15 or over in China were living with HIV; the prevalence rate was estimated at around 0.1% of the adult population. This compares to the prevalence rate in adults in the UK of around 0.2%.  You should exercise normal precautions to avoid exposure to HIV/AIDS. For more general information on how to do this see HIV and AIDS.

You should seek medical advice before travelling to China and ensure that all appropriate vaccinations are up-to-date. For further information on vaccination requirements, health outbreaks and general disease protection and prevention you should visit the websites of the National Travel Heath Network and Centre NaTHNaC and NHS Scotland's Fit For Travel or call NHS Direct on 0845 46 47.

For more general health information see Travel Health.

Avian Influenza (Bird Flu)

There are intermittent outbreaks of Avian Influenza (Bird Flu) in poultry in China that have resulted in small numbers of human fatalities (five so far in 2009, in Beijing, Shandong Province, Hunan Province, Xinjiang Uyghur Autonomous Region and Guangxi Zhuang Autonomous Region and three in 2008, in Guangxi, Guangdong and Hunan Provinces). These are usually confined to rural areas and infection is generally believed to arise from close contact with live infected poultry; infected animals are culled.  The latest cases to have been reported, all in January 2009, are one in Beijing, after having come into contact with poultry in Hebei Province, south of Beijing; one in Shandong Province, east of Beijing, one in Hunan Province, central southern China and, most recently, one in Xinjiang Uyghur Autonomous Region (north western China) and another in Guangxi Zhuang Autonomous Region (southern China).

Since the end of 2003, a number of human deaths have also occurred in Azerbaijan, Cambodia, Egypt, Indonesia, Iraq, Laos, Nigeria, Pakistan, Thailand, Turkey and Vietnam.

The risk to humans from Avian Influenza is believed to be low.  However, as a precaution, you should avoid visiting live animal markets, poultry farms and other places where you may come into close contact with domestic, caged or wild birds; and ensure poultry and egg dishes are thoroughly cooked.

The WHO has warned of the possibility that the Avian Influenza outbreaks could lead at some point to a human flu pandemic, if the virus mutates to a form, which is easily transmissible between people.

British nationals living longer term in an Avian Influenza affected region should take personal responsibility for their own safety in the event of a future pandemic, including considering their access to adequate healthcare and ensuring travel documents are up to date.