Category Archives: Pandemic

2009 Influenza Pandemic: Border Entry Issues

The Congressional Research Service recently prepared a report on the 2009 Influenza Pandemic for Congress. The report provides a brief overview of selected legal issues including emergency measures, civil rights, liability issues, and employment issues. The report also contains interesting snippets on inadmissibility under INA, border quarantines and border closure.


Inadmissibility of Infected Aliens

Those most easily excluded from the United States are aliens already infected with the influenza A(H1N1) virus. The Immigration and Nationality Act (INA) specifically bars aliens who are determined to have “a communicable disease of public health significance,” from receiving visas and admission into the United States. “A communicable disease of public health significance” is defined by the Secretary of Health and Human Services by regulation. Although the regulatory definition does not specifically include influenza A(H1N1), it does include, by reference, communicable diseases as listed in a Presidential Executive Order issued pursuant to section 361(b) of the Public Health Service Act. The relevant order, Executive Order 13295, as amended by Executive Order 13375, specifies “[i]nfluenza caused by novel or reemergent influenza viruses that are causing, or have the potential to cause, a pandemic” as a communicable disease for purposes of section 361(b). Thus, for purposes of the INA, the influenza A(H1N1) virus is a ground for inadmissibility into the United States. Of course, this law only applies to aliens, not citizens, and prior to inadmissibility being triggered, the alien must be diagnosed with the influenza A(H1N1) virus. These considerations could therefore prevent this provision from being the most effective means to interdict individuals infected with the influenza A(H1N1) virus from entering the country.


Border Quarantines of Citizens or Aliens

There are currently no legal provisions that can exclude American citizens from the United States solely because of an infection with a communicable disease. The primary means to prevent infected citizens from introducing these diseases into the United States is to place them into quarantine or isolation at the border rather than deny them entry outright. As noted above, the Secretary has the authority to promulgate regulations to prevent the entry and spread of communicable diseases from foreign countries into the United States. The implementing regulations at 42 C.F.R. Part 71 specify that when there is reason to believe an arriving person is infected with “any communicable disease listed in an Executive Order, as provided under section 361(b) of the Public Service Act,” the person may be isolated, quarantined, or placed under surveillance or disinfected if deemed necessary to prevent the introduction of the communicable disease. “Influenza caused by novel or reemergent influenza viruses that are causing, or have the potential to cause, a pandemic” is one such disease that can warrant quarantine.


Closing the Border

The most drastic measure discussed so far is “to close the borders.” Presumably, this would entail a blanket bar on all aliens and citizens seeking entry into the United States regardless of their health. There appear to be no laws specifically authorizing an executive agency to take such action. However, Congress could presumably enact a law to do so, at least with regard to aliens, because the Supreme Court has long recognized “the power to expel or exclude aliens as a fundamental sovereign attribute that is largely immune from judicial control. However, United States citizens cannot be barred from entering the United States. Thus, if Congress were to theoretically “close the borders,” it could do so only by excluding aliens. In the absence of an act of Congress, it may be possible for the President to “close the borders” to aliens by Executive Order. However, this course of action appears to be fraught with legal and practical challenges, which would likely result in extensive litigation. Because Congress has not given the President authority to conduct blanket closings of borders, it would appear that the President could do so only if the exclusion power is one where he has concurrent authority with Congress. Although this exclusion power is characterized as a power “exercised by the Government’s political departments largely immune from judicial control,” the President appears to have rarely exercised any authority within this realm outside of the authority expressly delegated by an act of Congress. Considering the rather extensive inadmissibility regime codified within the Immigration and Nationality Act, it would appear unlikely that the President can exercise this power without express congressional authorization.

Read the whole thing here.

Leave a comment

Filed under Consular Work, Evacuations, Govt Reports/Documents, Pandemic

H1N1 Vaccine for Foreign Service Personnel

H1N1 VaccineImage by ghinson via Flickr

At the DPB yesterday, a reporter inquired about provisions for Foreign Service personnel in the H1N1 outbreak:


QUESTION:
In regard to the H1N1 outbreak, what provisions are being made by the State Department on behalf of Foreign Service Officers serving at posts overseas? Are vaccines being made available to those serving overseas?


ANSWER: The Office of Medical Services expects the H1N1 vaccine will be available to most of our overseas missions sometime in December.

Because of the extremely limited amounts of vaccine available to the Department of State through the Centers for Disease Control and Prevention, the Office of Medical Services is purchasing additional H1N1 vaccine doses from the Department of Defense for shipment overseas to try to address our needs.

The Office of Medical Services already has shipped its initial allotments of the vaccine to Baghdad and Kabul where employees live in barrack-like conditions. The next distribution priority is to hardship posts where local medical care is inadequate, and these shipments have begun.

H1N1 remains sensitive to Tamiflu and Relenza, therefore all posts overseas have been stocked with enough of these anti-viral drugs to treat all individuals at post.

* * *

Would you zap me an email if you don’t get it by December? Excerpt below from U.S. Government Pandemic Policy for Americans Abroad, in case you have not seen it:

It is U.S. Government policy for all overseas employees under Chief of Mission authority and their accompanying dependents to plan for the possibility that they will remain abroad during a severe pandemic. Information for both official and private Americans on how to prepare for this possibility is contained in the flyer “ Options During a Pandemic ,” which urges Americans to maintain adequate provisions for a pandemic wave or waves that could last from two to twelve weeks.

Once the World Health Organization (WHO) confirms a severe pandemic, American citizens (including non-emergency government personnel and their dependents, as well as private citizens) who are residing or traveling overseas should consider returning to the United States while commercial travel options are still available. Americans will be permitted to re-enter the United States, although the U.S. Department of Health and Human Services/Centers for Disease Control and Prevention (HHS/CDC) may quarantine or isolate incoming travelers, depending on their health status and whether they are traveling from or through an area affected by pandemic influenza.

In the event of a severe pandemic, non-emergency U.S. Government employees and all dependents in affected areas will be encouraged to return to the United States while commercial transportation is still available. U.S. Government employees who return to the United States will be expected to work there during the pandemic unless they take leave. Private American citizens should make an informed decision: either remain abroad to wait out the pandemic, as noted above, or return to the United States while this option still exists. Any American (whether overseas in a private capacity or a U.S. Government employee or dependent) who chooses not to return to the United States via commercial means might have to remain abroad for the duration of the pandemic if transportation is disrupted or borders close. Americans should be aware that only in cases of a complete breakdown in civil order within a country will the U.S. Government consider a U.S. Government-sponsored evacuation operation.

Continue reading here:

Related Item:
Fact Sheet: 2009-H1N1, Pandemic Influenza, and H5N1 | HTML
The Atlantic: Does the Vaccine Matter | November 2009

Related articles by Zemanta

Leave a comment

Filed under Americans Abroad, Bugs, Evacuations, Foreign Service, Pandemic

In the Loop’s Name That Flu Contest Winners

According to Al Kamen, In the Loop’s Name the Flu contest was aimed at finding a moniker catchier than H1N1, neutral on Mexico and fair to America’s pork producers.

Apparently many hundreds of entries were received – “from as far away as Afghanistan, Slovakia, El Salvador and New Zealand — sifted themselves into broad categories: slams on 24/7 media hype; plays on the H1N1 name, some trying to work out anagrams that will be easier for people to remember; and creative ways to avoid defaming Mexico or speaking ill of pigs.”

CNN Flu, Fox News Flu, Ponzi Flu, NAFTA Flu, PC flu – were among the entries that got special mention in Al Kamen’s column on June 19. Not terribly exciting submissions or creative submissions I must say. A Foreign Service officer in El Salvador did submit “Y2K Flu,” adding: “The same hype and senseless waste of money. Twice.”

But — none of the names submitted would remind you to run to the bathroom and wash your hands one more time. The PONZI flu may remind you to check your wallet. The PC flu may urge you to check your computer’s temperature … you know what I mean? We need something bulky, severe and scary like SARS; just saying it out loud is big thud, a sure attention getter. We need something solid like that.

Read the results here.

Leave a comment

Filed under Current Stuff, Miscellaneous, Pandemic

In the Loop Name the Flu Contest

Al Kamen over in TWP’s In the Loop is running a Name the Flu contest. He wanted a better name for this thing – something more accurate than “swine flu,” less wonky than “H1N1,” in case this virus returns big in the fall. I agree that the name should be “something bold like SARS,” perhaps even catchy (but short). It might help folks remember to wash their hands or cover their mouth when they sneeze.

The 10 winners are promised fine-quality, In the Loop T-shirts. Send your entries via e-mail to nametheflu@washpost.com or mail them to In the Loop, The Washington Post, 1150 15th St. NW, Washington, D.C. 20071.You must include a phone number — home, work or cell — to be eligible. Just passing this along.

Deadline for entries is midnight this Wednesday, May 13. Read Al’s post here.

Doesn’t say anywhere that you must limit your entry to one — so go for it! Can you come up with your top ten names for this thingy?

Leave a comment

Filed under Current Stuff, Miscellaneous, Pandemic

Criminals Exploiting Swine Flu Outbreak?

On 30 April 2009, the INTERPOL warned of criminals potentially exploiting the swine flu outbreak through spam emails and websites selling illegal, unlicensed or fake medicine. Below is the media release; click here for the original post:

Unlicensed and illegal internet pharmacies take orders and payments with no assurance of the goods being delivered and those customers receiving goods have no guarantee of the safety, quality or effectiveness of the drugs, thereby seriously putting their health at risk.

Transactions via this type of unregulated sites also greatly increase the chances of cybercriminals stealing an individual’s credit card details and users’ computers being infected with password stealing viruses.

“It has been seen time and time again that following a global threat or natural disaster, criminals exploit the situation for their own financial gain and in this situation they are searching to take advantage of people’s fears about their health,” said INTERPOL’s Executive Director of Police Services, Jean-Michel Louboutin.

“By responding to spam swine flu emails or attempting to order medication online through illegal and unregulated websites, people are risking their wellbeing and their money.

“Any unsolicited emails containing deals or links to websites offering swine flu-related information packs or medicines should be treated with extreme caution,” added Mr Louboutin.

Internet security firms are reporting that around three to four per cent of spam mails currently being circulated are related to swine flu, with this number expected to increase. Similarly, hundreds of new web pages related to swine flu have been created in the past week.

Criminal organizations and individuals involved in the production of counterfeit pharmaceuticals may also attempt to take advantage of the current health situation through the manufacture of fake antiviral drugs.

“Any product which can be manufactured can be counterfeited, and while there is so far no evidence to suggest that fake antivirals are being manufactured in response to the swine flu outbreak, this is an area which we will continue to monitor in order to identify any cases if or when they emerge,” said Mr Louboutin.

Anyone seeking official updates and information about swine flu should consult the website of the World Health Organization (WHO) which is leading the global response to the outbreak.

For individual countries’ guidelines people should consult their national health authority website.


For flu treatment and devices, check out the CDC’s Swine Flu: Emergency Use Authorization (EUA) of Medical Products and Devices page.

What are the products currently under EUA?

Tamiflu (oseltamivir)

Relenza (zanamivir)

Swine Flu Test Kit


Click here for CDC’s What’s New on Swine Flu site. You can keep up with updates from the Centers for Disease Control and Prevention on the swine flu (now called H1N1) flu investigation by signing up for email updates, subscribing to RSS, or following CDC on Twitter.

Leave a comment

Filed under Americans Abroad, Current Stuff, Foreign Service, Pandemic, Technology

Criminals Exploiting Swine Flu Outbreak?

On 30 April 2009, the INTERPOL warned of criminals potentially exploiting the swine flu outbreak through spam emails and websites selling illegal, unlicensed or fake medicine. Below is the media release; click here for the original post:

Unlicensed and illegal internet pharmacies take orders and payments with no assurance of the goods being delivered and those customers receiving goods have no guarantee of the safety, quality or effectiveness of the drugs, thereby seriously putting their health at risk.

Transactions via this type of unregulated sites also greatly increase the chances of cybercriminals stealing an individual’s credit card details and users’ computers being infected with password stealing viruses.

“It has been seen time and time again that following a global threat or natural disaster, criminals exploit the situation for their own financial gain and in this situation they are searching to take advantage of people’s fears about their health,” said INTERPOL’s Executive Director of Police Services, Jean-Michel Louboutin.

“By responding to spam swine flu emails or attempting to order medication online through illegal and unregulated websites, people are risking their wellbeing and their money.

“Any unsolicited emails containing deals or links to websites offering swine flu-related information packs or medicines should be treated with extreme caution,” added Mr Louboutin.

Internet security firms are reporting that around three to four per cent of spam mails currently being circulated are related to swine flu, with this number expected to increase. Similarly, hundreds of new web pages related to swine flu have been created in the past week.

Criminal organizations and individuals involved in the production of counterfeit pharmaceuticals may also attempt to take advantage of the current health situation through the manufacture of fake antiviral drugs.

“Any product which can be manufactured can be counterfeited, and while there is so far no evidence to suggest that fake antivirals are being manufactured in response to the swine flu outbreak, this is an area which we will continue to monitor in order to identify any cases if or when they emerge,” said Mr Louboutin.

Anyone seeking official updates and information about swine flu should consult the website of the World Health Organization (WHO) which is leading the global response to the outbreak.

For individual countries’ guidelines people should consult their national health authority website.


For flu treatment and devices, check out the CDC’s Swine Flu: Emergency Use Authorization (EUA) of Medical Products and Devices page.

What are the products currently under EUA?

Tamiflu (oseltamivir)

Relenza (zanamivir)

Swine Flu Test Kit


Click here for CDC’s What’s New on Swine Flu site. You can keep up with updates from the Centers for Disease Control and Prevention on the swine flu (now called H1N1) flu investigation by signing up for email updates, subscribing to RSS, or following CDC on Twitter.

Leave a comment

Filed under Americans Abroad, Current Stuff, Foreign Service, Pandemic, Technology

All US Posts in Mexico Suspend Services

The US Embassy in Mexico has released an April 27 Public Announcement Update on the flu outbreak in the country. The US Embassy in Mexico City and all U.S. Consulates throughout the country have now suspended all non-essential services to the public until May 6.

“On April 27, the Government of Mexico announced that as a precautionary measure, all schools throughout the country from kindergarten through university level will remain closed until May 6. All government-sponsored events involving large crowds in Mexico City have also been canceled, and museums and most tourist attractions are closed.
[…]
Additionally, U.S. consulates in Mexico will suspend some nonimmigrant visa operations until May 6, but may see a limited number of applicants. More information will be provided on April 28, 2009 about nonimmigrant visa operations at U.S. consulates. If visa operations need to be suspended beyond May 6, we will inform the public as soon as possible.”

The announcement also states that operations at the U.S. consular agencies throughout Mexico may be curtailed. “Several are closing to the public entirely for walk-in services, seeing the public by appointment only.”

The US Mexico Mission covers all the nine US Consulates in Ciudad Juarez, Guadalajara, Hermosillo, Matamoros, Merida, Monterrey, Nogales, Nuevo Laredo, Tijuana and the 13 Consular Agencies in Acapulco, Cabo San Lucas, Cancún, Ciudad Acuña, Cozumel, Ixtapa/Zihuatanejo, Oaxaca, Piedras Negras, Playa del Carmen, Puerto Vallarta, Reynosa, San Luis Potosí and San Miguel de Allende.

See US Embassy Mexico’s Public Announcement page.


Updated: 1:08 PM

I should add that according to the WHO update (see Epidemic and Pandemic Alert and Response for daily update) as of 27 April 2009, the United States Government has reported 40 laboratory confirmed human cases of swine influenza A(H1N1), with no deaths. Mexico has reported 26 confirmed human cases of infection with the same virus, including seven deaths. Canada has reported six cases, with no deaths, while Spain has reported one case, with no deaths.

Although the alert has been bumped up to phase 4, the WHO advises no restriction of regular travel or closure of borders. “It is considered prudent for people who are ill to delay international travel and for people developing symptoms following international travel to seek medical attention, in line with guidance from national authorities. There is also no risk of infection from this virus from consumption of well-cooked pork and pork products. Individuals are advised to wash hands thoroughly with soap and water on a regular basis and should seek medical attention if they develop any symptoms of influenza-like illness.”

Related Post:

Related Items:

Leave a comment

Filed under Americans Abroad, Current Stuff, Foreign Service, Pandemic, Realities of the FS, U.S. Missions

All US Posts in Mexico Suspend Services

The US Embassy in Mexico has released an April 27 Public Announcement Update on the flu outbreak in the country. The US Embassy in Mexico City and all U.S. Consulates throughout the country have now suspended all non-essential services to the public until May 6.

“On April 27, the Government of Mexico announced that as a precautionary measure, all schools throughout the country from kindergarten through university level will remain closed until May 6. All government-sponsored events involving large crowds in Mexico City have also been canceled, and museums and most tourist attractions are closed.
[…]
Additionally, U.S. consulates in Mexico will suspend some nonimmigrant visa operations until May 6, but may see a limited number of applicants. More information will be provided on April 28, 2009 about nonimmigrant visa operations at U.S. consulates. If visa operations need to be suspended beyond May 6, we will inform the public as soon as possible.”

The announcement also states that operations at the U.S. consular agencies throughout Mexico may be curtailed. “Several are closing to the public entirely for walk-in services, seeing the public by appointment only.”

The US Mexico Mission covers all the nine US Consulates in Ciudad Juarez, Guadalajara, Hermosillo, Matamoros, Merida, Monterrey, Nogales, Nuevo Laredo, Tijuana and the 13 Consular Agencies in Acapulco, Cabo San Lucas, Cancún, Ciudad Acuña, Cozumel, Ixtapa/Zihuatanejo, Oaxaca, Piedras Negras, Playa del Carmen, Puerto Vallarta, Reynosa, San Luis Potosí and San Miguel de Allende.

See US Embassy Mexico’s Public Announcement page.


Updated: 1:08 PM

I should add that according to the WHO update (see Epidemic and Pandemic Alert and Response for daily update) as of 27 April 2009, the United States Government has reported 40 laboratory confirmed human cases of swine influenza A(H1N1), with no deaths. Mexico has reported 26 confirmed human cases of infection with the same virus, including seven deaths. Canada has reported six cases, with no deaths, while Spain has reported one case, with no deaths.

Although the alert has been bumped up to phase 4, the WHO advises no restriction of regular travel or closure of borders. “It is considered prudent for people who are ill to delay international travel and for people developing symptoms following international travel to seek medical attention, in line with guidance from national authorities. There is also no risk of infection from this virus from consumption of well-cooked pork and pork products. Individuals are advised to wash hands thoroughly with soap and water on a regular basis and should seek medical attention if they develop any symptoms of influenza-like illness.”

Related Post:

Related Items:

Leave a comment

Filed under Americans Abroad, Current Stuff, Foreign Service, Pandemic, Realities of the FS, U.S. Missions

PSA: CDC Symptoms of Swine Flu

More CDC videos on YouTube here.
Click here for other video downloads/podcast/transcript)

The CDC has also released tips on What You Can Do to Stay Healthy and every day preventive actions.


There are everyday actions people can take to stay healthy.

  • Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.

  • Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hands cleaners are also effective.
  • Avoid touching your eyes, nose or mouth. Germs spread that way.


Try to avoid close contact with sick people.

  • Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people.

  • If you get sick, CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.

Leave a comment

Filed under Americans Abroad, Current Stuff, Pandemic

PSA: CDC Symptoms of Swine Flu

More CDC videos on YouTube here.
Click here for other video downloads/podcast/transcript)

The CDC has also released tips on What You Can Do to Stay Healthy and every day preventive actions.


There are everyday actions people can take to stay healthy.

  • Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.

  • Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hands cleaners are also effective.
  • Avoid touching your eyes, nose or mouth. Germs spread that way.


Try to avoid close contact with sick people.

  • Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people.

  • If you get sick, CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.

Leave a comment

Filed under Americans Abroad, Current Stuff, Pandemic