U.S. Citizen Services

Advisories for Americans in Saudi Arabia

Talking Points for Consular Sections

• Recent confirmation that avian influenza caused by the H5N1 virus has spread to birds outside the original countries affected has highlighted the potential for a pandemic affecting both birds and humans.

• Confirmed cases of bird-to-human transmissions of avian influenza have occurred in the South East Asia region since 1997. Approximately 50% of these cases have resulted in death. The World Health Organization website provides up-to-date information on the countries affected and the number of deaths.

• The vast majority of the known human cases have resulted from direct contact with poultry, and there is only limited evidence to suggest possible human-to-human transmission.

• Concerns about the possibility of an avian influenza pandemic have prompted international and national efforts to institute pandemic preparedness measures. The Department of State is working with its embassies and consulates worldwide to prepare in the event of a pandemic.

• American citizens traveling to or living in countries where avian influenza is prevalent should consider the potential risks and keep informed of the latest medical guidance and information in order to make appropriate plans.

• The Department has asked its embassies and consulates to consider preparedness measures that take into consideration the fact that travel into or out of a country may not be possible, safe or medically advisable in the event of a pandemic.

• In making contingency plans for the official American community, we will look to guidance from the World Health Organization and the Centers for Disease Control, as conveyed through the Department s Medical Director.

• We will inform the American community about measures the Department takes with respect to its employees and their families, so that you can factor this into your own personal plans.

• A specific vaccine for humans that is effective against avian influenza has been tested but is not yet commercially available. Based upon limited data, the Center for Disease Control has suggested that the anti-viral medication oseltamavir (brand name-Tamiflu) may be effective in preventing or treating avian influenza.

• Embassies and Consulates are pre-positioning Tamiflu for eligible U.S. Government employees and their families serving abroad.

• There is no provision or legal authority that allows the U.S. government to provide American citizens traveling or living abroad with medications, including in the event of a pandemic.

• Tamiflu may not be readily available overseas, and American citizens traveling or living abroad who are interested in obtaining this medication are encouraged to consult with their physician.


• The exact effectiveness of Tamiflu in treating or preventing avian influenza is uncertain, and travelers should not rely on it as their only means of protection. Travelers should avoid live poultry. If in an area where human cases of avian influenza are occurring, travelers should consider avoiding crowded areas, such as markets and public transportation.

• Specific Centers for Disease Control travel information relating to avian influenza, including preventive measures, is available at http://www.cdc.gov/flu/avian/index.htm. World Health Organization guidance related to avian influenza is available at http://www.who.int/csr/disease/avian_influenza/en/

Questions and Answers:

Why isn’t the USG providing Tamiflu to private Americans overseas?

The Department of State lacks the legal authority to provide any type of medication, including Tamiflu, to private American citizens. State Department physicians and medical staff have an obligation to treat only those official employees, and their families, who are under Chief of Mission authority.

Will you evacuate Americans in the event of a pandemic?

Current medical thinking suggests that a stay in place response to a pandemic may be appropriate in certain countries or regions. In this scenario, people would be advised to exercise social distancing and avoid any form of public gathering where transmission of the disease could occur. Airplanes are a common venue for human-to-human transmission of viral infections due to proximity of travelers and recycling of air within the cabin. People who are not comfortable with this scenario should consider these factors when making their plans.

Whether the U.S. Government evacuates anyone will depend on a variety of factors specific to individual countries. Each U.S. Embassy has been asked to develop a contingency plan in the event of a pandemic, and to identify events that might prompt them to send employees and/or their dependents out of the country, assuming such travel is possible. Should the decision be made to send Embassy employees and/or their dependents out of a country, we will communicate this to the private American community so that people can plan accordingly. As in any other crisis, we will assess the availability of commercial transportation, the ability of people to travel to the United States or a third country, and other related factors in deciding on appropriate actions to assist Americans.

Should I begin taking antiviral medications such as Tamiflu if I'm planning a visit to Saudi Arabia?

Tamiflu (oseltamivir) is not available in Saudi Arabia. Travelers to any country that has reported cases of H5N1 among birds or humans should consider scheduling an appointment with their health care provider before traveling to discuss risks for potential exposure to H5N1. Risk of exposure and the decision to take a drug like Tamiflu, which, as yet, has no proven role for preventing human H5N1 infections, must be determined on a case-by-case basis. Only you and your health care provider can determine that risk and what the most appropriate precautions are for you.

Is it safe to eat poultry and eggs in Saudi Arabia?

Proper cooking of poultry will destroy the virus. There have been no reported human cases of avian influenza contracted from consumption of well-cooked poultry or eggs. Both humans and animals have contracted avian influenza from eating undercooked poultry products. Best practices during handling of raw poultry meat and usual recommended cooking practices for poultry products should be followed to lower the risk of common bacterial diseases spread by poor handling and cooking techniques. Eggs from infected poultry could also be contaminated with the virus and therefore care should be taken in handling eggs or raw egg products. Guidance on handling food to avoid spreading the virus is available on the websites for the Centers for Disease Control, the U.S. Department of Agriculture, and the World Health Organization.


What are the travel recommendations regarding the H5N1 bird flu outbreak in Asia?

The U.S. Centers for Disease Control in Atlanta currently advises that travelers to countries in Asia with known outbreaks of influenza A (H5N1) avoid poultry farms, contact with animals in live food markets, and any surfaces that appear to be contaminated with feces from poultry or other animals. For more information about travel recommendations, visit the Centers for Disease Control website at http://www.cdc.gov/travel/seasia.htm#country.

Do High Efficiency Particulate Air (HEPA) filters on airplanes offer protection?

Yes, if they are true HEPA filters, but many planes are not equipped with them. Airplanes are a common venue for human-to-human transmission of viral infections due to proximity of travelers and recycling of air within the cabin. You should not travel if you are ill or have a fever. If a neighbor is coughing or appears ill near you, move and tell the flight attendant. This is particularly important if you are flying from a country that has documented avian influenza cases in humans.

If I live in an area where diagnostic tests for AI are not available and I become sick with flu like symptoms, should I fly out?

If you develop influenza symptoms and are in a country known to have H5N1 among birds and/or humans, it is important to get immediate medical care. For this reason, you should visit your local doctor for treatment.

Are children more susceptible?

The World Health Organization and the Centers for Disease Control believe that children may be more susceptible due to their increased proximity socializing at schools and day care centers, as well as being more likely to come into contact with poultry or bird fecal matter during their play habits. It is unknown whether immunity differences in children have any significance, since we presume that the vast majority of humans have no immunity against the H5N1 virus.