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Cablegate: Avian Influenza Update - Wave Dying Out but Sample Sharing

VZCZCXRO5864
RR RUEHCHI RUEHDT RUEHHM RUEHLN RUEHMA RUEHPB RUEHPOD
DE RUEHHI #1265/01 1991733
ZNR UUUUU ZZH
R 181733Z JUL 07
FM AMEMBASSY HANOI
TO RUEHC/SECSTATE WASHDC 5838
INFO RUEHHM/AMCONSUL HO CHI MINH 3368
RUEHZS/ASEAN REGIONAL FORUM COLLECTIVE
RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE
RUEHUL/AMEMBASSY SEOUL 3179
RUEHKO/AMEMBASSY TOKYO 5746
RUEHHK/AMCONSUL HONG KONG 1234
RUEHGZ/AMCONSUL GUANGZHOU 0817
RUEHCN/AMCONSUL CHENGDU 0314
RUEHIN/AIT TAIPEI 1509
RUEAIIA/CIA WASHINGTON DC
RUEHPH/CDC ATLANTA GA
RUEHRC/DEPT OF AGRICULTURE WASHINGTON DC
RUEAUSA/DEPT OF HHS WASHINGTON DC
RUEKJCS/SECDEF WASHINGTON DC//USDP/ISA/AP//
RHMFISS/CJCS WASHINGTON DC//J2/J3/J5//
RHEFDIA/DIA WASHINGTON DC//DHO-3//
RHMFIUU/CDR USPACOM HONOLULU HI//J00/J2/J3/J5//
RHEFAFM/DIRAFMIC FT DETRICK MD//MA-1A//
RUEHSUN/USUN ROME IT

UNCLAS SECTION 01 OF 04 HANOI 001265

SIPDIS

SENSITIVE
SIPDIS

STATE FOR EAP/MLS, EAP/EP, INR, OES/STC, OES/IHA, MED
STATE PASS TO USAID FOR ANE AND GH
STATE PASS TO HHS/OGHA (STIEGER/VALDEZ/BELL/HICKEY)
CDC FOR OGHA (BLOUT/MCCALL) AND DIV-FLU (COX/MOHEN)
DEPARTMENT OF DEFENSE FOR OSD/ISA/AP (STERN)
HHS PASS TO FIC/NIH (GLASS)
USDA PASS TO APHIS, FAS (OSTA AND OCRA), FSIS
BANGKOK FOR RMO, CDC (MALISON), USAID (MACARTHUR/BRADY)
BEIJING FOR HHS HEALTH ATTACHE (ROSS)
PHNOM PENH FOR CDC INFLUENZA COORDINATOR(BRADY)
ROME FOR FAO
VIENTIANE FOR CDC INFLUENZA COORDINATOR (CORWIN)


E.O. 12958: N/A
TAGS: TBIO AMED AMGT CASC EAGR PINR KFLU VM
SUBJECT: AVIAN INFLUENZA UPDATE - WAVE DYING OUT BUT SAMPLE SHARING
CONTINUES

HANOI 00001265 001.2 OF 004


SENSITIVE BUT UNCLASSIFIED

REF: A. Hanoi 1147 B. Hanoi 890

1. (U) Summary. The Government of Vietnam (GVN) reports no human
cases infected with the H5N1 strain of highly pathologic avian
influenza A (HPAI) beyond the total of five confirmed cases since
May 1. There have been no cases among contacts and no common
sources of infection. Outbreaks of AI in poultry have substantially
dropped off since Post's previous reports. The GVN continues its
fully cooperative stance on sample sharing. End Summary.

Update of Five Human Cases
--------------------------

2. (U) A total of five human cases infected with H5N1 HPAI have been
reported by Ministry of Health (MOH) in 2007 (reftel A). Four were
males; all were young adults aged 19-29 years. Cases resided in
separate provinces all in the northern region of Vietnam. The dates
of onset of illness spanned May 10 to June 3, coincident with the
ascending wave of H5N1 HPAI outbreaks in ducks and chickens in the
region. There were no links between cases or known single source
exposures. Handling of infected poultry identified by epidemiologic
investigations is the most likely mode of infection. Two cases were
fatal; three recovered and have been discharged from hospital. Four
of the five patients required mechanical ventilation and extended
critical care for respiratory failure.

Human and Animal Sample Sharing
-------------------------------

3. (SBU) From the onset of the first human case in May, the MOH has
worked with WHO in an open and transparent fashion to promptly
report human cases, providing laboratory test results. Infection
with H5N1 virus was established in each case by RT-PCR at the MOH's
National Institutes of Hygiene and Epidemiology (NIHE) and confirmed
in specimens from the first two cases by a WHO Influenza
Collaborating Center (i.e., CDC, Atlanta). Sample sharing and its
importance were reported in the local media (reftel B). The
Director of NIHE, Dr. Hien reportedly said that the test results
from CDC were the same as the results NIHE had found when carrying
out the tests here in Vietnam, adding that NIHE would continue to
work jointly with the CDC to decode the H5N1 virus gene and keep
track of its transformation.

4. (SBU) H5N1 virus from the two cases confirmed to date is of
genomic clade 2.3, first identified in a human in Vietnam in October
2005, and endemic since 2005 in southern China and elsewhere in
Indochina. Transfer of specimens from the remaining three cases is
currently in process. Materials transfer issues, mostly external to
GVN, are under intensive review and some have been resolved. Some
of these have been described earlier (reftel A).

5. (SBU) Apart from HPAI, NIHE, which is a WHO-designated National
Influenza Center, routinely shares seasonal influenza isolates with
the WHO Collaborating Center, CDC, Atlanta. NIHE is currently
arranging a July transfer of 50 seasonal influenza virus isolates

HANOI 00001265 002.2 OF 004


comprising subtypes A/H3 and B.

6. (SBU) According to USAID's Regional Development Mission in
Bangkok, Vietnam poultry isolates are being shared among with
international reference laboratories, including those obtained in
the recent two waves of AI outbreaks in poultry that have occurred
since December 2006. Futue reporting will validate this
information and dtail the history and status of animal sample
shaing.

Animal Outbreaks Dropped Off Markedly
------------------------------------

7. (U) Animaloutbreaks due to H5N1 AI have dropped off markedly
Since May 1, there have been over 100 animal AIoutbreaks in 18 of
Vietnam's 64 provinces and muicipalities. The week of June 19 was
the peak o activity with 29 outbreaks recorded, whereas the wek of
July 3 had nine outbreaks and the week of uly 10 had only one.
(Note: See the epidemiologial curve on page 7 of the Food and
Agricultural rganization (FAO) situational update for Vietnam a
http://www.fao.org.vn/new1.pdf. End Note) Accoring to a Ministry
of Agriculture and Rural Develpment (MARD) official, as of July 10,
all but eight provinces have reached the 21-day mark to be declared
AI free.

8. (U) On July 5, the Head of the National AI Prevention and Control
Committee issued instruction No. 25 BNN/CD pertaining to the
continuous enhancement of AI prevention and control activities sent
to all provincial People's Committees, ministries and departments
under the National AI Prevention and Control Committee. The
emergency telegram laid out specific details for re-enforcing
prevention and control efforts.

Media Reports
-------------

9. (U) According to VietNamNet Bridge report on July 11,
agricultural authorities verified a poultry outbreak in Dien Bien
Province. From July 5 to 10, the Provincial Animal Health
Department found six farming families in three communes of Thanh
Yen, Thanh Hung and ThanhXuong in Dien Bien District, where around
500 ofa total 2,400 ducks died. All of the ducks were 25days-old
and had not been vaccinated. Testing dmonstrated H5N1 virus. The
local Bird Flu Contrl Board culled all fowl flocks in the two
communs of Thanh Xuong and Thanh Hung on July 10. The bard asked
the Dien Bien Provincial People's Commitee to announce a bird flu
epidemic in Dien Bien District.

10. (U) According to VietNamNet Bridge report on July 11, the MARD
Vice Minister requested southern provinces to close "egg hatching
areas" that fail to meet the standard to be on alert, adding that a
recent new outbreak in Ca Mau Province could herald new activity in
the southern Mekong Delta. The Provincial Animal Health Department
said possible AI outbreak in the South would be a consequence of
loose control over hatching, raising watery poultry and additional
vaccination. Ca Mau was asked to shut-down non-registered
egg-hatching premises and kill water fowl that are not vaccinated

HANOI 00001265 003.2 OF 004


properly.

USAID, CDC, HHS/OS, and NIH Activities
--------------------------------------

11. (U) The national influenza sentinel surveillance network,
supported by a CDC cooperative agreement with NIHE/MOH, is expanding
from 12 to 15 sites. CDC Influenza Coordinator completed site
evaluations to all but the three newly enlisted sites (i.e., Danang,
Tien Giang and Dong Nai Provinces). All 12 established sites are
fully operational and in high compliance with protocol procedures.


12. (U) The CDC cooperative agreement "Surveillance and Response to
Avian and Pandemic Influenza" with Vietnam Administration for
Preventive Medicine (VAPM)/MOH was activated by transfer of funds
June 2007. The first report of progress indicates a high level of
activity.

13. (U) The CDC cooperative agreement "Community Mobilization for
Enhanced Surveillance and Prevention of Avian Influenza in Vietnam
(Development of a Model)" with CARE reported in June that
project-trained animal and human health workers and village
volunteers at sentinel commune sites, Hai Phong Province were
successful in early detection and reporting of suspected HPAI in
poultry flocks, and in taking appropriate control and prevention
actions.

14. (U) USAID-sponsored plays encourage farmers to take action
against AI. Mobile road shows are helping rural communities in 28
provinces across Vietnam understand the dangers of Avian Influenza
and learn ways to detect and prevent the disease. Implemented by
the Academy for Educational Development (AED), the mobile road shows
include 20-minute plays on avian influenza, which are a combination
of family drama and comedy with essential information about the
disease woven into the plot. Seventy-eight shows are being held
from June to July, in provinces selected by the Department of Animal
Health.

15. (U) To mark the official start of its program in Can Tho, USAID
grantee Abt Associates held a workshop for local authorities, animal
and human health worker in Can Tho province. Within the workshop,
participants discussed ways to increase surveillance and reporting
of suspected AI cases; adopt safer poultry-handling practices and
impact behavior change in farmers, poultry workers and marketers,
health personnel, and the general public.

16. (U) To increasing AI private sector awareness,
USAID-sponsored an AI workshop on June 28, bringing together private
sector animal pharmaceutical and feed companies with local
authorities, to create a strategy for increased engagement of the
private sector in AI awareness-raising. Some 40 participants came
to Hanoi at the invitation of USAID-funded NGO Australian Foundation
for the Peoples of Asia and the Pacific.

17. (U) USAID sponsored the visit of a logistics technical
assistance team to establish an accountability and management system

HANOI 00001265 004.2 OF 004


for AI commodities for USAID partner agencies. The team developed
release protocols and standard operating procedures, reviewed
in-country distribution plans, identified potential logistics
challenges in the storage and distribution of commodities, trained
appropriate personnel in the proper receipt, storage, transportation
of the personal protective equipment and other commodities and
developed replenishment protocols schedules.

18. (SBU) After some challenging negotiations between MOH and
WHO-Vietnam with the assistance of U.S. Embassy Health Attache, MOH
sent a letter confirming receipt and acceptance of selection of
IVAC, Vietnam as the recipient of an over 2 million USD WHO award to
develop a human AI vaccine. This effort is largely funded by
HHS/OS.

19. (U) On August 6-11, the National Institute of Health is planning
two AI-related activities. The first is a workshop, "Avian
Influenza Virus Bioinformatics and Genomics Training Workshop," to
be held (see http://www.bioinfohelpdesk.org/AIV_Hanoi2007/ ). The
objective is to promote surveillance and rapid response to outbreaks
of avian influenza by advancing knowledge of the molecular genetics
of avian influenza viruses. The second is an international
conference co-hosted by NIHE, "NIH Multinatinal Influenza Seasonal
Mortality Study Asia Regional Meeting," (see
http://origem.info/misms/ program.php). Objectives include: i)
review epidemiology of influenza in Asia through presentations of
mortality models, transmission dynamics research, genomic mutation
patterns, and vaccination impact studies; ii) demonstrate utility of
secondary source data to study the epidemiology of influenza; iii)
establish collaborations for binational and multinational studies;
iv) communicate findings to policy makers; and v) analyze data
during a workshop on methodologies for influenza studies, including
possible expansion into discussion of primary data collection and
genomics.

MARINE

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