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Cablegate: Avian Influenza Update

VZCZCXRO3038
RR RUEHCHI RUEHDT RUEHHM RUEHNH
DE RUEHVN #0004/01 0020956
ZNR UUUUU ZZH
R 020956Z JAN 08
FM AMEMBASSY VIENTIANE
TO RUEHC/SECSTATE WASHDC 1726
INFO RUCNASE/ASEAN MEMBER COLLECTIVE
RUEHBJ/AMEMBASSY BEIJING 2229
RUEHBS/AMEMBASSY BRUSSELS 0332
RUEHBY/AMEMBASSY CANBERRA 1045
RUEHNE/AMEMBASSY NEW DELHI 0151
RUEHFR/AMEMBASSY PARIS 0253
RUEHRO/AMEMBASSY ROME 0132
RUEHKO/AMEMBASSY TOKYO 1221
RUEHCN/AMCONSUL CHENGDU 0226
RUEHCHI/AMCONSUL CHIANG MAI 0608
RUEHHK/AMCONSUL HONG KONG 7803
RUEHGV/USMISSION GENEVA 0621
RUEHIN/AIT TAIPEI 0149
RUEAIIA/CIA WASHDC
RUEHPH/CDC ATLANTA GA
RHHMUNA/CDR USPACOM HONOLULU HI
RUEHRC/DEPT OF AGRICULTURE WASHINGTON DC
RUEAUSA/DEPT OF HHS WASHINGTON DC
RUEKJCS/SECDEF WASHINGTON DC

UNCLAS SECTION 01 OF 06 VIENTIANE 000004

SIPDIS

SIPDIS

DEPT FOR G/AIAG (AMB LANG, PATTERSON, SUMMERS)
DEPT FOR EAP/MLS (BESTIC)
DEPT FOR CA/OCS/ACS/EAP
DEPT FOR EAP/EX
DEPT FOR EAP/EP
DEPT FOR INR
DEPT FOR OES/STC (BATES)
DEPT FOR OES/IHA (SINGER, COMELLA)
DEPT FOR MED
DEPT FOR H

STATE PASS TO USAID FOR ANE AND GH (CARROLL, CLEMENTS, JENNINGS)

STATE PASS TO USTR (BISBEE)

STATE PASS TO HHS/OGHA (WSTEIGER, ELVANDER, ABHAT)

CDC FOR NANCY COX
CDC FOR ANN MOEN
CDC FOR TONY MOUNTS

USDA WASHINGTON DC PASS TO APHIS

SECDEF FOR OSD/ISA/AP (STERN, SHUBERT)

BANGKOK FOR RMO
BANGKOK FOR USAID (MACARTHUR, BOWES)
BANGKOK FOR USDA/APHIS (CARDENAS)
BANGKOK FOR USCDC (MALONEY, ZIMMERMAN)

HANOI FOR DAVID DENNIS

PHNOM PENH FOR WILLIAM BRADY

ROME FOR FAO

USPACOM FOR FPA CHRISTIE
USPACOM FOR PACAF/SGZ (CINCO, PALMER)
USPACOM FOR J-52 (LACY)

E.O. 12958: N/A
TAGS: TBIO KFLU KPAO SOCI ECON SCUL PREL AMED AMGT CASC
EAGR, EAID, ETRD, MASS, LA
SUBJECT: Avian Influenza Update

REFS: A) 07 VIENTIANE 0705 B) 07 VIENTIANE 0625

VIENTIANE 00000004 001.2 OF 006


1. Summary: There have been no new cases of avian influenza in
humans or birds since the February-March 2007 outbreak. Progress in
enhancing the GOL's laboratory diagnostic capacity continues. The
GOL has reiterated its commitment to sharing viral isolates. A
PACOM-supported training exercise in August brought the Lao military
into AI planning or the first time. Another session, again
facilitated by PACOM, will be held on January 14-18. A
UN-coordinated AI planning exercise, long stalled due to turf
battles, finally took place in December. CDC has been involved in
numerous other initiatives, including private sector engagement, an
AI hot line, poultry safety workshops, and donation of more than
6000 sets of protective gear. USDA/APHIS, in partnership with CDC,
is conducting veterinary training. End summary.

No New Cases
------------

2. (U) No H5N1 human cases or bird/poultry outbreaks have occurred
since February/March 2007. Nevertheless, vigilance continues given
regional findings, including the first human case recognition in
neighboring Burma.

Enhancing Local Capacity
------------------------

3. (U) Considerable progress has been made in advancing laboratory
diagnostic capabilities at the National Center for Laboratory and
Epidemiology (NCLE). There have also been improvements to
Influenza-like Illness (ILI) surveillance efforts, taking into
account recommendations from the U.S. CDC-WHO Lao Collaboration

VIENTIANE 00000004 002.2 OF 006


Surveillance Assessment held October 2007.

4. (U) The enhancement of cell culture diagnostic capacity through
improved bio-safety enhancements is underway, supported by the U.S.
CDC-WHO Lao Collaboration in cooperation with Pasteur Institute.
This is a prerequisite for NCLE's designation by the WHO as a
National Influenza Center (NIC). Additionally, significant changes
to ILI surveillance strategy are being implemented to better capture
suspected and probable human H5N1 cases, again based on the October
2007 Assessment findings. Real-time Polymerase Chain Reaction
(PCR), stood up with assistance from NAMRU-2 Jakarta, is now used to
complement Reverse Transcriptate-PCR findings, used in the detection
of the first two human cases in Laos during the February/March 2007
outbreak. (Note: These are two different diagnostic technologies.
End note.)

Sharing of Viral Isolates
-------------------------

5. (U) In December 2007, the Government of Laos (GOL) reaffirmed its
commitment to the National Institute for Infectious Diseases (NIID)
Tokyo, via U.S. CDC Laos, that it would share influenza viral
isolates and data with the U.S. CDC Atlanta. The GOL originally
made this commitment in a letter to the U.S. CDC Laos AI Coordinator
in August 2007 (Ref A). NIID failed to respond to the August 2007
letter but has since acknowledged this December 2007 directive from
the GOL.

Military Cooperation
--------------------

6. (U) Planning is underway for an Avian and Pandemic Influenza

VIENTIANE 00000004 003.2 OF 006


Rapid Response Training Workshop, to be held on January 14-18, 2008.
In December, representatives from the Pacific Air Force Office of
International Health Affairs, Honolulu (PACAF SGZ), COL John Cinco
and MAJ Wesley Palmer, held planning sessions in Vientiane with UN
and GOL stakeholders, including LTC Dr. Chanthaphone Oudomsouk,
Chief of Disease Prevention Division, Medical Department, Ministry
of National Defense (MND), and LTC Dr. Xaysaveng Phommatha, Director
General, Institute of Disease Prevention, MND). The National Avian
and Human Influenza Coordinating Office (NAHICO), which coordinates
AI activities under the authority of the GOL's Prime Minister's
Office, will host the session, with significant assistance from the
Embassy. This initiative builds on momentum gained from a
PACOM-supported Avian Influenza Table Top Exercise Workshop, held on
August 2-3, 2007. The purpose of that workshop was to elevate the
role of the Lao Military in contributing to National AI response and
containment efforts (Ref B). In addition, military and health
officials took part in AI training hosted by PACOM's Center for
Excellence in Disaster Management & Humanitarian Assistance Studies.


Planning Exercises
------------------

7. (U) The U.S. CDC-WHO Lao Collaboration sponsored a series of
Pandemic Planning activities intended to promote the planning
process, culminating in a PANSTOP Exercise in December 2007. This
effort had been stalled, in large part due to conflicting approaches
within the UN organization including differences between the WHO and
the UN AI Coordinating Office, Laos. The participation of Dr. Mark
Keim of US CDC in Atlanta at this forum should lead to future
opportunities to take better advantage of unique U.S. CDC expertise
and experience in facilitating the pandemic planning process in

VIENTIANE 00000004 004.2 OF 006


Laos. Planning activities since October 2007 have focused on
organizing various departments in the Ministry of Health, in order
to promote planning in other sectors.

Engagement with NGOs and Private Sector
---------------------------------------

8. (U) The U.S. CDC Laos is cooperating with the Keenen Institute
Bangkok, supported by USAID, to engage the Lao private sector in
contributing to AI promotional and educational efforts. A workshop
forum organized by NAHICO will bring together Information Education
Committee (IEC) partners to better appreciate the advantages of
working with the private sector. This forum will be held in
Vientiane on January 11, 2008.

9. (U) The NAHICO "hotline" supported by the U.S. CDC-WHO Laos
Collaboration in partnership with CARE INTERNATIONAL/Laos and the UN
AI Coordinating Office became functional in December 2007. Software
programming design is in progress to allow for ongoing evaluations
of the system in facilitating AI communications and reporting.

10. (U) Care International/Laos, with support from the U.S. CDC,
will be conducting a Safe Poultry Practices Workshop in Laos'
Sayabouri Province on January 9-11, 2008. Assistance will be
provided by the USDA/APHIS in-country Representative, a Lao
national, working under the U.S. CDC banner. This activity is part
of a larger U.S. CDC-CARE effort to improve AI surveillance and
reporting in remote highland ethnic communities. A similar type of
workshop focused on Live Birds and Wet Markets was carried out by
Care International/Laos in November 2007 with support from USAID/Abt
Associates, with U.S. CDC (and USDA-APHIS) Lao participation.


VIENTIANE 00000004 005.2 OF 006


Protective Equipment
--------------------

11. (U) On November 27, 2007, the U.S. Embassy provided 6,000 sets
of personal protective equipment (PPE) from the U.S. CDC to the
Ministry of Health's National Center for Laboratory and Epidemiology
(NCLE) to help ensure the safety and well-being of rapid responders
and laboratory personnel while combating the threat of Pandemic
Avian and Human Influenza. Dr. Chanthanom Manodham, Director of the
Cabinet of the Ministry of Health (MOH), accepted the donation for
the GOL. An additional 4000 units of PPE have been received from
USAID Washington and will be distributed to the National Center for
Animal Health, MOH, and the Lao Military in January 2008.

Veterinary Training
-------------------

12. (U) USDA/APHIS, working with U.S. CDC Lao assistance and under
the U.S. CDC Lao banner, provided support for 11 Lao Veterinary
laboratory staff to attend two two-week regional training workshops
in Vietnam in November and December 2007. The goal of these
workshops was better cooperation between Lao and Vietnamese
laboratory veterinary specialists. The U.S. CDC AI Coordinator and
USDA/APHIS Lao Representative met subsequently with the returning
Lao staff members along with Dr. Bounlom, Director of the National
Center for Animal Health, to build on the training momentum in
developing a National Veterinary AI Testing Protocol. This Protocol
is designed to standardize procedures and force clear determination
with regard to the type of testing to be carried out at national,
provincial, and district levels and the types of equipment,
training, and supervision required to do so. Monthly meetings will
now be conducted during 2008 to formulate the details of this plan.

VIENTIANE 00000004 006.2 OF 006


MCGEEHAN

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