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Cablegate: Bird Flu in Morrelganj - Outbreak Management Case Study

VZCZCXRO5755
OO RUEHAST RUEHBI RUEHCI RUEHHM RUEHLH RUEHLN RUEHMA RUEHPB RUEHPOD
RUEHPW
DE RUEHKA #0193/01 0430812
ZNR UUUUU ZZH
O 120812Z FEB 08
FM AMEMBASSY DHAKA
TO RUEHC/SECSTATE WASHDC IMMEDIATE 6198
INFO RUEHRO/AMEMBASSY ROME PRIORITY 0454
RUEKJCS/SECDEF WASHDC
RUEHRC/DEPT OF AGRICULTURE WASHDC
RUEAUSA/DEPT OF HHS WASHDC
RUCPDOC/DEPT OF COMMERCE WASHDC
RUEHPH/CDC ATLANTA
RUEAIIA/CIA WASHINGTON DC
RUEKDIA/DIA WASHDC
RHHMUNA/CDR USPACOM HONOLULU HI
RUEHNE/AMEMBASSY NEW DELHI 0472
RUEHBI/AMCONSUL MUMBAI 0289
RUEHCG/AMCONSUL CHENNAI 0956
RUEHCI/AMCONSUL KOLKATA 1143
RUEHGV/USMISSION GENEVA 0649
RUEHUL/AMEMBASSY SEOUL 0312
RUEHKT/AMEMBASSY KATHMANDU 9521
RUEHLM/AMEMBASSY COLOMBO 8300
RUEHIL/AMEMBASSY ISLAMABAD 2023
RUEHBK/AMEMBASSY BANGKOK 8399
RUCNCLS/ALL SOUTH AND CENTRAL ASIA COLLECTIVE
RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE

UNCLAS SECTION 01 OF 05 DHAKA 000193

SIPDIS

SENSITIVE NOFORN
SIPDIS

USDA FOR DEPUTY UNDER SECRETARY/ETERPSTRA
USDA FOR OFSO/JDEVER
USDA FOR FAS/OA/MYOST/WKMILLER
USDA FOR FAS/OCRA/CALEXANDER/JCARVER
USDA FOR FAS/OSTA/CHAMILTON
USDA FOR APHIS/MFLEMINGS/TBURLESON
USAID FOR GH/HIDN/DCARROLL/MTROSTLE
USAID FOR ANE/SAA/FFULLER
USAID FOR ANE/TS/ACLEMENTS
SEOUL FOR APHIS/GEORGE ANDY BALL
BANGKOK FOR USAID
NEW DELHI FOR FAS
STATE FOR SCA, OES, SA/INS, EB/TPP, AVIAN INFLUENZA ACTION GROUP
DEPT PLS PASS CDC - COX AND BLOUNT AND HHS - STEIGER AND HICKEY

E.O. 12958: N/A
TAGS: KFLU EAGR PGOV PREL ECON ETRD WTO TBIO CASC AMED IN
BG

SUBJECT: BIRD FLU IN MORRELGANJ - OUTBREAK MANAGEMENT CASE STUDY

REF: DHAKA 00131

DHAKA 00000193 001.2 OF 005


1. (SBU) SUMMARY: An interagency assessment team (IAT) from State,
DOD, and USAID has been in southern Bangladesh's Khulna and Barisal
Divisions conducting an assessment of the Cyclone Sidr affected area
in support of USG rehabilitation and reconstruction efforts. The IAT
has been tasked to report on any suspected avian influenza (AI)
outbreaks or AI prevention operations encountered. Based on
observations of the IAT at one site (which corroborate second-hand
reports from other locations) post is concerned about serious gaps
and delays in the GOB's response to the current spate of AI
outbreaks occurring across Bangladesh. Direct observations from the
Morrelganj area indicate a general lack of bio-security measures and
AI awareness at the ground level. Post has provided the IAT with
applicable biosecurity directions. Post's Medical Officer has
assessed the risk of the IAT contracting AI as low; the IAT is
self-monitoring for symptoms of illness. END SUMMARY.

2. (SBU) Since January 20, an interagency assessment team (IAT) from
State, DOD, and USAID, has been in Morrelganj Upazila (county),
located in southern Bangladesh's Khulna Division, to conduct
assessments following Cyclone Sidr. On the morning of February 3, a
USAID-funded NGO notified the team that there was a possible
outbreak of avian influenza (AI) in the area. The suspected AI
outbreak occurred at a small-scale poultry farm located in
Morrelganj. This location is approximately one mile from the IAT
base. This area was significantly affected by the cyclone and is
only now beginning to rebuild. The infected farm itself was located
approximately 1/5 mile from the Khashiakhali River and 100 yards
from a pond with a pond sand filter which serves as the main source
of drinking water for the neighborhood.

Farm-Level Observations
-----------------------

3. (U) On February 3 IAT members spoke with the farm owners and
observed a poultry coop. The farmers stated that on February 1,
they observed dead and sick birds on their farm. The farmers
explained that they hired day laborers to remove the dead and sick
birds: they removed approximately 900 birds, leaving 125 apparently
healthy birds. (NOTE: The workers doing the bird removal wore no
special clothing or protective equipment, and likely did not
disinfect their shoes. END NOTE.) The dead birds were buried
adjacent to the chicken coop. The farmers then notified the local
authorities who dispatched a team to investigate. On February 2,
the upazila (administrative unit like a county) livestock officer
and a livestock team sprayed an unknown chemical disinfectant around
the farm area. The livestock officer told the farmers that the
birds likely died of Newcastle Disease (another common cause of
poultry die-offs, distinct from AI) and not AI. Additionally, they
said that they received no advice on to what to do next.

4. (U) The farmers told the IAT that they invested 450,000 taka (USD

DHAKA 00000193 002.4 OF 005


6,600) to establish the farm shortly after Cyclone Sidr. The
farmers had purchased 1,025 hens. The hens were being raised for
eggs and were just starting (before the die-off) to lay enough eggs
for commercial sale. The farmers added that they have not been
compensated for their losses and they have received no commitment
from the government to do so.

5. (U) During the farm visit, the IAT observed a stack of dead
chickens in the coop. Other chickens appeared listless and their
combs drooped. It was readily apparent that the birds not culled
earlier (deemed healthy a day prior) were now dying. Farmers were
handling these birds with bare hands and had no information about
the potential hazards of handling AI-infected poultry. The farmers
said that they have not sold any birds or eggs on the local market.
In the local markets, poultry traders told IAT members that since
there were no AI outbreaks in the area there was nothing to worry
about and they did not need to adopt any special procedures. Even
if some individuals seemed concerned, they seemed unaware of safety
precautions.

6. (U) IAT members spoke with neighbors located within a 200 yard
radius from the affected farm. Some of the neighbors told the team
that they knew about the outbreak but were not concerned. They
added that the local government told them it was Newcastle Disease
so there was nothing to fear. The team observed poultry in this
immediate vicinity, in small backyard holdings. The owners told us
that they were not instructed to do anything specific. One neighbor
informed the team that they previously wanted to vaccinate their
poultry but there was a problem with the vaccine.

Upazila Officials Concerned
----------------------------

7. (SBU) IAT members visited the head of the Upazila administration
(UNO), Krishna Kanta Biswas, to discuss the outbreak. Biswas told
the team that the local government was taking the outbreak very
seriously. He told the IAT that a checkpoint was established in the
northern portion of the upazila to ensure that no poultry entered
the area without a certificate of a being AI-free [COMMENT: No such
certification process exists. END COMMENT] In addition, poultry from
the affected area will not be allowed north of the river to prevent
the potential spread of the disease to other unions (townships) in
the upazila. However, he did not terminate poultry sales in
Morrelganj town.

8. (SBU) On February 3 the local livestock officer sent samples to
the nearest field test center in Barisal, about a 4-5 hour drive
away. The evening of February 3 Biswas received an initial result
from Barisal. Biswas stated that the news was not good, but the
initial finding had to be re-confirmed in Dhaka, suggesting that AI
needed to be evaluated by a subsequent test.

9. (SBU) Biswas told the team that they had previously received

DHAKA 00000193 003.2 OF 005


instructions about what to do in case of a suspected outbreak. He
noted that 5-6 months earlier, there was another suspected outbreak
in the upazila, not far from the present farm, but that a test
returned an inconclusive result due to a poor quality sample.
Biswas also noted that his offices were prepared to deal with an
outbreak and had seven sets of personal protective gear (PPE).
Biswas stated that if AI is confirmed, additional measures would be
taken. Some of these measures listed included culling birds within
a 1KM radius of the farm as well as stopping all poultry and egg
sales in the area. Also, a practice of using poultry waste (feces)
as fish food would be terminated. He did express concern that this
would have a significant economic impact in the area - which is
still recovering from the cyclone. Biswas asked about getting USG
assistance; he asked specifically for a technical expert. The IAT
leader told him that the request would be passed to the Embassy in
Dhaka.

10. (U) On February 4, national newspapers reported an AI outbreak
in Morrelganj. The Bangla paper Shamokal reported the following:
BEGIN TRANSLATED TEXT. At least 900 chickens of a farm died or
culled Sunday due to infection of avian influenza in Morrelganj
upazila of Bagerhat district. After hearing the news, fear spread
among the poultry farmers of the district. District Livestock
office said that red alert has been issued in Morrelganj upazila in
order to prevent spread of the disease. Transfer of all kinds of
poultry from or to Morrelganj has been banned. END TRANSLATED
TEXT.


ACTION: NOT TOO LITTLE, BUT POSSIBLY TOO LATE
---------------------------------------------


11. (SBU) On February 5, Biswas received confirmation from Dhaka
that the samples from Morrelganj were positive for AI. Although
sale of chickens appears to have stopped in the local market, eggs
continued to be sold. By 1800 hours, plans were underway to cull
the infected farm and surrounding areas.

12. (SBU) During the February 5 meeting with Biswas, the local
livestock officer told the IAT that he thought there were three main
causes for the outbreak. These include: (1) the hens were at their
first egg-laying stage and this results in lower immunity; (2) a
recent cold and rain period further reduced immunity; and (3)
vaccination management was poor. The livestock officer told us that
the vaccination procedures and general farm management is not
sufficient to prevent AI outbreaks.

13. (U) On the medical side, Biswas and the local medical officer
noted that the local hospital, located in Hoglabunia, across the
river from the affected area is ready to establish an isolation
ward. They also currently have a stockpile of approximately 100
AviFlu and TamiFlu capsules manufactured in Bangladesh by Square

DHAKA 00000193 004.2 OF 005


Pharmaceuticals. Biswas has already asked for additional
medication, though to date no patients have been admitted to the
hospital from the affected area with any symptoms of AI. Moving
forward, Biswas said he plans a large public information campaign
about the dangers of AI.

14. (SBU) On February 5 culling in Morrelganj began at some point
after 2100 hours and concluded on February 6 at approximately 0430.
Based on second hand reports from villagers, culling within a 1 KM
radius of the infected farm was conducted by 4 teams of 3 persons
each, who wore full-body PPEs with masks. Culled chickens were
placed in plastic bags and buried in holes throughout the area (not
in one consolidated hole.) Biswas was previously aware that the
holes should be approximately 8 feet deep. The IAT was unable to
determine if any disinfection was completed on the infected farm
during or after the culling, or on the culling teams' vehicles'
tires.

15. (SBU) During the culling approximately 30 police and army
personnel were also on hand, but they did not wear PPEs. The numbers
and owners of culled birds were recorded in a register, with a
promise for compensation (of 70 taka per bird - US$1) at a later
time. No further safety or health monitoring information was
provided to the farmers.

16. (SBU) On February 6, the IAT did not see any chickens in the
immediate 1KM vicinity of the infected farm. In the poultry market
2-3 KMs away from the infected farm, traders stated they had been
asked by Biswas to stop sales. Although there were no chickens for
sale, eggs were for sale and one seller offered he could provide
some chickens if the IAT wanted to buy some, albeit at higher
prices. None of the persons encountered in the wet market displayed
any concern about the potential health risks of the confirmed AI
outbreak less than 3KM away. Within a 10 KM zone of the AI infected
farm, free range chickens were observed in yards.

17. (SBU) While leaving Morrelganj on 06 February, the IAT could not
identify any apparent monitoring or restrictions on poultry trade or
movements of poultry into or out of the area (even between
upazillas). Per the GOB plan, there is meant to be a restriction on
poultry movements into or out of a 3KM radius of an infected farm.
It is not evident if or how controls on the poultry trade in the
vicinity of infected farm will be monitored.

18. (SBU) Given that at least three members of the IAT were on an
AI-infected farm during their interviewing of farmers, Post provided
applicable directions to the IAT for disinfecting their shoes,
clothing and the vehicle's wheel rims and tires. Post's RMO has
assessed the risk of the IAT contracting AI as low; the IAT is
self-monitoring for symptoms of illness.

Comment
-------

DHAKA 00000193 005.2 OF 005

19. (SBU) The AI outbreak in the Cyclone Sidr-affected region adds
yet another dimension of health risks and economic losses to an
already devastated area. In the immediate vicinity of the
Morrelganj outbreak many homes remain destroyed. Residents are
seeking funds to rebuild their shelters before the upcoming rainy
season. Poultry and fish are the main sources of protein. Poultry
related work provides income for many of the people in the region.
The government leadership in the areas visited by the IAT appear to
be taking minimum steps necessary to address the AI outbreak. The
entire AI response process appears top-down driven, with little
available resources for local level initiatives or action.

20. (SBU) The manner in which the GOB investigated, responded, and
managed the AI contaminated farm in Morrelganj does not demonstrate
compliance with standard biosecurity protocols and safety practices
and their own outbreak management protocol. AI-related information
for farmers, traders, teams performing culling, and the general
populaceis urgently needed at the local level.

21. (SBU) This is the first time that Post has directly observed the
GOB's management of a poultry die-off and the corresponding response
to a confirmed AI outbreak at a farm. Based on these findings, Post
gives added credence to additional second-hand information received
from other parts of the country reporting similar deficiencies in
the GOB's ground-level response. Post will continue its focused
efforts on augmenting the GOB's AI planning, testing, management and
response capacity. Additional reporting will be provided SEPTEL.

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