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Cablegate: Vietnam Avian Influenza Update: Scattered Poultry Outbreaks

VZCZCXRO4892
RR RUEHCHI RUEHCN RUEHDT RUEHHM RUEHLN RUEHMA RUEHPB RUEHPOD
DE RUEHHI #0304/01 0741027
ZNR UUUUU ZZH
R 141027Z MAR 08
FM AMEMBASSY HANOI
TO RUEHC/SECSTATE WASHDC 7412
INFO RUEHHM/AMCONSUL HO CHI MINH 4447
RUEHZS/ASEAN REGIONAL FORUM COLLECTIVE
RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE
RUEHUL/AMEMBASSY SEOUL 3303
RUEHKO/AMEMBASSY TOKYO 5845
RUEHHK/AMCONSUL HONG KONG 1381
RUEHGZ/AMCONSUL GUANGZHOU 0884
RUEHCN/AMCONSUL CHENGDU 0348
RUEHIN/AIT TAIPEI 1588
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 03 HANOI 000304

SIPDIS

SENSITIVE
SIPDIS

STATE FOR EAP/MLS, EAP/EP, INR, OES/STC, OES/IHA, MED
STATE PASS TO USAID FOR ANE AND GH
DEPARTMENT OF DEFENSE FOR OSD/ISA/AP (STERN)
HHS/OSSI/DSI PASS TO OGHA (WSTIEGER/LVALDEZ/CHICKEY/DMILLER) AND
FIC/NIH (RGLASS) AND DIV-FLU (COX/MOHEN)
CDC FOR COGH (SBLOUNT) AND CCID (SREDD)
USDA PASS TO APHIS, FAS (OSTA AND OCRA), FSIS
BANGKOK FOR RMO, CDC (MALISON), USAID (MACARTHUR/MBRADY) BANGKOK FOR
APHIS (NCARDENAS), REO(JWALLER)
BEIJING FOR HHS HEALTH ATTACHE (BROSS)
PHNOM PENH FOR CDC INFLUENZA COORDINATOR(BBRADY)
ROME FOR FAO
VIENTIANE FOR CDC INFLUENZA COORDINATOR (ACORWIN)


E.O. 12958: N/A
TAGS: TBIO AMED AMGT CASC EAGR PINR KFLU VM
SUBJECT: VIETNAM AVIAN INFLUENZA UPDATE: SCATTERED POULTRY OUTBREAKS
THROUGHOUT COUNTRY

REF: A. HANOI 197 B. HANOI 177

HANOI 00000304 001.2 OF 003


1. (U) Summary: Provinces in each region of the country have
reported poultry outbreaks in the past few weeks. Though localized
and easily controlled, the number of outbreaks continue to rise and
are occuring at a rate higher than during the same period last year.
A 23-year old woman died on February 25, the ninth consecutive
human fatality in the current wave of infection that began in May
2007. The Government of Vietnam (GVN) is again providing prompt
reports to the World Health Organization (WHO). At the same time,
GVN officials acknowledge continuing challenges in responding to the
disease, including complacency from local officials and the
population at large. Additionally, much of Vietnam's supply of
Tamiflu has expired or may soon do so, forcing the GVN to look for
other short-term options. End Summary.

GVN Reports Numerous Poultry Outbreaks
--------------------------------------

2. (U) Over the past few weeks, the GVN has reported animal
outbreaks in nine provinces (Quang Ninh, Hai Duong, Quang Tri, Tuyen
Quang, Ninh Binh, Vinh Long, Phu Tho, Ha Nam, and Hanoi) scattered
throughout the country, while declaring four other previously
infected provinces (Hai Duong, Long An, Nam Dinh, Thai Nguyen) free
of reported outbreaks for the past 21 days. Some provinces reported
multiple outbreaks in different districts. Typically, the disease
has struck small flocks of unvaccinated (or just vaccinated) ducks,
Muscovy ducks, and chickens. Though localized and easily
controlled, the outbreaks infected thousands of birds. After
testing confirmed the presence of H5N1, animal health officials
ordered the entire flocks culled.

Including Hanoi
---------------

3. (U) The outbreak in Hanoi was the first since March 2007 and
killed more than 2,000 ducks and chickens at a farm in Hanoi's
outlying district of Soc Son on March 3 and 4. Consistent with
other areas, the outbreak involved ducklings and chickens too young
for vaccination. Tran Manh Giang, head of the Hanoi Departmet of
Animal Health, told the local press that authorities culled the
remaining ducks and chickens on the farm, began a ten-day
sterilization period, and banned the transport of poultry from the
neighborhood. Nonetheless, Giang expressed concerns that the
outbreak would spread throughout the district despite the official
response.

GVN Dissatisfaction with Response in Several Localities
--------------------------------------------- ----------

4. (U) The Department of Animal Health (DAH) within the Ministry of
Agriculture and Rural Development (MARD) publicly expressed concern
with local efforts to prevent the disease. According to DAH,
negligence of local authorities in prevention activities contributed
to the outbreaks, as these officials failed to effectively monitor
the development of the disease or to ensure thorough vaccination of

HANOI 00000304 002.2 OF 003


local flocks. Additionally, DAH noted the problem of farmers
failing to report the deaths of their birds to authorities and
instead destroying the birds without proper disinfection. Officials
fear that animal outbreaks will recur and spread extensively as
farmers in Mekong Delta provinces use paddy grains left over on
fields after harvesting to feed new flocks of ducks.

GVN Response
------------

5. (U) In response, MARD has launched a month-long campaign too
disinfect the environment throughout the country in a bid to prevent
bird flu from spreading. Vice Minister Bui Ba Bong noted to the
media that current animal outbreaks were worse than those from last
year and stated that the campaign would focus on poultry farms,
waterfowl hatching centers, poultry slaughtering houses and markets.
Participants at a MARD-sponsored meeting agreed that central and
local officials need to focus on vaccinating new birds,
strengthening quarantine, controlling transportation, trade,
slaughtering and consuming poultry products, supervising each
household for early detection and containing the spread of the
disease and establishing a hot line to update information about the
disease. In addition, localities must carry out regular
sterilisation, apply safe measures in husbandry, check hatching and
raising units and the strengthen the capacity of locals to comply
with preventive measures.

Deaths of Civet Cats
--------------------

6. (U) Separately, on March 12, the media reported that avian
influenza killed four civets in a Vietnamese national park in Ninh
Binh province, one of the nine provinces with ongoing poultry
outbreaks, the second time the rare type of mammal was reported to
have died there of the H5N1 virus since 2005. According to a park
official, four endangered Owston's palm civets died early last month
at Cuc Phuong Park and tests of their samples found they had the
H5N1 virus. Park officials have now banned visitors from the area
surrounding the civets.

Most Recent Human Fatality
--------------------------

7. (U) On February 25, a 23 year old woman from Cam Khe District in
Phu Tho Province (approximately 50 kilometers west of Hanoi) died at
the National Institute of Infectious and Tropical Diseases (NIITD)
in Hanoi. She had become ill on February 14 after preparing and
sharing a meal of sick household chicken on February 12.
Reportedly, other chickens in the family flock had already died
prior to this meal. She was admitted to a provincial hospital on
February 19 before transfer to NIITD suffering from respiratory
failure on February 21. The National Institute of Health and
Epidemiology (NIHE) reported positive RT-PCR results to the WHO on
February 22. Each of the last nine human cases since May 2007 have
resulted in deaths. To date, we have seen no clustering of human
infections, though we note with concern the high mortality rate in

HANOI 00000304 003.2 OF 003


the current wave, which, while based upon a very small sample size,
may indicate that the virus is mutating into a more virulent form.


8. (U) Reports of other possible H5N1 infections proved to be
inaccurate and the victims instead diagnosed with influenza A
(unconfirmed) and influenza B, both commonly circulating human
influenza strains. The severe viral pneumonia component of the U.S.
Centers for Disease Control and Prevention (CDC) supported national
influenza sentinel surveillance system detected and enrolled both
patients. We estimate that each year approximately 10,000 people
die from influenza with many more becoming seriously ill, creating a
challenge for health officials to quickly determine which victims
suffer from H5N1.

USG Efforts to Ensure Prompt Reporting
--------------------------------------

9.(SBU) In response to concerns regarding delayed reporting of
diagnostic tests to WHO (refs A and B), CDC Influenza Coordinator
met with officials at the NIHE, the Vietnam Administration of
Preventative Medicine (VAPM), and Hanoi referral hospitals to urge
prompt notification and improved internal communications. Following
these meetings, both NIHE and VAPM met with the hospitals. Most
recently, communications seem to have improved and the GVN
immediately notified the WHO regarding the positive H5N1 test for
the latest human victim. Additionally, the Ministry of Health (MOH)
continues share information and virus isolates with the WHO
collaborating center Avian Influenza network, including CDC, and
VAPM included a WHO staffer in two of its most recent field
investgations.

Tamiflu Shortage
----------------

10. (U) NIITD reported a shortage of Tamiflu due to the expiration
of large portions of its stockpile, which had been donated by Taiwan
in 2005. Officials in Hai Duong already encountered this problem
when trying to provide prophylaxis to relatives and neighbors of a
young man who died from H5N1 (ref B), while Phu Tho, which has also
suffered an H5N1 fatality, also reported a lack of Tamiflu.
Per media reports, MOH has begun to search for new supplies and will
temporarily use Osetavimin, produced in Vietnam, as a short term
replacement, while Zuellig Pharma Vietnam (ZPV) donated a stock of
Tamiflu costing over VND120 million (approximately USD 7,500) for
use in a few medical facilities.

Michalak

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