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Cablegate: Cholera Reappears in Northern Vietnam

VZCZCXRO2020
RR RUEHCHI RUEHCN RUEHDT RUEHHM RUEHLN RUEHMA RUEHPB RUEHPOD
DE RUEHHI #0383/01 0941005
ZNR UUUUU ZZH
R 031005Z APR 08
FM AMEMBASSY HANOI
TO RUEHC/SECSTATE WASHDC 7536
INFO RUEHHM/AMCONSUL HO CHI MINH 4532
RUEHZS/ASEAN REGIONAL FORUM COLLECTIVE
RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE
RUEHPH/CDC ATLANTA GA
RUEHRC/DEPT OF AGRICULTURE WASHINGTON DC
RUCPDOC/DEPT OF COMMERCE WASHINGTON DC
RUEAUSA/DEPT OF HHS WASHINGTON DC
RUEHSUN/USUN ROME IT

UNCLAS SECTION 01 OF 02 HANOI 000383

SIPDIS

SENSITIVE
SIPDIS

STATE FOR EAP/MLS, EAP/EP, INR, OES/STC, OES/IHA, MED
STATE PASS TO USAID FOR ANE AND GH
HHS/OSSI/DSI PASS TO OGHA (WSTIEGER/LVALDEZ/CHICKEY), FIC/NIH
(GLASS), FDA (MPLAISER)
CDC/COGH FOR SBLOUT/KMCCALL/RARTHUR, PASS TO NCZVED/DFBMD/EDEB
(RTAUXE/EMINTZ) AND GDD, IEIP, DEOC
USDA PASS TO APHIS, FAS (OSTA AND OCRA), FSIS
BANGKOK FOR RMO, CDC (MMALISON/SMALONEY/AHENDERSON), USAID/RDM/A
(CBOWES/JMACARTHUR), APHIS (NCARDENAS), REO (JWALLER)
BEIJING FOR HHS HEALTH ATTACHE (BROSS)
ROME FOR FAO

E.O. 12958: N/A
TAGS: TBIO AMED AMGT CASC EAGR PINR VM
SUBJECT: CHOLERA REAPPEARS IN NORTHERN VIETNAM

REF: A. HANOI 2071 B. HANOI 2012 C. HANOI 1953 D. HANOI 1924 E.

HANOI 1891

HANOI 00000383 001.2 OF 002


1. (SBU) Summary. Three months after the Government of Vietnam
(GVN) announced the successful control of an outbreak of cholera
(ref A), the disease has reappeared in several provinces in northern
Vietnam, including Hanoi. Though international health experts
predicted the likelihood of small, episodic outbreaks in the months
following the main epidemic, the GVN's response indicates that local
officials take the spate of recent cases seriously and are
initiating an aggressive response. End Summary.

Cholera Returns
---------------

2. (SBU) In early March, hospitals in northern Vietnam began to
report an uptick in cases of severe acute diarrhea, some of which
are confirmed to be cholera. Though Vietnamese officials have yet
to provide official statistics, press reports and information from
informal contacts with health authorities indicate the
hospitalization of several hundred people, many at the National
Institute for Infectious and Tropical Diseases, which has reached
capacity with over 20 new patients each day. Other hospitals in
Hanoi report similar situations. Ministry of Health authorities
have confirmed that eight of the thirteen northern provinces that
suffered from the 2007 outbreak have seen new cases, with Hanoi the
most severely impacted. (Note: Earlier media reports of "acute
diarrhea" in Ho Chi Minh City appear unrelated and most likely
involve a Rotavirus infection, though we will continue to track the
situation in the south).

3. (SBU) Though GVN officials again typically refer to the outbreak
as "severe acute diarrhea" (ref C), and have minimized the nature of
the outbreak, they acknowledge that considerable numbers of patients
have tested positive for the Vibrio cholerae bacterium. The most
recent media reports list 85 persons in ten provinces as having
tested positive for cholera, with most of these from Hanoi. Once
again, authorities are scrambling to detect the sources of
infection. Officials at the National Institute of Hygiene and
Epidemiology (NIHE)/MOH reported informally to the World Health
Organization (WHO) that its prospective case control study indicates
the consumption of the combination of dog meat/shrimp paste/raw
herbs consumption in two-thirds of all cases, with raw herbs the
most likely culprit. A recent on-line article in Vietnam Net quoted
one doctor from NIITD claiming that raw vegetables caused the recent
flare up.

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

4. (U) GVN officials and international health experts expected some
level of recurrence of the epidemic of severe acute diarrhea that
last year affected 2,000 people in 17 northern provinces (of which
close to 300 people tested positive for cholera). While announcing
the end of the six-week epidemic last December, Deputy Minister of
Health Trinh Quan Huan warned that the disease would be likely to
recur during spring and summer 2008. However, while the media has
played up every new report, health officials continue to minimize
the severity of recent events. Nguyen Huy Nga, Head of the
Preventive Health and Environmental Agency under the MOH, stated
that few persons were suffering from severe acute diarrhea and that
the disease remained scattered. He then refused to disclose to the
press the total number of patients that had tested positive for
cholera.

5. (SBU) At the same time, central and provincial health officials
have swung into action, beginning with the institution of
consultations between NIHE, MOH and the WHO (Note: The CDC expert
who assisted the 2007 WHO response will return to Hanoi shortly to
provide additional assistance to the current WHO effort). MOH has
reissued messages warning everyone to avoid eating raw seafood and
exercise caution with the preparation and handling of fresh foods.

HANOI 00000383 002.2 OF 002


On April 1, Deputy Minister of Health Huan issued an urgent dispatch
seeking to ban the use of excrement to fertilize vegetables.
Following the report of numerous cases within the city limits, the
Hanoi Department of Health asked MOH to provide free cholera vaccine
to the whole population of Hanoi, while preventive health agencies
sterilized areas around the homes of patients. The Haiphong
Department of Health requested city authorities ban raw foods (such
as duck's blood curds) during the epidemic period.

Comment
-------

6. (SBU) GVN officials are taking steps to respond effectively to
this growing outbreak, and press attention is keeping their feet to
the fire. Encouragingly, Vietnamese health officials have already
communicated with the WHO. Though the numbers of cases in 2008 have
not yet reached (and may not reach) the levels of late 2007, we
continue to track the situation, the GVN response, and possible
impacts on the American community.

MICHALAK

© Scoop Media

 
 
 
 
 
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