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Cablegate: Vietnamese Officials Concerned, Not Alarmed, At

VZCZCXRO7313
OO RUEHCHI RUEHCN RUEHDT RUEHHM RUEHLN RUEHMA RUEHPB RUEHPOD
DE RUEHHI #0408/01 1001029
ZNR UUUUU ZZH
O 091029Z APR 08
FM AMEMBASSY HANOI
TO RUEHC/SECSTATE WASHDC 7573
INFO RUEAUSA/DEPT OF HHS WASHINGTON DC IMMEDIATE
RUEHHM/AMCONSUL HO CHI MINH 4553
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
RUEHSUN/USUN ROME IT

UNCLAS SECTION 01 OF 02 HANOI 000408

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 SECRETARY LEAVITT AND 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: VIETNAMESE OFFICIALS CONCERNED, NOT ALARMED, AT
REAPPEARANCE OF CHOLERA

REF: A. HANOI 383 B. 07 HANOI 2071 C. 07 HANOI 2012 D. 07 HANOI 1953
E. 07 HANOI 1924 F. 07 HANOI 1891

HANOI 00000408 001.2 OF 002


1. (SBU) The current outbreak of severe acute diarrhea continues to
spread. Dr. Nguyen Huy Nga, Director General of the Preventative
Health and Environmental Agency of the Ministry of Health (MOH),
recently announced tests confirming the presence of cholera in
patients in two additional northern provinces, Ninh Binh and Hai
Duong, increasing the total number of cholera-impacted provinces to
12, including the central provinces of Thanh Hoa and Quang Binh. By
contrast, the 2007 outbreaks did not spread beyond northern Vietnam.
Cholera has hit Hanoi most severely, with 12 out of 14 Hanoi
districts affected. Most victims in the current outbreak were
exposed to the bacteria in Hanoi, including some who then traveled
to surrounding provinces. The single case identified in the central
province of Quang Binh is considered to have been exposed in Hanoi.
At the same time, Nga noted that Hai Phong and Thanh Hoa provinces
appeared to experience separate outbreaks. (Note: cases of severe
diarrhea in Ho Chi Minh City have tested negative for cholera). In
discussions with Embassy HHS/CDC staff on April 8, Nga noted that
the current wave of severe acute diarrhea, began on March 6 and has
led to more than 700 identified cases of severe acute diarrhea, more
than 120 of which have tested positive for cholera. Similar to last
year's events (ref B), the GVN has not recorded any deaths to date
associated with the outbreak.

Outbreak Appears Foodborne, Not Waterborne
------------------------------------------

2. (SBU) Nga informed Embassy HHS/CDC staff that most cases appear
to be associated with consumption of herbs and raw vegetables served
at dog meat restaurants and by street vendors. Nga stated that MOH
investigations had not identified any large point source exposures
or clusters arising from drinking contaminated water and that there
was no evidence of contaminated municipal water sources. At the
same time, however, he noted that environmental testing had found
Vibrio cholerae contamination of surface water at several sites in
Hanoi, including some of the many ponds and lakes in the city. On
April 8, Viet Nam News reported that the Hanoi People's Committee
called for cleanup of 30 lakes in the city, noting contamination
with untreated sewage and refuse from nearby markets. The newspaper
cited the Ministry of Natural Resources and Environment as saying
that almost all of the 110 lakes in Hanoi are contaminated with
untreated sewage and that all posed a serious health risk. In one
hard hit district, municipal authorities were taking steps to shut
down market vendors and local restaurants with substandard health
and safety conditions and to demolish substandard temporary housing
posing an environmental hazard.

GVN Concerned, Not Alarmed
--------------------------

3. (SBU) Nga expressed concern with the current situation but not
alarm, differing from some of the more sensational press reports.
Nga has not sought additional WHO assistance beyond the two advisors
scheduled to arrive later this week, including a CDC epidemiologist
stationed in Bangkok, who responded to the first wave in December.
He will arrive tomorrow on a previously arranged visit to provide
support to cholera studies initiated in November 2007 (ref D).

Vietnamese Press, However, Expressing Alarm
-------------------------------------------

4. (U) Vietnam's state controlled media has highlighted the outbreak
for the past several weeks, providing additional factual details,
while emphasizing the potential seriousness of the outbreak.
According to reports late last week in Tuoi Tre (Youth) newspaper,
Bach Mai hospital in Hanoi has reported 80 percent of the 40
patients recently admitted for severe acute diarrhea have tested
positive for cholera, a larger number and percentage than in the
October 2007 outbreak. The paper further reported that the National

HANOI 00000408 002.2 OF 002


Institute for Infectious and Tropical Diseases in Hanoi had admitted
nearly 300 patients -- almost 40 per day -- with severe acute
diarrhea and that 70 to 80 percent of those tested were infected
with cholera, also substantially higher than last year.

EMBASSY COORDINATION
--------------------

5. (SBU) HHS/CDC experts in Hanoi have reviewed current warden
notice posted in December with CON and MED in Hanoi, determined it
is still accurate, and working with the Hanoi-based team preparing
for the visit of Secretary Leavitt's delegation, have taken all
necessary precautions, all of which are in conformance with the
guidance contained in the December warden message. Post does not
believe that a new warden message is warented at this time.

MICHALAK

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