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Cablegate: First Cholera Case in Ho Chi Minh City

VZCZCXRO3612
OO RUEHAST RUEHCHI RUEHCN RUEHDH RUEHDT RUEHHM RUEHLN RUEHMA RUEHPB
RUEHPOD RUEHSL RUEHTM RUEHTRO
DE RUEHHI #0421/01 1020956
ZNR UUUUU ZZH
O 110956Z APR 08 ZDK
FM AMEMBASSY HANOI
TO RUEHC/SECSTATE WASHDC 7595
INFO RUEAUSA/DEPT OF HHS WASHINGTON DC IMMEDIATE
RUEHHM/AMCONSUL HO CHI MINH 4570
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 000421

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: FIRST CHOLERA CASE IN HO CHI MINH CITY

REF: A HANOI 408 B. HANOI 383 C. 07 HANOI 2071

HANOI 00000421 001.8 OF 002


1. (SBU) Ho Chi Minh City reported its first case of cholera in the
current outbreak, a 71 year old woman from Thu Duc district.
According to Dr. Nguyen Van Chau, Director of the Ho Chi Minh City
Health Department, the woman was admitted to Ho Chi Minh City
Medical Hospital on April 6 suffering from severe diarrhea. On
April 9, she tested positive for Vibrio cholerae Ogawa serotype. Ho
Chi Minh City health authorities have initiated an epidemiological
investigation to determine the source of her exposure. Possible
sources include raw vegetables purchased at a local market or close
contact with two neighbors, who recently returned from northern Nam
Dinh province - one of the eleven northern provinces reporting
severe acute diarrhea outbreaks. No other patients under treatment
at other hospitals in Ho Chi Minh City (refs A and B), including
Children's Hospitals 1 and 2 and the Tropical Diseases Center have
tested positive for cholera.

National Numbers
----------------

2. (U) The Ministry of Health reported yesterday reported nearly 900
cases of severe acute diarrhea in 17 provinces nationwide. Though
the northern region (particularly Hanoi, Haiphong, Ha Tay, and Thanh
Hoa provinces) suffered the most cases, other provinces including
Quang Binh, Quang Ninh, and Thua Thien-Hue in the central region
most recently reported severe cases. According to Vietnam
Television (VTV), the National Institute of Tropical and Infectious
Diseases in Hanoi has now admitted 533 diarrhea patients, of which
254 tested positive for cholera bacteria. VTV further reported that
85 to 90 percent of new patients have tested positive for cholera -
a substantial increase over the 2007 outbreak. Tran Van Tho, Deputy
Director of the Haiphong Department of Health, told the press that
up to 90 percent of cases of severe acute diarrhea in that province
had tested positive for cholera.

Hard to Stop the Spread of Cholera
----------------------------------

3. (U) Vietnamese health officials show growing concern that the
outbreaks could spread even further. The National Institute of
Hygiene and Epidemiology (NIHE) detected cholera bacterium in 15
water samples taken from Hanoi, Hai Phong, Thanh Hoa and Ha Tay, in
three vegetable samples taken from a market in Hai Phong and in a
sample of boiled dog meat in Hai Phong. Dr. Nguyen Tran Hien,
Director of NIHE, told the press that the broad geographic
dispersion of cholera patients, combined with the ability of cholera
bacteria to live in water, makes it difficult to prevent the
expansion of cholera cases. For example, provincial officials along
the Hanoi-Ho Chi Minh City railway worry that excrement from
infected train passengers could pollute local waterways, causing
further spread.

Responses Continue
------------------

4. (U) GVN response efforts continue. However, while the Ministry
of Health (MOH) reportedly has finalized its master plan on cholera
prevention, it has yet to promulgate standard procedures for
controlling contamination of lakes, ponds, and canals that can be a
source of cholera bacteria. In response to positive tests at Linh
Quang Lake in Hanoi, city health workers dredged and cleaned the
lake, pouring in 1.4 tons of Choloramin B at a cost of 70 million
dong (approximately USD 4,400), and removed a market and tore down
temporary housing that had sprung up on its boundaries. Haiphong
has banned the selling of shrimp paste, raw vegetables, and raw meat
salads.

Underlying Factors Unchanged
----------------------------

5. (U) According to Dr. Tran Dang, Head of the Food Hygiene Safety

HANOI 00000421 002.8 OF 002


Agency, six factors have caused the boom of diarrhea and cholera:
unhygienic eating habits, unhygienic raw or processed foods, poor
treatment of excrement and waste, failure to wash hands prior to
meals, poor food maintenance, and control of waste from existing
diarrhea or cholera patients. Dang stated that the Ministry of
Health could only control the final factor. The problem is
particularly difficult in poor or rural areas where many households
do not have sanitary facilities or do not obey health agency
instructions. For example, in one hard hit hamlet where 43
patients tested positive for cholera, residents do not have toilets
and use river water, which tested positive for the cholera bacteria,
to irrigate their paddy fields.

Embassy Believes Current Notice Remains Sufficient
--------------------------------------------- -----

6. (U) The Embassy has reviewed our current notice to American
citizens regarding cholera prevention. The Medical Unit and Health
Attache continue to believe that this guidance, which is consistent
with recommendations from Vietnamese health officials, remains
appropriate and does not need updating at this time.

MICHALAK

© Scoop Media

 
 
 
 
 
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