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Cablegate: Avian Influenza Update - Human Fatality Despite Decrease In

VZCZCXRO9077
RR RUEHCHI RUEHDT RUEHHM RUEHLN RUEHMA RUEHPB RUEHPOD
DE RUEHHI #1365/01 2141723
ZNR UUUUU ZZH
R 021723Z AUG 07
FM AMEMBASSY HANOI
TO RUEHC/SECSTATE WASHDC 5978
INFO RUEHHM/AMCONSUL HO CHI MINH 3444
RUEHZS/ASEAN REGIONAL FORUM COLLECTIVE
RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE
RUEHUL/AMEMBASSY SEOUL 3187
RUEHKO/AMEMBASSY TOKYO 5752
RUEHHK/AMCONSUL HONG KONG 1243
RUEHGZ/AMCONSUL GUANGZHOU 0821
RUEHCN/AMCONSUL CHENGDU 0318
RUEHIN/AIT TAIPEI 1514
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 02 HANOI 001365

SIPDIS

SENSITIVE
SIPDIS

STATE FOR EAP/MLS, EAP/EP, AIAG, OES/IHA, MED
STATE PASS TO USAID FOR ANE AND GH
STATE PASS TO HHS/OGHA (STIEGER/VALDEZ/BELL/HICKEY)
CDC FOR OGHA (BLOUT/MCCALL) AND DIV-FLU (COX/MOHEN)
DEPARTMENT OF DEFENSE FOR OSD/ISA/AP (STERN)
HHS PASS TO FIC/NIH (GLASS)
USDA PASS TO APHIS, FAS (OSTA AND OCRA), FSIS
BANGKOK FOR RMO, CDC (MALISON), USAID (MACARTHUR/BRADY)
BEIJING FOR HHS HEALTH ATTACHE (ROSS)
PHNOM PENH FOR CDC INFLUENZA COORDINATOR(BRADY)
VIENTIANE FOR CDC INFLUENZA COORDINATOR (CORWIN)
ROME FOR FAO

E.O. 12958: N/A
TAGS: TBIO AMED AMGT CASC EAGR PINR KFLU VM
SUBJECT: AVIAN INFLUENZA UPDATE - HUMAN FATALITY DESPITE DECREASE IN
POULTRY OUTBREAKS

REF: A) HANOI 1265; B) HANOI 1333; C) HANOI 890

HANOI 00001365 001.2 OF 002


1. (U) Summary: On July 31, the Government of Vietnam (GVN) reported
a fatal case of a pregnant 22 year-old woman from rural Ha Tay
province infected with the H5N1 strain of highly pathologic avian
influenza. The case appears to be isolated and not related to an
active poultry outbreak or human cluster. Outbreaks of AI in
poultry have substantially dropped off as previously reported (ref
A). The GVN continues its fully cooperative stance on sample
sharing. End Summary.

Report of Isolated Human Death
------------------------------

2. (U) On July 31, the Ministry of Health (MOH) reported a fatal
case of AI in a pregnant 22 year-old woman from rural Ha Tay
province, which is proximal to Hanoi. She was admitted to Bach Mai
Hospital on July 24 with breathing difficulties, was placed on
mechanical ventilation and died five days later. H5N1 infection was
confirmed by RT-PCR testing at a national laboratory. Field
investigations did not identify a source of infection. There was no
evidence of poultry outbreaks in the area surrounding her home, and
no recent reports of outbreaks from Ha Tay or surrounding provinces.
Close contacts of the patient were placed on Tamiflu. This case is
the sixth reported human case and the third death reported since May
2007.

Animal Outbreaks Drop Off Markedly
----------------------------------

3. (U) Avian influenza outbreak activity in poultry has dropped
markedly in recent weeks. The week of June 29 was the peak of
activity in the fifth outbreak wave that began May 1 with 29
outbreaks recorded. Of the 20 provinces affected with poultry
outbreaks since May 1, only three provinces (Dien Bien in the
northern region, Dong Thap in the southern region and Quang Binh in
the central region) have reported any outbreaks in the past 21
days.

Human and Animal Sample Sharing
-------------------------------

4. (SBU) Concerns continue with timely submission of clinical
specimens from suspected cases to the World Health Organization
(WHO) for independent reference laboratory confirmation, despite
repeated requests from WHO to the MOH. Of the 6 cases reported by
GVN since May 2007, specimens from only the first two cases have
been provided to WHO for confirmatory testing.

5. (SBU) Results of reference laboratory testing of clinical
specimens of the first two cases by WHO Collaborating Center in
Atlanta promptly confirmed that the H5N1 virus causing illness
belonged to Clade 2.3 genomic sublineage, only once before
identified in Vietnam as a cause of infection in humans in November
2005. Clade 2.3 H5N1 viruses are considered to be the newly
dominant genomic sublineage in the region.

6. (SBU) On July 27 ESTHOff and CDC Avian Influenza Advisor

HANOI 00001365 002.2 OF 002


delivered talking points and non-paper entitled "Goals for Meeting
of WHO Interdisciplinary Working Group" to the Ministry of Health's
International Cooperation Department General Director Dr. Tran Trong
Hai (ref B). More details on the GVN's official stance on sample
sharing and vaccine access were reported earlier (ref C).

MARINE

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