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Cablegate: Cholera Outbreak Confirmed in Northern Vietnam

VZCZCXRO2704
RR RUEHCHI RUEHCN RUEHDT RUEHHM RUEHLN RUEHMA RUEHPB RUEHPOD
DE RUEHHI #1921/01 3131017
ZNR UUUUU ZZH
R 091017Z NOV 07
FM AMEMBASSY HANOI
TO RUEHC/SECSTATE WASHDC 6685
INFO RUEHHM/AMCONSUL HO CHI MINH 3923
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 001921

SIPDIS

SENSITIVE
SIPDIS

STATE FOR EAP/MLS, EAP/EP, INR, OES/STC, OES/IHA, MED
STATE PASS TO USAID FOR ANE AND GH
STATE PASS TO HHS/OGHA (WSTIEGER/LVALDEZ/CHICKEY)
CDC FOR OGHA (SBLOUT/KMCCALL) AND FOODBORNE DIV (RTAUXE)
HHS PASS TO FIC/NIH (GLASS) AND TO FDA (MPLAISER)
USDA PASS TO APHIS, FAS (OSTA AND OCRA), FSIS
BANGKOK FOR RMO, CDC (MMALISON), USAID (JMACARTHUR/MBRADY) BANGKOK
FOR 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 OUTBREAK CONFIRMED IN NORTHERN VIETNAM

REF: Hanoi 1771

HANOI 00001921 001.2 OF 002


1.(SBU) Summary: The Government of Vietnam (GVN) has confirmed an
outbreak of acute watery diarrhea in persons living in the northern
part of the nation. Initially linked to unsafe food, primarily raw
shrimp paste, the outbreak now may be spreading through contact with
infected patients or contaminated water. The GVN has confirmed that
approximately 15 percent of the 600 persons infected to date tested
positive for cholera. The GVN has issued a series of warnings to
the public, stockpiled medication, sent medical workers to infected
locales, and agreed to provide free medical treatment to those
suffering from diarrhea. Additionally, the Vietnamese Ministry of
Health (MOH) recently asked the World Health Organization (WHO) for
assistance responding to the situation. U.S. Centers for Disease
Control (CDC) in Hanoi has offered expert support to the WHO, if
needed. End Summary.

2. (U) On November 4, the GVN confirmed an additional 148 cases of
acute diarrhea among hospitalized patients in northern Vietnam,
bringing the total to over 600 since the outbreak was first detected
on October 23. The numbers of infected persons has spiked in the
past few days and officials are concerned that the actual numbers
might be substantially higher. The hospital wards of the National
Institute for Infectious and Tropical Diseases, Hanoi, have been
inundated with patients, necessitating a search by MOH for more
hospital beds. Officials believe they have traced the epidemic to
raw shrimp paste produced in coastal Thanh Hoa province, which
recently suffered from flooding related to typhoon Lekima (reftel).
Though Hanoi has seen the most patients, at least 11 municipalities
and provinces throughout northern Vietnam have reported related
cases. To date, southern Vietnam has not been affected.

3. (SBU) Over the weekend, Minister of Health Nguyen Quoc Trieu
announced that 15 percent of those suffering from acute diarrhea had
tested positive for the cholera bacterium. MOH officials further
informed Embassy staff that the clinical presentations of many of
the cases are classic for cholera. Initial victims consumed tainted
raw foods, particularly shrimp paste, along with pork and
vegetables. However, the GVN has now stated that the epidemic also
may be spreading through secondary infections among caretakers and
through exposure to contaminated drinking water. Continued flooding
in the central region of the country, particularly if exacerbated by
the expected landfall of typhoon Peipah later this week, could
facilitate further spread of the disease.

4. (U) Last week, the GVN moved to contain the outbreak, instituting
new food safety checks and suspending the use of all raw shrimp
paste. Through media reports, the MOH warned the public of
potential high fatality rates for untreated patients and advised
people to properly cook foods. The central government sent several
health teams to various provinces to inspect the local conditions
and Deputy Minister of Health Trinh Quan Huan asked local
authorities to quarantine infected areas as the MOH's National
Institute of Hygiene and Epidemiology (NIHE) continues to analyze
disease samples. The GVN has stockpiled medications and sterile
equipment and has organized training courses for health care
professionals. Prime Minister Nguyen Tan Dung announced that the
GVN would provide free treatment to all hospital patients suffering
from acute diarrhea to encourage sick persons to present themselves
for treatment.

5. (SBU) Consistent with Vietnam's obligations under the recently
revised International Health Regulations, the MOH notified the WHO
as the epidemic spread and requested WHO assistance. Press reports
state that Vietnam also informed neighboring countries about the
outbreak. U.S. CDC officers in Hanoi, in coordination with Bangkok
and CDC headquarters in Atlanta, continue to communicate with the
WHO and MOH. Through the Embassy Health Attache, CDC has offered to
support the WHO with technical assistance, if requested. Post has
provided relevant information to the delegation of Secretary of
Commerce Gutierrez, currently in Hanoi, and has drafted a warden
message for Washington clearance to Americans living in Vietnam
advising them of the situation and providing information to minimize

HANOI 00001921 002.2 OF 002


the risk of exposure. The Embassy medical unit will follow up with
local health providers to update Embassy contingency planning.

MICHALAK

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