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Cablegate: (Sbu) Avian H5n1 Influenza a Human Fatality, Vietnam

VZCZCXRO4737
RR RUEHCN RUEHHM RUEHRN
DE RUEHHI #1290/01 3360335
ZNR UUUUU ZZH
R 020335Z DEC 09
FM AMEMBASSY HANOI
TO RUEHC/SECSTATE WASHDC 0510
INFO RHMCSUU/CDR USPACOM HONOLULU HI
RHMFISS/CJCS WASHINGTON DC
RUEAIIA/CIA WASHINGTON DC
RUEAUSA/DEPT OF HHS WASHINGTON DC
RUEHC/DEPT OF AGRICULTURE WASHINGTON DC
RUEHCN/AMCONSUL CHENGDU 0001
RUEHGV/USMISSION GENEVA 0011
RUEHGZ/AMCONSUL GUANGZHOU 0002
RUEHHI/AMEMBASSY HANOI
RUEHHK/AMCONSUL HONG KONG 0032
RUEHHM/AMCONSUL HO CHI MINH CITY 0218
RUEHIN/AIT TAIPEI TW 0003
RUEHKO/AMEMBASSY TOKYO 0034
RUEHPH/CDC ATLANTA GA
RUEHRC/DEPT OF AGRICULTURE USD FAS WASHINGTON DC
RUEHRN/USMISSION UN ROME 0006
RUEHUL/AMEMBASSY SEOUL 0031
RUEKJCS/SECDEF WASHINGTON DC

UNCLAS SECTION 01 OF 02 AMEMBASSY HANOI 001290

SENSITIVE
SIPDIS
STATE FOR EAP/MLS, EAP/EP, INR, OES/STC, OES/IHA, MED,AND OES/IHB (DFANTOZZI, CPATTERSON, CSHAPIRO)
STATE PASS TO USAID GH (GSTEELE, DCARROLL, ACLEMENTS)
DEPARTMENT OF DEFENSE FOR OSD/ISA/AP (STERN)
HHS/OSSI/DSI PASS TO FIC/NIH (RGLASS), OGHA (JMONAHAN, MABDOO, SCUMMINGS, DMILLER), ASPR (MPERDUE, RROBINSON)
CDC FOR COGH (SBLOUNT), CCID (SREDD) AND DIV-FLU (NCOX, AMOEN)
USDA PASS TO APHIS, FAS (OSTA AND OCRA), FSIS
BANGKOK FOR USAID (MACARTHUR/AATHWIN), APHIS (HHOWARD/RTANAKA) AND CDC (MSIMMERMAN)
BEIJING FOR HHS HEALTH ATTACHE (EYUAN) AND CDC (JMCFARLAND)
PHNOM PENH FOR CDC INFLUENZA COORDINATOR (PKITSUTANI)
ROME FOR FAO (JZINGESER)
VIENTIANE FOR CDC INFLUENZA COORDINATOR (ACORWIN)

E.O. 12958: N/A
TAGS: TBIO EAID EAGR PREL KFLU VM
SUBJECT: (SBU) Avian H5N1 influenza A human fatality, Vietnam

REF: Hanoi 418; 2008 Hanoi 409

SENSTIVE BUT UNCLASSIFIED

REF A. Hanoi 418; B. 2008 Hanoi 409

1. (U) Summary: On November 30, 2009, Vietnam's Ministry of Health
(MOH) reported the death of a 23 year-old man in Dien Bien province
(in northern Vietnam) from the avian H5N1 strain of influenza A.
Over one month earlier, on October 21, Dien Bien had reported a
poultry outbreak. This is the first human case in this province
and the first in Vietnam since the onset of cooler weather. The
last human case was reported on April 24 (REF A) and this is the
fifth case reported from Vietnam in 2009, each of them fatal.
Reporting from the MOH was prompt and a field team will be deployed
December 2. Since December 2003, the MOH has reported a total of
112 cases of human infection with 57 deaths. End Summary.

2. (U) The 23 year-old man was from Sam Min commune, Dien Bien
City, Dien Bien province, which borders China and Laos. On
November 18 the patient had onset of high fever, cough, and
breathing difficulty. He went to two outpatient health facilities,
first a commune health station on November 24, and then a district
level polyclinic on November 25. He was referred to the Dien Bien
provincial hospital on November 26. At the hospital he was
diagnosed with severe pneumonia and was administered intravenous
antibiotics. It is not yet known whether he was also given
antiviral medication. Health care providers suspected the
diagnosis of H5N1 infection, so respiratory samples were taken and
sent to MOH's National Institute of Hygiene and Epidemiology
(NIHE). His condition deteriorated and he died on November 28. On
November 29, NIHE reported that the respiratory samples were
positive for H5N1.

3. (SBU) There are few historic details available at this point,
but the MOH website reported that the patient ate duck blood
pudding (traditionally uncooked) one week prior to the onset of
symptoms. MOH reports no additional suspect cases; a MOH field
team will be deployed December 2 to investigate. Based on a
conversation with an MOH official, there are no reports of sick or
dead poultry in the area of patient's home. However, the victim's
commune is located along a stream from an area where dead poultry
had been discarded in the past.

4. (SBU) Dien Bien province borders both China and Laos, with few
checkpoints to prevent the transborder illegal poultry trade (REF
B). On October 21, 2009, within 10 km of the deceased's household,
Dien Bien province had a outbreak in chickens and ducks caused by
H5N1, in two communes, totaling nine households, the first since

HANOI 00001290 002 OF 002


February. Approximately 2,300 poultry were destroyed on October
24. Prior to the poultry outbreak, the province had been
considered "low risk," and not routinely targeted for vaccination.
Subsequently, a limited vaccination program was started.
Investigations were underway to determine whether the disease may
be endemic in the area or may have been transported from other
provinces. After the outbreak in October, NIHE requested the local
Preventative Medicine Center to provide additional community
education on H5N1 prevention, and to enhance existing Severe Viral
Pneumonia (SVP) surveillance to monitor for possible H5N1
infections in humans. This SVP surveillance is a nationwide
project done in cooperation with CDC, and has detected 18 of
Vietnam's 19 reported human cases of H5N1 (including this one)
since its inception in 2006. This is the first case of human H5N1
since April in Vietnam, and the first confirmed in Dien Bien
province.
Michalak

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