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Viewing cable 06RANGOON437, BURMA AI OUTBREAK SITE ASSESSMENT

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Reference ID Created Released Classification Origin
06RANGOON437 2006-03-30 09:23 2011-08-25 00:00 UNCLASSIFIED//FOR OFFICIAL USE ONLY Embassy Rangoon
This record is a partial extract of the original cable. The full text of the original cable is not available.
UNCLAS SECTION 01 OF 02 RANGOON 000437 
 
SIPDIS 
 
SENSITIVE 
SIPDIS 
 
STATE FOR EAP/MLS; PACOM FOR FPA; UDSA FOR FAS/PECAD, 
FAS/CNMP, FAS/AAD, APHIS; BANGKOK FOR USAID (JOHN 
MACARTHUR), APHIS 
 
E.O. 12958: N/A 
TAGS: EAGR EAID AMED PGOV PREL CASC TBIO KFLU BM
SUBJECT: BURMA AI OUTBREAK SITE ASSESSMENT 
 
REF: RANGOON 399 
 
1. (SBU) SUMMARY.  A joint FAO/WHO team, accompanied by a 
USAID Regional Infectious Diseases advisor and a FSN from the 
Foreign Agricultural Service (FAS), assessed an AI outbreak 
in Sagaing and Mandalay Divisions, Burma, on March 17-18. 
Government of Burma (GOB) officials reported cases to the OIE 
promptly and allowed full access to outbreak sites by 
FAO/WHO/USG.  Numerous concerns exist about the preparedness 
of the GOB to respond to this outbreak.  Urgent needs 
include: rapid response team supplies, technical assistance 
to contain spread of infection and increase surveillance, and 
diagnostic strengthening.  END SUMMARY. 
 
2. (U) In February 2006, poultry die-offs, originally 
ascribed to non-H5N1 causes, occurred in Shwebo, Kanbalu, and 
Zigon townships in Sagaing Division, northern Burma.  In 
early March, these die-offs expanded to 4 townships in 
Mandalay Division. 
 
3. (U) GOB Livestock Breeding and Veterinary Department 
(LBVD) officials were alerted to the outbreak on March 8. 
LBVD officials initiated an investigation.  Specimens from 
the farms initially tested positive by rapid tests for 
influenza type A on March 9.  Local PCR tests confirmed 
sub-type H5 on March 12, at which time the suspected H5N1 
infection was reported to OIE.  FAO and WHO were briefed on 
the outbreak by GOB officials on March 13 and LBVD made an 
informal request to them for assistance.  Specimens were 
submitted to the National Institute of Animal Health 
laboratories in Thailand for H5N1 confirmation.  H5N1 was 
confirmed by the Thai laboratory on March 16 and specimens 
were sent to Australia for genetic sequencing. 
 
4. (U) The GOB response included the collection of specimens, 
active case surveillance for other unusual poultry die-offs, 
quarantine of affected farms, a temporary ban on the sale of 
poultry products in affected areas, and restriction of 
movement of poultry products and equipment.  Depopulation 
activities were initiated on all 56 infected farms in the two 
divisions. 
 
5. (U) As of March 18, 14 chicken farms, 10 quail farms, and 
1 quail hatchery had been affected with high mortality in the 
greater Mandalay area.  A total of 49,598 chickens and quail 
died or were culled.  The GOB planned to cull all farm and 
backyard poultry in a 3 km radius of infected farms (approx. 
20,000 birds) in Sagaing Division by March 24.  Mandalay 
Division culled birds on non-affected farms if they were 
found to have had any contact with affected farms. 
 
6. (U) GOB Ministry of Health (MOH) officials initiated 
active and passive surveillance for human cases in health 
facilities and local communities, disseminated a standard 
case definition to health workers, and designated a special 
hospital for suspected human cases.  The designated hospital 
has a small number of PPEs, one ventilator, and few 
medicines.  There are a total of 10 Tamiflu treatment doses 
in Mandalay Division.  The GOB disseminated public awareness 
posters produced by MOH, UNICEF, and WHO, and state 
television reported the outbreak on March 15.  The state-run 
newspaper, "The New Light of Myanmar," reported the outbreak 
on March 16 in both their Burmese and English editions, and 
other print media followed suit. 
 
7. (SBU) After reporting the outbreak to OIE and 
communicating with the FAO regional office, the GOB agreed to 
allow FAO, WHO, and USAID access to the outbreak sites.  The 
joint UN team, including the USAID Regional Infectious 
Diseases Advisor and the FAS FSN representative in Burma, 
departed for Mandalay on March 17.  GOB officials welcomed 
the team's presence and assistance.  LBVD and MOH officials 
were open with information and provided the team with 
regional and local maps of the affected areas and farms.  The 
team was taken to the farms, including one that was in the 
process of being depopulated and disinfected.  The assessment 
team noted numerous deficiencies in the quality of the GOB 
response team's activities.  GOB officials were receptive to 
the team's constructive suggestions and took corrective 
action. 
 
8. (SBU) WHO and USAID staff met with the Department of 
Health officials in Mandalay for a briefing on current human 
health response activities.  Again, health officials were 
open and willing to answer all questions.  The assessment 
team was then able to access the local hospital designated 
for receiving Avian Influenza cases. 
 
9. (SBU) USAID funds, provided directly to FAO, have 
purchased 200 PPEs, 500 liters of disinfectant, 50 backpack 
sprayers, and a small number of bio-secure specimen shipping 
containers.  Technical assistance was provided by the 
USAID-funded FAO Regional Advisor for Avian Influenza and the 
USAID RDMA Infectious Diseases Advisor.  The Government of 
Japan, through JICA, provided funding for a Thai senior 
virologist for a 2-week consultancy in laboratory 
diagnostics, as well as for dissemination in Burma of a small 
number of public awareness posters on AI.  The Royal Thai 
Government will fund diagnostic reagents for 1,000 samples. 
FAO/Rome has released $45,000 of emergency funds to the Burma 
country FAO office to assist with containment activities, and 
WHO/SEARO provided $20,000 to the WHO Burma country office. 
 
10. (SBU) COMMENT: Burma is a risk country for H5N1 
infections.  The current outbreak highlights that the 
surveillance for Highly Pathogenic Avian Influenza is 
sensitive enough to detect unusual die-offs.  When H5N1 is 
suspected, the GOB has shown unusual willingness to report 
the cases to the international community and to allow free 
access to affected sites.  The GOB response to this outbreak 
also highlights that many challenges remain in making the 
National Plan operational.  Burma urgently needs 
strengthening of surveillance and diagnostics, including 
collection, processing, and testing of both animal and human 
specimens.  Medium to long-term in-country presence of 
international human and animal health experts in Avian 
Influenza is crucial to assist the technical ministries with 
coordination and enhancement of preparedness and control 
activities, and to sustain the open information-sharing shown 
in response to this outbreak.  END COMMENT. 
STOLTZ