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Viewing cable 07RANGOON272, BURMA AI UPDATE: NO NEW OUTBREAKS, MORE HELP NEEDED

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Reference ID Created Released Classification Origin
07RANGOON272 2007-03-14 06:42 2011-08-25 00:00 UNCLASSIFIED//FOR OFFICIAL USE ONLY Embassy Rangoon
VZCZCXRO4610
OO RUEHCHI RUEHDT RUEHHM RUEHNH
DE RUEHGO #0272/01 0730642
ZNR UUUUU ZZH
O 140642Z MAR 07
FM AMEMBASSY RANGOON
TO RUEHC/SECSTATE WASHDC IMMEDIATE 5857
INFO RUCNASE/ASEAN MEMBER COLLECTIVE
RUEHBJ/AMEMBASSY BEIJING 1366
RUEHBY/AMEMBASSY CANBERRA 0222
RUEHKA/AMEMBASSY DHAKA 4498
RUEHNE/AMEMBASSY NEW DELHI 3793
RUEHUL/AMEMBASSY SEOUL 7318
RUEHKO/AMEMBASSY TOKYO 4870
RUEHVI/AMEMBASSY VIENNA 0066
RUEHCI/AMCONSUL CALCUTTA 1074
RUEHCN/AMCONSUL CHENGDU 1089
RUDKIA/AMCONSUL CHIANG MAI 0916
RUEAUSA/DEPT OF HHS WASHDC
RUEHRC/DEPT OF AGRICULTURE WASHINGTON DC
RUEHPH/CDC ATLANTA GA
RUEHRC/USDA FAS WASHDC
RHHMUNA/CDR USPACOM HONOLULU HI
RHEHNSC/NSC WASHDC
RUEKJCS/SECDEF WASHDC
RUEKJCS/JOINT STAFF WASHDC
UNCLAS SECTION 01 OF 04 RANGOON 000272 
 
SIPDIS 
 
SENSITIVE 
SIPDIS 
 
STATE FOR EAP/MLS, G/AIAG; PACOM FOR FPA; USDA FOR 
FAS/PECAD, FAS/CNMP, FAS/AAD, APHIS; BANGKOK FOR 
USAID:JMACARTHUR, APHIS:NCARDENAS, REO:JWALLER 
 
E.O. 12958: N/A 
TAGS: EAGR EAID AMED PGOV PREL CASC TBIO KFLU BM
SUBJECT: BURMA AI UPDATE: NO NEW OUTBREAKS, MORE HELP NEEDED 
 
REF: A. RANGOON 247 
 
     B. RANGOON 232 AND PREVIOUS 
 
RANGOON 00000272  001.2 OF 004 
 
 
1. (SBU) The government of Burma has reported no new 
outbreaks of AI since the culling of affected poultry in 
Rangoon was completed on March 2.  The GOB has reported no 
suspected cases in humans.  In the affected areas of Rangoon, 
officials continue to monitor the health of poultry and 
humans, and have restricted the movement and sale of poultry 
products.  GOB officials publicly acknowledged the crucial 
role of FAO and WHO assistance in their successful 
containment of the February outbreak.  Donors met to review 
the FAO request to the World Bank AI Trust Fund, but none of 
the potential donors had plans to fund additional AI programs 
in Burma.  Visiting Bangkok USAID Health Advisors 
complimented the GOB's quick response to this outbreak, and 
noted areas that will require more attention in the future, 
including better communication between animal and human 
health officials, and shifting the focus of the search for 
the source of AI outbreak from wild birds to other 
possibilities.  As urged by USAID visitors, the GOB publicly 
confirmed AI outbreaks in the government press.  GOB 
cooperation and coordination with the international community 
remains strong.  End summary. 
 
Update on Outbreaks and Measures Taken 
-------------------------------------- 
2. (U) Officials from the Livestock Breeding and Veterinary 
Department (LBVD), WHO, and FAO briefed USAID Infectious 
Diseases Team Leader Dr. John MacArthur on the successful 
containment of the Rangoon AI outbreak in poultry, which 
occurred from February 23 through final culling on March 2. 
Officials reported no new outbreaks since then, and no 
suspected human cases. 
 
3. (SBU) LBVD officials described the first outbreak at a 
chicken and duck farm, reported by the owner on February 27. 
After some poultry tested positive for HPAI, official teams 
culled all poultry on the farm on the night of February 28, 
and began to monitor all humans and backyard poultry within a 
one kilometer radius.  At a visit to the farm on March 9, 
officials told us that they had not made any decision on 
compensation for the farmer's estimated $2,500 loss.  The 
farmer said he was not willing to relocate his poultry 
operations to Rangoon's designated Livestock Zone, ten miles 
away. The site of the fourth and final outbreak, on February 
26 through March 1, occurred at a small commercial farm where 
the owner kept 156 layers in cages.  All birds were culled on 
March 2, and officials extended restricted and control zones 
around the farm. 
 
 4. (U) In the "restricted area" of one kilometer radius, 
protective measures include: testing of all poultry deaths; 
pathology testing in cases of high mortality rates; and 
prohibition of movement of poultry products, equipment, feed, 
manure, and fertile eggs into, within, and out of the 
restricted area.  Measures taken in the "control area" of 
seven-kilometer radius include: passive surveillance; 
investigating the pathology of birds in cases of high 
mortality rates; daily telephone or personal surveillance of 
community and village poultry sites; and prohibition of 
movement of the same poultry-related products into, out of, 
and within the controlled area. 
 
5. (U) The LBVD Director General described the GOB AI 
strategy as "Early Protection, Early Warning, Early 
Prevention," and emphasized that the government follows FAO 
and OIE guidelines.  A Rangoon-based Task Force, headed by 
 
RANGOON 00000272  002.2 OF 004 
 
 
the LBVD Director-General, includes members from Livestock 
Ministry from Nay Pyi Taw, the Rangoon office of LBVD, and 
Veterinary Science students.  The Task Force fields two 
investigative teams, two culling teams, two disinfection 
teams, and four surveillance teams.  Officials said they will 
continue to investigate possible sources of AI at the four 
outbreak sites, identified as: wild birds; the origins of 
recently purchased day-old chicks and feed; visits by an egg 
collector and a manure collector; visits by farm occupants to 
a live bird market; and the close proximity of a 
slaughterhouse. 
 
Concerns and Needs 
------------------ 
6. (SBU) While praising the GOB's quick, effective response 
to the Rangoon outbreak, USAID Advisors identified several 
areas of concern during meetings with GOB, FAO and WHO 
officials, including: animal and human health coordination 
and communication; lack of strong epidemiology; inadequate 
lab technician capacity; uninformed risk communications; 
limited equipment supplies; lack of a compensation scheme; 
and lack of an operational plan to implement emergency 
vaccination. 
 
7. (SBU) Animal/Human Health Coordination: The LBVD Director 
General told us that the Livestock Ministry had been given 
authority to act independently in accordance with FAO and OIE 
guidelines on AI.  WHO AI Coordinator Jum Coninx told us that 
her Ministry of Health (MoH) colleagues, while included on 
Rapid Response Teams and in daily meetings, were not kept 
well informed about the results from the animal lab testing, 
and did not receive timely information on poultry cullers who 
should be kept under MoH surveillance.  FAO plans to hire an 
international project coordinator, who would manage animal 
health programs and coordinate with human health agencies, to 
improve communications. 
 
8. (SBU) Human Health Issues: Coninx said that health 
officials were well prepared to respond to the Rangoon 
outbreak, but expressed concern about their capacity to 
respond to a wider emergency.  She reported that the Ministry 
of Health has developed standard operating procedures and a 
case definition for suspected AI patients.  Coninx said WHO 
imported equipment for medical personnel to monitor cases in 
health facilities, but noted that more Rapid Test Kits were 
needed.   She expressed concern that human health labs were 
not busy testing specimens from humans as part of the 
surveillance effort.  Priorities for WHO include epidemiology 
training for field personnel, more PPEs, operational costs 
for outbreak surveillance activities, building capacity at 
the National Health Lab, training for private General 
Practitioners, case management training, and bringing 
training down to district and local levels. 
 
9. (SBU) Epidemiology: FAO and WHO representatives agreed 
that epidemiology capacity in Burma was weak.  The FAO 
advisor urged GOB technicians to decrease the focus on wild 
birds, all of which have tested negative for HPAI, and has 
strained lab capabilities.  Instead, the GOB should follow 
the "epidemiology trail" to and from the affected farms more 
aggressively to identify the source of the virus.  Other 
assistance in this area of expertise will come when a new 
epidemiologist arrives at WHO to assist Coninx.  Also, FAO 
will bring in Dr. Harvey Westbury for a month-long return 
visit to provide technical assistance for lab staff, and has 
requested funding in its World Bank proposal for training to 
strength diagnostic capacities. 
 
 
RANGOON 00000272  003.2 OF 004 
 
 
10. (SBU) Risk Communications: GOB-owned news outlets have 
reported daily on the official response to the outbreak and 
on the results of tests on domestic poultry and wild birds. 
Press announcements were highly technical in nature, however, 
and did not clearly confirm the presence of AI.  Both USAID 
and FAO advisors urged GOB interlocutors to be clearer in 
their public announcements.  On March 11, the government 
media confirmed the presence of AI, as recommended by the 
advisors. 
 
11. (SBU) Personal Protective Equipment Sets: FAO and WHO 
requested additional PPEs to create an adequate stock to 
respond to a major outbreak, as well as to replace the PPEs 
used by cullers, Rapid Response Teams, investigators, health 
workers and disinfection teams in the current outbreak 
response.  They want to ensure sufficient are on hand so that 
the protective equipment gets used routinely, rather than 
saved. 
 
12. (U) Animal Health: FAO called donors together on March 9 
to comment on a proposal to the World Bank AI Trust Fund. 
During the presentation, FAO reps identified the most 
pressing needs on the animal health side: implementing 
intensive surveillance; strengthening capacity of animal 
health workers, especially in epidemiology; improving 
coordination and communication with the private sector, human 
health officials, and the international community; developing 
the legal structure for compensation and emergency 
vaccination; making practical operational plans to implement 
contingency plans that now only exist only on paper; 
maintaining current surveillance, diagnostic and response 
activities; developing a knowledge and skills base of 
epidemiologists, veterinarians, and lab technicians; 
improving risk communications; and analyzing the 
socio-economic factors and impact of AI in the poultry sector. 
 
Foreign and Official Assistance 
------------------------------- 
13. (SBU) The FAO proposal requests $1 million from the World 
Bank Animal and Human Influenza Trust Fund to support program 
planning, coordination, and management, and to enhance 
surveillance, diagnostic and outbreak containment activities. 
 WHO's proposal to the World Bank AI Trust Fund for 
assistance on the human health side is under negotiation.  At 
the FAO meeting, other donors were queried about their 
intention to provide emergency assistance for response 
efforts.  AusAID, the Japanese Trust Fund, ADB, and JICA have 
ongoing programs, and China and Thailand have provided 
in-kind assistance, but no donors planned any new or 
additional support.  WHO and FAO confirmed the need for 
additional PPEs, and Dr. MacArthur began discussions to 
identify other emergent needs and funding gaps in the 
preparedness plan. 
 
14. (SBU) Burmese officials continue to welcome foreign 
expertise on AI.  They willingly provide information about 
their activities and implement advice given by international 
experts.  Ministry staff, including the Director-General of 
LBVD, personally accompanied USAID, World Bank and embassy 
visitors to the site of the first outbreak, and encouraged 
their questions.  LBVD facilitated expedited visa and travel 
arrangements for USAID visitors.  The GOB confirmed the 
presence of AI in Burma in the daily government press 
announcements two days after FAO urged such an announcement. 
Emboff described at a March 8 meeting the improper handling 
of chickens at local markets, and on March 11, LBVD conducted 
training sessions for shopkeepers at two major Rangoon 
markets.  LBVD shares information on its surveillance 
 
RANGOON 00000272  004.2 OF 004 
 
 
activities and lab results with the embassy on a daily basis. 
 
15. (U) This cable was cleared by Dr. John MacArthur, 
USAID/RDMA. 
VILLAROSA