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Viewing cable 07HANOI1026, AVIAN INFLUENZA UPDATE - MORE POULTRY OUTBREAKS

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Reference ID Created Released Classification Origin
07HANOI1026 2007-06-01 08:29 2011-08-25 00:00 UNCLASSIFIED//FOR OFFICIAL USE ONLY Embassy Hanoi
VZCZCXRO2315
RR RUEHCHI RUEHDT RUEHHM RUEHLN RUEHMA RUEHPB RUEHPOD
DE RUEHHI #1026/01 1520829
ZNR UUUUU ZZH
R 010829Z JUN 07
FM AMEMBASSY HANOI
TO RUEHC/SECSTATE WASHDC 5529
INFO RUEHHM/AMCONSUL HO CHI MINH 3150
RUEHZS/ASEAN REGIONAL FORUM COLLECTIVE
RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE
RUEHBK/AMEMBASSY BANGKOK 5759
RUEHJA/AMEMBASSY JAKARTA 0676
RUEHUL/AMEMBASSY SEOUL 3166
RUEHKO/AMEMBASSY TOKYO 5731
RUEHVN/AMEMBASSY VIENTIANE 3987
RUEHHK/AMCONSUL HONG KONG 1203
RUEHGZ/AMCONSUL GUANGZHOU 0802
RUEHCN/AMCONSUL CHENGDU 0303
RUEHSUN/USUN ROME IT
RUEHIN/AIT TAIPEI 1496
RUEAIIA/CIA WASHINGTON DC
RUEHPH/CDC ATLANTA GA
RUEAUSA/DEPT OF HHS WASHINGTON DC
RUEHRC/DEPT OF AGRICULTURE 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//
UNCLAS SECTION 01 OF 04 HANOI 001026 
 
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 (STIEGER, VALDEZ, BELL, HICKEY) 
CDC (COX AND MOHEN) 
USDA PASS TO APHIS 
DEPARTMENT OF DEFENSE FOR OSD/ISA/AP (STERN) 
BANGKOK FOR RMO, CDC, USAID (MACARTHUR AND BRADY) 
VIENTIANE FOR CDC (CORWIN) 
ROME FOR FAO 
 
E.O. 12958: N/A 
TAGS: TBIO KFLU AMED AMGT CASC EAGR PINR SOCI VM
SUBJECT: AVIAN INFLUENZA UPDATE - MORE POULTRY OUTBREAKS 
 
 
HANOI 00001026  001.2 OF 004 
 
 
SENSITIVE BUT UNCLASSIFIED 
 
REF: HANOI 973 and previous 
 
1. (U) Summary: Vietnam is experiencing a new wave of H5N1 AI 
outbreaks in poultry.  In May 2007, poultry outbreaks have been 
reported in 12 provinces and municipalities throughout the country. 
The Government of Vietnam's (GVN) public health response to the 
reported first human case since November 2005 was swift and 
appropriate, but only after the case-patient arrived at the Bach Mai 
Hospital's Intensive Care Unit.  Several days lapsed between the 
case-patient's initial contact with sick and dead poultry and this 
response, indicating that there remain gaps at the village- and 
district-levels.  The 30-year old man from Vinh Phuoc Province is 
recovering and has been taken off a ventilator.  The Partnership for 
Avian and Human Influenza (PAHI) held its first meeting on May 29. 
USAID Vietnam hosted a USG implementing partners meeting on May 30 
to provide programmatic updates, share ideas on recent outbreaks and 
provide informal updates on USG-funded activities.  End Summary. 
 
Human Case 
---------- 
 
2. (SBU) Per reftel, a 30 year-old man from northern Vietnam's Vinh 
Phuc Province has been confirmed as the first human case of highly 
pathologic AI since November 2005.  This case-patient from Thach Da 
Commune, Me Linh District, Vinh Phuc Province slaughtered chickens 
for a wedding party of 100 people on May 5.  Response teams reported 
that the chickens had been purchased in neighboring northern Ha Tay 
Province and that some were reported to have been ill or dead at 
time of the slaughtering.  On May 10, the case-patient developed an 
illness with fever, cough, and difficulty in breathing; milder 
symptoms may have arisen 2-3 days earlier.  In the period May 11-14, 
the case-patient became progressively more ill, and on May 14 he was 
admitted overnight at the district clinic.  On May 15, he was 
transferred to Bach Mai Hospital, Hanoi, where he was hospitalized 
on a general medical ward with a diagnosis of pneumonia. 
 
3. (SBU) The patient's condition deteriorated further over the next 
several days and on May 18 he was transferred to the Bach Mai 
Intensive Care Unit for mechanical ventilation.  On May 19, the 
National Institutes of Hygiene and Epidemiology (NIHE) was notified 
of a case of severe viral pneumonia and, following protocol, a team 
was dispatched to collect clinical specimens and exposure 
information.  Results of polymerase chain reaction (PCR) testing 
available later that day were positive for H5N1 infection; results 
were confirmed with repeat PCR and preliminary sequencing was 
performed and reported to higher authorities on May 20.  At that 
point, information became available on exposure to sick chickens at 
time of slaughtering. 
 
4. (SBU) On May 21-22, a team comprised of epidemiology, laboratory, 
and sanitarian staff from the Ministry of Health's (MOH) Preventive 
Medicine Department at central and local level levels and NIHE, a 
clinician from Hospital Infectious and Tropical Diseases, Hanoi, and 
District Animal Health staff investigated circumstances at the site 
of probable exposure, Me Linh District, Vinh Phuc Province, and took 
appropriate prevention and control actions.  Investigations and 
 
HANOI 00001026  002.2 OF 004 
 
 
control measures were also carried out at the health facilities 
where the patient had received treatment.  Approximately 40 health 
care workers and 70 family members and other close contacts were 
administered prophylactic 7-day courses of oseltamivir (Tamiflu). 
Epidemiologic investigations revealed only one contact with 
symptoms, a 16-year old niece with a mild upper respiratory illness 
who was H5N1 test negative and recovered without consequence. 
Intensive area surveillance over the next week identified no further 
persons with suspect symptoms, and no AI outbreaks in Me Linh 
District or Ha Tay Province.  By May 30, the patient's condition was 
reported to be much improved and recovering without need for 
ventilator assistance. 
 
5. (SBU) Comment.  The GVN's public health response to this human 
case was swift and appropriate, but only after the case-patient 
arrived at the Bach Mai Hospital's Intensive Care Unit.  Several 
days lapsed between the case-patient's initial contact with dead 
poultry and this response, indicating that there remain gaps at the 
village- and district-level.  This case illustrates the need for 
continuing USG's activities at the grassroots level and particularly 
with farmers and village animal and human health workers.  USG 
implementing partners reveal that awareness levels are not equal in 
all provinces and districts, with many areas still having quite low 
levels of awareness (e.g., how one contracts HPAI).  End Comment. 
 
Animal Outbreaks 
---------------- 
 
6. (SBU) Vietnam is experiencing a new wave of H5N1 AI outbreaks in 
poultry.  In May 2007, poultry outbreaks have been reported in 12 
provinces and municipalities, including Nghe An, Nam Dinh, Son La, 
Hai Phong, Quang Ninh, Bac Giang, Ninh Binh, Bac Ninh, Vinh Phuc and 
Ha Nam in the north, and Dong Thap and Can Tho in the south.  The 
most recent poultry outbreaks have occurred in northern Nam Dinh and 
Ninh Binh Provinces and southern Dong Thap Province.  The outbreaks 
in Vietnam have mostly affected unvaccinated, immature duck flocks, 
but smaller numbers of older birds have also been affected.  As 
previously reported, all of the outbreaks were quickly brought under 
control.  Response measures included culling, vaccinating 
surrounding flocks, disinfecting poultry pens, restricting of the 
movement of poultry beyond outbreak areas and animal quarantine. 
 
7. (U) The Minister of Agriculture and Rural Development (MARD) Cao 
Duc Phat stated at a session of the National Steering Committee for 
Bird Flu Control and Prevention on May 29 that all waterfowl must 
either be immediately vaccinated or culled.  Media reports indicate 
that since early May over 49,000 poultry have been found either dead 
or have been culled by animal health workers. 
 
Partnership for Avian and Human Influenza 
----------------------------------------- 
 
8. (U) The GVN hosted a plenary meeting of the Partnership for Avian 
and Human Influenza (PAHI) and formally established its Secretariat 
office on May 29.  Beyond the original nine signatory partners, 
which includes the U.S. Mission, three additional non-governmental 
organizations (NGO) joined the PAHI.  The GVN's national plan calls 
for USD 250 million in assistance.  The GVN has pledged to 
 
HANOI 00001026  003.2 OF 004 
 
 
contribute 50 percent of this amount.  The international donors have 
delivered about USD 70 million, leaving a gap of about USD 55 
million.  The USG remains the second largest donor to PAHI, second 
only to Japan. 
 
9. (SBU) During the original negotiation and clearance of the PAHI 
framework document, Japan pushed for decreasing the perception of 
the binding nature of the framework by suggesting that the document 
be changed from a memorandum of understanding to a simple agreement. 
 Although this point was conceded, Japan did not sign at the meeting 
in November 2006.  At the May 29 plenary, Japan left prior to the 
signing portion of the agenda, but pledged to sign sometime in the 
future. 
 
10. (U) The PAHI Secretariat serves to: a) facilitate and coordinate 
donor commitments and funding; b) serve as a platform for 
information exchange and policy development; and c) harmonize 
monitoring and evaluation efforts.  The Secretariat announced plans 
to add two other technical working groups, one each on animal and 
human health activities to compliment the existing communications 
workgroup, which predates PAHI. 
 
11. (SBU) The announcement of the technical workgroups was welcomed 
by the USG AI in-country team, who has been advocating since 
November 2006 for the addition of technical workgroup function to 
better harmonize efforts across donors programs.  There was open 
support that PAHI examine ongoing USG planning efforts on monitoring 
and evaluation. 
 
12. (SBU) United Nations Resident Coordinator John Hendra concluded 
the meeting by summarizing two important points: a) the need to draw 
out the total funds spent and pledged to date, by the implementing 
start date of the national plan as well as to justify with current 
figures on the gap; and b) to need to further discuss and address 
the GVN's organization structure as illustrated in the national plan 
versus the current operating approach. 
 
13. (SBU) Comment: Post believes the PAHI has to-date succeeded to 
deliver its objectives.  The PAHI has leveraged the USG's investment 
in building capacity for highly pathological AI in Vietnam through 
the promotion of openness, transparency and accountability.  End 
Comment. 
 
USG Implementing Partners Meeting 
--------------------------------- 
 
14. (SBU) USAID Vietnam hosted a USG implementing partners meeting 
on May 30 to provide programmatic updates, share ideas on recent 
outbreaks and provide informal updates on USG-funded activities. 
Thirteen representatives of USAID, State, CDC, FAO, Abt Associates, 
AED, AVSF, CRS, and Kenan Institute attended.  Topics discussed 
include the status of 2007 supplemental funding for AI, the current 
grassroots level demand and use of rapid testing kits, farmers' 
compensation for culled poultry, the barriers to conducting a 
comprehensive poultry vaccination campaign, sharing methodologies 
and results of various KAP surveys, gaps in local knowledge levels 
and the use of mass media and television, a pilot supply chain 
management activity, development of public-private partnership 
 
HANOI 00001026  004.2 OF 004 
 
 
activities, discussions between the MOH and CARE to expand their 
model village-based surveillance activity and the MOH's response to 
the human case-patient. 
 
MARINE