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Viewing cable 08DHAKA193, BIRD FLU IN MORRELGANJ - OUTBREAK MANAGEMENT CASE STUDY

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Reference ID Created Released Classification Origin
08DHAKA193 2008-02-12 08:12 2011-08-25 00:00 UNCLASSIFIED Embassy Dhaka
VZCZCXRO5755
OO RUEHAST RUEHBI RUEHCI RUEHHM RUEHLH RUEHLN RUEHMA RUEHPB RUEHPOD
RUEHPW
DE RUEHKA #0193/01 0430812
ZNR UUUUU ZZH
O 120812Z FEB 08
FM AMEMBASSY DHAKA
TO RUEHC/SECSTATE WASHDC IMMEDIATE 6198
INFO RUEHRO/AMEMBASSY ROME PRIORITY 0454
RUEKJCS/SECDEF WASHDC
RUEHRC/DEPT OF AGRICULTURE WASHDC
RUEAUSA/DEPT OF HHS WASHDC
RUCPDOC/DEPT OF COMMERCE WASHDC
RUEHPH/CDC ATLANTA
RUEAIIA/CIA WASHINGTON DC
RUEKDIA/DIA WASHDC
RHHMUNA/CDR USPACOM HONOLULU HI
RUEHNE/AMEMBASSY NEW DELHI 0472
RUEHBI/AMCONSUL MUMBAI 0289
RUEHCG/AMCONSUL CHENNAI 0956
RUEHCI/AMCONSUL KOLKATA 1143
RUEHGV/USMISSION GENEVA 0649
RUEHUL/AMEMBASSY SEOUL 0312
RUEHKT/AMEMBASSY KATHMANDU 9521
RUEHLM/AMEMBASSY COLOMBO 8300
RUEHIL/AMEMBASSY ISLAMABAD 2023
RUEHBK/AMEMBASSY BANGKOK 8399
RUCNCLS/ALL SOUTH AND CENTRAL ASIA COLLECTIVE
RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE
UNCLAS SECTION 01 OF 05 DHAKA 000193 
 
SIPDIS 
 
SENSITIVE NOFORN 
SIPDIS 
 
USDA FOR DEPUTY UNDER SECRETARY/ETERPSTRA 
USDA FOR OFSO/JDEVER 
USDA FOR FAS/OA/MYOST/WKMILLER 
USDA FOR FAS/OCRA/CALEXANDER/JCARVER 
USDA FOR FAS/OSTA/CHAMILTON 
USDA FOR APHIS/MFLEMINGS/TBURLESON 
USAID FOR GH/HIDN/DCARROLL/MTROSTLE 
USAID FOR ANE/SAA/FFULLER 
USAID FOR ANE/TS/ACLEMENTS 
SEOUL FOR APHIS/GEORGE ANDY BALL 
BANGKOK FOR USAID 
NEW DELHI FOR FAS 
STATE FOR SCA, OES, SA/INS, EB/TPP, AVIAN INFLUENZA ACTION GROUP 
DEPT PLS PASS CDC - COX AND BLOUNT AND HHS - STEIGER AND HICKEY 
 
E.O. 12958: N/A 
TAGS: KFLU EAGR PGOV PREL ECON ETRD WTO TBIO CASC AMED IN
BG 
 
SUBJECT: BIRD FLU IN MORRELGANJ - OUTBREAK MANAGEMENT CASE STUDY 
 
REF: DHAKA 00131 
 
DHAKA 00000193  001.2 OF 005 
 
 
1. (SBU) SUMMARY:  An interagency assessment team (IAT) from State, 
DOD, and USAID has been in southern Bangladesh's Khulna and Barisal 
Divisions conducting an assessment of the Cyclone Sidr affected area 
in support of USG rehabilitation and reconstruction efforts. The IAT 
has been tasked to report on any suspected avian influenza (AI) 
outbreaks or AI prevention operations encountered.  Based on 
observations of the IAT at one site (which corroborate second-hand 
reports from other locations) post is concerned about serious gaps 
and delays in the GOB's response to the current spate of AI 
outbreaks occurring across Bangladesh.  Direct observations from the 
Morrelganj area indicate a general lack of bio-security measures and 
AI awareness at the ground level. Post has provided the IAT with 
applicable biosecurity directions. Post's Medical Officer has 
assessed the risk of the IAT contracting AI as low; the IAT is 
self-monitoring for symptoms of illness. END SUMMARY. 
 
2. (SBU) Since January 20, an interagency assessment team (IAT) from 
State, DOD, and USAID, has been in Morrelganj Upazila (county), 
located in southern Bangladesh's Khulna Division, to conduct 
assessments following Cyclone Sidr.  On the morning of February 3, a 
USAID-funded NGO notified the team that there was a possible 
outbreak of avian influenza (AI) in the area.  The suspected AI 
outbreak occurred at a small-scale poultry farm located in 
Morrelganj. This location is approximately one mile from the IAT 
base.  This area was significantly affected by the cyclone and is 
only now beginning to rebuild.  The infected farm itself was located 
approximately 1/5 mile from the Khashiakhali River and 100 yards 
from a pond with a pond sand filter which serves as the main source 
of drinking water for the neighborhood. 
 
Farm-Level Observations 
----------------------- 
 
3.  (U) On February 3 IAT members spoke with the farm owners and 
observed a poultry coop.  The farmers stated that on February 1, 
they observed dead and sick birds on their farm.  The farmers 
explained that they hired day laborers to remove the dead and sick 
birds: they removed approximately 900 birds, leaving 125 apparently 
healthy birds.  (NOTE: The workers doing the bird removal wore no 
special clothing or protective equipment, and likely did not 
disinfect their shoes. END NOTE.) The dead birds were buried 
adjacent to the chicken coop.  The farmers then notified the local 
authorities who dispatched a team to investigate.  On February 2, 
the upazila (administrative unit like a county) livestock officer 
and a livestock team sprayed an unknown chemical disinfectant around 
the farm area.  The livestock officer told the farmers that the 
birds likely died of Newcastle Disease (another common cause of 
poultry die-offs, distinct from AI) and not AI.  Additionally, they 
said that they received no advice on to what to do next. 
 
4. (U) The farmers told the IAT that they invested 450,000 taka (USD 
 
DHAKA 00000193  002.4 OF 005 
 
 
6,600) to establish the farm shortly after Cyclone Sidr.  The 
farmers had purchased 1,025 hens. The hens were being raised for 
eggs and were just starting (before the die-off) to lay enough eggs 
for commercial sale.  The farmers added that they have not been 
compensated for their losses and they have received no commitment 
from the government to do so. 
 
5. (U) During the farm visit, the IAT observed a stack of dead 
chickens in the coop.  Other chickens appeared listless and their 
combs drooped.  It was readily apparent that the birds not culled 
earlier (deemed healthy a day prior) were now dying.  Farmers were 
handling these birds with bare hands and had no information about 
the potential hazards of handling AI-infected poultry.  The farmers 
said that they have not sold any birds or eggs on the local market. 
In the local markets, poultry traders told IAT members that since 
there were no AI outbreaks in the area there was nothing to worry 
about and they did not need to adopt any special procedures.  Even 
if some individuals seemed concerned, they seemed unaware of safety 
precautions. 
 
6. (U) IAT members spoke with neighbors located within a 200 yard 
radius from the affected farm.  Some of the neighbors told the team 
that they knew about the outbreak but were not concerned.  They 
added that the local government told them it was Newcastle Disease 
so there was nothing to fear.  The team observed poultry in this 
immediate vicinity, in small backyard holdings.  The owners told us 
that they were not instructed to do anything specific. One neighbor 
informed the team that they previously wanted to vaccinate their 
poultry but there was a problem with the vaccine. 
 
Upazila Officials Concerned 
---------------------------- 
 
7. (SBU) IAT members visited the head of the Upazila administration 
(UNO), Krishna Kanta Biswas, to discuss the outbreak.  Biswas told 
the team that the local government was taking the outbreak very 
seriously.  He told the IAT that a checkpoint was established in the 
northern portion of the upazila to ensure that no poultry entered 
the area without a certificate of a being AI-free [COMMENT: No such 
certification process exists. END COMMENT] In addition, poultry from 
the affected area will not be allowed north of the river to prevent 
the potential spread of the disease to other unions (townships) in 
the upazila.  However, he did not terminate poultry sales in 
Morrelganj town. 
 
8. (SBU) On February 3 the local livestock officer sent samples to 
the nearest field test center in Barisal, about a 4-5 hour drive 
away.  The evening of February 3 Biswas received an initial result 
from Barisal. Biswas stated that the news was not good, but the 
initial finding had to be re-confirmed in Dhaka, suggesting that AI 
needed to be evaluated by a subsequent test. 
 
9. (SBU) Biswas told the team that they had previously received 
 
DHAKA 00000193  003.2 OF 005 
 
 
instructions about what to do in case of a suspected outbreak.  He 
noted that 5-6 months earlier, there was another suspected outbreak 
in the upazila, not far from the present farm, but that a test 
returned an inconclusive result due to a poor quality sample. 
Biswas also noted that his offices were prepared to deal with an 
outbreak and had seven sets of personal protective gear (PPE). 
Biswas stated that if AI is confirmed, additional measures would be 
taken.  Some of these measures listed included culling birds within 
a 1KM radius of the farm as well as stopping all poultry and egg 
sales in the area.  Also, a practice of using poultry waste (feces) 
as fish food would be terminated.  He did express concern that this 
would have a significant economic impact in the area - which is 
still recovering from the cyclone.  Biswas asked about getting USG 
assistance; he asked specifically for a technical expert.  The IAT 
leader told him that the request would be passed to the Embassy in 
Dhaka. 
 
10. (U) On  February 4, national newspapers reported an AI outbreak 
in Morrelganj.  The Bangla paper Shamokal reported the following: 
BEGIN TRANSLATED TEXT. At least 900 chickens of a farm died or 
culled Sunday due to infection of avian influenza in Morrelganj 
upazila of Bagerhat district.  After hearing the news, fear spread 
among the poultry farmers of the district.  District Livestock 
office said that red alert has been issued in Morrelganj upazila in 
order to prevent spread of the disease.  Transfer of all kinds of 
poultry from or to Morrelganj has been banned.  END TRANSLATED 
TEXT. 
 
 
ACTION: NOT TOO LITTLE, BUT POSSIBLY TOO LATE 
--------------------------------------------- 
 
 
11. (SBU) On February 5, Biswas received confirmation from Dhaka 
that the samples from Morrelganj were positive for AI.  Although 
sale of chickens appears to have stopped in the local market, eggs 
continued to be sold.  By 1800 hours, plans were underway to cull 
the infected farm and surrounding areas. 
 
12. (SBU) During the February 5 meeting with Biswas, the local 
livestock officer told the IAT that he thought there were three main 
causes for the outbreak.  These include: (1) the hens were at their 
first egg-laying stage and this results in lower immunity; (2) a 
recent cold and rain period further reduced immunity; and (3) 
vaccination management was poor.  The livestock officer told us that 
the vaccination procedures and general farm management is not 
sufficient to prevent AI outbreaks. 
 
13. (U) On the medical side, Biswas and the local medical officer 
noted that the local hospital, located in Hoglabunia, across the 
river from the affected area is ready to establish an isolation 
ward.  They also currently have a stockpile of approximately 100 
AviFlu and TamiFlu capsules manufactured in Bangladesh by Square 
 
DHAKA 00000193  004.2 OF 005 
 
 
Pharmaceuticals.  Biswas has already asked for additional 
medication, though to date no patients have been admitted to the 
hospital from the affected area with any symptoms of AI.  Moving 
forward, Biswas said he plans a large public information campaign 
about the dangers of AI. 
 
14. (SBU) On February 5 culling in Morrelganj began at some point 
after 2100 hours and concluded on February 6 at approximately 0430. 
Based on second hand reports from villagers, culling within a 1 KM 
radius of the infected farm was conducted by 4 teams of 3 persons 
each, who wore full-body PPEs with masks. Culled chickens were 
placed in plastic bags and buried in holes throughout the area (not 
in one consolidated hole.)  Biswas was previously aware that the 
holes should be approximately 8 feet deep.  The IAT was unable to 
determine if any disinfection was completed on the infected farm 
during or after the culling, or on the culling teams' vehicles' 
tires. 
 
15. (SBU) During the culling approximately 30 police and army 
personnel were also on hand, but they did not wear PPEs. The numbers 
and owners of culled birds were recorded in a register, with a 
promise for compensation (of 70 taka per bird - US$1) at a later 
time.  No further safety or health monitoring information was 
provided to the farmers. 
 
16. (SBU) On February 6, the IAT did not see any chickens in the 
immediate 1KM vicinity of the infected farm. In the poultry market 
2-3 KMs away from the infected farm, traders stated they had been 
asked by Biswas to stop sales. Although there were no chickens for 
sale, eggs were for sale and one seller offered he could provide 
some chickens if the IAT wanted to buy some, albeit at higher 
prices.  None of the persons encountered in the wet market displayed 
any concern about the potential health risks of the confirmed AI 
outbreak less than 3KM away. Within a 10 KM zone of the AI infected 
farm, free range chickens were observed in yards. 
 
17. (SBU) While leaving Morrelganj on 06 February, the IAT could not 
identify any apparent monitoring or restrictions on poultry trade or 
movements of poultry into or out of the area (even between 
upazillas).  Per the GOB plan, there is meant to be a restriction on 
poultry movements into or out of a 3KM radius of an infected farm. 
It is not evident if or how controls on the poultry trade in the 
vicinity of infected farm will be monitored. 
 
18. (SBU) Given that at least three members of the IAT were on an 
AI-infected farm during their interviewing of farmers, Post provided 
applicable directions to the IAT for disinfecting their shoes, 
clothing and the vehicle's wheel rims and tires.  Post's RMO has 
assessed the risk of the IAT contracting AI as low; the IAT is 
self-monitoring for symptoms of illness. 
 
Comment 
------- 
 
DHAKA 00000193  005.2 OF 005 
 
 
 
19. (SBU) The AI outbreak in the Cyclone Sidr-affected region adds 
yet another dimension of health risks and economic losses to an 
already devastated area.  In the immediate vicinity of the 
Morrelganj outbreak many homes remain destroyed.  Residents are 
seeking funds to rebuild their shelters before the upcoming rainy 
season.  Poultry and fish are the main sources of protein.  Poultry 
related work provides income for many of the people in the region. 
The government leadership in the areas visited by the IAT appear to 
be taking minimum steps necessary to address the AI outbreak.  The 
entire AI response process appears top-down driven, with little 
available resources for local level initiatives or action. 
 
20. (SBU) The manner in which the GOB investigated, responded, and 
managed the AI contaminated farm in Morrelganj does not demonstrate 
compliance with standard biosecurity protocols and safety practices 
and their own outbreak management protocol.  AI-related information 
for farmers, traders, teams performing culling, and the general 
populaceis urgently needed at the local level. 
 
21. (SBU) This is the first time that Post has directly observed the 
GOB's management of a poultry die-off and the corresponding response 
to a confirmed AI outbreak at a farm.  Based on these findings, Post 
gives added credence to additional second-hand information received 
from other parts of the country reporting similar deficiencies in 
the GOB's ground-level response.  Post will continue its focused 
efforts on augmenting the GOB's AI planning, testing, management and 
response capacity.  Additional reporting will be provided SEPTEL.