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Viewing cable 08HANOI408, VIETNAMESE OFFICIALS CONCERNED, NOT ALARMED, AT

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Reference ID Created Released Classification Origin
08HANOI408 2008-04-09 10:29 2011-08-25 00:00 UNCLASSIFIED//FOR OFFICIAL USE ONLY Embassy Hanoi
VZCZCXRO7313
OO RUEHCHI RUEHCN RUEHDT RUEHHM RUEHLN RUEHMA RUEHPB RUEHPOD
DE RUEHHI #0408/01 1001029
ZNR UUUUU ZZH
O 091029Z APR 08
FM AMEMBASSY HANOI
TO RUEHC/SECSTATE WASHDC 7573
INFO RUEAUSA/DEPT OF HHS WASHINGTON DC IMMEDIATE
RUEHHM/AMCONSUL HO CHI MINH 4553
RUEHZS/ASEAN REGIONAL FORUM COLLECTIVE
RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE
RUEHPH/CDC ATLANTA GA
RUEHRC/DEPT OF AGRICULTURE WASHINGTON DC
RUCPDOC/DEPT OF COMMERCE WASHINGTON DC
RUEHSUN/USUN ROME IT
UNCLAS SECTION 01 OF 02 HANOI 000408 
 
SIPDIS 
 
SENSITIVE 
SIPDIS 
 
STATE FOR EAP/MLS, EAP/EP, INR, OES/STC, OES/IHA, MED 
STATE PASS TO USAID FOR ANE AND GH 
HHS/OSSI/DSI PASS TO SECRETARY LEAVITT AND OGHA 
(WSTIEGER/LVALDEZ/CHICKEY), FIC/NIH (GLASS), FDA (MPLAISER) 
CDC/COGH FOR SBLOUT/KMCCALL/RARTHUR, PASS TO NCZVED/DFBMD/EDEB 
(RTAUXE/EMINTZ) AND GDD, IEIP, DEOC 
USDA PASS TO APHIS, FAS (OSTA AND OCRA), FSIS 
BANGKOK FOR RMO, CDC (MMALISON/SMALONEY/AHENDERSON), USAID/RDM/A 
(CBOWES/JMACARTHUR), APHIS (NCARDENAS), REO (JWALLER) 
BEIJING FOR HHS HEALTH ATTACHE (BROSS) 
ROME FOR FAO 
 
E.O. 12958: N/A 
TAGS: TBIO AMED AMGT CASC EAGR PINR VM
SUBJECT: VIETNAMESE OFFICIALS CONCERNED, NOT ALARMED, AT 
REAPPEARANCE OF CHOLERA 
 
REF: A. HANOI 383 B. 07 HANOI 2071 C. 07 HANOI 2012 D. 07 HANOI 1953 
E. 07 HANOI 1924 F. 07 HANOI 1891 
 
HANOI 00000408  001.2 OF 002 
 
 
1. (SBU) The current outbreak of severe acute diarrhea continues to 
spread.  Dr. Nguyen Huy Nga, Director General of the Preventative 
Health and Environmental Agency of the Ministry of Health (MOH), 
recently announced tests confirming the presence of cholera in 
patients in two additional northern provinces, Ninh Binh and Hai 
Duong, increasing the total number of cholera-impacted provinces to 
12, including the central provinces of Thanh Hoa and Quang Binh.  By 
contrast, the 2007 outbreaks did not spread beyond northern Vietnam. 
 Cholera has hit Hanoi most severely, with 12 out of 14 Hanoi 
districts affected.  Most victims in the current outbreak were 
exposed to the bacteria in Hanoi, including some who then traveled 
to surrounding provinces.  The single case identified in the central 
province of Quang Binh is considered to have been exposed in Hanoi. 
At the same time, Nga noted that Hai Phong and Thanh Hoa provinces 
appeared to experience separate outbreaks.  (Note: cases of severe 
diarrhea in Ho Chi Minh City have tested negative for cholera).  In 
discussions with Embassy HHS/CDC staff on April 8, Nga noted that 
the current wave of severe acute diarrhea, began on March 6 and has 
led to more than 700 identified cases of severe acute diarrhea, more 
than 120 of which have tested positive for cholera.  Similar to last 
year's events (ref B), the GVN has not recorded any deaths to date 
associated with the outbreak. 
 
Outbreak Appears Foodborne, Not Waterborne 
------------------------------------------ 
 
2. (SBU) Nga informed Embassy HHS/CDC staff that most cases appear 
to be associated with consumption of herbs and raw vegetables served 
at dog meat restaurants and by street vendors.  Nga stated that MOH 
investigations had not identified any large point source exposures 
or clusters arising from drinking contaminated water and that there 
was no evidence of contaminated municipal water sources.  At the 
same time, however, he noted that environmental testing had found 
Vibrio cholerae contamination of surface water at several sites in 
Hanoi, including some of the many ponds and lakes in the city.  On 
April 8, Viet Nam News reported that the Hanoi People's Committee 
called for cleanup of 30 lakes in the city, noting contamination 
with untreated sewage and refuse from nearby markets.  The newspaper 
cited the Ministry of Natural Resources and Environment as saying 
that almost all of the 110 lakes in Hanoi are contaminated with 
untreated sewage and that all posed a serious health risk.  In one 
hard hit district, municipal authorities were taking steps to shut 
down market vendors and local restaurants with substandard health 
and safety conditions and to demolish substandard temporary housing 
posing an environmental hazard. 
 
GVN Concerned, Not Alarmed 
-------------------------- 
 
3. (SBU) Nga expressed concern with the current situation but not 
alarm, differing from some of the more sensational press reports. 
Nga has not sought additional WHO assistance beyond the two advisors 
scheduled to arrive later this week, including a CDC epidemiologist 
stationed in Bangkok, who responded to the first wave in December. 
He will arrive tomorrow on a previously arranged visit to provide 
support to cholera studies initiated in November 2007 (ref D). 
 
Vietnamese Press, However, Expressing Alarm 
------------------------------------------- 
 
4. (U) Vietnam's state controlled media has highlighted the outbreak 
for the past several weeks, providing additional factual details, 
while emphasizing the potential seriousness of the outbreak. 
According to reports late last week in Tuoi Tre (Youth) newspaper, 
Bach Mai hospital in Hanoi has reported 80 percent of the 40 
patients recently admitted for severe acute diarrhea have tested 
positive for cholera, a larger number and percentage than in the 
October 2007 outbreak.  The paper further reported that the National 
 
HANOI 00000408  002.2 OF 002 
 
 
Institute for Infectious and Tropical Diseases in Hanoi had admitted 
nearly 300 patients -- almost 40 per day -- with severe acute 
diarrhea and that 70 to 80 percent of those tested were infected 
with cholera, also substantially higher than last year. 
 
EMBASSY COORDINATION 
-------------------- 
 
5. (SBU) HHS/CDC experts in Hanoi have reviewed current warden 
notice posted in December with CON and MED in Hanoi, determined it 
is still accurate, and working with the Hanoi-based team preparing 
for the visit of Secretary Leavitt's delegation, have taken all 
necessary precautions, all of which are in conformance with the 
guidance contained in the December warden message.  Post does not 
believe that a new warden message is warented at this time. 
 
MICHALAK