VIETNAM - AVIAN FLU UPDATE #7

UNCLAS HANOI 000309

SIPDIS


FOR CA/OCS/ACS/EAP; EAP/EX; EAP/BCLTV
BANGKOK FOR RMO, CDC, AID (TDOLAN)
STATE PASS HHS for Marie Haring Sweeney
USDA FOR FAS/PASS TO APHIS

E.O. 12958: N/A
TAGS: AMED AMGT CASC EAGR TBIO VM AFLU
SUBJECT: VIETNAM - AVIAN FLU UPDATE #7

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CURRENT STATUS
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1. (U) WE ARE AWARE OF DISCREPANCIES BETWEEN THE NUMBERS OF
CASES OF AVIAN INFLUENZA (AI) IN HUMANS IN OUR CABLES,
REPORTED BY WHO, AND THE NUMBER REPORTED BY THE GVN'S MOH.
THE STATISTICS REPORTED IN OUR CABLES REFLECT WHAT WE
BELIEVE TO BE MOST RECENT RELIABLE NUMBERS BASED ON THE
DISCUSSIONS HELD EACH NIGHT BY MEMBERS OF THE WHO AI
INVESTIGATIVE TEAM (INCLUDING CDC AND OTHER INTERNATIONAL
EPIDEMIOLOGISTS AND CLINICIANS). MOST RECENT DISCUSSIONS
INDICATE THAT THERE ARE 13 CASES OF LABORATORY-CONFIRMED H5
INFLUENZA IN HUMANS, ALTHOUGH THE MOH HAS OFFICIALLY
REPORTED 10. THE BULK OF THESE CASES HAVE OCCURRED IN OR
AROUND HANOI AND A FEW ARE IN HCMC. ONE OF THE NEWLY
CONFIRMED CASES IS A DEATH IN THE CENTRAL PROVINCES, THE
FIRST IN THAT REGION. IN ADDITION, WE ARE AWARE THAT THE
LOCAL AND INTERNATIONAL PRESS IS REPORTING ADDITIONAL CASES
OF H5 INFLUENZA IN HUMANS. THESE ACTUALLY REFLECT A
COMBINATION OF "POSSIBLE" CASES OF INFLUENZA A BASED ON
RAPID TESTING. THESE MAY OR MAY NOT BE H5. THE FIGURES
ALSO INCLUDE "SUSPECT" CASES OF FEVER AND RESPIRATORY
SYMPTOMS IN HUMANS THAT ARE BEING INVESTIGATED BUT THAT MAY
OR MAY NOT BE INFLUENZA. CDC HANOI CONFIRMS THAT OVER 50
CASES OF SUSPECTED OR POSSIBLE INFLUENZA ARE BEING
INVESTIGATED BY MOH (OFTEN WITH THE ASSISTANCE OF THE WHO
INVESTIGATIVE TEAM); MOST OF THESE WILL NOT HAVE INFLUENZA
AS SEVERAL ARE BEING RULED OUT DAILY.

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FOOT AND MOUTH DISEASE
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2. (U) There is also an active foot and mouth outbreak in
Vietnam. This alone is not alarming as Vietnam regularly
suffers from foot and mouth outbreaks several times per
year. However, pigs infected by foot and mouth may be more
vulnerable to both avian and human influenza, and thus more
of a risk in mixing the viruses leading to human-to-human
community spread.

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AFFECTED PROVINCES
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3. (U) REGARDING INFLUENZA IN BIRDS, THE NUMBER OF
PROVINCES REPORTING BIRD DEATHS RELATED TO AVIAN INFLUENZA
HAS INCREASED TO 53 (OF 64). THE LOCAL PAPERS DESCRIBE
CULLING EFFORTS ON THE FRONT PAGE; HOWEVER, THE WHO
INVESTIGATIVE TEAM MEETINGS INDICATE THAT WITH THE EXCEPTION
OF A FEW PROVINCES, MOST CULLING IS ACTUALLY PICKING UP DEAD
BIRDS. AVAILABILITY OF PERSONAL PROTECTIVE EQUIPMENT (PPE)
REMAINS LIMITED. INCENTIVES FOR POULTRY GROWERS TO
SURRENDER BIRDS ARE ALSO LIMITED.


4. (U) ACCORDING TO A SPREADSHEET DEVELOPED BY THE MINISTRY
OF AGRICULTURE AND RURAL DEVELOPMENT'S DEPARTMENT OF ANIMAL
HEALTH, FIRST REPORTS OF AVIAN FLU IN VIETNAM OCCURRED IN
DECEMBER 2003 IN 11 PROVINCES SCATTERED AROUND THE COUNTRY.
THE NUMBER OF REPORTED AREAS AFFECTED HAS INCREASED RAPIDLY
IN RECENT DAYS AT BOTH THE PROVINCIAL AND COMMUNE LEVEL,
POSSIBLY BECAUSE OFFICIALS HAVE RETURNED FROM THE WEEK-LONG
TET HOLIDAYS AND ARE DOING MORE REPORTING, AND ALSO POSSIBLY
BECAUSE THE MEDIA HAS FOCUSED ATTENTION ON THE ISSUE.
BURGHARDT