VIETNAM: AVIAN INFLUENZA WEEKLY REPORT FOR DECEMBER

UNCLAS SECTION 01 OF 05 HANOI 003240

SIPDIS

FOR USAID/RDM-A/BANGKOK PRIORITY
STATE FOR G; CA/OCS/ACS/EAP; EAP/EX; EAP/BCLTV; EAP/EP; INR;
OES/STC (PBATES); OES/IHA (DSINGER AND NCOMELLA)
BANGKOK FOR RMO, CDC, USAID/RDM/A (MFRIEDMAN AND JMACARTHUR)
USDA FOR FAS/PASS TO APHIS
DEPARTMENT OF DEFENSE FOR OSD/ISA/AP (LSTERN)
USAID FOR ANE AND GH (DCARROLL, SCLEMENTS AND PCHAPLIN)
STATE PASS USTR (ELENA BRYAN)
STATE ALSO PASS HHS/OGHA (EELVANDER)

E.O. 12958: N/A
TAGS: AMED AMGT CASC EAGR PINR SOCI PGOV TBIO VM AFLU
SUBJECT: VIETNAM: AVIAN INFLUENZA WEEKLY REPORT FOR DECEMBER
9, 2005

REF: A) HANOI 3190, B) HCMC 1269


1. (SBU) Summary. There have been no new human Avian
Influenza (AI) deaths since the confirmed October 29 death
of a Hanoi man. The total number of active AI-affected
provinces and cities decreased to 15 out of Vietnam's 64
provinces and cities, but localized poultry outbreaks have
spread. The Government of Vietnam (GVN) has banned over-the-
counter sales of Tamiflu to build up a national stockpile.
The GVN has plans to produce Oseltamivir, a generic version
of Tamiflu, beginning in June 2006, but under an agreement
with Roche GVN will not be allowed to export the product.
Deputy Prime Minister Pham Gia Khiem has agreed with a
Ministry of Agriculture and Rural Development (MARD)
proposal to kill all 62 million waterfowl across the
country. Local authorities in Ho Chi Minh City (HCMC),Hue
and Danang adopted extreme measures such as poisoning and
hunting wild birds in public areas, but have since been
ordered to cease. The World Health Organization (WHO) and
Food and Agriculture Organization (FAO) provided guidance to
GVN food safety authorities after growing concern among
officials and public of contracting AI from consumption of
poultry and eggs. The Mission has received approval from
GVN to begin its communication and awareness project for
rural farmers and later this month will host an AI
diagnostic training for 20 animal health technicians,
thereby enhancing GVN's ability to track the spread of AI in
poultry. End Summary.

No New Confirmed AI Human Fatalities
--------------


2. (U) There have been no new confirmed AI human fatalities
since the October 29 death of a Hanoi man reported
previously. The most recent confirmed bird flu victim
remains to be the 15-year old boy from Haiphong who is in
stable condition. As reported previously (Ref A),a three-
year-old boy from southern Tien Giang Province who has
remained hospitalized is infected with bird flu according to
initial tests. Those results have yet to be confirmed by
WHO.

The Scoop on Tamiflu
--------------


3. (SBU) Contrary to reports in the international and local
press, Post has learned that Swiss manufacturer Roche has
not licensed GVN to produce branded "Tamiflu", but if an AI
pandemic occurs, GVN will be able to produce the generic
medicine named Oseltamivir. Under conditions of the
agreement, Vietnam-produced Oseltamivir will be for use in
Vietnam only and not for export. The GVN has plans to
produce Oseltamivir beginning in June 2006, but details of
how local producers will extract shikimic acid on a
commercial scale from domestically grown star anis remain
unclear.


4. (U) Roche has also agreed to supply or sell the GVN 25
million Tamiflu capsules before the end of 2006. The
company is reportedly in talks with eight companies to
produce the drug locally. In Hanoi, prices of the medicine
have range from USD 35 to 70 for a box of 10 capsules.


5. (U) A circular issued on November 23 banned the over-the-
counter sales of Tamiflu to build up a national stockpile in
case of a mass AI outbreak. According to press reports,
Health Minister Tran Thi Trung Chien gave the order in early
November in the face of intense demand for the drug.
Provincial authorities have been ordered to ban local sales
of Tamiflu doses and to stockpile them in national reserves.


6. (U) On December 8, the MOH announced that 420,000
Tamiflu capsules had been allocated to hospitals in all 64
cities and provinces. It is unknown how many of these doses
are from the 600,000 capsules donated by the Government of
Taiwan, half of which have been allocated to eight "leader"
hospitals in Hanoi and HCMC.

Infections In Poultry Spreads, But In Fewer Provinces
-------------- --------------


7. (U) The number of current, active AI-affected provinces
decreased to 15 this week, down from the 17 provinces and
cities reported previously. Quang Ninh and Ha Giang
provinces in northern Vietnam are the latest to report AI
outbreaks in poultry. AI poultry outbreaks continue to
spread within affected localities of Hai Phong, Vinh Phuc
and Cao Bang Provinces in northern Vietnam. AI currently
exists in 63 districts of 15 provinces, specifically Bac
Giang, Bac Ninh, Cao Bang, Hai Duong, Hoa Binh, Ninh Binh,
Phu Tho, Son La, Thai Nguyen, Thanh Hoa, Haiphong, Vinh
Phuc, Long An, Quang Ninh and Nghe An.


8. (U) Specimens from suspected poultry in the northern
province of Yen Bai are being tested for the viruses. Tests
showed that poultry in the two central provinces of Quang
Nam and Quang Ngai and the southern province of Dong Thap
were not infected with bird flu viruses. Hanoi, three
northern provinces of Thai Binh, Hoa Binh and Hung Yen, and
two southern provinces of Bac Lieu and Long An have met
criteria for announcing an end to bird flu outbreaks - that
is, detecting no new poultry outbreaks for at least three
weeks.

Authorities Adopt Drastic Measures to Protect Public Health
-------------- --------------


9. (U) On December 8, Deputy Prime Minister Pham Gia Khiem
signed off on a proposal to kill all 62 million waterfowl
across the country, according to Minister of Agriculture and
Rural Development and head of the National Steering Board on
Bird Flu Prevention and Control Cao Duc Phat. Minister Phat
said to local press that 90 percent of waterfowl blood
samples tested positive to the virus, and that if waterfowl
continue to be raised, Vietnam will not be able to stamp out
the bird flu epidemic.


10. (U) On November 30, the MARD had announced that it
would not order the culling of the entire poultry stock in
the country, which numbers roughly 220 million fowl. Since
AI began ravaging poultry farms across Vietnam in late
November 2003, authorities have reportedly culled about 66
million fowl. Since the latest wave of AI outbreaks began
in early October 2005, 2.88 million fowl have been culled.


11. (U) During this latest round, Hai Duong Province in
northern Vietnam has culled 714,000 fowl, of which 142,000
fowl (primarily ducks, geese and quail) were culled within a
three-day period earlier this week. Most of the poultry
found to be infected were ducks, leading the Hai Duong
People's Committee to order all ducks and geese destroyed.


12. (U) In efforts to stem a potential pandemic and
minimize human infection, authorities in HCMC have adopted
strict measures including the banning of poultry and pet
birds, keeping open only three official slaughterhouses, and
monitoring the transport of poultry into the city.
Officials from neighboring provinces, however, have openly
criticized such measures, stating in the press that HCMC
authorities should allow more of the existing poultry from
the countryside be sold in Vietnam's largest city of over
six million people. One official from Tien Giang Province's
Animal Health Department was quoted in local press saying
"Poultry consumption has ground to a halt, really hurting
our farmers," for which the head of HCMC's Animal Health
Department replied "Though the market is now frozen, the
city's tight control is vital in protecting human health."
With the regulations in effect, transport of live birds from
neighboring provinces has fallen by 75-80 percent. Only
8,000 to 9,000 birds are slaughtered daily compared to
39,000-40,000 previously.


13. (SBU) While Deputy Prime Minister Nguyen Tan Dzung has
asked localities to continue taking regular preventive
measures and add more drastic ones to cope with AI
outbreaks, officials in HCMC, Danang and Hue are apparently
willing to take extreme, unilateral measures. Despite
previous denial by HCMC Animal Health officials (ref A),
sources from an international non-governmental organization
have corroborated international press reports that HCMC
authorities have used Dipterex, a deadly poison agent, to
cull wild pigeons in public areas. Authorities pulled back
from a full feral pigeon culling campaign after they
realized that the pigeons fly off after consuming the deadly
poison and, hence, could cause a public health concern if
subsequently eaten by humans.


14. (SBU) In Danang and Hue, officials within the
Departments of Animal Health have confirmed similar reports
in the local press that authorities have contracted bands of
hunters to shoot feral pigeons and wild birds within the
city bounds. Hue Department of Animal Health Director
Nguyen Van Hung declared, "All birds that fly in the sky of
Hue City will be killed." During an eight-day period, only
300 pigeons and a few cattle egrets were extirpated. The
hunters receive VND 10,000 (USD 0.63) per bird. During the
first two days of the campaign, 211 feral doves were shot,
some of which were eaten by locals to celebrate Vietnam's
success at the Southeast Asian Games held in the Philippines
last week.


15. (SBU) In response to such drastic measures, the WHO and
FAO submitted a letter to Deputy Prime Minister Dzung and
MARD Minister Phat imploring the GVN not to cull wild bird
populations. In response, the GVN issued a letter on
December 6 to the three Provincial People's Committees
ordering them to halt the killing of pigeons and wild birds.
The letter stated that the killing of pigeons and wild birds
is not a national policy and that this practice is not only
an inappropriate measure, but is also likely to cause bad
effects to the ecosystem.

Injecting Reason and Reassure
--------------


16. (U) On December 8, Deputy Prime Minister Pham Gia
Khiem, quoting WHO and FAO sources, encouraged local people
to consume safe poultry and poultry products. The WHO and
FAO provided guidance to GVN food safety authorities after
growing concern among officials and public of contracting AI
from consumption of poultry and eggs. The three-page
document states "In areas where there is no bird flu
outbreak in poultry, there is no risk that consumers will be
exposed to the virus via the handling of consumption of
poultry and poultry products."


17. (U) On December 6, the Ministry of Natural Resources
and Environment distributed guidelines to local authorities
on how to correctly destroy and bury diseased poultry in
order to protect the environment and prevent further spread
of AI. Before burial, staff wearing proper personal
protective gear must chemically disinfect poultry.


18. (SBU) USAID Regional Infectious Diseases Advisor and
EconOff from HCMC reported on how four provinces in the
Mekong Delta have prepared for an AI outbreak (Ref B). The
report provides an in-depth look at surveillance and
outbreak response, the nationwide poultry vaccination
program, and the need to raise public awareness. The
principle finding is that strengthening surveillance and
public awareness are essential for strengthening Vietnam's
capacity to stem a possible AI epidemic.

USG Assistance Underway
--------------


19. (U) The U.S. Agency for International Development
(USAID) has received approval from GVN to begin a rapid
survey in two provinces on the most appropriate public
education outreach materials for rural farmers. The project
will provide technical assistance and support to train
information officers of the Ministry of Culture and
Information in AI to ensure that correct and appropriate
information is disseminated through the media. The project
also has an AI Behavior Change Communication activity under
which a local firm, Ogilvy Public Relations, will train 600
reporters in Hanoi, Hue and HCMC on AI reporting during
December.


20. (U) The U.S. Department of Agriculture (USDA) will host
an AI diagnostic training seminar in December for 20
technicians in the Department of Animal Health in Hanoi.
The USDA trainers will bring equipment and supplies
including an additional real-time PCR machine, which can
identify the genetic makeup of the virus in a specimen, to
complement the more antiquated diagnostic equipment the
Vietnamese currently use. This training will prepare the
Vietnamese participants for using six new real-time PCR's
scheduled to arrive later this month. Proper use of the
machines will substantially enhance Vietnam's ability to
track the spread of AI in poultry.

"...And Treatment for All"
--------------


21. (U) The Ministry of Health (MOH) has proposed to the
GVN to guarantee free treatment to expatriates, in addition
to Vietnamese who have contracted AI. Vice Minister Trinh
Quang Huan told reporters on December 6 that the MOH has
proposed a free treatment policy for foreigners who have
been living and working in Vietnam.

MARINE