VIETNAM - AVIAN FLU: SITUATION REPORT

UNCLAS SECTION 01 OF 03 HANOI 000467

SIPDIS

FOR CA/OCS/ACS/EAP; EAP/EX; EAP/BCLTV; OES/STC (M.GOLDBERG);
OES/IHA (D.SINGER AND N.COMELLA)
BANGKOK FOR RMO, CDC
STATE PASS HHS
USDA FOR FAS/PASS TO APHIS
DEPARTMENT OF DEFENSE FOR OSD/ISA/AP FOR LEW STERN

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

REF: Hanoi 316

Summary
--------------


1. The outbreak of Avian Influenza, subtype H5N1, in
Vietnam resulted in approximately 1 million dead or
destroyed ducks and chickens, and 13 cases in humans. Human-
to-human transmission has been confirmed in one very close
family contact situation (i.e., from an infected individual
to the primary caregiver in the family),but there currently
have been no confirmed or suspected cases of second or third
generation spread, or spread in casual contact situations.
The Government of Vietnam (GVN) now seems to recognize that
this will be a recurring problem if eradication and
prevention measures are not taken seriously. The GVN is
working with the international community to develop both a
short-term emergency response strategy, and a long-term
prevention and eradication strategy. Embassy Hanoi has
assembled an Avian Influenza Working Group (AIWG) that
coordinates with the Consulate General in Ho Chi Minh City.
The AIWG is developing tripwires for use if the situation
worsens and has made recommendations for preparedness and
prevention within the Embassy community.

Case Count/Statistics
--------------


2. The Ministry of Agriculture and Rural Development (MARD)
reports that this is the second of two outbreaks - the first
began in December 2003 with peaks in December and around the
Vietnamese Lunar New Year holiday and dwindled to a small
number of sporadic cases in March and April 2004. During
the first outbreak, the Government of Vietnam destroyed more
than 43 million birds (30 million chickens and 13 million
ducks). The second outbreak officially began in April
2004, is following the same timing in terms of peaks in
December and around the Lunar New Year, and seems to be
infecting smaller numbers of poultry. Both outbreaks have
been centered in the Mekong and Red River Deltas where
conditions are more conducive to the spread of the virus.


3. In Fowl: According to the Ministry of Agriculture and
Rural Development, as of February 22, 2005, there have been
approximately 750 reports of avian influenza in flocks in 35
provinces (last year's outbreak occurred in 57 provinces).
The Vietnamese Department of Animal Health reported that as
of February 21, no new cases of avian influenza were
recorded in 12 of these provinces during the first two weeks
of February. Since the start of this second outbreak, 1.2
million poultry have been culled, substantially less than
the same period last year.


4. In Humans: As of February 22, 2005, there have been 13
reported cases of avian influenza in humans since December

2004. Of the 13 reported cases, 12 have resulted in death.
Since the report of the first case in 2003, the fatality
rate is approximately 75%, but this may be misleading. The
World Health Organization (WHO) officials note that some of
these fatalities may have been avoidable with earlier
detection or more advanced medical care. It is unknown how
many cases have gone undetected, undiagnosed, or unreported.


5. While human-to-human transmission has been confirmed in
one very close family contact situation (i.e., from an
infected individual to the primary caregiver in the family),
there currently have been no confirmed or suspected cases of
second or third generation spread, or spread in casual
contact situations.


6. Recently, the media has reported on two deaths from
encephalitis in which the individuals had no respiratory
symptoms, but later tested positive for the H5N1 virus.
When asked about these cases, the Preventive Medicine
Department of the Ministry of Health (MOH) reported that
they did not know of this research and have no comment.

GVN Response
--------------


7. To date, the GVN has been more transparent regarding its
handling of the outbreak than in the past. The GVN has
analyzed the problem, recognized its limitations, requested
assistance, and considered both short-term and long-term
solutions regarding outbreaks in animals. Recently, the GVN
seems to have recognized that this is a problem that will
recur regularly if prevention and eradication measures are
not thorough.


8. A number of informational briefings have been held for
the diplomatic and `donor' communities. On February 3,
2005, WHO and the Food and Agriculture Organization of the
United Nations (FAO) briefed the diplomatic community and on
February 21, 2005, MARD, MOH, WHO, and FAO briefed the donor
community.


9. MARD reported that since last year they have improved
surveillance, reporting, laboratory capability, and the
involvement of public organizations; but challenges remain
in lack of trained staff, laboratory capacity, current
poultry industry practices (mostly small family farms with
varying flocks and herds raised together),and a lack of
understanding of the disease. An outline of the current GVN
response strategy includes: increasing public awareness,
continuing emergency response, considering vaccination of
poultry, prevention of circulation of the virus, developing
an effective compensation system for farmers with affected
flock, changing current poultry industry practices, and
research into the disease. MARD specifically requested
international assistance in the form of experts to aid with
diagnosis, vaccination, and research, and strengthening
capabilities of laboratories, veterinary science, grassroots
efforts, and training.


10. At the February 21st meeting, FAO presented a proposal
to donors to establish an AI Technical Support Unit (TSU) to
lead the GVN response to the current emergency, and in the
long-term complement the ongoing AI Emergency Recovery
Project. Full text of the proposal is available upon
request.

Ducks Role in AI Transmission Significant
--------------


11. As noted above, MARD reports that AI outbreaks in
chicken may be highly correlated with duck production and
rice cultivation. Ducks may multiply the challenge of AI
because they can serve as carriers of the disease, spreading
the virus to other fowl without showing symptoms or
suffering fatality. In addition, they are raised in
conditions that are particularly unhygienic, and often in
the waters of rice paddies in close contact with workers.

Embassy Preparedness
--------------


12. Embassy Hanoi has established an Avian Influenza Working
Group (AIWG),in cooperation with the Consulate General in
Ho Chi Minh City, to track the situation, advise the front
office, and monitor preparedness in the Embassy and
Consulate General. The AIWG is chaired by Consular Chief
Jennifer Savage and includes representatives from RSO, PAS,
HHS/CDC, CONS, DAO, MED, MGMT, HHS, FAS, AID, and CONGEN
HCMC.


13. The AIWG is developing tripwires that will be used to
guide consideration of recommended responses to developments
and changes in the outbreak situation. The Embassy and
Consulate General have begun preventative cleaning measures
and circulated the prevention recommendations from HHS/CDC
and WHO among the official and private American communities.
For preparedness purposes, stock of supplies are being
reviewed and medevac options are being researched and
confirmed.


14. A summary of the on-going Second Regional Meeting on
Avian Influenza held by FAO/OIE in Ho Chi Minh City will be
reported septel.
MARINE