VIETNAM - AVIAN FLU: SITUATION REPORT NO.2

UNCLAS SECTION 01 OF 02 HANOI 000626

SIPDIS

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E.O. 12958: N/A
TAGS: AMED AMGT CASC EAGR TBIO VM AFLU
SUBJECT: VIETNAM - AVIAN FLU: SITUATION REPORT NO.2

REF: Hanoi 316
Case Count/Statistics
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1. In humans: As of March 7th, the WHO officially reports
21 cases of Avian Influenza, H5N1 (AI) in humans in Vietnam
during the 2004-2005 outbreak, 13 of which have resulted in
death. The four cases reported in February include: a) A
21-year-old man from Thai Binh Province. He developed
symptoms on 14 February and was admitted to hospital on 20
February. B) His 14-year-old sister, also from Thai Binh
Province. She developed symptoms on 21 February and was
hospitalized the following day. C) A 69-year-old man, also
from Thai Binh Province. He developed symptoms on 19
February, was admitted to hospital the same day, and died on
23 February. D) A 35-year-old woman from Hanoi. She
developed symptoms on 18 February and was hospitalized on 24
February.

2. Although they don't appear in WHO's official case
counts, the media is reporting on three cases in Vietnam (a
nurse, and two non-symptomatic relatives of patients, all of
who have tested positive for AI) that are receiving
particular attention. Initial indications are that these
cases may not indicate a change in the virus or give cause
for alarm. They are probably consistent with other,
previously reported cases and/or may be the result of
increased surveillance. Details on these recent cases
follow in paras 5 and 6.

3. In Poultry: Cases continue, however, MARD reported that
of the 35 infected provinces/cities found to have bird flu
incidences this year, in 18 of these provinces/cities,
including Hanoi and HCMC, there were no new cases detected
in the last 21 days (as of March 7). On March 7, there was
one case detected in Tra Vinh province--400 ducks were
destroyed. On March 6, there were 7 new cases in Bac Lieu,
Ben Tre, and Dong Thap provinces--where 2,877 ducks were
destroyed. On a more positive note, Vietnam's Ministry of
Agriculture and Rural Development (MARD)'s Veterinary
Department said on March 7, that, "As of March 6, eighteen
out of 35 bird flu-affected provinces and cities across Viet
Nam had not reported any new cases for three weeks."
The Nurse
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4. A 26-year old male nurse in Thai Binh province, who
treated AI patients, is hospitalized and has tested positive
for AI. While WHO still reports that this case is "under
investigation" and cannot provide official guidance, we have
received a more informal readout from the Medical Director
of the local SOS International Clinic (a private, for-profit
clinic). The Medial Director, Dr. Bruce Miller, is well-
connected with both WHO and MOH and indicated that his
opinion was that of the WHO. He believes that this is a
likely case of human-to-human transmission, but not an
indication of a change in the virus or a cause for alarm.
The nurse likely has sustained close contact with the
patient, just have we have seen in other family clusters,
and vigilant use of PPE cannot be confirmed. However, he
reports that the nurse lived in a rural area and did have
other opportunities for exposure to the virus, so human-to-
human transmission will likely never be confirmed or ruled-
out in this case. He believes this case to be very similar
to others in which human-to-human transmission was suspected
or confirmed and does not believe this case indicates a
change in the virus or its transmission.
Non-Symptomatic but Positive for H5N1
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5. The BBC and other media outlets reported today on two
patients (61 and 81 years old),also from Thai Binh
province, who are non-symptomatic, but have tested positive
for AI. The WHO is not surprised at this development. They
report that the GVN is improving and expanding its contact
surveillance, and it has long been suspected that cases with
no or mild symptoms are going undetected. WHO reported that
it is not possible at this point to know whether the
detection of these cases now is coincidental, a result of
improved surveillance, or an indication of increased
transmissibility in the AI virus.
Hanoi AI Working Group
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6. Post's Working Group benefits from cooperation and
participation the numerous relevant agencies at Post -
including HHS, CDC, DOD, FAS, and AID. Whenever needed, we
are happy to serve as a resource for the Department's
Working Group and provide input as "on the ground" experts
whenever requested.
MARINE