THAILAND'S SECOND HUMAN AVIAN INFLUENZA DEATH IN

UNCLAS SECTION 01 OF 04 BANGKOK 004792 SIPDIS ////// C O R R E D T E D COPY //// CORRECTING ADDRESSEE (BUMED) ONLY SENSITIVE SIPDIS DEPARTMENT FOR S/ES-O AND G/AIAG/JLANGE AND CPATTERSON DEPARTMENT FOR CA/OCS/ACS, EAP/EX, EAP/MLS, EAP/IET, A/MED DEPARTMENT FOR OES/FO, OES/EID, OES/STC, OES/PCI, OES/IHA USAID FOR ANE/AA KUNDER, GH/HIDN CARROLL, OFDA LEVY HHS FOR WSTEIGER, ABHAT, MSTLOUISAND, OGHA ELVANDER, HHS/NIH CDC FOR NCID LEDUC AND COX DEPARTMENT OF AGRICULTURE FOR OSEC AND APHIS DEPARTMENT OF AGRICULTURE FOR FAS/DLP/HWETZEL FAS/ICD/LAIDIG DEPARTMENT OF DEFENSE FOR OSD/ISA/AP FOR LEW STERN USPACOM ALSO PASS TO J07 NSC FOR JMELINE PARIS FOR FAS/AG MINISTER COUNSELOR/OIE ROME FOR FAO BEIJING FOR ESTH - SELIGSOHN AND SHAPIRO CANBERRA FOR APHIS/DHANNAPEL JAKARTA FOR NAMRU BLAIR, USAID KRAMER HANOI FOR USAID ZVINAKIS, HHS IADEMARCO AND DENNIS VIENTIANE FOR CORWIN RANGOON FOR TIDWELL E.O. 12958: N/A TAGS: TBIO EAGR KFLU PGOV SOCI TH SUBJECT: THAILAND'S SECOND HUMAN AVIAN INFLUENZA DEATH IN THE PAST TWO WEEKS REF: A. BANGKOK 4530 B. BANGKOK 4612 C. BANGKOK 4613 BANGKOK 00004792 001.4 OF 004 ¶1. (U) Summary: Thailand's Ministry of Public Health (MOPH) confirmed by laboratory testing that a second human avian influenza death in as many weeks occurred on August 3 in Uthaithani, a province in west-central Thailand. Testing of veterinary samples from the man's home returned negative results, prompting an exchange of barbs between officials from the Department of Livestock Development (DLD) and MOPH. On August 6, livestock officials culled 20,000 chickens on a poultry farm in another district of Uthaithani Province after 200 chickens reportedly died there en masse. Meanwhile, on July 31, DLD veterinary laboratory testing did detect H5N1 avian influenza in a poultry outbreak in Nakhon Phanom Province in Thailand's far northeast. End Summary. Thailand's Second Human Avian Influenza Death in 2006 -------------- -------------- ¶2. (U) Dr. Thawat Suntrajarn, the Director-General of the MOPH's Department of Disease Control, told Bangkok-based CDC personnel that Thailand's second human influenza death of the year was a 27-year-old patient admitted to the Uthaithani provincial hospital on July 30 with fever and shortness of breath. He died at the hospital on August 3. (Thailand's first human avian influenza death of 2006 occurred on July ¶24. See Ref A.) The 27-year-old reportedly had buried a dead chicken in his backyard on July 17. Laboratory tests for avian influenza undertaken at the hospital were inconclusive, but the results of Polymerase Chain Reaction (PCR) DNA testing on specimens sent to both the Thai National Institute of Health and Bangkok's Siriraj hospital on August BANGKOK 00004792 002.2 OF 004 5 were positive for H5N1 avian influenza. ¶3. (U) On August 7, the Bangkok Post reported that veterinary samples taken from both dead and live chickens at the man's home all tested negative. The article quoted Kamnuan Ungchusak, Director of MOPH's Bureau of Epidemiology as saying, "I'm not surprised that the (DLD's) test could not find the H5N1 virus in poultry samples from the house because the test was conducted long after the man was infected by the virus, and most of the chickens were already dead." ¶4. (U) The article quoted the DLD's Disease Control Bureau Director Nirundorn Aungtragoolsuk as saying, "Since the H5N1 bird flu virus was not detected at the victim's house and in the nearby vicinity, public health officials should find out how and where the man contracted the virus." ¶5. (SBU) The frustration expressed by these officials to the Bangkok Post hints at a deeper tension between MOPH and the Ministry of Agriculture's DLD. Privately, MOPH officials have expressed to us in harsher words a growing frustration with DLD. Theoretically, surveillance of poultry should be the first indicator of the presence of H5N1, leading to increased public health surveillance of humans in poultry-affected areas. But in Thailand, just the opposite scenario is occurring - detection of H5N1 in humans is preceding reports of H5N1 in poultry. To be fair, in comparison to MOPH, the DLD has less manpower, less experience, and less funding to conduct disease surveillance. DLD is also frustrated that farmers continue to neglect reporting or even hide poultry deaths from officials, causing BANGKOK 00004792 003.2 OF 004 them to arrive too late on the scene to obtain good laboratory specimens. Poultry Die-Off in Uthaithani Province... -------------- ¶6. (U) The Bangkok Post also reported on August 7 that DLD officials culled approximately 20,000 chickens on a farm in another district of Uthaithani Province after 200 chickens reportedly died there "en masse." Embassy Bangkok-based Regional Environmental and Health Officer was unable to reach DLD officials in Bangkok to inquire whether veterinary samples were taken from the affected flock for laboratory testing. The province, which is further south than Phichit, Phitsanulok, Sukothai, and Uttaradit provinces, where large numbers of poultry die-offs were reported in July, nevertheless lies in the broad belt that runs north from Bangkok to the Lao border where there is a heavy concentration of chicken farming, as well as the raising of fighting cocks. ...And Another Way Out in the Northeast -------------- ¶7. (U) Meanwhile, from July 16 to July 24, 2241 layer chickens died on 78 farms and households in Nakhon Phanom Province in Thailand's extreme northeast corner. On July 29, DLD's Upper Northeastern Regional Veterinary Research and Development Center, detected H5 avian influenza virus in samples taken from the dead birds. On August 1, the National Institute of Animal Health in Bangkok confirmed the full identification of the virus as H5N1. DLD made a preliminary report to the World Organization for Animal Health (OIE) on BANGKOK 00004792 004.2 OF 004 July 31 with a follow-up report on August 2. DLD also culled more than 300,000 poultry in the province, made arrangements to compensate owners 75 percent of the value of the culled birds, and took samples from nearly 12,000 poultry within a 5-km radius of the infected farm, including more than 10,500 chickens and more than 900 ducks from 734 farms or households. CDC-Bangkok has conducted active surveillance for severe pneumonia in Nakhon Phanom since 2003, and is deeply integrated into the outbreak response. ¶8. (U) Various Thai media reported that Thai officials believed the virus arrived in Nakhon Phanom on contaminated egg trays from Laos, but gave no evidence for their conclusions. In its official report to the OIE, the DLD stated that the source of the outbreak in Nakhon Phanom was "unknown or inconclusive." Thailand has since restricted cross-border transport of poultry and poultry products from Laos. ARVIZU