BURMA AI OUTBREAK UPDATE - MARCH 20

UNCLAS SECTION 01 OF 03 RANGOON 000372 SIPDIS SENSITIVE SIPDIS STATE FOR EAP/MLS; PACOM FOR FPA; UDSA FOR FAS/PECAD, FAS/CNMP, FAS/AAD, APHIS; BANGKOK FOR USAID (JOHN MACARTHUR),APHIS E.O. 12958: N/A TAGS: EAGR EAID AMED PGOV PREL CASC TBIO KFLU BM SUBJECT: BURMA AI OUTBREAK UPDATE - MARCH 20 REF: A. SECSTATE 43425 ¶B. RANGOON 364 ¶C. RANGOON 345 ¶1. (U) SUMMARY. No human cases of AI have been reported in Burma to date. A joint FAO/WHO assessment team, accompanied by USAID Bangkok Infectious Diseases Advisor and Embassy's FSN agricultural specialist, visited hospitals and poultry farms in Mandalay and Sagaing Divisions on March 17-18 to gather further information on AI cases among birds in Burma. Burmese authorities have culled poultry and banned the sale and transport of poultry and eggs from affected areas, although FAO and WHO remain concerned about the possibility of spreading the infections by the methods used. Embassy has polled foreign donor missions, but none seem ready to help meet the most urgent needs relayed by the FAO and WHO to help the GOB contain the spread of AI in Burma. END SUMMARY. ¶2. (SBU) A joint FAO/WHO assessment team returned to Rangoon from Mandalay on March 19 to brief FAO, WHO, and Livestock Breeding and Veterinary Department (LBVD) officials. USAID Bangkok's Infectious Diseases Advisor, Dr. John MacArthur, who participated in the Mandalay assessment team visit, briefed the Charge before returning to Bangkok on March 19 and will separately report his findings to Washington. Both he and FSN reported receiving complete access to the various sites, including a last-minute request to see the hospital set up to the handle human cases. USAID advisor also received more up-to-date documents than Ministry of Health (MOH) officials in Rangoon had. ¶3. (SBU) Key findings of the FAO/WHO assessment team include: -- Although Burma first reported possible AI on March 12 after poultry die-offs in Mandalay District, earlier suspected outbreaks occurred in Khin Oo, Zeegon, and Shwebo townships (in Sagaing Division, northwest of Mandalay) in early February 2006. -- 1,500 chickens died in Shwebo township (8 percent of the total flock of 18,100 birds at 60 chicken farms, including 26 commercial layer farms, there). -- The die-offs began in the first week of February but officials did not notice for two weeks because the rapid test used cannot identify H5N1. -- As chickens there did not respond to medicine and began to die in large numbers, some poultry farmers in Shwebo sold their remaining birds to a chicken wholesaler in Mandalay. Unconfirmed rumors suggest that about 1,500 chickens were also smuggled by train from Shwebo to Myitkyina (Kachin State) and most were dead or dying when discovered by GOB officials; LBVD is now testing samples for AI. -- LBVD officials have begun culling all poultry in a 3-kilometer radius of the Kywesekan site in Mandalay where authorities first confirmed the H5N1 virus. 18 chicken and quail farms are affected. Authorities have also established an additional 7-kilometer control zone and banned all movement of livestock, poultry, and equipment from poultry farms within the area. -- FAO and USAID visitors at the culling sites expressed some concern that the methods used (improper disposal of used PPEs, failure of visitors to disinfect their shoes, stray dogs allowed to roam freely near the piles of dead chickens) could spread the virus to other poultry farms that the same LBVD staff visit. Local officials agreed to modify culling procedures based on advice from the survey teams. -- The Mandalay District Commander has banned all sales of eggs and chicken at town markets, Army officers have instructed soldiers and their families to avoid consuming chicken and eggs. A list of infected sites we received from LBVD officials revealed numerous military-owned poultry and quail farms in the vicinity of the Mandalay site. -- The government is not offering compensation to poultry owners or commercial farmers, but LBVD officials have assured those whose flocks they cull that they will be eligible to receive new stock and feed free of charge at a later date. FAO has advised LBVD officials that the 21-day disease-free minimum may be too short of a time period and recommended LBVD waits longer before restocking any culled flocks. -- The FAO/WHO visitors also recommended that LBVD officials work more closely with the MOH and arrange joint team visits to suspected sites so one can focus on quarantining and culling birds while the other screens humans for potential cases. -- No human AI cases have been detected in Burma to date. -- According to NGO contacts, the two individuals hospitalized in Mandalay for observation after contact with AI-infected poultry (ref C) both tested positive for malaria, not influenza. -- The GOB is continuing its aggressive public awareness campaign, with daily television broadcasts and newspaper articles encouraging people to report dead birds, prepare and cook meat safely, and practice proper hygiene. ¶3. (SBU) WHO Burma's AI coordinator, Kanokporn Coninx, told emboffs on March 18 of additional concerns. WHO believes some Mandalay poultry farm owners may have attempted to send their stock to distant markets ahead of visits by AI investigation teams. WHO staff have also heard reports of a disease outbreak among poultry in Mon State in southern Burma, near the Thailand border. The Deputy Minister of Health and GOB technicians traveled to the affected area on March 20 to investigate further. ¶4. (SBU) Charge met on March 17 with the Canadian and EU Ambassadors to Burma, both based in Bangkok. They said that neither Canada nor the EU plans immediate AI assistance to Burma. Canadian Amb. Comeau said Canada did not plan any direct AI assistance, but would likely support FAO and WHO in their regional efforts. EU Ambassador Hamburger deferred to Brussels. Neither government has a plan to respond to Burma's most urgent needs for PPEs, laboratory testing equipment, or outside medical/veterinary expertise. ¶5. (SBU) Other missions in Burma had similar reactions. All are aware of recent AI developments in country, but none have plans to offer immediate assistance, either directly to the GOB or via FAO/WHO. The Koreans will offer flu shots to KOICA volunteers in Burma (especially those in the Mandalay region) and are reviewing long-term aid options. Australia and the U.K. have no plans to provide immediate assistance. Prior to the recent outbreak, the German Embassy recommended to Berlin that they fund a request from WHO/FAO Rangoon for donor support but has not yet received a response. Tokyo had decided prior to the outbreak to give $10 million to FAO Burma and $2 million to UNICEF Burma for AI public awareness activities, and the GOB Ministry of Health and Ministry of Livestock and Fisheries have both approached the Japanese Embassy for further assistance in response to the outbreak. Japan is reviewing these requests. ¶6. (SBU) COMMENT: As they cope with a significant AI outbreak in central Burma, GOB officials have shown remarkable openness in sharing information and allowing access for foreign officials, including our USAID advisor, to sites under investigation. They clearly recognize the need for public awareness and fast action to contain the spread of AI and the threat it poses to both human and animal populations. Unfortunately, the international donor community does not appear prepared to respond rapidly to the spreading infection. LBVD and MOH officials continue to appeal for technical expertise to ensure their quarantining, culling, monitoring, and treatment efforts are effective. They have proven responsive to USAID advisor's recommendations. Technical experts would not only help make Burma's response to this AI crisis more effective at an early stage, they would also provide up-close opportunities to observe GOB surveillance and end-use accountability, and transit this information to the outside world. The window has been opened to us; now we must find ways to keep it open. END COMMENT. VILLAROSA