Identifier
Created
Classification
Origin
06RANGOON437
2006-03-30 09:23:00
UNCLASSIFIED//FOR OFFICIAL USE ONLY
Embassy Rangoon
Cable title:  

BURMA AI OUTBREAK SITE ASSESSMENT

Tags:  EAGR EAID AMED PGOV PREL CASC TBIO KFLU BM 
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This record is a partial extract of the original cable. The full text of the original cable is not available.
UNCLAS SECTION 01 OF 02 RANGOON 000437 

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 SITE ASSESSMENT

REF: RANGOON 399

UNCLAS SECTION 01 OF 02 RANGOON 000437

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 SITE ASSESSMENT

REF: RANGOON 399


1. (SBU) SUMMARY. A joint FAO/WHO team, accompanied by a
USAID Regional Infectious Diseases advisor and a FSN from the
Foreign Agricultural Service (FAS),assessed an AI outbreak
in Sagaing and Mandalay Divisions, Burma, on March 17-18.
Government of Burma (GOB) officials reported cases to the OIE
promptly and allowed full access to outbreak sites by
FAO/WHO/USG. Numerous concerns exist about the preparedness
of the GOB to respond to this outbreak. Urgent needs
include: rapid response team supplies, technical assistance
to contain spread of infection and increase surveillance, and
diagnostic strengthening. END SUMMARY.


2. (U) In February 2006, poultry die-offs, originally
ascribed to non-H5N1 causes, occurred in Shwebo, Kanbalu, and
Zigon townships in Sagaing Division, northern Burma. In
early March, these die-offs expanded to 4 townships in
Mandalay Division.


3. (U) GOB Livestock Breeding and Veterinary Department
(LBVD) officials were alerted to the outbreak on March 8.
LBVD officials initiated an investigation. Specimens from
the farms initially tested positive by rapid tests for
influenza type A on March 9. Local PCR tests confirmed
sub-type H5 on March 12, at which time the suspected H5N1
infection was reported to OIE. FAO and WHO were briefed on
the outbreak by GOB officials on March 13 and LBVD made an
informal request to them for assistance. Specimens were
submitted to the National Institute of Animal Health
laboratories in Thailand for H5N1 confirmation. H5N1 was
confirmed by the Thai laboratory on March 16 and specimens
were sent to Australia for genetic sequencing.


4. (U) The GOB response included the collection of specimens,
active case surveillance for other unusual poultry die-offs,
quarantine of affected farms, a temporary ban on the sale of

poultry products in affected areas, and restriction of
movement of poultry products and equipment. Depopulation
activities were initiated on all 56 infected farms in the two
divisions.


5. (U) As of March 18, 14 chicken farms, 10 quail farms, and
1 quail hatchery had been affected with high mortality in the
greater Mandalay area. A total of 49,598 chickens and quail
died or were culled. The GOB planned to cull all farm and
backyard poultry in a 3 km radius of infected farms (approx.
20,000 birds) in Sagaing Division by March 24. Mandalay
Division culled birds on non-affected farms if they were
found to have had any contact with affected farms.


6. (U) GOB Ministry of Health (MOH) officials initiated
active and passive surveillance for human cases in health
facilities and local communities, disseminated a standard
case definition to health workers, and designated a special
hospital for suspected human cases. The designated hospital
has a small number of PPEs, one ventilator, and few
medicines. There are a total of 10 Tamiflu treatment doses
in Mandalay Division. The GOB disseminated public awareness
posters produced by MOH, UNICEF, and WHO, and state
television reported the outbreak on March 15. The state-run
newspaper, "The New Light of Myanmar," reported the outbreak
on March 16 in both their Burmese and English editions, and
other print media followed suit.


7. (SBU) After reporting the outbreak to OIE and
communicating with the FAO regional office, the GOB agreed to
allow FAO, WHO, and USAID access to the outbreak sites. The
joint UN team, including the USAID Regional Infectious
Diseases Advisor and the FAS FSN representative in Burma,
departed for Mandalay on March 17. GOB officials welcomed
the team's presence and assistance. LBVD and MOH officials
were open with information and provided the team with
regional and local maps of the affected areas and farms. The
team was taken to the farms, including one that was in the
process of being depopulated and disinfected. The assessment
team noted numerous deficiencies in the quality of the GOB
response team's activities. GOB officials were receptive to
the team's constructive suggestions and took corrective
action.


8. (SBU) WHO and USAID staff met with the Department of
Health officials in Mandalay for a briefing on current human
health response activities. Again, health officials were
open and willing to answer all questions. The assessment
team was then able to access the local hospital designated
for receiving Avian Influenza cases.


9. (SBU) USAID funds, provided directly to FAO, have
purchased 200 PPEs, 500 liters of disinfectant, 50 backpack
sprayers, and a small number of bio-secure specimen shipping
containers. Technical assistance was provided by the
USAID-funded FAO Regional Advisor for Avian Influenza and the
USAID RDMA Infectious Diseases Advisor. The Government of
Japan, through JICA, provided funding for a Thai senior
virologist for a 2-week consultancy in laboratory
diagnostics, as well as for dissemination in Burma of a small
number of public awareness posters on AI. The Royal Thai
Government will fund diagnostic reagents for 1,000 samples.
FAO/Rome has released $45,000 of emergency funds to the Burma
country FAO office to assist with containment activities, and
WHO/SEARO provided $20,000 to the WHO Burma country office.


10. (SBU) COMMENT: Burma is a risk country for H5N1
infections. The current outbreak highlights that the
surveillance for Highly Pathogenic Avian Influenza is
sensitive enough to detect unusual die-offs. When H5N1 is
suspected, the GOB has shown unusual willingness to report
the cases to the international community and to allow free
access to affected sites. The GOB response to this outbreak
also highlights that many challenges remain in making the
National Plan operational. Burma urgently needs
strengthening of surveillance and diagnostics, including
collection, processing, and testing of both animal and human
specimens. Medium to long-term in-country presence of
international human and animal health experts in Avian
Influenza is crucial to assist the technical ministries with
coordination and enhancement of preparedness and control
activities, and to sustain the open information-sharing shown
in response to this outbreak. END COMMENT.
STOLTZ