BURMA AI UPDATE - APRIL 4

UNCLAS SECTION 01 OF 03 RANGOON 000459 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 UPDATE - APRIL 4 REF: A. RANGOON 437 ¶B. RANGOON 399 ¶1. (U) SUMMARY. On March 31, WHO/FAO Burma briefed UN agencies and diplomatic missions on the country's AI situation. A Ministry of Livestock and Fisheries (MLF) director gave a chronology of the AI outbreaks in central Burma, which began on March 3, and the GOB's efforts to control the disease. He updated the number of farms, chickens, and quails affected in the six townships where outbreaks occurred. The Ministry of Health official reported that health authorities quarantined eight persons from outbreak sites who displayed flu-like symptoms, but all had tested negative and been released by March 31. WHO provided increased cooperation and coordination among key stakeholders and noted that the GOB invited both WHO and FAO to participate in their National AI Subcommittee, the first time international organizations had joined a government taskforce. The FAO representative reported on the second FAO/WHO joint visit to the outbreak areas on March 29-20. She observed that outbreaks continue to occur on new farms in Sagaing and Mandalay divisions, but AI outbreaks have been contained so far in these two areas. If the outbreaks continue for two to three more weeks, the GOB may initiate vaccination of poultry in a buffer zone around the outbreak sites. WHO and FAO appealed to donors to help with critically needed equipment and supplies to prevent the further spread of AI in Burma. END SUMMARY. ¶2. (SBU) WHO and FAO held a joint briefing on AI, joined by officials of the Ministry of Health (MOH) and the Ministry of Livestock and Fisheries (MLF),for UN agency heads and diplomatic missions in Rangoon on March 31. The MOH asked WHO not to invite international NGOs or any Burmese not working for the GOB. When asked why, the WHO representative said the GOB feared that members of the NLD might try to attend the briefing uninvited. This ban prevented Embassy FSN agricultural specialist from attending the meetings, even though she had been permitted to visit the outbreak sites around Mandalay. HOW IT BEGAN ¶3. (U) Dr. Than Hla, Director of the MLF's Division of Disease Control and Veterinary Services, gave a detailed chronology of AI outbreaks in six townships of Sagaing and Mandalay divisions and steps the authorities had taken to contain the outbreaks, starting March 3. As of March 30, outbreaks had occurred at 114 chicken farms and 60 quail farms in Mandalay Division and 89 farms in Sagaing Division. Dr. Than Hla speculated that the disease may have come to Burma via wild birds visiting Mahananda Lake near Shwebo, Sagaing Division, or through the smuggling of commercial chicks from China. ¶4. (SBU) Dr. Than Hla thanked JICA (Japan International Cooperation Agency) and FAO for PPEs and other essential supplies. Note: USAID Bangkok purchased the emergency supplies for FAO including 200 PPEs, 500 liters of disinfectant concentrate, 50 backpack sprayers, and some biosafe specimen containers. Although there were USG stockpiles of PPEs in the region, they could not be accessed in a timely manner. Due to the emergency nature of the response and given the FAO Regional AI Coordinator's and USAID's Infectious Diseases Advisor Dr. John MacArthur's imminent departure for Burma, where they planned to supervise distribution of the supplies, FAO purchased the supplies from distributors in Thailand and used USAID's account code. End Note. ¶5. (U) Although the GOB planned to destroy all chickens in a radius of 3 km from affected farms, Than Hla acknowledged that in practice authorities have been destroying chickens up to a radius of only 1 km to date. The authorities said lack of protective gear and equipment was the major constraint. The GOB has no plan to offer compensation to farmers whose poultry flocks they have killed off, but Than Hla said MLF will restock affected farms with day-old chicks once they eradicate the disease and may offer preferential loans to affected farmers. ¶6. (U) The March 31 issue of "The New Light of Myanmar" published an report from MLF with details of new outbreaks in central Burma during the last week of March. The article also mentioned recent die-offs of ducks in Bago Division (50 miles north of Rangoon) and 20 pigeons that died at a monastery in Kyauktan Township (15 miles from downtown Rangoon) and confirmed that the dead birds tested negative for AI. The newspaper continues to publish daily updates and instructions for the public on how to prevent and control AI. NO HUMAN CASES SO FAR ¶7. (U) Dr. Tin Nyunt, Deputy Director General of the Department of Health, reported that the MOH has designated two hospitals as referral centers for human AI cases -- one in Rangoon and one in Mandalay. Following the outbreak in central Burma, authorities admitted eight persons with flu-like symptoms (six from Mandalay -- including two veterinarians working with the field teams -- and two from Sagaing) to Mandalay General Hospital. All tested negative for AI and by March 31 the last person returned home from hospital. ¶8. (U) Dr. Tin Nyunt noted that the MOH now has a total Tamiflu stock of 1,000 doses. In response to the outbreak, the MOH distributed 75 PPEs, 15 courses of Tamiflu, and 30 rapid test kits each to the two affected divisions for their use in monitoring suspect human cases. WHO'S RESPONSE ¶9. (U) Kanokporn Coninx, WHO Burma's AI coordinator, reported that WHO/FAO sent a second assessment team to Mandalay March 29-30 and worked with ministerial counterparts to prepare guidelines on outbreak response and containment. WHO has provided technical support, helped coordinate stakeholders, and worked jointly with FAO to mobilize resources. WHO reported that the GOB recently invited both WHO and FAO to participate in the National AI Subcommittee, a first in Burma. In response to the current outbreak, WHO/SEARO released $20,000 in emergency funds, 300 courses of Tamiflu, 200 PPEs, 2,000 liters of disinfectant, and 500 rapid test kits. An epidemiology consultant will come to Burma soon to fill a critical need in WHO's team. CONTAINING THE OUTBREAK ¶10. (U) Dr. Wantanee Kalpravidh, FAO Regional AI Coordinator, returned from Mandalay hours before the briefing. She reported that AI outbreaks have spread to adjacent townships in the 2-3 weeks since the initial discovery, but that they remained confined to Sagaing and Mandalay divisions so far. Although authorities issued strict controls on the movement of people and poultry in the affected areas, they have limited capacity to enforce the rules, which remains a major constraint to containing the outbreaks. ¶11. (U) Dr. Wantanee listed key strategies for containing the outbreak, including: more effective culling on affected farms, improved quarantine and movement control, improved decontamination, increased surveillance, better biosecurity, greater public awareness, and better protection for field teams. She also said that if AI outbreaks continue to occur on new farms for 2-3 weeks more, it would be necessary to implement "emergency ring vaccination" in conjunction with the above strategies. She stressed that it was important to utilize only quality vaccines or the outbreaks could become worse. The MLF is surveying a viable buffer zone around the affected townships if conditions indicate the use of vaccination. Dr. Wantanee remained cautiously optimistic that authorities can stop the outbreaks through careful surveillance and containment activities. AN APPEAL FOR MORE ASSISTANCE ¶12. (U) Dr. Wantanee listed FAO's most urgent needs as electric generators to support the labs, containment equipment, a biohazard handling system, and consumable supplies for laboratories. She estimated that $300,000 would be sufficient to procure equipment and supplies needed for the next three months. She has prepared a detailed list for any donors who wish to help. ¶13. (SBU) WHO has forwarded a $7 million joint WHO/FAO proposal for implementing AI activities in Burma to international donors, including USAID at a meeting in Bangkok on March 8. WHO ventured that even $4 million would be a significant help in the crisis. An Australian representative told us that the Australian Government is seriously considering support for some of the hardware needs listed in the proposal. VILLAROSA