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