VIETNAM - AVIAN INFLUENZA UPDATE

UNCLAS SECTION 01 OF 04 HANOI 000107 SIPDIS SIPDIS STATE FOR EAP/MLS, EAP/EP, INR, OES/STC, OES/IHA, MED STATE PASS TO USAID FOR ANE AND GH STATE PASS TO HHS/OGHA (WSTIEGER, EELVANDER AND ABHAT) USDA PASS TO APHIS DEPARTMENT OF DEFENSE FOR OSD/ISA/AP (LSTERN) BANGKOK FOR RMO, CDC, USAID (JMACARTHUR AND MBRADY) ROME FOR FAO E.O. 12958: N/A TAGS: TBIO KFLU AMED AMGT CASC EAGR PINR SOCI VM SUBJECT: VIETNAM - AVIAN INFLUENZA UPDATE HANOI 00000107 001.2 OF 004 SENSITIVE BUT UNCLASSIFIED REF: A) HANOI 73 B) HO CHI MINH 10 AND PREVIOUS ¶1. (SBU) Summary. There have been no reported H5N1 avian influenza (AI) human cases in Vietnam this year and none reported in 2006. H5N1 AI poultry outbreaks have occurred within the past 21 days in 19 districts in seven southernmost Mekong Delta provinces, namely: Ca Mau, Bac Lieu, Hau Giang, Vinh Long, Kien Giang, Tra Vinh and Soc Trang. On January 16, Prime Minister Nguyen Tan Dung ordered closer inter-agency cooperation at all levels to combat the increasing number of poultry outbreaks, which have occurred in three new provinces since last week. Preliminary results of last week's GVN/WHO/FAO field assessment to the Mekong Delta indicate that most poultry die-offs have been associated with illegally reared and unvaccinated ducks, especially hatchlings. In Hanoi, a random visit to one of the city's main wet markets revealed a lack of biosafety measures and what appeared to be the sale of illegal Chinese poultry. End Summary. ¶2. (U) There have been no confirmed H5N1 AI human cases in Vietnam this year and none reported in 2006. Poultry Outbreaks Continue in Mekong Delta Provinces -------------- -------------- ¶3. (U) Ministry of Agricultural and Rural Development (MARD) officials have confirmed media reports indicating that H5N1 AI poultry outbreaks have occurred within the past 21 days in 19 districts in seven southernmost Mekong Delta provinces, namely: Ca Mau, Bac Lieu, Hau Giang, Vinh Long, Kien Giang, Tra Vinh and Soc Trang. Tra Vinh, Bac Lieu and Soc Trang Provinces were added to the list since last week (reftel A). As of January 16, 18,000 birds have died and an additional 23,000 poultry have reportedly been culled. In response to this outbreak activity, over 2.1 million poultry have been vaccinated, including 325,000 chickens and 1.8 million ducks. GVN Top Leadership Mobilized to Poultry Outbreaks -------------- -------------- ¶4. (U) Various local news media reported that Prime Minister Nguyen Tan Dung signed on January 16 an emergency decree to contain H5N1 poultry outbreaks by ordering all centrally-managed governmental agencies, including public health and animal health offices at provincial, district and commune-levels to work closely with the Fatherland Front and other mass organizations for the dissemination of public information to combat the spread of AI. At a meeting of the National Steering Committee on Avian Flu Control in Hanoi on January 16, PM Dung reportedly urged animal health agencies to collaborate with local police and traffic police forces to strictly monitor the production, slaughter and transportation of poultry, particularly to urban areas and other areas in outbreak-free zones. PM Dung also urged the MARD to coordinate closely with customs officers and border guards to prevent the illegal importation of poultry and poultry products in border areas. ¶5. (U) State media reported on action taken by officials in Ho Chi Minh City (HCMC) and Can Tho City. Vice Chairman of HCMC People's Committee Mr. Nguyen Thanh Tai ordered local authorities to crack down on illegal transportation networks and unlicensed slaughterhouses in the metropolitan area. Such networks do not have proper biosafety standards. According to the HCMC Avian Influenza Steering Committee, HCMC is the main market for poultry produced in the Mekong Delta region, accounting for roughly forty percent of the HANOI 00000107 002.2 OF 004 city's total consumption of poultry. In addition, two steering committees have been established in Can Tho City to oversee the containment efforts and additional animal health experts have been dispatched to the region to support efforts underway. Experts Focused on Duck Vaccines and Public Information -------------- -------------- ¶6. (U) The MARD, with support from the U.N. Food and Agriculture Organization (FAO),is reportedly conducting research to develop a new H5N1 vaccine for ducklings and is funded by USAID to conduct vaccine efficacy trials to determine appropriate timing of vaccines in Muscovy ducks. MARD Minister Cao Duc Phat has indicated to donors that MARD expects to receive 4.5 million doses of H5N9 vaccine for Muscovy ducks by January 19. Meanwhile, MARD plans to launch a new general breeding practice campaign in February 2007 that will focus on improving household farm sanitation practices. GVN's Phase II Integrated Operational Program Underway -------------- -------------- ¶7. (SBU) On January 9, MARD Minister Cao Duc Phat convened a meeting of the Partnership for Avian and Human Influenza (PAHI) that included a signing ceremony for the second phase program. After a brief update on the poultry outbreaks in the Mekong Delta, Minister Phat described the GVN's response, including: 1) tasking local authorities to monitor all households raising chickens and ducks; 2) verifying that all poultry are vaccinated and vaccinating those that are not; 3) implementing a disinfection campaign in every province; 4) organizing stricter control of all poultry movement; and 5) examining the biosafety of every market and slaughterhouse. Minister Phat indicated that a telegram was sent to all provinces the previous day that ordered the deployment of animal health authorities to the district and commune level to ensure the above measures are implemented. Minister Phat concluded by noting that he was leaving to attend a meeting where all provincial leaders would discuss measures to prevent the spread of AI. ¶8. (SBU) At the same meeting, U.N. Resident Coordinator John Hendra congratulated MARD for formulating and implementing the Integrated Operational Program on Human and Avian Influenza and noted that phase two of the Joint Program represents a more conservative long-term capacity building program to help the GVN become better prepared for and respond to the infectious disease threat. Mr. Hendra indicated that donors have pledged 90 percent of what was called for at the last donors conference and congratulated the GVN for its response, highlighting their integrated animal and human health approach, the strong national leadership and the enhanced coordination between government agencies, bilateral donors and U.N. agencies. ¶9. (SBU) Following on Mr. Hendra's remarks, Dr. Hans Troedsson, WHO Representative, provided an impromptu summary of lessons learned from Vietnam's AI approach, including: 1) there needs to be a coordinated approach by animal and human health professionals; 2) you cannot buy-off AI; financial resources must be paired with appropriate technical assistance; and 3) there are no quick fixes to the threat of an AI pandemic. Long-term commitment and investment is needed to halt the spread of AI. ¶10. (SBU) Finally, FAO Representative Andrew Speedy stated that the secret of Vietnam's success was strong government support and SIPDIS coordinated donor contributions. While vaccination has been at the heart of the country's strategy to control the disease, it is only one element of the comprehensive national strategy that includes HANOI 00000107 003.2 OF 004 culling infected birds, tight control on movement of poultry, widespread surveillance testing, improved hygiene measures, better laboratories and targeted public awareness campaigns. In order to detect outbreaks before they become widespread, public health authorities need to combine timely intelligence based on consistent and transparent information sharing with an improved understanding of the interaction between poultry production and its impact on human behavior. Preliminary Results of Joint Field Assessment -------------- ¶11. (SBU) Representatives of HHS/OS, CDC, WHO, FAO and UNICEF met on January 15 to debrief last week's joint GVN/WHO/FAO field assessment to the Mekong Delta. During the meeting, technical debate focused on the increased number of provinces (currently seven) experiencing H5N1 AI outbreaks in poultry. Most poultry die-offs have been associated with illegally reared and unvaccinated ducks, especially hatchlings. The infection of vaccinated chicken flocks appears to be minimal. The GVN/WHO/FAO team is preparing a report that will provide the GVN with recommendations based on their observations. ¶12. (SBU) H5N1 AI outbreaks in poultry were first reported in early December from Ca Mau Province, where die-offs continue. This southernmost area of the Mekong Delta is an inundated coastal flood plain relying heavily on river and canal transportation networks between districts and communes. Hence, inaccessibility is thought to have hindered poultry vaccination and other prevention programs in these relatively remote areas. Serosurveillance studies of poultry in Ca Mau have shown poor levels of immuno-protection. ¶13. (SBU) COMMENT: The GVN has acted aggressively to institute control and containment measures, but reported outbreak activity continues to extend northward from Ca Mau toward HCMC. It is unknown whether these outbreaks and observed patterns of spread result from new virus introductions into susceptible flocks or from transfer of infection within flocks from silent carriers to susceptible immatures as they are hatched, or to a combination of both. The poultry outbreaks present unusual opportunities to conduct evaluations of how well the government-proscribed prevention and control practices have been carried out and to conduct analytic epidemiologic studies of farms to identify outbreak risk factors. However, it is uncertain if there is sufficient partner and GVN willingness, resources and infrastructure to successfully carry out such work. Currently, it is difficult to gauge the speed and extent of the spread due to unknown measures of completeness, accuracy and timeliness of disease detection, laboratory confirmation and reporting. END COMMENT. A Case for the Poultry Enforcement Agency? -------------- ¶14. (SBU) On January 12, USAID consultants working on AI activities visited the Ha Vi market on the outskirts of Hanoi to informally investigate conditions at one of the city's largest live poultry markets. On this particular day, no disinfectants or biosafety measures were visible, despite governmental decrees mandating their use. A number of Chinese-origin chickens (presumably smuggled, unvaccinated birds) were for sale. In addition, several vendors were selling live birds from burlap sacks along the outside perimeter of the market. Subsequent to their visit, the consultants received a phone call from local authorities who ngrily demanded that they should have been warne that foreigners were visiting the market, presuably to prepare the disinfectant and other safety measures. (COMMENT: Ha Vi Market is one of the man wet markets in HANOI 00000107 004.2 OF 004 Hanoi. If this market does not regularly practice biosafety measures, then other smaller and less visible markets may also fail to maintain regular biosafety measures. END COMMENT) MARINE