AVIAN INFLUENZA UPDATE - HUMAN FATALITY DESPITE DECREASE IN

UNCLAS SECTION 01 OF 02 HANOI 001365 SIPDIS SENSITIVE SIPDIS STATE FOR EAP/MLS, EAP/EP, AIAG, OES/IHA, MED STATE PASS TO USAID FOR ANE AND GH STATE PASS TO HHS/OGHA (STIEGER/VALDEZ/BELL/HICKEY) CDC FOR OGHA (BLOUT/MCCALL) AND DIV-FLU (COX/MOHEN) DEPARTMENT OF DEFENSE FOR OSD/ISA/AP (STERN) HHS PASS TO FIC/NIH (GLASS) USDA PASS TO APHIS, FAS (OSTA AND OCRA),FSIS BANGKOK FOR RMO, CDC (MALISON),USAID (MACARTHUR/BRADY) BEIJING FOR HHS HEALTH ATTACHE (ROSS) PHNOM PENH FOR CDC INFLUENZA COORDINATOR(BRADY) VIENTIANE FOR CDC INFLUENZA COORDINATOR (CORWIN) ROME FOR FAO E.O. 12958: N/A TAGS: TBIO AMED AMGT CASC EAGR PINR KFLU VM SUBJECT: AVIAN INFLUENZA UPDATE - HUMAN FATALITY DESPITE DECREASE IN POULTRY OUTBREAKS REF: A) HANOI 1265; B) HANOI 1333; C) HANOI 890 HANOI 00001365 001.2 OF 002 ¶1. (U) Summary: On July 31, the Government of Vietnam (GVN) reported a fatal case of a pregnant 22 year-old woman from rural Ha Tay province infected with the H5N1 strain of highly pathologic avian influenza. The case appears to be isolated and not related to an active poultry outbreak or human cluster. Outbreaks of AI in poultry have substantially dropped off as previously reported (ref A). The GVN continues its fully cooperative stance on sample sharing. End Summary. Report of Isolated Human Death -------------- ¶2. (U) On July 31, the Ministry of Health (MOH) reported a fatal case of AI in a pregnant 22 year-old woman from rural Ha Tay province, which is proximal to Hanoi. She was admitted to Bach Mai Hospital on July 24 with breathing difficulties, was placed on mechanical ventilation and died five days later. H5N1 infection was confirmed by RT-PCR testing at a national laboratory. Field investigations did not identify a source of infection. There was no evidence of poultry outbreaks in the area surrounding her home, and no recent reports of outbreaks from Ha Tay or surrounding provinces. Close contacts of the patient were placed on Tamiflu. This case is the sixth reported human case and the third death reported since May ¶2007. Animal Outbreaks Drop Off Markedly -------------- ¶3. (U) Avian influenza outbreak activity in poultry has dropped markedly in recent weeks. The week of June 29 was the peak of activity in the fifth outbreak wave that began May 1 with 29 outbreaks recorded. Of the 20 provinces affected with poultry outbreaks since May 1, only three provinces (Dien Bien in the northern region, Dong Thap in the southern region and Quang Binh in the central region) have reported any outbreaks in the past 21 days. Human and Animal Sample Sharing -------------- ¶4. (SBU) Concerns continue with timely submission of clinical specimens from suspected cases to the World Health Organization (WHO) for independent reference laboratory confirmation, despite repeated requests from WHO to the MOH. Of the 6 cases reported by GVN since May 2007, specimens from only the first two cases have been provided to WHO for confirmatory testing. ¶5. (SBU) Results of reference laboratory testing of clinical specimens of the first two cases by WHO Collaborating Center in Atlanta promptly confirmed that the H5N1 virus causing illness belonged to Clade 2.3 genomic sublineage, only once before identified in Vietnam as a cause of infection in humans in November ¶2005. Clade 2.3 H5N1 viruses are considered to be the newly dominant genomic sublineage in the region. ¶6. (SBU) On July 27 ESTHOff and CDC Avian Influenza Advisor HANOI 00001365 002.2 OF 002 delivered talking points and non-paper entitled "Goals for Meeting of WHO Interdisciplinary Working Group" to the Ministry of Health's International Cooperation Department General Director Dr. Tran Trong Hai (ref B). More details on the GVN's official stance on sample sharing and vaccine access were reported earlier (ref C). MARINE