AVIAN INFLUENZA UPDATE - NEW HUMAN FATALITY

UNCLAS SECTION 01 OF 02 HANOI 001444 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 - NEW HUMAN FATALITY REF: A) HANOI 1265; B) HANOI 1365 HANOI 00001444 001.2 OF 002 ¶1. (U) Summary: On August 7, the Government of Vietnam (GVN) reported the death of a 15 year-old boy from Thanh Hoa province infected with the H5N1 strain of highly pathologic avian influenza. The case appears isolated and not related to larger poultry outbreaks or human clusters. Outbreaks of AI in poultry have substantially dropped off, as previously reported (ref A). End Summary. Report of Isolated Human Death -------------- ¶2. (U) On August 7, the Ministry of Health (MOH) reported the death from AI of a 15 year-old boy from Thanh Hoa province, approximately 85 miles south of Hanoi. The victim reportedly became ill on July 27, after exposure to a batch of hatchling ducks his family had purchased from a neighboring commune. The ducks became ill and died soon after purchase. The boy entered a local hospital on August 2, which placed him on mechanical ventilation. He died en route to Bach Mai Hospital in Hanoi on August 3. RT-PCR testing at a national laboratory confirmed H5N1 infection. Vietnamese officials report no evidence of poultry outbreaks in the area surrounding his home or elsewhere in the province. The MOH placed close contacts of the patient on Tamiflu. This case marks the seventh reported human case and the fourth death reported since May 2007. On July 28, a pregnant 22-year old woman from Ha Tay province, proximal to Hanoi, succumbed to AI (ref B). Animal Outbreaks Remain Low -------------- ¶3. (U) Avian influenza outbreak activity in poultry dropped markedly in July and has remained low since. The week of June 29 was the peak of activity in the fifth outbreak wave that began May 1 with 29 outbreaks recorded. To date, 3 provinces remain under observation, having had outbreaks in the past 21 days: Pien Bien (10 wards/communes),Dong Thap (4 communes) and Quang Binh (1 commune). An August 8, 2007 report of dead poultry in Dien Bien led to the Sub-District of Animal Health culling one household's ducks and chickens; however it is unknown if authorities took samples to diagnose H5N1 and if so, the results of those samples. The first AI vaccination campaign of 2007 continues with a total of 160.5 million birds vaccinated thus far, including 86.62M chickens, 70.08M ducks and 3.83M muscovy ducks. Large livestock companies additionally administered over 32.55 million doses of TROVAC vaccine. Human and Animal Sample Sharing -------------- ¶4. (SBU) During a farewell call on outgoing Minister of Health Chien, the Ambassador noted the need for timely submission of clinical specimens from suspected cases to the World Health Organization (WHO) for independent reference laboratory confirmation. (Note: As reported in ref. B, the GVN has provided specimens from only two of the first six human cases reported since May 2007 to WHO for confirmatory testing, despite repeated requests.) Minister Chien agreed on the importance of rapid sample sharing. HANOI 00001444 002.2 OF 002 ¶5. (U) On the animal health side, the GVN continues to promptly provide samples. Since 2004, the National Center of Veterinary Diagnosis (NCVD),Department of Animal Health, Ministry of Agriculture and Rural Development (MARD) has consistently sent the isolates of avian influenza to the CDC Influenza Division in Atlanta. In March and July of this year, NCVD sent HPAI isolates to CDC, and has also dispatched samples to the Australian Animal Health Laboratory. The Regional Animal Health Center in Ho Chi Minh City also reported sending poultry samples from southern Vietnam directly to the Australian Animal Health Laboratory though the NCVD has yet to confirm this. No Confirmation of Vietnamese Mediation with Indonesia -------------- -------------- ¶6. (U) Earlier this month, The Chinese Xinhua news service published a report that Vietnamese Prime Minister Nguyen Tan Dzung was traveling to Indonesia to "mediate Indonesia's dispute with the WHO over the provision of samples." Local press reports instead have highlighted Vietnamese-Indonesian discussions of trade and the fight against corruption, lumping health care and epidemics into a laundry list of other issues covered. However, MOH Vice-Minister Cao Minh Quang, whose portfolio covers pharmaceuticals, accompanied the Prime Minister on the trip raising the possibility that the two nations discussed this issue. We will seek more information. MARINE