CHOLERA OUTBREAK CONFIRMED IN NORTHERN VIETNAM

UNCLAS SECTION 01 OF 02 HANOI 001921 SIPDIS SENSITIVE 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/LVALDEZ/CHICKEY) CDC FOR OGHA (SBLOUT/KMCCALL) AND FOODBORNE DIV (RTAUXE) HHS PASS TO FIC/NIH (GLASS) AND TO FDA (MPLAISER) USDA PASS TO APHIS, FAS (OSTA AND OCRA),FSIS BANGKOK FOR RMO, CDC (MMALISON),USAID (JMACARTHUR/MBRADY) BANGKOK FOR APHIS (NCARDENAS),REO(JWALLER) BEIJING FOR HHS HEALTH ATTACHE (BROSS) ROME FOR FAO E.O. 12958: N/A TAGS: TBIO AMED AMGT CASC EAGR PINR VM SUBJECT: CHOLERA OUTBREAK CONFIRMED IN NORTHERN VIETNAM REF: Hanoi 1771 HANOI 00001921 001.2 OF 002 1.(SBU) Summary: The Government of Vietnam (GVN) has confirmed an outbreak of acute watery diarrhea in persons living in the northern part of the nation. Initially linked to unsafe food, primarily raw shrimp paste, the outbreak now may be spreading through contact with infected patients or contaminated water. The GVN has confirmed that approximately 15 percent of the 600 persons infected to date tested positive for cholera. The GVN has issued a series of warnings to the public, stockpiled medication, sent medical workers to infected locales, and agreed to provide free medical treatment to those suffering from diarrhea. Additionally, the Vietnamese Ministry of Health (MOH) recently asked the World Health Organization (WHO) for assistance responding to the situation. U.S. Centers for Disease Control (CDC) in Hanoi has offered expert support to the WHO, if needed. End Summary. ¶2. (U) On November 4, the GVN confirmed an additional 148 cases of acute diarrhea among hospitalized patients in northern Vietnam, bringing the total to over 600 since the outbreak was first detected on October 23. The numbers of infected persons has spiked in the past few days and officials are concerned that the actual numbers might be substantially higher. The hospital wards of the National Institute for Infectious and Tropical Diseases, Hanoi, have been inundated with patients, necessitating a search by MOH for more hospital beds. Officials believe they have traced the epidemic to raw shrimp paste produced in coastal Thanh Hoa province, which recently suffered from flooding related to typhoon Lekima (reftel). Though Hanoi has seen the most patients, at least 11 municipalities and provinces throughout northern Vietnam have reported related cases. To date, southern Vietnam has not been affected. ¶3. (SBU) Over the weekend, Minister of Health Nguyen Quoc Trieu announced that 15 percent of those suffering from acute diarrhea had tested positive for the cholera bacterium. MOH officials further informed Embassy staff that the clinical presentations of many of the cases are classic for cholera. Initial victims consumed tainted raw foods, particularly shrimp paste, along with pork and vegetables. However, the GVN has now stated that the epidemic also may be spreading through secondary infections among caretakers and through exposure to contaminated drinking water. Continued flooding in the central region of the country, particularly if exacerbated by the expected landfall of typhoon Peipah later this week, could facilitate further spread of the disease. ¶4. (U) Last week, the GVN moved to contain the outbreak, instituting new food safety checks and suspending the use of all raw shrimp paste. Through media reports, the MOH warned the public of potential high fatality rates for untreated patients and advised people to properly cook foods. The central government sent several health teams to various provinces to inspect the local conditions and Deputy Minister of Health Trinh Quan Huan asked local authorities to quarantine infected areas as the MOH's National Institute of Hygiene and Epidemiology (NIHE) continues to analyze disease samples. The GVN has stockpiled medications and sterile equipment and has organized training courses for health care professionals. Prime Minister Nguyen Tan Dung announced that the GVN would provide free treatment to all hospital patients suffering from acute diarrhea to encourage sick persons to present themselves for treatment. ¶5. (SBU) Consistent with Vietnam's obligations under the recently revised International Health Regulations, the MOH notified the WHO as the epidemic spread and requested WHO assistance. Press reports state that Vietnam also informed neighboring countries about the outbreak. U.S. CDC officers in Hanoi, in coordination with Bangkok and CDC headquarters in Atlanta, continue to communicate with the WHO and MOH. Through the Embassy Health Attache, CDC has offered to support the WHO with technical assistance, if requested. Post has provided relevant information to the delegation of Secretary of Commerce Gutierrez, currently in Hanoi, and has drafted a warden message for Washington clearance to Americans living in Vietnam advising them of the situation and providing information to minimize HANOI 00001921 002.2 OF 002 the risk of exposure. The Embassy medical unit will follow up with local health providers to update Embassy contingency planning. MICHALAK