AVIAN INFLUENZA UPDATE - POULTRY OUTBREAKS QUELLED

UNCLAS SECTION 01 OF 03 HANOI 000303 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, DBELL AND ABHAT) STATE PASS TO CDC (NCOX AND AMOHEN) 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: AVIAN INFLUENZA UPDATE - POULTRY OUTBREAKS QUELLED HANOI 00000303 001.2 OF 003 SENSITIVE BUT UNCLASSIFIED REF: HANOI 107, HANOI 73 AND PREVIOUS ¶1. (SBU) Summary: The Government of Vietnam (GVN) has announced the successful containment of H5N1 outbreaks in poultry after experiencing 21 outbreak-free days. During January 29-31, Senior Advisor for East and Southeast Asia Charles Patterson traveled with ESTHOff, CONGEN ECONOff and CDC Influenza Advisor to Can Tho, Hau Giang and Dong Thap Provinces in the Mekong Delta. The USG team consulted with local authorities to better understand the AI poultry outbreak situation in the Delta, government strategies to contain the outbreaks and local capacity in response planning. End Summary. ¶2. (U) There have been no confirmed H5N1 AI human cases in Vietnam this year and none reported in 2006. Poultry Outbreaks Quelled in Mekong Delta -------------- ¶3. (SBU) On February 14, the National Steering Committee for Avian Influenza Prevention and Control, which is chaired by the Minister of Agricultural and Rural Development (MARD) Cao Duc Phat, announced the successful containment of H5N1 outbreaks in poultry, after 21 outbreak-free days. In early December, the first poultry outbreaks of 2006 were detected in southernmost Ca Mau Province, and within weeks, numerous outbreaks were reported throughout seven Mekong Delta provinces. These outbreaks affected mostly unvaccinated ducklings and did not spread to large commercial chicken flocks. Media outlets have reported Minister Phat eating "safe" chicken and warning the public to properly cook meats in the ramp-up to this week's Tet Lunar New Year holiday, in which chicken is traditionally served. Since the recurrence of AI in the Mekong Delta late last year, aggressive control actions were taken including vaccination of nearly 13 million birds, mostly waterfowl. USG Team Visits Mekong Delta Provinces -------------- ¶4. (SBU) On January 29-31, (AIAG) Senior Advisor for East and Southeast Asia Charles Patterson traveled with ESTHOff, CONGEN ECONOff and CDC Influenza Advisor to Can Tho, Hau Giang and Dong Thap Provinces in the Mekong Delta. The USG team consulted with local authorities to better understand the AI poultry outbreak situation in the Delta, government strategies to contain the outbreaks and local capacity in response planning. The USG team was warmly received by GVN officials in all three provinces. Observations and findings were shared at the ESTH regional conference in Bangkok on February 7. ¶5. (SBU) In Can Tho City, the team met with the Director of the Regional Animal Health Center Nguyen Ba Thanh. Director Thanh reported that, beginning on December 6, 2006, outbreaks occurred in remote area of Ca Mau Province in mostly unvaccinated ducklings between 1.5 to 3 months of age with high mortality. The first cases occurred in backyard chickens before moving to small flocks of Peking and Muscovy ducks; large flocks of mature ducks were apparently not heavily affected. Reports reached GVN officials only on December 17. By that time, outbreaks were occurring throughout in Ca Mau and Bac Lieu, the earliest and hardest hit provinces. Government officials eventually had to deal with poultry outbreaks in approximately 100 sites in eight contiguous provinces of the Mekong Delta. In all, 70 to 80 percent of samples collected in HANOI 00000303 002.2 OF 003 affected areas tested positive for H5N1. Disease did not spread to larger commercial flocks which had recently completed 2nd round of vaccination (H5N1 in ducks, H5N2 in chickens). ¶6. (SBU) Director Thanh spoke candidly about some of the underlying challenges of the "serious and hard to control" poultry outbreaks, including: 1) outbreaks occur in poor, remote areas with few local animal health staff, poor communications systems, low levels of surveillance, and difficulties in implementing control actions; 2) nearly all poultry are backyard, free-range flocks and farmers do not readily follow government instructions on preventive measures, such as use of enclosures; 3) regulations banning duck raising and controlling free-range flocks have not been strictly followed; 4) vaccinations are incomplete, especially of backyard flocks, due to lack of compliance and no vaccine available for Muscovy ducks; 5) inability to control transportation of poultry from affected areas to markets; 6) local animal health officials are not under the direct authority of central and regional MARD staff. Responding to a question about what actions would be more responsive, Thanh indicated that more should be done to clamp down and implement existing government regulations, especially at household level. Thanh added that duck rearing should be banned until February 27 and that all duck hatchlings should be culled, which he noted is unfeasible given the lack of any compensation scheme for poor villagers. ¶7. (SBU) In Can Tho City, the USG team also met with the Deputy Director of Animal Health and the Chief Inspector of Animal Health, both members of the Can Tho City AI Steering Committee. While Can Tho experienced no poultry outbreaks in 2006, three households experienced outbreaks in early January, 2007. In Can Tho, there are inter-agency teams capable to respond to outbreaks at city, district and commune-levels. The city employs seven animal health inspectors at the department level and five inspectors in each of the seven districts within the city. A mobile task force is also deployable to conduct surprise inspections. Subsequently, the team visited Ngoc Xuan slaughterhouse, one of the city's biggest and newest, which capable of processing 3,000 birds on a normal day. From a layman's perspective, the operation appeared crude and fairly easy for sick birds to infect others in the holding pens. ¶8. (SBU) The USG team also met with Dr. Nguyen Chu Nghi, Deputy Director of the Health Department and Preventative Health Center of Can Tho City, which has a population of 1.12 million. Five human health rapid response teams are standing by at the city-level, complemented by an additional three teams at district-level and two teams at each commune-level. City-level rapid response teams comprise of an epidemiologist, clinician, environmentalist/sanitarian, lab technician, and occasionally an animal health worker. In the event of a suspected H5N1 human case at the district level, city and district-level teams are dispatched to work together. The health response teams also coordinate with animal health response teams to test blood of animal health workers administering vaccinations, inspecting hygiene of slaughterhouses and markets, and inspecting the decontamination of affected households and neighboring households in affected areas. In the event of an epidemic, respirators will be in short supply. The tuberculosis hospital has seven units, the regional hospital has two units and each district hospital has only one unit. ¶9. (SBU) In Hau Giang Province, the USG team was received by Vice Chairman of the Provincial People's Committee Mr. Tran Thanh Lap and all nineteen heads of provincial departments and units that comprise the Provincial AI Steering Committee. Director of the Department of HANOI 00000303 003.2 OF 003 Agriculture and Rural Development Mr. Nguyen Van Dong, Permanent Head of the steering committee, provided a detailed briefing of the poultry outbreaks, which began in 2004. Between December 26, 2006 and January 12, 2007, Hau Giang experienced 20 outbreaks in seven communes of two districts. In total, 300 birds were recorded sick or dead, while another 8,000 birds were culled. The Committee reiterated the main challenges in quelling the poultry outbreaks, namely the inability to control wandering duck flocks and the inability to enforce restrictions on hatching of ducks at grassroots levels. The Committee believes that the vaccination campaigns have helped to prevent the spread of AI, and recommend that the timing of the vaccinations be administered before the high-risk months of July and December. The meeting was filmed by a local television crew. ¶10. (SBU) The USG team then met with the Vice Director of Hau Giang Provincial Hospital Dr. Pham Tham Phuong. The hospital has an AI action group with nine staff members. A few physicians and nurses have received training at the Pasteur Institute in HCMC on recognition and reporting of cases, diagnosis, case management and infection control. The hospital has two isolation beds and three beds in infectious diseases ward. In the event of an epidemic, patients are to receive treatment at provincial-level hospitals and, if necessary, transfer patients to referral hospitals such as the Tropical Diseases Hospital and Pediatric Hospital Number 1, both located in HCMC. ¶11. (SBU) In Dong Thap Province, the USG team met with the Director of the Department Agriculture and Rural Development Mr. Nguyen Van Dung. Dong Thap Province follows national guidelines on control and prevention disease in poultry, including mass propaganda, educating and enhancing awareness of the community leadership. Mr. Dung reiterated the lessons learned from neighboring provinces, namely: immunization of poultry is a critical feature to prevent occurrence; the need to reform poultry industry to move toward large scale rearing using modern practices where vaccination and bio-security measures are feasible (NOTE: 60 percent of rearing is small scale, 30 percent is medium and 10 percent is large-scale presently). He noted that the largest challenge is to educate the public to follow government instructions and for farmers to change risky practices. ¶12. (SBU) Finally, the USG team visited a CDC-funded project implemented by CARE International and the Lai Vung District Women's Union to develop a model of commune mobilization for behavioral change education and enhanced surveillance by recognizing the signs of sick birds. The project focuses on improving knowledge, attitude and behavior at the grassroots level. The model is being implemented in 16 communes in four of the province's nine districts. In total, 19,000 people have attended 313 meetings sponsored by the project. ALOISI