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