VZCZCXRO2311
RR RUEHCHI RUEHDT RUEHHM RUEHLN RUEHMA RUEHNH RUEHPB
DE RUEHBK #4530/01 2080235
ZNR UUUUU ZZH
R 270235Z JUL 06
FM AMEMBASSY BANGKOK
TO RUEHC/SECSTATE WASHDC 0493
INFO RUCNASE/ASEAN MEMBER COLLECTIVE
RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE
RUEHNE/AMEMBASSY NEW DELHI 4019
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RUEHUL/AMEMBASSY SEOUL 1935
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RUEHMO/AMEMBASSY MOSCOW 1239
RUEHKB/AMEMBASSY BAKU 0048
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RUEHEG/AMEMBASSY CAIRO 0251
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RUEHIN/AIT TAIPEI 8669
RUEHGV/USMISSION GENEVA 1683
RUEAUSA/DEPT OF HHS WASHINGTON DC
RUEHPH/CDC ATLANTA GA
RUEHRC/DEPT OF AGRICULTURE WASHINGTON DC
RUEHRC/DEPT OF AGRICULTURE USD FAS WASHINGTON DC 0753
RUEKJCS/SECDEF WASHINGTON DC//USDP/ISA/AP//
RUEKDIA/DIA WASHINGTON DC//DHO-3//
RHHMUNA/CDR USPACOM HONOLULU HI//J00/J2/J3/J5//

UNCLAS SECTION 01 OF 08 BANGKOK 004530 
 
SIPDIS 
 
SENSITIVE 
SIPDIS 
 
DEPARTMENT FOR G/AIAG/JLANGE 
DEPARTMENT FOR EAP/MLS 
DEPARTMENT FOR OES/STC/MGOLDBERG AND PBATES 
DEPARTMENT FOR OES/PCI/ASTEWART 
DEPARTMENT FOR OES/IHA/DSINGER AND NCOMELLA 
DEPARTMENT PASS TO USAID/ANE/CLEMENTS AND GH/CARROLL 
DEPARTMENT PASS CDC FOR COGH SDOWELL AND NCID/IB AMOEN 
DEPARTMENT PASS HHS/OGHA/WSTEIGER AND MSTLOUIS 
DEPARTMENT OF AGRICULTURE FOR OSEC AND APHIS 
DEPARTMENT OF AGRICULTURE FOR FAS/DLP/HWETZEL AND DEPARTMENT OF 
AGRICULTURE FOR FAS/ICD/LAIDIG, PETTRIE 
DEPARTMENT OF DEFENSE FOR OSD/ISA/AP FOR LEW STERN 
PARIS FOR FAS/AG MINISTER COUNSELOR/OIE 
ROME FOR FAO 
 
E.O. 12958: N/A 
TAGS: TBIO KFLU SOCI PGOV EAID EAGR KPAO XE
 
SUBJECT: AVIAN INFLUENZA RE-SURFACES IN THAILAND; ONE HUMAN DEATH 
AMID NUMEROUS POULTRY DIE-OFFS 
 
BANGKOK 00004530  001.2 OF 008 
 
 
¶1.  (U) Summary: Numerous die-offs of poultry have occurred in 
Thailand over the past month, concentrated mostly in the central and 
north-central provinces.  Despite testing of samples taken from the 
dead birds over the month-long period, government veterinary 
laboratories failed to detect the virus until July 24 when they 
isolated H5N1 virus from the carcass of a single fighting cock. 
Today, July 26, all doubts about the cause of the poultry die-offs 
vanished when the Minister of Public Health confirmed that the death 
of a 17-year-old boy in a province with heavy poultry fatalities was 
caused by H5N1 avian influenza.  Although the Minister's quick 
confirmation and open communication is commendable, serious 
questions remain why the virus was not detected earlier in the 
veterinary laboratories.  End summary. 
 
Poultry Die-Offs in July 
---------------------------- 
¶2.  (U) The Bangkok Post reported on July 4 that "more than 2000 
poultry have died... within the Phichit Province" about 200 miles 
north of Bangkok.  The article said that local livestock officials 
were running tests on the dead poultry, but that they suspected E. 
Coli (a species of bacteria) to be the cause of the die-off. 
 
¶3.  (U) During the month of July, numerous other poultry die-offs 
occurred in Phichit, Phitsanulok, Sukothai, and Uttaridit Provinces 
in north-central Thailand as well as in other provinces in the 
country.  The Department of Livestock Development (DLD), under the 
Ministry of Agriculture and Cooperatives, reported on July 16, that 
 
BANGKOK 00004530  002.2 OF 008 
 
 
large numbers of fowl had recently died in 430 tambons [sub 
districts] in 50 provinces.   Although a DLD official told the 
Bangkok Post that "the department did not rule out the possibility 
of a re-emergence of the [avian influenza] virus," laboratory tests 
had yielded negative results. 
 
¶4.  (U) On July 22, Professor Prasert Thongcharoen, a microbiologist 
at Bangkok's Siriraj Hospital, told The Nation newspaper in a 
telephone interview after returning from Phitsanulok Province that 
he had strong doubts about the accuracy of official reports of 
avian-flu tests on dead birds by livestock authorities.  "To be 
fair, they might have checked the samples and simply could not 
detect the virus," said Prasert. "Yet, once again, things are so 
obvious." 
 
Avian Influenza Detected in a Single Poultry Sample 
--------------------------------------------- ------- 
¶5.  (U) Finally, on the morning of July 24, using Reverse 
Transcriptase-Polymerase Chain Reaction (RT-PCR) methodology, the 
DLD's Lower Northern Regional Veterinary Research and Development 
Center in Phitsanulok Province detected avian influenza H5 virus in 
a sample taken from a household in Phichit Province's Bang Mun Nak 
District where 31 fighting cocks and free-range chickens had died 
over several days beginning July 16.  The authorities took immediate 
and stringent containment measures, including culling of the 
remaining 295 chickens on the Phichit farm, putting a 10-km radius 
quarantine and surveillance zone around the farm, and imposing a 
 
BANGKOK 00004530  003.2 OF 008 
 
 
total ban on the transport of poultry in the province to prevent 
villagers from trying to smuggle out potentially infected birds.  On 
the same day, the DLD submitted a formal report to the World 
Organization for Animal Health (OIE), notified the UN's Food and 
Agriculture Organization (FAO), and the Minister of Agriculture and 
Cooperatives called a news conference to inform the public. 
 
Human Death Attributed to Avian Influenza 
----------------------------------------- 
 
¶6.  (U) Since July 22, at least seven persons in Phichit Province 
and two persons in nearby Uttaridit Province (where poultry have 
succumbed in large numbers over the past three weeks) have been 
admitted to the provincial hospitals with flu-like symptoms.  All of 
the patients had contact with sick or dead poultry or with wild 
birds.  Laboratory testing performed on samples taken from all of 
the patients, including from the 17-year-old boy, tested negative 
for avian influenza virus.  Further testing of samples taken from 
the dead teenager, however, confirmed the presence of H5N1 avian 
influenza. 
 
¶7.  (U) The young man had buried between 10 and 20 chickens that had 
died of unknown causes in his village on July 10.  He became ill 
July 15 and went to the district hospital with heavy coughing on 
July 18.  A rapid test carried out that day was negative for 
influenza, and a chest x-ray was normal.  He was sent home, but 
returned to the hospital on July 20 with a high temperature.  The 
 
BANGKOK 00004530  004.2 OF 008 
 
 
first diagnosis was dengue fever and he was admitted for treatment. 
His conditions deteriorated, and he was sent to Phichit provincial 
hospital on July 22 where he died on July 24. 
 
¶8.  (U) At 11:30 a.m. on July 26, the Ministry of Public Health 
(MOPH) confirmed via press release that a sputum specimen from the 
17-year-old boy had tested positive for H5N1 virus.  The 
announcement included a clinical history of the boy's illness, but 
specified neither the laboratory nor the testing method.  MOPH 
officials in Bangkok told Bangkok-based CDC personnel that these 
tests were performed in provincial or regional laboratories, and 
have not yet been confirmed by Thai National Institute of Health 
(NIH).  The Bangkok CDC personnel have not yet received any requests 
for assistance with confirmatory testing.   Until Thai the NIH 
confirms the laboratory results, they must be considered 
preliminary. 
 
¶9.  (U)  In the same press release, MOPH also announced that 20 
specimens from human cases have been tested for H5N1; in addition to 
the one positive, half have tested negative for H5N1 but positive 
for another common respiratory pathogen, and the rest are pending or 
inconclusive.  The release also stated that more than 2000 specimens 
from poultry have been tested, with H5N1 found only in the sample 
taken in Bang-Moon-Nak District (near to the Tubklor District where 
the single human laboratory-positive case resided).  Shortly after 
the press release, Minister of Public Health Phinij Jarusombat 
briefed the media at a press conference in Bangkok. 
 
BANGKOK 00004530  005.2 OF 008 
 
 
 
Serious Questions for the Agriculture Ministry 
--------------------------------------------- - 
¶10.  While the Minister of Public Health's quick confirmation and 
open communication is commendable, serious questions remain why the 
virus was not detected earlier among the 2000 poultry specimens 
tested by the Agriculture Ministry's veterinary laboratories. 
Earlier detection and public knowledge of H5N1 as the cause of the 
poultry die-offs would have put health authorities, as well as the 
general population, on higher guard, possibly preventing the death 
of the 17-year-old. 
 
¶11.  (SBU) On July 24, Senator Nirun Phitakwatchara publicly called 
on the Minister of Agriculture to resign for his mismanagement of 
bird flu monitoring.  The Senator had earlier accused the ministry 
of covering up the re-emergence of bird flu for fear the country's 
poultry exports would be hit.  He recalled that the ministry had 
tried to cover up bird flu outbreaks when the virus first came to 
Thailand in late 2003 and early 2004. 
 
¶12.  (SBU) Officials at the World Health Organization (WHO) office 
in Thailand said they were aware of allegations of cover up, but saw 
no reason to doubt the integrity of the responsible Thai authorities 
at this stage.  Privately, however, an FAO official told Embassy 
Regional Environmental Officer that he was concerned about the 
possibility of politicians trying to hide the cause of the poultry 
outbreaks in the hopes the die-offs would subside quickly and 
 
BANGKOK 00004530  006.2 OF 008 
 
 
without human illness. 
 
¶13.  (SBU) Comment:  The Ministry of Agriculture and Cooperatives 
likely did try to hide the presence of avian influenza in poultry in 
Thailand in late 2003.  However, since January 2004, Thailand has 
worked hard to become a model of exemplary and timely reporting of 
avian influenza to the OIE, FAO, and WHO.  It works closely with 
CDC, the U.S. Embassy, and other international entities, and has 
been subject to close international scrutiny.  That said, USAID has 
been hearing "rumors" for some time about ongoing outbreaks in 
private commercial farms.  And there are strong and obvious economic 
incentives to Thailand's politically powerful commercial poultry 
industry to maintain an "avian influenza-free" Thailand that can 
begin re-exporting raw chicken meat. 
 
¶14.  (U) Comment Continued: Assuming there has been no intentional 
cover-up, there still remains the question of why the H5N1 virus is 
not being detected in veterinary laboratory testing of poultry we 
now believe to have been infected with the virus.   It is possible 
that the problem is technical in nature.  During the visit to 
Thailand last May of Special Representative for Avian and Pandemic 
Influenza Ambassador John Lange, the Deputy Director-General of the 
Department of Livestock Development (DLD) said that the DLD 
routinely pools samples when conducting surveillance.  There is a 
long history of pooling specimens as a cost effective way of 
performing screening with expensive reagents.  Moreover, RT-PCR 
methodology is extremely sensitive, capable of detecting and 
 
BANGKOK 00004530  007.2 OF 008 
 
 
amplifying viral DNA in the tiniest amounts.  Pooling of large 
numbers of samples, however, could theoretically dilute the virus 
and at some point decrease the sensitivity of the test.  FAO 
currently recommends pooling specimens in batches of 5-10, and 
mathematical models support that recommendation.  Post was unable 
today to confirm whether the DLD complies with FAO's 5-10 specimens 
per batch recommendation.  Post also points out that improper 
collection, storage, and transport of samples can negatively impact 
laboratory testing. 
 
¶15.  (U) Comment Continued:  Thailand has a well-deserved reputation 
for good public awareness and education campaigns, good 
community-based surveillance, rapid outbreak investigation and 
control, and prompt laboratory confirmation related to avian 
influenza.  The USG and other international donors and organizations 
have been instrumental in assisting Thailand achieve these 
competencies.  The re-surfacing of avian influenza in Thailand, 
then, shows that the virus can only be controlled, and not totally 
eliminated.  Moreover, the re-surfacing of the virus in Thailand, 
along with the negative laboratory tests on specimens from poultry 
die-offs, the misdiagnosis of the first human case of avian 
influenza in Thailand in over six months, and the reported continued 
human contact with sick and dead poultry in affected areas 
demonstrates the continuing need for basic public awareness, 
education and hygiene messages, better animal husbandry practices, 
improved disease surveillance among birds and humans, practical 
training of animal and human health providers, and improved capacity 
 
BANGKOK 00004530  008.2 OF 008 
 
 
of technicians in specimen collection and laboratory procedures. 
Arvizu