VZCZCXRO3258
PP RUEHCHI RUEHDT RUEHHM RUEHLN RUEHMA RUEHNH RUEHPB
DE RUEHBK #4792/01 2192334
ZNR UUUUU ZZH
P 072334Z AUG 06
FM AMEMBASSY BANGKOK
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UNCLAS SECTION 01 OF 04 BANGKOK 004792 
 
SIPDIS 
 
////// C O R R E D T E D  COPY //// CORRECTING ADDRESSEE 
(BUMED) ONLY 
 
SENSITIVE 
SIPDIS 
 
DEPARTMENT FOR S/ES-O AND G/AIAG/JLANGE AND CPATTERSON 
DEPARTMENT FOR CA/OCS/ACS, EAP/EX, EAP/MLS, EAP/IET, A/MED 
DEPARTMENT FOR OES/FO, OES/EID, OES/STC, OES/PCI, OES/IHA 
USAID FOR ANE/AA KUNDER, GH/HIDN CARROLL, OFDA LEVY 
HHS FOR WSTEIGER, ABHAT, MSTLOUISAND, OGHA ELVANDER, HHS/NIH 
CDC FOR NCID LEDUC AND COX 
DEPARTMENT OF AGRICULTURE FOR OSEC AND APHIS 
DEPARTMENT OF AGRICULTURE FOR FAS/DLP/HWETZEL FAS/ICD/LAIDIG 
DEPARTMENT OF DEFENSE FOR OSD/ISA/AP FOR LEW STERN 
USPACOM ALSO PASS TO J07 
NSC FOR JMELINE 
PARIS FOR FAS/AG MINISTER COUNSELOR/OIE 
ROME FOR FAO 
BEIJING FOR ESTH - SELIGSOHN AND SHAPIRO 
CANBERRA FOR APHIS/DHANNAPEL 
JAKARTA FOR NAMRU BLAIR, USAID KRAMER 
HANOI FOR USAID ZVINAKIS, HHS IADEMARCO AND DENNIS 
VIENTIANE FOR CORWIN 
RANGOON FOR TIDWELL 
 
E.O. 12958: N/A 
TAGS: TBIO EAGR KFLU PGOV SOCI TH
SUBJECT: THAILAND'S SECOND HUMAN AVIAN INFLUENZA DEATH IN 
THE PAST TWO WEEKS 
 
REF: A. BANGKOK 4530 B. BANGKOK 4612 C. BANGKOK 4613 
 
BANGKOK 00004792  001.4 OF 004 
 
 
¶1. (U) Summary: Thailand's Ministry of Public Health (MOPH) 
confirmed by laboratory testing that a second human avian 
influenza death in as many weeks occurred on August 3 in 
Uthaithani, a province in west-central Thailand.  Testing of 
veterinary samples from the man's home returned negative 
results, prompting an exchange of barbs between officials 
from the Department of Livestock Development (DLD) and MOPH. 
On August 6, livestock officials culled 20,000 chickens on a 
poultry farm in another district of Uthaithani Province after 
200 chickens reportedly died there en masse.  Meanwhile, on 
July 31, DLD veterinary laboratory testing did detect H5N1 
avian influenza in a poultry outbreak in Nakhon Phanom 
Province in Thailand's far northeast.  End Summary. 
 
Thailand's Second Human Avian Influenza Death in 2006 
--------------------------------------------- -------- 
¶2. (U) Dr. Thawat Suntrajarn, the Director-General of the 
MOPH's Department of Disease Control, told Bangkok-based CDC 
personnel that Thailand's second human influenza death of the 
year was a 27-year-old patient admitted to the Uthaithani 
provincial hospital on July 30 with fever and shortness of 
breath.  He died at the hospital on August 3.  (Thailand's 
first human avian influenza death of 2006 occurred on July 
¶24.  See Ref A.)  The 27-year-old reportedly had buried a 
dead chicken in his backyard on July 17.  Laboratory tests 
for avian influenza undertaken at the hospital were 
inconclusive, but the results of Polymerase Chain Reaction 
(PCR) DNA testing on specimens sent to both the Thai National 
Institute of Health and Bangkok's Siriraj hospital on August 
 
BANGKOK 00004792  002.2 OF 004 
 
 
5 were positive for H5N1 avian influenza. 
 
¶3. (U) On August 7, the Bangkok Post reported that veterinary 
samples taken from both dead and live chickens at the man's 
home all tested negative.  The article quoted Kamnuan 
Ungchusak, Director of MOPH's Bureau of Epidemiology as 
saying, "I'm not surprised that the (DLD's) test could not 
find the H5N1 virus in poultry samples from the house because 
the test was conducted long after the man was infected by the 
virus, and most of the chickens were already dead." 
 
¶4. (U) The article quoted the DLD's Disease Control Bureau 
Director Nirundorn Aungtragoolsuk as saying, "Since the H5N1 
bird flu virus was not detected at the victim's house and in 
the nearby vicinity, public health officials should find out 
how and where the man contracted the virus." 
 
¶5. (SBU) The frustration expressed by these officials to the 
Bangkok Post hints at a deeper tension between MOPH and the 
Ministry of Agriculture's DLD.  Privately, MOPH officials 
have expressed to us in harsher words a growing frustration 
with DLD.  Theoretically, surveillance of poultry should be 
the first indicator of the presence of H5N1, leading to 
increased public health surveillance of humans in 
poultry-affected areas. But in Thailand, just the opposite 
scenario is occurring - detection of H5N1 in humans is 
preceding reports of H5N1 in poultry.  To be fair, in 
comparison to MOPH, the DLD has less manpower, less 
experience, and less funding to conduct disease surveillance. 
 DLD is also frustrated that farmers continue to neglect 
reporting or even hide poultry deaths from officials, causing 
 
BANGKOK 00004792  003.2 OF 004 
 
 
them to arrive too late on the scene to obtain good 
laboratory specimens. 
 
Poultry Die-Off in Uthaithani Province... 
----------------------------------------- 
¶6.  (U) The Bangkok Post also reported on August 7 that DLD 
officials culled approximately 20,000 chickens on a farm in 
another district of Uthaithani Province after 200 chickens 
reportedly died there "en masse."  Embassy Bangkok-based 
Regional Environmental and Health Officer was unable to reach 
DLD officials in Bangkok to inquire whether veterinary 
samples were taken from the affected flock for laboratory 
testing.  The province, which is further south than Phichit, 
Phitsanulok, Sukothai, and Uttaradit provinces, where large 
numbers of poultry die-offs were reported in July, 
nevertheless lies in the broad belt that runs north from 
Bangkok to the Lao border where there is a heavy 
concentration of chicken farming, as well as the raising of 
fighting cocks. 
 
...And Another Way Out in the Northeast 
--------------------------------------- 
¶7. (U) Meanwhile, from July 16 to July 24, 2241 layer 
chickens died on 78 farms and households in Nakhon Phanom 
Province in Thailand's extreme northeast corner.  On July 29, 
DLD's Upper Northeastern Regional Veterinary Research and 
Development Center, detected H5 avian influenza virus in 
samples taken from the dead birds.  On August 1, the National 
Institute of Animal Health in Bangkok confirmed the full 
identification of the virus as H5N1.  DLD made a preliminary 
report to the World Organization for Animal Health (OIE) on 
 
BANGKOK 00004792  004.2 OF 004 
 
 
July 31 with a follow-up report on August 2.  DLD also culled 
more than 300,000 poultry in the province, made arrangements 
to compensate owners 75 percent of the value of the culled 
birds, and took samples from nearly 12,000 poultry within a 
5-km radius of the infected farm, including more than 10,500 
chickens and more than 900 ducks from 734 farms or 
households.  CDC-Bangkok has conducted active surveillance 
for severe pneumonia in Nakhon Phanom since 2003, and is 
deeply integrated into the outbreak response. 
 
¶8. (U) Various Thai media reported that Thai officials 
believed the virus arrived in Nakhon Phanom on contaminated 
egg trays from Laos, but gave no evidence for their 
conclusions.  In its official report to the OIE, the DLD 
stated that the source of the outbreak in Nakhon Phanom was 
"unknown or inconclusive."  Thailand has since restricted 
cross-border transport of poultry and poultry products from 
Laos. 
ARVIZU