VZCZCXRO9212
RR RUEHCHI RUEHDT RUEHLN RUEHMA RUEHNH RUEHPB
DE RUEHHM #1128/01 2770958
ZNR UUUUU ZZH
R 040958Z OCT 06
FM AMCONSUL HO CHI MINH CITY
TO RUEHC/SECSTATE WASHDC 1546
INFO RUEHHM/AMCONSUL HO CHI MINH CITY 1632
RUEHHI/AMEMBASSY HANOI 1098
RUCNARF/ASEAN REGIONAL FORUM COLLECTIVE
RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE
RUEHUL/AMEMBASSY SEOUL 0011
RUEHKO/AMEMBASSY TOKYO 0011
RUEHHK/AMCONSUL HONG KONG 0097
RUEHGZ/AMCONSUL GUANGZHOU 0014
RUEHCN/AMCONSUL CHENGDU 0011
RUEHIN/AIT TAIPEI 0025
RUEAIIA/CIA WASHDC
RUEHPH/CDC ATLANTA GA
RUEAUSA/DEPT OF HHS WASHINGTON DC
RUEHRC/USDA FAS WASHDC
RUEKJCS/SECDEF WASHINGTON DC
RUEKJCS/CJCS WASHINGTON DC//J2/J3/J5//
RHEFDIA/DIA WASHINGTON DC//DHO-3//
RHMFIUU/CDR USPACOM HONOLULU HI//J00/J2/J3/J5//
RHEFAFM/DIRAFMIC FT DETRICK MD//MA-1A//

UNCLAS SECTION 01 OF 03 HO CHI MINH CITY 001128 
 
SIPDIS 
 
SENSITIVE 
SIPDIS 
 
STATE FOR G, CA/OCS/ACS/EAP, EAP/EX, EAP/MLS, EAP/EP, INR, OES/ST 
STATE PASS TO USAID FOR ANE AND GH (DCARROLL, SCLEMENTS AND PCHAP 
STATE PASS TO USTR (DBISBEE) 
STATE PASS TO HHS/OGHA (WSTIEGER, EELVANDER AND ABHAT) 
USDA PASS TO APHIS 
DEPARTMENT OF DEFENSE FOR OSD/ISA/AP (LSTERN) 
BANGKOK FOR RMO, CDC, USAID (MFRIEDMAN, JMACARTHUR AND MBRADY) 
ROME FOR FAO 
 
E.O. 12958: N/A 
TAGS: TBIO KFLU AMED AMGT CASC EAGR PINR SOCI VM
SUBJECT: AVIAN INFLUENZA PREPAREDNESS IN CENTRAL VIETNAM 
 
REF: 05 HCMC 0891 B) HCMC 0810 C) HANOI 2361 AND PREVIOUS 
 
HO CHI MIN 00001128  001.2 OF 003 
 
 
¶1. (SBU) Summary:  Econoff visited Danang, Quang Nam, and Thua 
Thien Hue provinces in Central Vietnam to assess provincial 
Avian Influenza (AI) preparedness activities.  Animal Health and 
Preventive Health authorities are generally satisfied with 
current AI prevention programs in their provinces, citing the 
lack of an AI outbreak in poultry or humans since 2004 as proof 
of success.  Animal Health officials cite inadequate resources, 
the lack of an AI vaccine for geese, and the diffused, backyard 
nature of the poultry industry as the primary challenges to AI 
prevention in poultry.  Per GVN priorities, health authorities 
in Central Vietnam are focusing on poultry vaccination, disease 
detection, and public outreach but lack the resources to handle 
widespread cases of AI in humans.  End Summary. 
 
ANIMAL HEALTH AND POULTRY VACCINATIONS 
-------------------------------------- 
 
¶2. (SBU) EconOff met in September with Mr. Tran Van Quan, 
Director of the Regional Center for Animal Health in Danang 
City.  Covering nine provinces in the Central Highlands and 
Central Coastal provinces in Vietnam, the center is responsible 
for the surveillance and vaccination of 18.3 million birds. 
Unable to test for the presence of Avian Influenza in diseased 
birds, the center's fifteen doctors send blood samples to Hanoi 
or Ho Chi Minh City and usually receive test results within 24 
hours.  Quan reported that by the end of September 2006, 90 
percent of the region's poultry would be vaccinated against H5N1 
with Chinese-made vaccines, provided by the GVN. 
Post-vaccination surveillance (Ref B) included the testing of 
9,000 specimens from the region's nine provinces, all of which 
showed no signs of carrying the virus.  While AI was detected in 
poultry in eight of the region's nine provinces in 2004, the 
region has had no new reported cases of AI in poultry in 2005 or 
2006, leading Quan to declare victory in the fight against AI in 
poultry in Central Vietnam. 
 
¶3. (SBU) Mr. Pham Ngoc Anh, Director of Animal Health for Quang 
Nam Province, agreed with Director Quan's assessment that animal 
health authorities were successful in combating AI in poultry 
but cited several remaining challenges.  Anh reported that 80 
percent of the province's three million poultry have been 
vaccinated at least once in 2006.  Anh said that given the 
backyard nature of the province's poultry industry, most birds 
probably receive only one shot per year, thereby raising the 
risk of infection in at-risk flocks.  Anh also claimed that 
during a suspected poultry outbreak in 2005, animal health 
authorities in HCMC were back-logged with blood specimens to 
test for AI and were unable to alert provincial authorities as 
to whether or not the virus was present in diseased poultry. 
The tests eventually came back negative for AI, but not before 
animal health authorities had culled 327,000 birds.  USDA and 
USAID are currently providing funding and training for the 
upgrade of veterinary labs in Danang and southern Vietnam.  When 
completed, the upgraded labs will have the capability to 
independently confirm the presence of H5N1 in poultry. 
 
¶4. (SBU) Directors Quan and Anh, as well as Thua Thien Hue Vice 
Director of Agriculture and Rural Development Hoang Huu He, 
confirmed that the results of post-vaccination poultry testing 
showed variations in the presence of viral antibodies across 
provincial districts and among bird species.  Animal health 
authorities in all three provinces confirmed, on average, the 
presence of viral antibodies in 70 percent of animals, the 
 
HO CHI MIN 00001128  002.2 OF 003 
 
 
minimum acceptable level set by the GVN.  (Comment: Animal 
health authorities in Ho Chi Minh City and the Mekong Delta 
reported wide ranges in the presence of viral antibodies in 
vaccinated poultry, fluctuating from 0 to 96 per cent in some 
areas and almost always below 70 per cent in ducks.  It is 
unusual that animal health authorities in all three provinces 
were adamant that poultry flocks in their provinces exactly met 
the GVN minimum standard.  End Comment.)  Quan reported that the 
twice-yearly vaccination of poultry was not adequate and 
suggested all poultry be vaccinated every four months to 
adequately maintain viral resistance levels, especially in 
ducks, the primary vector for AI.  All three directors 
reiterated the need for the GVN to deliver a vaccination 
campaign for geese, thus far unavailable to poultry farmers in 
Vietnam. (Note:  While animal health authorities in Hanoi 
reported to USDA officials that vaccines are being used on 
geese, provincial animal health authorities reported to EconOff 
that geese remain an unvaccinated, at-risk population.  End 
Note.) 
 
¶5. (SBU) Animal health authorities in Hue, Danang, and Quang Nam 
all cited inadequate resources as their greatest concern in 
fighting AI.  Quan reported that the primary problem in the 
Danang animal health region is the presence of illegal 
hatcheries and the lack of well-trained health inspectors to 
monitor the GVN's ban on the raising of poultry in major urban 
areas.  Animal health authorities are present on-site at 
slaughterhouses, but the department lacks enough officials to 
survey urban markets more than once a week.  (Comment: The lack 
of trained inspectors and surveillance personnel, even in major 
urban areas such as Danang, is an indication that 
provincial-level authorities still lack effective surveillance 
networks throughout rural districts, thereby increasing the risk 
of poultry outbreaks and unreported infections.  End Comment.) 
 
PREPARING FOR LIMITED CASES OF AI IN HUMANS 
------------------------------------------- 
 
¶6. (SBU) The GVN has mandated that every provincial commune have 
at least one doctor working on AI prevention and surveillance, 
but of Danang, Quang Nam and Thua Thien Hue, only Thua Thien Hue 
has so far been able to comply; it reportedly has stationed one 
doctor in each of the province's 156 communes.  Thua Thien Hue, 
along with Danang and Quang Nam, still lacks resources to handle 
widespread AI infection in humans.  The province has designated 
three hospitals to handle AI cases:  Hue City Hospital, Phong 
Dien Hospital, and the 1,200-bed General Hospital of Hue City, 
each of which is equipped with isolation rooms, respirators, and 
limited supplies of Tamiflu.  Hue City, a traditional education 
center in Vietnam, has also designated the 300-bed University 
Hospital for the exclusive use of AI patients in a pandemic 
situation.  Mr. Nguyen Dung, Director of the Health Service of 
Thua Thien Hue, admitted that while the province can handle 
several hundred cases, only ten to fifteen patients can be 
isolated and placed on a respirator at any given time.  The 
province is currently dependent on the Pasteur Institutes in Nha 
Trang and Ho Chi Minh City for the testing of suspected AI 
cases, though a new center for research on respiratory diseases 
is scheduled to open in late 2007. 
 
¶7. (SBU) Health officials in Danang and Quang Nam also report 
being able to cope with only a few cases of AI in humans.  Mr. 
Ton That Thanh, Director of Preventive Health in Danang, and Dr. 
Tran Van Hoan, Vice Director of Preventive Health in Quang Nam, 
 
HO CHI MIN 00001128  003.2 OF 003 
 
 
admitted there are only two or three isolation rooms in each of 
the designated AI hospitals, General Hospital of Danang and the 
General Hospital of Quang Nam.  Hoan reported the GVN provided 
Quang Nam with 3,000 doses of Tamilfu in 2005, but the province 
has yet to receive any new medication from the central 
government in 2006.  Health officials in both provinces rely on 
the Pasteur Institute in Nha Trang and the National Institute 
for Health in Hanoi for confirmation of H5N1 in samples taken 
from suspected AI patients, a process that can take up to ten 
days. 
 
PUBLIC AWARENESS TO THE THREAT A PRIORITY 
------------------------------------------ 
 
¶8. (SBU) Quang Nam is one of three provinces in Vietnam 
designated for an expanded public outreach program on AI 
awareness.  Along with Ha Tay Province in northern Vietnam and 
Ben Tre Province in the Mekong Delta, Quang Nam has instituted a 
two-pronged approach to AI prevention: increase public awareness 
and provide assistance to poultry farmers to heighten sanitation 
levels.  The public awareness program, begun in early 2006, 
targets all media sources, including television, newspapers, 
leaflets, and GVN-sponsored community groups such as the Women's 
Union and Youth Union.  In addition, teams of human and animal 
health workers travel around the province providing chemicals to 
clean chicken coops and materials and guidance for the 
construction of fenced-in, isolated poultry-raising areas. Hoan 
of Quang Nam Preventive Health stressed the need to increase AI 
awareness among individual households on the commune level and 
reiterated the commonly-held opinion that changing the methods 
by which individual households keep backyard flocks is a 
difficult but crucial requirement in the GVN's fight against AI. 
 
COMMENT 
------- 
 
¶9. (SBU) Health officials in Thua Thien Hue, Quang Nam, and 
Danang were all unanimous in their belief that the GVN's 
national AI prevention program has been successful in preventing 
further outbreaks of AI in poultry and humans.  That said, 
several gaps exist.  On the animal health side, provincial 
authorities lack the resources to adequately monitor and confirm 
poultry outbreaks at the commune level.  While hospitals have 
taken steps to prepare for cases of AI in humans, provincial 
health authorities have the resources to properly treat only a 
handful of patients.  The provinces of Central Vietnam, 
following GVN national guidelines, have prioritized poultry 
vaccination, disease surveillance and public outreach.  Resource 
constraints at the national and provincial levels have made the 
large-scale mobilization of public health resources for the 
possibility of widespread cases of AI in humans impractical. 
Consequently, even relatively well-prepared provinces and cities 
lack the resources to handle widespread cases of AI in humans. 
End Comment. 
WINNICK