VZCZCXRO5231
RR RUEHCHI RUEHDT RUEHHM RUEHLN RUEHMA RUEHPB RUEHPOD
DE RUEHHI #0973/01 1441055
ZNR UUUUU ZZH
R 241055Z MAY 07
FM AMEMBASSY HANOI
TO RUEHC/SECSTATE WASHDC 5470
INFO RUEHHM/AMCONSUL HO CHI MINH 3106
RUEHZS/ASEAN REGIONAL FORUM COLLECTIVE
RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE
RUEHBK/AMEMBASSY BANGKOK 5707
RUEHJA/AMEMBASSY JAKARTA 0673
RUEHUL/AMEMBASSY SEOUL 3133
RUEHKO/AMEMBASSY TOKYO 5698
RUEHVN/AMEMBASSY VIENTIANE 3954
RUEHHK/AMCONSUL HONG KONG 1169
RUEHGZ/AMCONSUL GUANGZHOU 0799
RUEHCN/AMCONSUL CHENGDU 0300
RUEHSUN/USUN ROME IT
RUEHIN/AIT TAIPEI 1493
RUEAIIA/CIA WASHINGTON DC
RUEHPH/CDC ATLANTA GA
RUEAUSA/DEPT OF HHS WASHINGTON DC
RUEHRC/DEPT OF AGRICULTURE WASHINGTON DC
RUEKJCS/SECDEF WASHINGTON DC//USDP/ISA/AP//
RHMFISS/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 HANOI 000973 
 
SIPDIS 
 
SENSITIVE 
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 (STIEGER, VALDEZ, BELL, BHAT, HICKEY) 
STATE PASS TO CDC (COX AND MOHEN) 
USDA PASS TO APHIS 
DEPARTMENT OF DEFENSE FOR OSD/ISA/AP (STERN) 
BANGKOK FOR RMO, CDC, USAID (MACARTHUR AND BRADY) 
ROME FOR FAO 
 
E.O. 12958: N/A 
TAGS: TBIO KFLU AMED AMGT CASC EAGR PINR SOCI VM
SUBJECT: AVIAN INFLUENZA UPDATE - PERSISTENT SPORADIC ANIMAL 
OUTBREAKS GIVE RISE TO HUMAN SUSPECT CASE 
 
 
HANOI 00000973  001.2 OF 003 
 
 
SENSITIVE BUT UNCLASSIFIED 
 
REF: HANOI 725 and previous 
 
¶1. (U) Summary: After a month-long period of no highly pathogenic 
avian influenza (AI) outbreaks in animals, limited outbreaks in 
poultry have been reported in five provinces, including Hanoi.  One 
suspected human case, a 30-year old man from Vinh Phuoc Province, is 
recovering but still in critical condition at the Bach Mai hospital 
in Hanoi.  Initial test results for H5N1 AI, which are being 
confirmed, are positive for the virus.  GVN has indicated it will 
send material into the World Health Organization (WHO) Collaborating 
Network.  The first round of the annual poultry vaccination campaign 
continues.  The Partnership for Avian and Human Influenza (PAHI) 
established its Secretariat office and plans to host its first 
meeting on May 29.  End Summary. 
 
Human Case 
---------- 
 
¶2. (SBU) A 30-year old man from northern Vietnam's Vinh Phuc 
province has been hospitalized with severe pneumonia and respiratory 
failure consistent with AI.  The man's relatives reported to the 
media that he handled chicken carcasses before becoming ill.  The 
man is currently in critical condition at the Bach Mai hospital in 
Hanoi.  Initial test results for H5N1 AI by PCR are positive for the 
virus.  An investigation and confirmatory testing is underway and 
required before labeling it as an official case.  If confirmed, this 
will be the first case in humans since November 2005. 
 
¶3. (SBU) At a May 23 meeting between Ministry of Agriculture and 
Rural Development (MARD) official and Agricultural Counselor on a 
separate subject, MARD informally revealed that this human suspect 
case from Me Linh District in Vinh Phuc Province was presented to 
the National Steering Committee Weekly meeting on Tuesday May 15 by 
Ministry of Health's (MOH) Administration of Preventive Medicine. 
The positive laboratory result was presented to the Committee on 
Tuesday May 22.  Animal samples have been taken and results are 
expected on Thursday May 24.  There were no prior official reports 
of AI animal outbreaks in the area where this case occurred since 
¶2004.  However, MARD unofficially reports that, upon further 
investigation, they have uncovered unconfirmed reports of limited 
chicken die-offs.  This area produces far more chickens than ducks 
and there is no reported history of duck exposure or duck illness. 
 
¶4. (SBU) According to unofficial reports from the WHO and MOH 
(including an interview with one of the leads on the investigative 
team), the affected person is a 30-year old farmer and was exposed 
to chickens May 5 or 6.  He reportedly prepared chickens for a 
wedding party of about 100 persons, some of which were sick when 
killed and some of which may have been already dead before 
preparation.  Two other women helped with the preparation of the 
birds but did not help kill the chickens.  The women did not become 
ill.  The index case may have been symptomatic as early as May 7, 
but by May 11 he was symptomatic and progressively worsened with 
fever, cough, and shortness of breath by May 14.  He presented to 
the local commune level polyclinic on May 15 and was treated 
overnight.  On May 15 he was transferred to Hanoi because his 
 
HANOI 00000973  002.2 OF 003 
 
 
condition worsened.  On May 18 he was admitted to the intensive care 
unit (ICU) with decreased responsiveness, in respiratory failure, 
was intubated and mechanically ventilated.  Initial testing was by 
PCR at MOH's National Institute of Hygiene and Epidemiology (NIHE) 
and completed within 6 hours of admission to the ICU.  The positive 
result was available the next morning.  The patient was started on 
oseltamivir (Tamiflu). 
 
¶5. (SBU) On May 21, the GVN dispatched a joint MOH/MARD 
investigative team to the originating province.  Molecular DNA 
sequencing was just completed and confirms the presence of H5N1 
virus.  Information from the dispatched team preliminarily report 
that there are no associated cases among close human contacts, 
although a media report pointed to a young nephew or niece of the 
index case who accompanied him to the clinic was being investigated 
for a respiratory illness but tested negative for the presence of 
H5N1 AI virus.  About 90 close contacts have been started on 
oseltamivir (Tamiflu) for prevention; no wedding guests are being 
treated.  The patient's condition is slightly improved today. 
 
Animal Outbreaks 
---------------- 
 
¶6. (SBU) Vietnam met the definition for an AI outbreak free period 
based on a 21-day stretch, with no reported outbreaks from March 30 
to May 5, 2007.  The MARD reported a limited outbreak in northern 
Vietnam's Nghe An Province on May 6 of an outbreak that was 
determined to have begun on May 1.  This was followed by a series of 
confirmed outbreaks (ten total) in Nghe An, Quang Ninh, Son La and 
Nam Dinh Provinces in the north and Can Tho and Dong Thap Provinces 
in the south, all of which involved unvaccinated and recently 
hatched ducklings (including Muscovy ducks).  Although one of the 
outbreaks involved three household farms where 1,298 out of 3,800 
ducks died, most die-offs involved one isolated household farm and 
less than several hundred ducks.  All of the outbreaks were quickly 
brought under control.  Response measures included culling, 
vaccinating surrounding flocks, disinfecting poultry pens, 
restricting of the movement of poultry beyond outbreak areas and 
animal quarantine. 
 
¶7. (U) Local media continue to report details of most outbreaks, 
providing information on the size of flocks, the location, 
interventions, and in one case, the name of the farmer.  More 
recently, media reports have more thoroughly covered the supplier 
aspect of the duck industry, including the private sector, quoting 
agricultural officials saying that some localities in the northern 
and central regions have not yet fully complied with the MARD's 
strict regulations on egg hatching and waterfowl breeding. 
 
¶8. (SBU) MARD's Department of Animal Health (DAH) Deputy Director 
and Chief Veterinary Epidemiologist Hoang Van Nam told Agricultural 
Counselor that the National AI Steering Committee met on May 22 to 
discuss the recently occurring outbreaks.  Nam blamed the recent 
outbreaks on the poor management of provincial vaccination programs, 
pledging to send more senior officials to address the program's 
problems directly.  A Hanoi-based FAO expert acknowledged that 
"compliance is a huge issue."  He added that the GVN's veterinary 
field staff are "fed up" with the massive workload and that farmers 
 
HANOI 00000973  003.2 OF 003 
 
 
are less willing to cooperate, despite occasional and sporadic 
outbreaks.  Our source also speculated that the lack of human cases 
gave health authorities a false sense of security. 
 
Vaccinations 
------------ 
 
¶9. (U) Sixty of Vietnam's 64 provinces are conducting the first 
round of vaccinations for 2007.  The first round consists of two 
shots, separated in time.  As of May 22, MARD reports that 116.6 
million poultry have been vaccinated including 73.3 million 
chickens, 40.1 million ducks and 3.2 million Muscovy ducks. 
Currently, 34 provinces have completed first round shots.  Nine 
provinces are preparing for second round shots.  FAO-Vietnam 
estimates the first round of vaccination will cost about USD 6 
million for the vaccine.  Three provinces have fully completed the 
entire two-shot vaccination round.  In addition, large livestock 
companies administered more than 5.6 million doses of TROVAC Aih5, 
an AI poultry pox vector vaccine. 
 
Partnership for Avian and Human Influenza 
-------------------- 
 
¶10. (U) The Partnership for Avian and Human Influenza (a body formed 
last year composed of GVN and donor organizations) has established a 
Secretariat Office within the International Cooperation Department 
 
SIPDIS 
of MARD.  Dr. David Payne is the resident international advisor 
(email: david.pahi.htqt@mard.gov.vn) with a newly recruited 
Secretariat Manager, Ms. Dao Thu Trang (email: 
 
SIPDIS 
trang.pahi.htqt@mard.gov.vn).  A plenary meeting will be held on May 
¶29.  The draft agenda includes a: a) briefing on national situation 
and response; b) update on management and coordination activities of 
PAHI; c) update on ODA-funded AHI activities; and d) opportunity for 
additional members to sign the PAHI's Partnership Framework, 
originally chartered on November 1, 2006. 
 
¶11. (SBU) Comment: Although there has been a recent increase in the 
frequency of animal outbreaks, the previously reported downward 
trend in the number and scope of poultry outbreaks since 2004 still 
holds true.  The fact that recent outbreaks are restricted mostly to 
unvaccinated duck hatchlings is reassuring.  However, the threat of 
complacency continues to be a challenge for the GVN and 
international partners to maintain momentum.  With regards to the 
reported human case, initial contacts within the MOH, WHO and MARD 
reveal that the GVN's system is responding in a systematic and 
adequate manner.  The event calls attention to the need to build 
capacity on both the animal and human side. 
 
MARINE