VZCZCXRO5864
RR RUEHCHI RUEHDT RUEHHM RUEHLN RUEHMA RUEHPB RUEHPOD
DE RUEHHI #1265/01 1991733
ZNR UUUUU ZZH
R 181733Z JUL 07
FM AMEMBASSY HANOI
TO RUEHC/SECSTATE WASHDC 5838
INFO RUEHHM/AMCONSUL HO CHI MINH 3368
RUEHZS/ASEAN REGIONAL FORUM COLLECTIVE
RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE
RUEHUL/AMEMBASSY SEOUL 3179
RUEHKO/AMEMBASSY TOKYO 5746
RUEHHK/AMCONSUL HONG KONG 1234
RUEHGZ/AMCONSUL GUANGZHOU 0817
RUEHCN/AMCONSUL CHENGDU 0314
RUEHIN/AIT TAIPEI 1509
RUEAIIA/CIA WASHINGTON DC
RUEHPH/CDC ATLANTA GA
RUEHRC/DEPT OF AGRICULTURE WASHINGTON DC
RUEAUSA/DEPT OF HHS 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//
RUEHSUN/USUN ROME IT

UNCLAS SECTION 01 OF 04 HANOI 001265 
 
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/HICKEY) 
CDC FOR OGHA (BLOUT/MCCALL) AND DIV-FLU (COX/MOHEN) 
DEPARTMENT OF DEFENSE FOR OSD/ISA/AP (STERN) 
HHS PASS TO FIC/NIH (GLASS) 
USDA PASS TO APHIS, FAS (OSTA AND OCRA), FSIS 
BANGKOK FOR RMO, CDC (MALISON), USAID (MACARTHUR/BRADY) 
BEIJING FOR HHS HEALTH ATTACHE (ROSS) 
PHNOM PENH FOR CDC INFLUENZA COORDINATOR(BRADY) 
ROME FOR FAO 
VIENTIANE FOR CDC INFLUENZA COORDINATOR (CORWIN) 
 
 
E.O. 12958: N/A 
TAGS: TBIO AMED AMGT CASC EAGR PINR KFLU VM
SUBJECT: AVIAN INFLUENZA UPDATE - WAVE DYING OUT BUT SAMPLE SHARING 
CONTINUES 
 
HANOI 00001265  001.2 OF 004 
 
 
SENSITIVE BUT UNCLASSIFIED 
 
REF: A. Hanoi 1147 B. Hanoi 890 
 
¶1. (U) Summary. The Government of Vietnam (GVN) reports no human 
cases infected with the H5N1 strain of highly pathologic avian 
influenza A (HPAI) beyond the total of five confirmed cases since 
May 1.  There have been no cases among contacts and no common 
sources of infection.  Outbreaks of AI in poultry have substantially 
dropped off since Post's previous reports.  The GVN continues its 
fully cooperative stance on sample sharing.  End Summary. 
 
Update of Five Human Cases 
-------------------------- 
 
¶2. (U) A total of five human cases infected with H5N1 HPAI have been 
reported by Ministry of Health (MOH) in 2007 (reftel A).  Four were 
males; all were young adults aged 19-29 years.  Cases resided in 
separate provinces all in the northern region of Vietnam.  The dates 
of onset of illness spanned May 10 to June 3, coincident with the 
ascending wave of H5N1 HPAI outbreaks in ducks and chickens in the 
region.  There were no links between cases or known single source 
exposures.  Handling of infected poultry identified by epidemiologic 
investigations is the most likely mode of infection.  Two cases were 
fatal; three recovered and have been discharged from hospital.  Four 
of the five patients required mechanical ventilation and extended 
critical care for respiratory failure. 
 
Human and Animal Sample Sharing 
------------------------------- 
 
¶3. (SBU) From the onset of the first human case in May, the MOH has 
worked with WHO in an open and transparent fashion to promptly 
report human cases, providing laboratory test results.  Infection 
with H5N1 virus was established in each case by RT-PCR at the MOH's 
National Institutes of Hygiene and Epidemiology (NIHE) and confirmed 
in specimens from the first two cases by a WHO Influenza 
Collaborating Center (i.e., CDC, Atlanta).  Sample sharing and its 
importance were reported in the local media (reftel B).  The 
Director of NIHE, Dr. Hien reportedly said that the test results 
from CDC were the same as the results NIHE had found when carrying 
out the tests here in Vietnam, adding that NIHE would continue to 
work jointly with the CDC to decode the H5N1 virus gene and keep 
track of its transformation. 
 
¶4. (SBU) H5N1 virus from the two cases confirmed to date is of 
genomic clade 2.3, first identified in a human in Vietnam in October 
2005, and endemic since 2005 in southern China and elsewhere in 
Indochina.  Transfer of specimens from the remaining three cases is 
currently in process.  Materials transfer issues, mostly external to 
GVN, are under intensive review and some have been resolved.  Some 
of these have been described earlier (reftel A). 
 
¶5. (SBU) Apart from HPAI, NIHE, which is a WHO-designated National 
Influenza Center, routinely shares seasonal influenza isolates with 
the WHO Collaborating Center, CDC, Atlanta.  NIHE is currently 
arranging a July transfer of 50 seasonal influenza virus isolates 
 
HANOI 00001265  002.2 OF 004 
 
 
comprising subtypes A/H3 and B. 
 
¶6. (SBU) According to USAID's Regional Development Mission in 
Bangkok, Vietnam poultry isolates are being shared among with 
international reference laboratories, including those obtained in 
the recent two waves of AI outbreaks in poultry that have occurred 
since December 2006.  Futue reporting will validate this 
information and dtail the history and status of animal sample 
shaing. 
 
Animal Outbreaks Dropped Off Markedly 
------------------------------------ 
 
¶7. (U) Animaloutbreaks due to H5N1 AI have dropped off markedly 
Since May 1, there have been over 100 animal AIoutbreaks in 18 of 
Vietnam's 64 provinces and muicipalities.  The week of June 19 was 
the peak o activity with 29 outbreaks recorded, whereas the wek of 
July 3 had nine outbreaks and the week of uly 10 had only one. 
(Note: See the epidemiologial curve on page 7 of the Food and 
Agricultural rganization (FAO) situational update for Vietnam a 
http://www.fao.org.vn/new1.pdf. End Note)  Accoring to a Ministry 
of Agriculture and Rural Develpment (MARD) official, as of July 10, 
all but eight provinces have reached the 21-day mark to be declared 
AI free. 
 
¶8. (U) On July 5, the Head of the National AI Prevention and Control 
Committee issued instruction No. 25 BNN/CD pertaining to the 
continuous enhancement of AI prevention and control activities sent 
to all provincial People's Committees, ministries and departments 
under the National AI Prevention and Control Committee.  The 
emergency telegram laid out specific details for re-enforcing 
prevention and control efforts. 
 
Media Reports 
------------- 
 
¶9. (U) According to VietNamNet Bridge report on July 11, 
agricultural authorities verified a poultry outbreak in Dien Bien 
Province.  From July 5 to 10, the Provincial Animal Health 
Department found six farming families in three communes of Thanh 
Yen, Thanh Hung and ThanhXuong in Dien Bien District, where around 
500 ofa total 2,400 ducks died.  All of the ducks were 25days-old 
and had not been vaccinated.  Testing dmonstrated H5N1 virus.  The 
local Bird Flu Contrl Board culled all fowl flocks in the two 
communs of Thanh Xuong and Thanh Hung on July 10.  The bard asked 
the Dien Bien Provincial People's Commitee to announce a bird flu 
epidemic in Dien Bien District. 
 
¶10. (U) According to VietNamNet Bridge report on July 11, the MARD 
Vice Minister requested southern provinces to close "egg hatching 
areas" that fail to meet the standard to be on alert, adding that a 
recent new outbreak in Ca Mau Province could herald new activity in 
the southern Mekong Delta.  The Provincial Animal Health Department 
said possible AI outbreak in the South would be a consequence of 
loose control over hatching, raising watery poultry and additional 
vaccination.  Ca Mau was asked to shut-down non-registered 
egg-hatching premises and kill water fowl that are not vaccinated 
 
HANOI 00001265  003.2 OF 004 
 
 
properly. 
 
USAID, CDC, HHS/OS, and NIH Activities 
-------------------------------------- 
 
¶11. (U) The national influenza sentinel surveillance network, 
supported by a CDC cooperative agreement with NIHE/MOH, is expanding 
from 12 to 15 sites.  CDC Influenza Coordinator completed site 
evaluations to all but the three newly enlisted sites (i.e., Danang, 
Tien Giang and Dong Nai Provinces).  All 12 established sites are 
fully operational and in high compliance with protocol procedures. 
 
 
¶12. (U) The CDC cooperative agreement "Surveillance and Response to 
Avian and Pandemic Influenza" with Vietnam Administration for 
Preventive Medicine (VAPM)/MOH was activated by transfer of funds 
June 2007.  The first report of progress indicates a high level of 
activity. 
 
¶13. (U) The CDC cooperative agreement "Community Mobilization for 
Enhanced Surveillance and Prevention of Avian Influenza in Vietnam 
(Development of a Model)" with CARE reported in June that 
project-trained animal and human health workers and village 
volunteers at sentinel commune sites, Hai Phong Province were 
successful in early detection and reporting of suspected HPAI in 
poultry flocks, and in taking appropriate control and prevention 
actions. 
 
¶14. (U) USAID-sponsored plays encourage farmers to take action 
against AI.  Mobile road shows are helping rural communities in 28 
provinces across Vietnam understand the dangers of Avian Influenza 
and learn ways to detect and prevent the disease.  Implemented by 
the Academy for Educational Development (AED), the mobile road shows 
include 20-minute plays on avian influenza, which are a combination 
of family drama and comedy with essential information about the 
disease woven into the plot.  Seventy-eight shows are being held 
from June to July, in provinces selected by the Department of Animal 
Health. 
 
¶15. (U) To mark the official start of its program in Can Tho, USAID 
grantee Abt Associates held a workshop for local authorities, animal 
and human health worker in Can Tho province.  Within the workshop, 
participants discussed ways to increase surveillance and reporting 
of suspected AI cases; adopt safer poultry-handling practices and 
impact behavior change in farmers, poultry workers and marketers, 
health personnel, and the general public. 
 
¶16. (U) To increasing AI private sector awareness, 
USAID-sponsored an AI workshop on June 28, bringing together private 
sector animal pharmaceutical and feed companies with local 
authorities, to create a strategy for increased engagement of the 
private sector in AI awareness-raising.  Some 40 participants came 
to Hanoi at the invitation of USAID-funded NGO Australian Foundation 
for the Peoples of Asia and the Pacific. 
 
¶17. (U) USAID sponsored the visit of a logistics technical 
assistance team to establish an accountability and management system 
 
HANOI 00001265  004.2 OF 004 
 
 
for AI commodities for USAID partner agencies.  The team developed 
release protocols and standard operating procedures, reviewed 
in-country distribution plans, identified potential logistics 
challenges in the storage and distribution of commodities, trained 
appropriate personnel in the proper receipt, storage, transportation 
of the personal protective equipment and other commodities and 
developed replenishment protocols schedules. 
 
¶18. (SBU) After some challenging negotiations between MOH and 
WHO-Vietnam with the assistance of U.S. Embassy Health Attache, MOH 
sent a letter confirming receipt and acceptance of selection of 
IVAC, Vietnam as the recipient of an over 2 million USD WHO award to 
develop a human AI vaccine.  This effort is largely funded by 
HHS/OS. 
 
¶19. (U) On August 6-11, the National Institute of Health is planning 
two AI-related activities.  The first is a workshop, "Avian 
Influenza Virus Bioinformatics and Genomics Training Workshop," to 
be held (see http://www.bioinfohelpdesk.org/AIV_Hanoi2007/ ).  The 
objective is to promote surveillance and rapid response to outbreaks 
of avian influenza by advancing knowledge of the molecular genetics 
of avian influenza viruses.  The second is an international 
conference co-hosted by NIHE, "NIH Multinatinal Influenza Seasonal 
Mortality Study Asia Regional Meeting," (see 
http://origem.info/misms/ program.php).  Objectives include: i) 
review epidemiology of influenza in Asia through presentations of 
mortality models, transmission dynamics research, genomic mutation 
patterns, and vaccination impact studies; ii) demonstrate utility of 
secondary source data to study the epidemiology of influenza; iii) 
establish collaborations for binational and multinational studies; 
iv) communicate findings to policy makers; and v) analyze data 
during a workshop on methodologies for influenza studies, including 
possible expansion into discussion of primary data collection and 
genomics. 
 
MARINE