VZCZCXRO2704
RR RUEHCHI RUEHCN RUEHDT RUEHHM RUEHLN RUEHMA RUEHPB RUEHPOD
DE RUEHHI #1921/01 3131017
ZNR UUUUU ZZH
R 091017Z NOV 07
FM AMEMBASSY HANOI
TO RUEHC/SECSTATE WASHDC 6685
INFO RUEHHM/AMCONSUL HO CHI MINH 3923
RUEHZS/ASEAN REGIONAL FORUM COLLECTIVE
RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE
RUEHPH/CDC ATLANTA GA
RUEHRC/DEPT OF AGRICULTURE WASHINGTON DC
RUCPDOC/DEPT OF COMMERCE WASHINGTON DC
RUEAUSA/DEPT OF HHS WASHINGTON DC
RUEHSUN/USUN ROME IT

UNCLAS SECTION 01 OF 02 HANOI 001921 
 
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 (WSTIEGER/LVALDEZ/CHICKEY) 
CDC FOR OGHA (SBLOUT/KMCCALL) AND FOODBORNE DIV (RTAUXE) 
HHS PASS TO FIC/NIH (GLASS) AND TO FDA (MPLAISER) 
USDA PASS TO APHIS, FAS (OSTA AND OCRA), FSIS 
BANGKOK FOR RMO, CDC (MMALISON), USAID (JMACARTHUR/MBRADY) BANGKOK 
FOR APHIS (NCARDENAS), REO(JWALLER) 
BEIJING FOR HHS HEALTH ATTACHE (BROSS) 
ROME FOR FAO 
 
E.O. 12958: N/A 
TAGS: TBIO AMED AMGT CASC EAGR PINR VM
SUBJECT: CHOLERA OUTBREAK CONFIRMED IN NORTHERN VIETNAM 
 
REF: Hanoi 1771 
 
HANOI 00001921  001.2 OF 002 
 
 
1.(SBU) Summary: The Government of Vietnam (GVN) has confirmed an 
outbreak of acute watery diarrhea in persons living in the northern 
part of the nation.  Initially linked to unsafe food, primarily raw 
shrimp paste, the outbreak now may be spreading through contact with 
infected patients or contaminated water.  The GVN has confirmed that 
approximately 15 percent of the 600 persons infected to date tested 
positive for cholera.  The GVN has issued a series of warnings to 
the public, stockpiled medication, sent medical workers to infected 
locales, and agreed to provide free medical treatment to those 
suffering from diarrhea.  Additionally, the Vietnamese Ministry of 
Health (MOH) recently asked the World Health Organization (WHO) for 
assistance responding to the situation.  U.S. Centers for Disease 
Control (CDC) in Hanoi has offered expert support to the WHO, if 
needed.  End Summary. 
 
¶2. (U) On November 4, the GVN confirmed an additional 148 cases of 
acute diarrhea among hospitalized patients in northern Vietnam, 
bringing the total to over 600 since the outbreak was first detected 
on October 23.  The numbers of infected persons has spiked in the 
past few days and officials are concerned that the actual numbers 
might be substantially higher.  The hospital wards of the National 
Institute for Infectious and Tropical Diseases, Hanoi, have been 
inundated with patients, necessitating a search by MOH for more 
hospital beds.  Officials believe they have traced the epidemic to 
raw shrimp paste produced in coastal Thanh Hoa province, which 
recently suffered from flooding related to typhoon Lekima (reftel). 
Though Hanoi has seen the most patients, at least 11 municipalities 
and provinces throughout northern Vietnam have reported related 
cases.  To date, southern Vietnam has not been affected. 
 
¶3. (SBU) Over the weekend, Minister of Health Nguyen Quoc Trieu 
announced that 15 percent of those suffering from acute diarrhea had 
tested positive for the cholera bacterium.  MOH officials further 
informed Embassy staff that the clinical presentations of many of 
the cases are classic for cholera.  Initial victims consumed tainted 
raw foods, particularly shrimp paste, along with pork and 
vegetables.  However, the GVN has now stated that the epidemic also 
may be spreading through secondary infections among caretakers and 
through exposure to contaminated drinking water.  Continued flooding 
in the central region of the country, particularly if exacerbated by 
the expected landfall of typhoon Peipah later this week, could 
facilitate further spread of the disease. 
 
¶4. (U) Last week, the GVN moved to contain the outbreak, instituting 
new food safety checks and suspending the use of all raw shrimp 
paste.  Through media reports, the MOH warned the public of 
potential high fatality rates for untreated patients and advised 
people to properly cook foods.  The central government sent several 
health teams to various provinces to inspect the local conditions 
and Deputy Minister of Health Trinh Quan Huan asked local 
authorities to quarantine infected areas as the MOH's National 
Institute of Hygiene and Epidemiology (NIHE) continues to analyze 
disease samples.  The GVN has stockpiled medications and sterile 
equipment and has organized training courses for health care 
professionals.  Prime Minister Nguyen Tan Dung announced that the 
GVN would provide free treatment to all hospital patients suffering 
from acute diarrhea to encourage sick persons to present themselves 
for treatment. 
 
¶5. (SBU) Consistent with Vietnam's obligations under the recently 
revised International Health Regulations, the MOH notified the WHO 
as the epidemic spread and requested WHO assistance.  Press reports 
state that Vietnam also informed neighboring countries about the 
outbreak.  U.S. CDC officers in Hanoi, in coordination with Bangkok 
and CDC headquarters in Atlanta, continue to communicate with the 
WHO and MOH.  Through the Embassy Health Attache, CDC has offered to 
support the WHO with technical assistance, if requested.  Post has 
provided relevant information to the delegation of Secretary of 
Commerce Gutierrez, currently in Hanoi, and has drafted a warden 
message for Washington clearance to Americans living in Vietnam 
advising them of the situation and providing information to minimize 
 
HANOI 00001921  002.2 OF 002 
 
 
the risk of exposure.  The Embassy medical unit will follow up with 
local health providers to update Embassy contingency planning. 
 
MICHALAK