VZCZCXRO7048
RR RUEHAST RUEHCHI RUEHCN RUEHDT RUEHHM RUEHLN RUEHMA RUEHPB RUEHPOD
RUEHTM RUEHTRO
DE RUEHHI #0103/01 0410858
ZNR UUUUU ZZH
R 100858Z FEB 09
FM AMEMBASSY HANOI
TO RUEHC/SECSTATE WASHDC 9112
INFO RUEHHM/AMCONSUL HO CHI MINH 5559
RUEHZS/ASEAN REGIONAL FORUM COLLECTIVE
RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE
RUEHUL/AMEMBASSY SEOUL 3431
RUEHKO/AMEMBASSY TOKYO 5991
RUEHHK/AMCONSUL HONG KONG 1630
RUEHGZ/AMCONSUL GUANGZHOU 0018
RUEHCN/AMCONSUL CHENGDU 0381
RUEHIN/AIT TAIPEI 1643
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 03 HANOI 000103 
 
SENSITIVE 
SIPDIS 
 
STATE FOR EAP/MLS, EAP/EP, INR, OES/STC, OES/IHA, MED, OGAC 
STATE PASS TO USAID FOR ANE AND GH 
DEPARTMENT OF DEFENSE FOR OSD/ISA/AP (STERN) 
HHS/OSSI/DSI PASS TO FIC/NIH (RGLASS) AND OGHA 
(LVALDEZDMILLER/MABDOO) 
USAID FOR ASIA (MELLIS, DSHARMA, CJENNINGS) AND GH (KHILL, 
DCARROLL) 
CDC FOR COGH (SBLOUNT), CCID (SREDD) AND DIV-FLU(COX/MOHEN) 
USDA PASS TO APHIS, FAS (OSTA AND OCRA), FSIS 
BANGKOK FOR RMO, CDC (MMALISON), USAID (MACARTHUR/MBRADY/CBOWES), 
APHIS (NCARDENAS), REO (HHOWARD) 
BEIJING FOR HHS HEALTH ATTACHE (BROSS) 
PHNOM PENH FOR CDC INFLUENZA COORDINATOR(BBRADY) 
ROME FOR FAO 
VIENTIANE FOR CDC INFLUENZA COORDINATOR (ACORWIN) 
 
E.O. 12958: N/A 
TAGS: TBIO AMED EAGR PINR KFLU VM
SUBJECT: AVIAN INFLUENZA SPREADS IN VIETNAM: NEW HUMAN INFECTION AND 
ANIMAL OUTBREAKS 
 
REF: A. Hanoi 65 B.  Hanoi 21 
 
HANOI 00000103  001.2 OF 003 
 
 
1.(U) Summary:  Vietnam reported that a young woman in northern 
Quang Ninh province tested positive for the H5N1 virus.  This is 
Vietnam's second confirmed human infection in the last six weeks 
(refs A and B).  Authorities also reported several poultry outbreaks 
in the southern Mekong Delta and in north-central Nghe An province. 
While we expect to see increased infections during this time of 
year, these cases also reflect continuing difficulties faced by the 
Government of Vietnam (GVN)in ensuring compliance with disease 
prevention initiatives.  On a positive note, the National Institute 
of Hygiene and Epidemeology has included as representative from the 
World Health Organization (WHO) in its field investigation in Quang 
Ninh.  End Summary. 
 
Human infection 
--------------- 
 
¶2. (SBU) On February 6, tests confirmed that a 23-year-old woman in 
rural Dam Ha district in northern Quang Ninh province (about 150 
kilometers northeast of Hanoi and 30 kilometers from the Chinese 
border) was infected with the H5N1 virus.  The victim, a member of 
the Dao ethnic minority, had eaten the meat from sick neighborhood 
chickens that had been slaughtered several days prior to becoming 
ill. The patient was admitted to the hospital on February 3 and 
remains in critical condition, breathing with the assistance of a 
respirator.   Five other family members who had also eaten the 
chicken showed no symptoms.  Vietnam's Ministry of Health has sent 
experts from the National Institute of Hygiene and Epidemiology and 
the National Institute for Infectious and Tropical Diseases, both in 
Hanoi, to Quang Ninh to investigate the case.  WHO officials report 
good coordination among animal and human health officials in 
responding to the infection and stated that NIHE had invited a WHO 
expert to join its investigation team in Quang Ninh.  from either 
the World Health Organizaton or the UN Food and Agricultural 
Organization in these investigative teams.  There have now been 108 
reported AI cases and 52 deaths in Vietnam. 
 
Animal outbreaks start in Ca Mau 
-------------------------------- 
 
¶3. (U) Three provinces in the southern Mekong Delta recently 
reported poultry outbreaks, along with the northern province of Nghe 
An.  First reported in a single flock of ducks in Cau Mau province 
at the nation's southern tip, H5N1 now has been found in several 
other districts in Ca Mau and in neighboring Soc Trang and Hau 
Giang.  In the initial outbreak in Ca Mau, more than 460 ducks 
tested positive for the disease at the end of January.  Dozens of 
ducks in a largely unvaccinated flock began dying on January 19 
though the farmer did not inform local officials until the following 
week. Soon thereafter, H5N1 was found in birds in ten flocks in four 
communes spread over three districts.  Eventually, local officials 
culled more than 4,000 chickens and ducks in the area.  The last 
poultry outbreak was reported in Ca Mau in September 2008. 
 
 
HANOI 00000103  002.2 OF 003 
 
 
And then Spread into Other Mekong Provinces 
------------------------------------------- 
 
¶4. (U) Last week, authorities reported possibly-related outbreaks in 
Soc Trang and Hau Giang provinces, along with additional outbreaks 
within Ca Mau.  The risk of additional contagion remains high) as 
farmers in the Mekong Delta harvest their spring-winter rice crops 
and allow flocks of ducks to move from farm to farm to eat the 
leftover rice kernels;  not all flocks have been vaccinated or 
vaccinated properly;  cold weather; 4) lack of awareness and 
responsibility of farmers; and lack of veterinary resources.  After 
the initial outbreak in Ca Mau, animal health officials in Soc Trang 
reported an H5N1 outbreak in a flock of 700 ducks, resulting the 
deaths of over 500 birds.  Before the Tet holiday period began on 
January 26, the birds had shown symptoms of the disease and began 
dying.  Samples from some of the dead birds then tested positive for 
the H5N1 virus.  As of February 7, AI has affected three communes in 
two districts of Soc Trang, causing 1,435 chicken and ducks culled. 
On 8 February the Department of Animal Health (DAH) reported poultry 
outbreak in four communes in one district in Hau Giang, adjacent to 
Soc Trang province, infecting 840 birds.  This pattern of outbreak 
activity first appearing in southernmost Cau Mau province and moving 
northward toward Ho Chi Minh City along major transport lines, may 
repeat similar pattern of occurrences in December 2006 and January 
2007 when as many as 10 southern provinces were affected. (Note: 
Earlier this month in north-central Nghe An province, nearly 200 
ducks bred at a local farm died). 
 
Poor Response May Have Facilitated Outbreaks 
-------------------------------------------- 
 
¶5. (U) The recent outbreaks in the Mekong Delta have left officials 
scrambling to prevent a wider outbreak and to deflect criticism for 
the ongoing cases.  Officials in Ho Chi Minh City have temporarily 
halted import of poultry from the infected provinces to prevent the 
spread of H5N1.  The Ho Chi Minh City People's Committee Chairman 
also asked local veterinary forces to crack down on illegal poultry 
trading areas. Following reports of the possible spread of H5N1 
throughout Ca Mau and into Soc Trang and Hau Giang, Ministry of 
Agriculture and Rural Development (MARD) officials publicly blamed 
local farmers officials for their slow response.  Local officials, 
in turn, fingered the owner of the flock, noting that many locals 
had become complacent as animal outbreaks decreased.  Both noted 
that, while public awareness of the risks has increased, some 
farmers simply dispose of ducks and chickens that sicken and die, at 
times throwing the carcasses into canals.  Despite this latest 
outbreak, local media reported that the central DAH, within MARD 
remained skeptical that local officials would implement all GVN 
guidelines. 
 
¶6. (U) An attempt by the Hanoi People's Committee to ban the 
widespread use of motorbikes or bicycles to transport poultry and 
livestock to prevent an epidemic  was withdrawn less than one week 
after its implementation.  Despite the ban, meat products continue 
to stream into the city by motorbike as officials try to figure out 
 
HANOI 00000103  003.2 OF 003 
 
 
an enforcement scheme.  Second, the Ministry of Justice questioned 
the legal basis for the ban and stated that the ban was impractical. 
Related requirements for upgraded animal slaughtering practices were 
geared towards larger, commercial operations and did not take into 
account the small-scale nature of many poultry operations. 
 
Villagers Prevent Poultry Destruction 
------------------------------------- 
 
¶7. (U) As widely reported in local and regional press, recent 
efforts to destroy 1,500 chickens (about three tons) smuggled from 
China descended into chaos as over 100 villagers overwhelmed police 
and health authorities to loot the chickens.  As officials in Hanoi 
removed the dead birds from a truck to burn in a pit, villagers 
grabbed the chickens and ran off, despite the fact that the 
officials explained that the chickens might be infected with H5N1 
and had been sprayed with various disinfectants rendering them 
inedible.  While some villagers ran off with their booty, many 
others later discarded the birds, which remained on the ground the 
next day.  Local media highlighted poor public awareness of the 
risks of avian influenza. 
 
Comment 
------- 
 
¶8.  (SBU) This was a tough week for Vietnamese efforts to combat 
avian influenza.  Though the delayed reporting and response was 
likely exacerbated by the Tet holiday, which officially ran from 
January 26 to 30, the most recent human infection and animal 
outbreaks typify weak links in Vietnam's prevention scheme. 
Villagers, particularly those belonging to minority tribes, continue 
to slaughter and consume sick poultry, despite government public 
awareness programs.  Small-scale poultry breeders easily become 
complacent if they do not experience an outbreak for a season or two 
and local officials do not always respond promptly or provide 
adequate notification to central authorities or neighboring 
provinces.  Poor Vietnamese are willing to risk contracting H5N1 for 
free chickens.  Finally, the small-scale nature of much of the 
informal poultry trade makes it difficult for officials to design 
feasible and enforceable prevention initiatives. 
 
MICHALAK