US embassy cable - 04HANOI309

UNCLAS HANOI 000309 
 
SIPDIS 
 
 
FOR CA/OCS/ACS/EAP; EAP/EX; EAP/BCLTV 
BANGKOK FOR RMO, CDC, AID (TDOLAN) 
STATE PASS HHS for Marie Haring Sweeney 
USDA FOR FAS/PASS TO APHIS 
 
E.O. 12958: N/A 
TAGS: AMED, AMGT, CASC, EAGR, TBIO, VM, AFLU 
SUBJECT:  VIETNAM  - AVIAN FLU UPDATE #7 
 
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CURRENT STATUS 
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1.  (U) WE ARE AWARE OF DISCREPANCIES BETWEEN THE NUMBERS OF 
CASES OF AVIAN INFLUENZA (AI) IN HUMANS IN OUR CABLES, 
REPORTED BY WHO, AND THE NUMBER REPORTED BY THE GVN'S MOH. 
THE STATISTICS REPORTED IN OUR CABLES REFLECT WHAT WE 
BELIEVE TO BE MOST RECENT RELIABLE NUMBERS BASED ON THE 
DISCUSSIONS HELD EACH NIGHT BY MEMBERS OF THE WHO AI 
INVESTIGATIVE TEAM (INCLUDING CDC AND OTHER INTERNATIONAL 
EPIDEMIOLOGISTS AND CLINICIANS).  MOST RECENT DISCUSSIONS 
INDICATE THAT THERE ARE 13 CASES OF LABORATORY-CONFIRMED H5 
INFLUENZA IN HUMANS, ALTHOUGH THE MOH HAS OFFICIALLY 
REPORTED 10.  THE BULK OF THESE CASES HAVE OCCURRED IN OR 
AROUND HANOI AND A FEW ARE IN HCMC.  ONE OF THE NEWLY 
CONFIRMED CASES IS A DEATH IN THE CENTRAL PROVINCES, THE 
FIRST IN THAT REGION.  IN ADDITION, WE ARE AWARE THAT THE 
LOCAL AND INTERNATIONAL PRESS IS REPORTING ADDITIONAL CASES 
OF H5 INFLUENZA IN HUMANS.  THESE ACTUALLY REFLECT A 
COMBINATION OF "POSSIBLE" CASES OF INFLUENZA A BASED ON 
RAPID TESTING.  THESE MAY OR MAY NOT BE H5.  THE FIGURES 
ALSO INCLUDE "SUSPECT" CASES OF FEVER AND RESPIRATORY 
SYMPTOMS IN HUMANS THAT ARE BEING INVESTIGATED BUT THAT MAY 
OR MAY NOT BE INFLUENZA.  CDC HANOI CONFIRMS THAT OVER 50 
CASES OF SUSPECTED OR POSSIBLE INFLUENZA ARE BEING 
INVESTIGATED BY MOH (OFTEN WITH THE ASSISTANCE OF THE WHO 
INVESTIGATIVE TEAM); MOST OF THESE WILL NOT HAVE INFLUENZA 
AS SEVERAL ARE BEING RULED OUT DAILY. 
 
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FOOT AND MOUTH DISEASE 
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2.  (U) There is also an active foot and mouth outbreak in 
Vietnam.  This alone is not alarming as Vietnam regularly 
suffers from foot and mouth outbreaks several times per 
year.  However, pigs infected by foot and mouth may be more 
vulnerable to both avian and human influenza, and thus more 
of a risk in mixing the viruses leading to human-to-human 
community spread. 
 
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AFFECTED PROVINCES 
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3.  (U) REGARDING INFLUENZA IN BIRDS, THE NUMBER OF 
PROVINCES REPORTING BIRD DEATHS RELATED TO AVIAN INFLUENZA 
HAS INCREASED TO 53 (OF 64).  THE LOCAL PAPERS DESCRIBE 
CULLING EFFORTS ON THE FRONT PAGE; HOWEVER, THE WHO 
INVESTIGATIVE TEAM MEETINGS INDICATE THAT WITH THE EXCEPTION 
OF A FEW PROVINCES, MOST CULLING IS ACTUALLY PICKING UP DEAD 
BIRDS.  AVAILABILITY OF PERSONAL PROTECTIVE EQUIPMENT (PPE) 
REMAINS LIMITED.  INCENTIVES FOR POULTRY GROWERS TO 
SURRENDER BIRDS ARE ALSO LIMITED. 
 
4.  (U) ACCORDING TO A SPREADSHEET DEVELOPED BY THE MINISTRY 
OF AGRICULTURE AND RURAL DEVELOPMENT'S DEPARTMENT OF ANIMAL 
HEALTH, FIRST REPORTS OF AVIAN FLU IN VIETNAM OCCURRED IN 
DECEMBER 2003 IN 11 PROVINCES SCATTERED AROUND THE COUNTRY. 
THE NUMBER OF REPORTED AREAS AFFECTED HAS INCREASED RAPIDLY 
IN RECENT DAYS AT BOTH THE PROVINCIAL AND COMMUNE LEVEL, 
POSSIBLY BECAUSE OFFICIALS HAVE RETURNED FROM THE WEEK-LONG 
TET HOLIDAYS AND ARE DOING MORE REPORTING, AND ALSO POSSIBLY 
BECAUSE THE MEDIA HAS FOCUSED ATTENTION ON THE ISSUE. 
BURGHARDT