US embassy cable - 04HANOI347

UNCLAS HANOI 000347 
 
SIPDIS 
 
FOR CA/OCS/ACS/EAP; EAP/EX; EAP/BCLTV 
BANGKOK FOR RMO, CDC, AID (TDOLAN) 
STATE PASS HHS 
USDA FOR FAS/PASS TO APHIS 
 
E.O. 12958: N/A 
TAGS: AMED, AMGT, CASC, EAGR, TBIO, VM, AFLU 
SUBJECT:  VIETNAM  - AVIAN FLU (AI) UPDATE #10 
 
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CURRENT STATUS 
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1.  (U) THE WHO INVESTIGATIVE TEAM INDICATES THAT TYPE 
SPECIFIC LABORATORY TESTS HAVE CONFIRMED THE TWO NEW CASES 
OF H5 INFLUENZA IN HUMANS, BRINGING THE TOTAL NUMBER OF 
HUMAN CASES IN VIETNAM TO 18 (13 OF WHOM HAVE DIED).  THESE 
TWO NEW CASES WERE HOSPITALIZED IN HCMC, AND INCLUDE A 6 
YEAR-OLD BOY AND AN ADULT CASE. 
 
2.  (U) HOSPITALS ARE REPORTING CRITICAL SHORTAGES OF 
PERSONAL PROTECTIVE EQUIPMENT (PPE) FOR MEDICAL PERSONNEL. 
SHORTAGES OF PPE CONTINUE AMONG CULLERS AND OTHERS WHO 
HANDLE POTENTIALLY INFECTED BIRDS. 
 
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PIGS 
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3.  (U) Despite initial press reports of evidence of large- 
scale influenza infection in pigs/swine in Vietnam, there is 
still no laboratory or other evidence whatsoever that this 
is the case.  Subsequent press reports by FAO Rome, WHO, and 
the Vietnam government have been consistent in stating that 
these press reports were in error.  While surveillance of 
pigs continues, there is no evidence that pigs are currently 
a reservoir for this virus.  Recently, results from a large 
series of samples from pigs in affected provinces tested 
outside of Vietnam found no evidence of influenza. 
 
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HUMAN-TO-HUMAN 
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4.  (U) INVESTIGATION HAS CONTINUED ON THE QUESTION OF HUMAN- 
TO-HUMAN TRANSMISSION IN THE THAI BINH PROVINCE FAMILY 
CLUSTER.  LABORATORY TESTS (PCR) APPARENTLY INDICATE THAT 
THE TWO SISTERS IN THAT CLUSTER WERE BOTH INFECTED WITH THE 
SAME STRAIN OF H5N1 FOUND IN POULTRY IN VIETNAM -- PERHAPS 
STRENGTHENING THE LIKELIHOOD THAT INFLUENZA IN THESE YOUNG 
WOMEN MAY HAVE INDEED BEEN SPREAD FROM ONE PERSON TO 
ANOTHER, BUT RULING OUT MUTATION OR MIXING OF THE VIRUS TO 
FACILITATE THAT TRANSMISSION.  IT IS UNLIKELY THAT PERSON-TO- 
PERSON SPREAD CAN EVER BE DEFINITIVELY CONFIRMED IN THIS 
CLUSTER. 
 
5.  (U) ADDITIONAL TESTING BASED ON EARLY VIETNAMESE SAMPLES 
CONTINUES IN SEVERAL LABORATORIES TO ASSESS EVIDENCE FOR ANY 
MUTATION OR MIXING OF THE CURRENT H5 AVIAN VIRUS THAT COULD 
REPRESENT A NEW FLU STRAIN THAT CAN BE EASILY TRANSMITTED 
AMONG HUMANS. DISCUSSIONS INDICATE THAT THUS FAR, NO 
EVIDENCE OF MUTATION OR MIXING HAS BEEN FOUND. 
BURGHARDT