AVIAN INFLUENZA IN VIETNAM Cum ga”

AVIAN INFLUENZA IN VIETNAM
‘Cum ga”

Le Thi Kim Thoa MD. MPH
Senior lecturer of Hygiene and Epidemiology

Ha Noi Medical University
1 Ton That tung Ha noi

Viet Nam
Telephone:
Fax:

84 4 5744 556
84 4 5744 557

E-mail:


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AVIAN INFLUENZA IN VIETNAM
Purpose: To provide the lessons on avian flu
in Viet Nam
Contents:
1. Introduction
2. Short terms strategy
3. Long-terms strategy
4. Lessons learnt
5. How to keep sustainable

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Introduction
• Avian influenza A (AIA) is an infectious disease,
caused by H5N1 virus that can survive for long
periods [ in bird faeces for at least 35 days at
temperature (40C]
• The disease occurs worldwide "bird flu"
• H5N1 virus transmitted from farm to farm by the
movement of live poultry (faeces), people (when
contaminated shoes, clothing, vehicles, equipment,
feed, and cages)
• Restriction on the movement of live poultry, both
within and between countries.
WHO 2006

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AIA [H5N1] outbreaks
• Began in Asia in mid-2003 reported by nine Asian
countries (Viet Nam listed 2)
• Now spread to Europe
• Become endemics in several countries including
Viet Nam among most chicken population ‘Cum ga’
• In late July 2005, focus in Asia to affect poultry and
wild birds in Russia
• Greatest present concern for human health (number
of cases and deaths)

WHO 2006

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Global avian influenza

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‘Cum ga’ OUTBREAKS
in Viet Nam
• ‘Cum ga’ outbreaks among poultry population
before humans
• Three ‘cum ga’ outbreaks among humans
paralleled with three ‘cum ga’ outbreaks in
poultry population
• ‘Cum ga’ outbreaks among humans started the
beginning 2004

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‘Cum ga’ OUTBREAKS
among poultry population

• ‘Cum ga’ outbreaks among poultry started
2003
• Appear at the South first and then the North
• Very fast speed
• Spread out quickly
• All (61 provinces) reported outbreaks in
poultry; 44,5 millions poultry killed among
300 millions poultry population
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“Cum ga” OUTBREAKS
among humans in Viet Nam
• Very severe disease, high mortality among
infected patients
• Children first and then adults
• Rural and then urban
• The first case on December , 2003
• Total 93 cases and 42 deaths
• CFR: 45.2 %
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Exposures detected
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•
•
•

•
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Directly contacted
Slaughtered ill poultry
Resided in poultry outbreak regions
Eaten swan’s blood curd
Contacted patients with H5N1
Care patients

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Clinical features
among ‘cum ga’ patients
• Initial syndromes
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–
–
–
–
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Fever
Myalgia
Headaches
Cough
Coryza
Diarrhea

– Pleura effusion
– Pneumothorax
– Respiratory failure

• Others

• Respiratory syndromes

–
–
–
–

Hepatomegaly
Delirium
Cerebral hemorrhage
Multiple organ failure

– Chest paint
– Crepitation
Viet Nam National Institute
for Clinical Research in T

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12


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Short term strategy
Emergency actions

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•
•
•
•
•
•
•

Communication
Build up a network for ‘cum ga’ prevention
Provided relevant documents
Supervision at different levels
Destroy poultry and domestic birds
Meetings and training
Vaccinated for poultry
Supports from organizations and other countries
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Communication
Contents
•
•
•

•
•
•

‘cum ga’ information
Relevant documents
Control measures
Relevant documents
Policies
Roles and tastes of all
sectors and
organizations at
different levels

• Mass media
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–
–
–
–
–

Television
Newspapers
Radio
Meetings
Training
Internet

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Body networking
Multi sectors participated
Health sector to be as a main coodinator
Central level:
Provincial level
District level
Commune level
Village level
Group level
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Relevant documents
• Instructions
– Government at different level
– Health sector
– Agriculture sector

• Guidelines
– Ministry of health
– Ministry of argricultrure

• Reports
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Supervisions
• Destroy poultry and their production

including eggs at the outbreak areas, in a
radius of 3 km
• Do not allow: poultry transport, buy and sell
poultry and process poultry during outbreaks
• Vaccination for poultry
• Disinfestations for breeding facilities
• Isolated uninfected poultry
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Destroy poultry
• Destroy completely in outbreak areas around
– Forced destroy
– Voluntary destroy

• Destroyed numbers of poultry:

From 10 Jan 2005 to 30 Jan 2006:
Total poultry destroyed:
3 962 528:
- chickens:
1 334 499
- ducks, swans and grooses: 2 128 134

• Destroy measures:

– Dig bury holes all suspected poultry
– Burn infected and dead poultry
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Supports:
• International organizations
– USDP
– WHO
– UNICEF

• 5 Countries: 6.8 million USD
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–
–
–
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Australia
Holland
Finland
Switzerland
Luxembourg
MOH

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Effects
• Community participation in all activities from
the central levels to individual level.
• A lot of documents provided
• Stop outbreaks among poultry in all provinces
• No new human case in December 2005.

• Vaccination has been process for all
provinces
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Impacted
• To make the fear of eating poultry and their
products
• Severe losses economics
• Loss a large and good foods
• Markets in disorder (most prizes of food up)
• Poultry farmers loss their incomes after “dry
storm”, become the poor.
• A big amount of valuable birds were killed
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Long terms prevention
• Objective: No epidemic occur in both poultry and
humans
• Strengthen the supervision system at different level
• Review and develop the policies realistic
• To encourage all communities participating in
prevention
• Education of prevention measures
• Continue to support from international organizations
and countries
• Sharing experiences
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Lessons learnt
• Identify the first case in both poultry and
humans as soon as possible
• Information on ‘cum ga’ correctly in time
• Participation
• Produce the timely decisions
• Develop policies in terms of compensations
and loan fund supports
• How to sustain the effects
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‘cum ga’
outbreaks
In Viet Nam
• outbreaks
among poultry
in 61 provinces
(all)
• outbreaks
among humans
in 32 provinces
(>50%)

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