Viet Nam's Integrated National Response

Viet Nam has committed significant national resources to the fight against avian influenza and prevention of a human pandemic.

A high-level National Steering Committee for Avian Influenza has been established by the Prime Minister to supervise Viet Nam's overall response. The National Steering Committee has developed three main documents outlining Viet Nam's medium- to long-term strategy and pandemic response plan:

Controlling the virus in poultry

Culling of poultry with compensation - more than 50 million poultry have been culled in Viet Nam since late 2003 in an effort to reduce the circulation of the virus in poultry:

Controls on production, movement and sale - during peak outbreak periods the Government has enforced closure of markets and banned poultry movements, together with increased surveillance and farm disinfections.

During the last epidemic wave, in November 2005, the Government has also banned hatching of ducklings in order to lower the population of ducks which are typically left scavenging in open ponds in very bio-insecure conditions.

Poultry vaccination - Since October 2005, mass poultry vaccination has been added as a further control measure. 246 million vaccine doses were administered in the first round of vaccinations from October 2005 to January 2006, including 166.9 million in chickens and 78.5 million in ducks. Most birds received 2 injections. A second vaccination campaign is being implemented in March and April 2006.

Protecting human health and preparing for a possible human pandemic

Pandemic preparedness planning - a National Preparedness Plan has been developed under the leadership of the National Steering Committee, with specific action plans developed by ministries.

Surveillance and response systems are being strengthened - suspected and actual cases and their contacts are being closely monitored, and an early warning and response system (EWARS) is being developed. This will include a new National Electronic Surveillance Network, trained and equipped Provincial and district level rapid response teams, development of a Field Epidemiology Training Course, review of legislation on infectious disease control, and enhanced border controls.

Strengthening diagnostic capacity - laboratory capacity to diagnose H5N1 viruses currently exists at the National Institute for Hygiene and Epidemiology (NIHE) in Hanoi and the Pasteur Institute in HCMC, but needs to be strengthened. Regional, provincial, and mobile laboratory facilities will be upgraded, and the capacity and safety of laboratory staff will be improved through biosafety training courses and updated guidelines.

Strengthening curative care capacity - the capacity of the hospital system to recognize and respond to human cases of HPAI and influenza is being strengthened, and preparations are being made for the possibility of an influenza pandemic scenario in which there is a sudden, large increase in demand for curative care across Vietnam.

Improving research - the transition from an emergency response phase to medium-term control presents new opportunities to conduct scientific research that can guide HPAI prevention and control strategies. The focus is on determining the risk factors for severe illness with H5N1 influenza and its transmission, determining the prevalence of H5N1 among different populations, expanding the options for laboratory screening tests, and monitoring the genetic variability of the virus.

Public awareness raising for behaviour change - Mass communications campaigns for animal health workers, poultry producers, human health care workers and the general public are being carried out using the mass media and other information channels.

This is being supported by an Avian Influenza Information, Education and Communication (IEC) Network.

Good results but continuing risks

Viet Nam's efforts have achieved significant results in recent months. No new poultry outbreak has been detected since mid-December 2005, with no human cases since mid-November 2005.

However, there remains a high risk that the virus could return to poultry and again pose a threat to humans. The virus is still thought to be circulating in bird populations within Viet Nam especially in wild birds and water fowl which can shed the virus without showing any symptoms. It is also suspected that the environment is still contaminated with H5N1 virus.

Virus outbreaks in poultry and human cases continue to be reported in neighboring countries and the virus has reached many new countries throughout the world.