Dataset Information

Primary care influenza-like illness surveillance in Ho Chi Minh City, Vietnam 2013-2015.

ABSTRACT: BACKGROUND:Year-round transmission of influenza has been detected in Vietnam through both national surveillance and other epidemiological studies. Understanding the demographic and clinical features of influenza-like illness (ILI) presenting to primary care in urban Vietnam is vital to understand these transmission dynamics. METHODS:An observational study of patients with ILI in Ho Chi Minh City, Vietnam, was conducted between August 2013 and November 2015 in a mix of public and private primary care settings. Molecular testing for influenza A and influenza B and 12 other respiratory viruses was performed. RESULTS:A total of 1152 ILI patients were recruited. 322 and 136 subjects tested positive for influenza A and influenza B, respectively. 193 subjects tested positive for another respiratory virus; most commonly rhinovirus and parainfluenza virus 3. Influenza was detected in 81% of the 116 study weeks. Three peaks of influenza activity were detected; an H3N2 peak April-June 2014, an influenza B peak July-December 2014, and a mixed H3N2 and H1N1 peak March-September 2015. Subjects recruited from private clinics were more likely to have higher income and to have reported previous influenza vaccination. Antibiotic use was common (50.3%) despite limited evidence of bacterial infection. CONCLUSION:Influenza in southern Vietnam has complex transmission dynamics including periods of intense influenza activity of alternating types and subtypes. Broadening surveillance from hospital to the community in tropical settings is feasible and a valuable for improving our understanding of the global spread and evolution of the virus.

SUBMITTER: Todd S

PROVIDER: S-EPMC6086852 | biostudies-literature | 2018 Sep

REPOSITORIES: biostudies-literature

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Primary care influenza-like illness surveillance in Ho Chi Minh City, Vietnam 2013-2015.

Todd Stacy S Huong Nguyen Thi Cam NTC Thanh Nguyen Thi Le NTL Vy Nguyen Ha Thao NHT Hung Nguyen Thanh NT Thao Tran Thi Nhu TTN Phuong Huynh Thi HT van Doorn Rogier R Hang Vu Thi Ty VTT Chau Nguyen Van Vinh NVV Read Jonathan M JM Lalloo David G DG Boni Maciej F MF

Influenza and other respiratory viruses 20180707 5

<h4>Background</h4>Year-round transmission of influenza has been detected in Vietnam through both national surveillance and other epidemiological studies. Understanding the demographic and clinical features of influenza-like illness (ILI) presenting to primary care in urban Vietnam is vital to understand these transmission dynamics.<h4>Methods</h4>An observational study of patients with ILI in Ho Chi Minh City, Vietnam, was conducted between August 2013 and November 2015 in a mix of public and p ...[more]

PMID: 29858879

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Project description:BACKGROUND:To date, little is known about the initial spread and response to the 2009 pandemic of novel influenza A ("2009 H1N1") in tropical countries. Here, we analyse the early progression of the epidemic from 26 May 2009 until the establishment of community transmission in the second half of July 2009 in Ho Chi Minh City (HCMC), Vietnam. In addition, we present detailed systematic viral clearance data on 292 isolated and treated patients and the first three cases of selection of resistant virus during treatment in Vietnam. METHODS AND FINDINGS:Data sources included all available health reports from the Ministry of Health and relevant health authorities as well as clinical and laboratory data from the first confirmed cases isolated at the Hospital for Tropical Diseases in HCMC. Extensive reverse transcription (RT)-PCR diagnostics on serial samples, viral culture, neuraminidase-inhibition testing, and sequencing were performed on a subset of 2009 H1N1 confirmed cases. Virological (PCR status, shedding) and epidemiological (incidence, isolation, discharge) data were combined to reconstruct the initial outbreak and the establishment of community transmission. From 27 April to 24 July 2009, approximately 760,000 passengers who entered HCMC on international flights were screened at the airport by a body temperature scan and symptom questionnaire. Approximately 0.15% of incoming passengers were intercepted, 200 of whom tested positive for 2009 H1N1 by RT-PCR. An additional 121 out of 169 nontravelers tested positive after self-reporting or contact tracing. These 321 patients spent 79% of their PCR-positive days in isolation; 60% of PCR-positive days were spent treated and in isolation. Influenza-like illness was noted in 61% of patients and no patients experienced pneumonia or severe outcomes. Viral clearance times were similar among patient groups with differing time intervals from illness onset to treatment, with estimated median clearance times between 2.6 and 2.8 d post-treatment for illness-to-treatment intervals of 1-4 d, and 2.0 d (95% confidence interval 1.5-2.5) when treatment was started on the first day of illness. CONCLUSIONS:The patients described here represent a cross-section of infected individuals that were identified by temperature screening and symptom questionnaires at the airport, as well as mildly symptomatic to moderately ill patients who self-reported to hospitals. Data are observational and, although they are suggestive, it is not possible to be certain whether the containment efforts delayed community transmission in Vietnam. Viral clearance data assessed by RT-PCR showed a rapid therapeutic response to oseltamivir.

Dataset Information

Primary care influenza-like illness surveillance in Ho Chi Minh City, Vietnam 2013-2015.

Publications

Primary care influenza-like illness surveillance in Ho Chi Minh City, Vietnam 2013-2015.

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