A prospective multi-center observational study of children hospitalized with diarrhea in Ho Chi Minh City, Vietnam.

We performed a prospective multicenter study to address the lack of data on the etiology, clinical and demographic features of hospitalized pediatric diarrhea in Ho Chi Minh City (HCMC), Vietnam. Over 2,000 (1,419 symptomatic and 609 non-diarrheal control) children were enrolled in three hospitals over a 1-year period in 2009-2010. Aiming to detect a panel of pathogens, we identified a known diarrheal pathogen in stool samples from 1,067/1,419 (75.2%) children with diarrhea and from 81/609 (13.3%) children without diarrhea. Rotavirus predominated in the symptomatic children (664/1,419; 46.8%), followed by norovirus (293/1,419; 20.6%). The bacterial pathogens Salmonella, Campylobacter, and Shigella were cumulatively isolated from 204/1,419 (14.4%) diarrheal children and exhibited extensive antimicrobial resistance, most notably to fluoroquinolones and third-generation cephalosporins. We suggest renewed efforts in generation and implementation of policies to control the sale and prescription of antimicrobials to curb bacterial resistance and advise consideration of a subsidized rotavirus vaccination policy to limit the morbidity due to diarrheal disease in Vietnam

An Outbreak of Severe Infections with Community-Acquired MRSA Carrying the Panton-Valentine Leukocidin Following Vaccination

Background: Infections with community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) are emerging worldwide. We investigated an outbreak of severe CA-MRSA infections in children following out-patient vaccination. Methods and Findings: We carried out a field investigation after adverse events following immunization (AEFI) were reported. We reviewed the clinical data from all cases. S. aureus recovered from skin infections and from nasal and throat swabs were analyzed by pulse-field gel electrophoresis, multi locus sequence typing, PCR and microarray. In May 2006, nine children presented with AEFI, ranging from fatal toxic shock syndrome, necrotizing soft tissue infection, purulent abscesses, to fever with rash. All had received a vaccination injection in different health centres in one District of Ho Chi Minh City. Eight children had been vaccinated by the same health care worker (HCW). Deficiencies in vaccine quality, storage practices, or preparation and delivery were not found. Infection control practices were insufficient. CA-MRSA was cultured in four children and from nasal and throat swabs from the HCW. Strains from children and HCW were indistinguishable. All carried the Panton-Valentine leukocidine (PVL), the staphylococcal enterotoxin B gene, the gene complex for staphylococcal-cassette-chromosome mec type V, and were sequence type 59. Strain HCM3A is epidemiologically unrelated to a strain of ST59 prevalent in the USA, althoughthey belong to the same lineage. Conclusions. We describe an outbreak of infections with CA-MRSA in children, transmitted by an asymptomatic colonized HCW during immunization injection. Consistent adherence to injection practice guidelines is needed to prevent CA-MRSA transmission in both in- and outpatient settings

Quantifying biomass and canopy cover of submerged aquatic vegetation on an offshore island

International audienceThe coverage and biomass of submerged aquatic vegetation (SAV) are vital characteristics of marine resourcemanagement and development. However, using in situ measurements to assess the distributionand biomass of SAV is challenging because SAV distribution varies with biomass, substrate type, anddepth, making it difficult to monitor. Satellite remote sensing is an advanced tool that can tackle thisproblem. In this study, several techniques, such as atmospheric correction, water column correction,and supervised classification, were integrated with Landsat-8 images to map SAV distribution on anoffshore island in Viet Nam, Ly Son island. The substrate-classifying result had high accuracy (OA =92.6%, K = 0.9 ). The coastal, blue, and green bands of Landsat-8 were used to estimate the SAVbiomass using a polynomial regression (RMSE = ±1440.6 g fresh m−2, R2 = 0.71). The results showedthat the total fresh biomass of SAV in Ly Son island is 14551.04 tonnes, with a corresponding areaof 332.1 hectares, equivalent to an average biomass of 4381.5 ± 1440.6 g fresh m−2. The distributionand biomass maps of SAV produced in this study could be used as input to measure the attributes ofSAV biodiversity, contributing more effectively to monitoring marine ecosystems in Viet Nam

Characterization of hospital and community-acquired respiratory syncytial virus in children with severe lower respiratory tract infections in Ho Chi Minh City, Vietnam, 2010

BackgroundHuman respiratory syncytial virus (RSV) is an important community and nosocomial pathogen in developed countries but data regarding the importance of RSV in developing countries are relatively scarce.MethodsDuring a 1-year surveillance study in 2010, we took serial samples from children admitted to the Emergency Unit of the Respiratory Ward of Children's Hospital 1 in Ho Chi Minh City, Vietnam. RSV was detected within 72hours of admission to the ward in 26% (376/1439; RSV A: n=320; RSV B: n=54; and RSV A and B: n=2). Among those negative in the first 72hours after admission, 66% (25/377) acquired nosocomial RSV infection during hospitalization (RSV A: n=22; and RSV B: n=3).ResultsChildren with nosocomial RSV infection were younger (P=0001) and had a longer duration of hospitalization (

Enterovirus 71–associated Hand, Foot, and Mouth Disease, Southern Vietnam, 2011

We prospectively studied 3,791 children hospitalized during 2011 during a large outbreak of enterovirus 71–associated hand, foot, and mouth disease in Vietnam. Formal assessment of public health interventions, use of intravenous immunoglobulin and other therapies, and factors predisposing for progression of disease is needed to improve clinical management

Successful thrombectomy of top-of-the-basilar artery occlusion - difficult to detect in clinical practice: A case report

Top-of-the-basilar artery occlusion frequently causes infarction of the midbrain, thalamus, and portions of the temporal and occipital lobes as the vascular supply of these regions comes from the posterior communicating and posterior cerebral arterial tributaries of the basilar artery. Clinical signs include an array of visual, oculomotor, and behavioral abnormalities, usually without prominent motor dysfunction, which makes diagnosis challenging for those inexperienced with these sign. We describe a 59-year-old male presenting with acute ischemic stroke due to top-of-the-basilar artery occlusion. Despite attempting several paraclinical examinations relating the sudden coma with Glasgow Coma Scale of 6 points, the neuroimaging detected the large vessel occlusion that was difficult to recognize. After confirming top-of-the-basilar artery occlusion, the recanalization was realized immediately. The patient was discharged with good clinical recovery

The natural history and transmission potential of asymptomatic severe acute respiratory syndrome coronavirus 2 infection

Background Little is known about the natural history of asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Methods We conducted a prospective study at a quarantine center for coronavirus disease 2019 in Ho Chi Minh City, Vietnam. We enrolled quarantined people with reverse-transcription polymerase chain reaction (RT-PCR)–confirmed SARS-CoV-2 infection, collecting clinical data, travel and contact history, and saliva at enrollment and daily nasopharyngeal/throat swabs (NTSs) for RT-PCR testing. We compared the natural history and transmission potential of asymptomatic and symptomatic individuals. Results Between 10 March and 4 April 2020, 14 000 quarantined people were tested for SARS-CoV-2; 49 were positive. Of these, 30 participated in the study: 13 (43%) never had symptoms and 17 (57%) were symptomatic. Seventeen (57%) participants imported cases. Compared with symptomatic individuals, asymptomatic people were less likely to have detectable SARS-CoV-2 in NTS collected at enrollment (8/13 [62%] vs 17/17 [100%]; P = .02). SARS-CoV-2 RNA was detected in 20 of 27 (74%) available saliva samples (7 of 11 [64%] in the asymptomatic group and 13 of 16 [81%] in the symptomatic group; P = .56). Analysis of RT-PCR positivity probability showed that asymptomatic participants had faster viral clearance than symptomatic participants (P  Conclusions Asymptomatic SARS-CoV-2 infection is common and can be detected by analysis of saliva or NTSs. The NTS viral loads fall faster in asymptomatic individuals, but these individuals appear able to transmit the virus to others

Clinical characteristics and laboratory values of children on admission, and outcome

†<p>Date of vaccination unless otherwise stated.</p>‡<p>HBV: Hepatitis B virus. Both received Euvax B™; MMR: Measles, Mumps, Rubella. All received Priorix™; varicella: Varilrix^R.</p>§<p>swelling at injection site beyond the expected after routine vaccination.</p>∥<p>Inotropes used were dopamine, dobutamine, noradrenaline.</p>**<p>MRSA: methicillin-resistant <i>Staphylococcus aureus</i>. NA denotes not available, a plus sign positive or present, and a minus sign negative or absent.</p>*<p>Normal ranges are as follows: hemoglobin concentration, 105–135 g/L; leukocyte count, 6 to 17.5·10⁹/L; platelet count, 150 to 400·10⁹/L; alanine aminotransferase (ALT) level, below 37 U/L; aspartate aminotransferase (AST) level, below 40 U/L; creatine phosphokinase (CK) below 200 U/L; serum creatinine concentration, 18–80 µmol/L;</p