Pathogenicity of an H5N1 avian influenza virus isolated in Vietnam in 2012 and reliability of conjunctival samples for diagnosis of infection

The continued spread of highly pathogenic avian influenza virus (HPAIV) subtype H5N1 among poultry in Vietnam poses a potential threat to animals and public health. To evaluate the pathogenicity of a 2012 H5N1 HPAIV isolate and to assess the utility of conjunctival swabs for viral detection and isolation in surveillance, an experimental infection with HPAIV subtype H5N1 was carried out in domestic ducks. Ducks were infected with 10[superscript 7.2] TCID[subscript 50] of A/duck/Vietnam/QB1207/2012 (H5N1), which was isolated from a moribund domestic duck. In the infected ducks, clinical signs of disease, including neurological disorder, were observed. Ducks started to die at 3 days-post-infection (dpi), and the study mortality reached 67%. Viruses were recovered from oropharyngeal and conjunctival swabs until 7 dpi and from cloacal swabs until 4 dpi. In the ducks that died or were sacrificed on 3, 5, or 6 dpi, viruses were recovered from lung, brain, heart, pancreas and intestine, among which the highest virus titers were in the lung, brain or heart. Results of virus titration were confirmed by real-time RT-PCR. Genetic and phylogenetic analysis of the HA gene revealed that the isolate belongs to clade 2.3.2.1 similarly to the H5N1 viruses isolated in Vietnam in 2012. The present study demonstrated that this recent HPAI H5N1 virus of clade 2.3.2.1 could replicate efficiently in the systemic organs, including the brain, and cause severe disease with neurological symptoms in domestic ducks. Therefore, this HPAI H5N1 virus seems to retain the neurotrophic feature and has further developed properties of shedding virus from the oropharynx and conjunctiva in addition to the cloaca, potentially posing a higher risk of virus spread through cross-contact and/or environmental transmission. Continued surveillance and diagnostic programs using conjunctival swabs in the field would further verify the apparent reliability of conjunctival samples for the detection of AIV.Japan Society for the Promotion of Science (Grant-in-Aid for Bilateral Joint Projects)Heiwa Nakajima FoundationNational Institute of Allergy and Infectious Diseases (U.S.) (Contract HHSN2662007000010C

Aquatic emergency preparedness and response system in Viet Nam

Viet Nam is one of the top worldwide producers of aquaculture products which accounts for about 22 percent of total agricultural GDP of Viet Nam. Recently, diseases have become the biggest challenge for global aquaculture development therefore the Vietnamese government has paid close attention to develop an effective aquatic emergency preparedness and response system to timely deal with disease introduction and outbreaks. The Department of Animal Health (DAH), under the Ministry of Agriculture and Rural Development (MARD), which is the competent authority of aquatic animal health management. To monitor transboundary diseases (especially the OIE-listed diseases), the current Vietnamese regulations only allow import of aquatic animals and its products which are certified as disease-free by competent authority of exporting country, and export aquatic animals and its products complying with importing conditions of importing country. Regional Animal Health Offices (belong to DAH) shall carry out sampling for testing pathogens and isolation for imported aquatic animals and its products as regulated in Circular 26/2016/TT-BNNPTNT dated 30 June 2016 before granting permit to import or export. For domestic transportation of aquatic animals, provincial sub DAH is responsible for monitoring infectious pathogens to certify disease-free status of aquatic animals before issuing health certificate for movement. In addition, a reporting and response system to aquatic animal diseases was established in the country from farm level to central level (DAH). Early detection and warning of diseases is critical for disease prevention and control, thus since 2014, the DAH has implemented national surveillance programs focusing on dangerous diseases in the key farming species (brackish-water shrimps, pangasius catfish) according to Circular 04/2016/TT-BNNPTNT dated 10 May 2016 of MARD and support exportation of aquatic animals and its products complying with international regulations and importing countries based on OIE recommendations and Circular 14/2016/TT-BNNPTNT dated 2 June 2016

Carbonization and H3PO4 activation of fern Dicranopteris linearis and electrochemical properties for electric double layer capacitor electrode

Today, the world’s climate change is a growing problem, plant carbon sequestration is one of the effective ways to mitigate climate change by reducing greenhouse gases, mostly carbon gases. Dicranopteris linearis (D. linearis), a common fern species in the tropic or subtropic ecoregions, has been recently recognized as a potential feedstock to produce highly porous biochar. This study aims to enhance the specific surface area (SSA) and pore volumes of biochars derived from the D. linearis by H3PO4 activation and examine electrical properties of the activated biochars and their possible usage for the electric double-layer capacitor (EDLC) electrode. The treated raw fern was activated with H3PO4 85% by the three different mixing ratios 1:0, 1:1, and 1:3 (w/w) and then pyrolysis under N2 flow maintained at 500 °C for 1 h. The performance as the electrode for an EDLC was evaluated in 1 mol L−1 H2SO4 solution for the H3PO4-activated samples. The SSA and pore volumes were drastically increased after activation. The maximum SSA and pore volume were 1212 m2 g−1 and 1.43 cm3 g−1, respectively for the biochar activated at 400 °C with a weight mixing ratio 1:3 (w/w) between the fern and H3PO4 acid while these values of the biochar at 400 °C were 12 m2 g−1 and 0.02 cm3 g−1, respectively. The biochar activated at 600 °C with the mixing ratio 1:1 (w/w) showed the maximum capacitance value, ca. 108 F g−1 at 1 mV s−1. The activation using H3PO4 showed a positive tendency to enhance electrochemical properties and it could be a premise toward a higher performance of EDLC from the D. linearis derived activated biochar

Rapid integrated assessment of food safety and nutrition related to pork consumption of regular consumers and mothers with young children in Vietnam

Pork is the most common and widely consumed meat product in Vietnam. The study aimed to assess nutrition and food safety risks and opportunities associated with pork value chains in Vietnam. Twenty-nine focus group discussions (FGD) were conducted in Hung Yen and Nghe An provinces with 164 participants who were both regular pork consumers and mothers with young children. In each province, three districts were selected, and in each district we selected one commune. To assess the quality of pork, we took 30 swab samples of pig carcasses at slaughterhouses, 90 pork samples at slaughterhouses and markets and analysed all samples for total bacterial count (TBC), coliforms, water holding capacity and pH. The results showed that pork was the main livestock product consumed and women are responsible for buying and preparing food for daily meals. Pork was the main animal sourced food (ASF) for Vietnamese consumers, for 50–60% of ASF. There was little knowledge of zoonotic diseases. The findings suggest further studies to address consumers’ concern on chemical contamination. Most market pork samples were not within the allowable range of limits standards of Vietnam for bacterial contamination: 90% of samples were above the official permissible limit for TBC and 98% did not meet standards for coliforms. Fifty percent of samples had acceptable pH but only 5% had acceptable water holding capacity. There were no significant differences in pork quality between intensifying Hung Yen and traditional Nghe An provinces, although there was a tendency for samples from Hung Yen to have better compliance. This rapid assessment revealed considerable interest and knowledge on pork nutrition and safety and found some behavioural but few quality and safety differences between traditional and intensifying systems. This indicated marketed pork is of low quality and safety, and a lack of support to consumers in making good choices

Point-of-care C-reactive protein testing to reduce inappropriate use of antibiotics for non-severe acute respiratory infections in Vietnamese primary health care: a randomised controlled trial

Background Inappropriate antibiotic use for acute respiratory tract infections is common in primary health care, but distinguishing serious from self-limiting infections is diffi cult, particularly in low-resource settings. We assessed whether C-reactive protein point-of-care testing can safely reduce antibiotic use in patients with non-severe acute respiratory tract infections in Vietnam. Method We did a multicentre open-label randomised controlled trial in ten primary health-care centres in northern Vietnam. Patients aged 1–65 years with at least one focal and one systemic symptom of acute respiratory tract infection were assigned 1:1 to receive either C-reactive protein point-of-care testing or routine care, following which antibiotic prescribing decisions were made. Patients with severe acute respiratory tract infection were excluded. Enrolled patients were reassessed on day 3, 4, or 5, and on day 14 a structured telephone interview was done blind to the intervention. Randomised assignments were concealed from prescribers and patients but not masked as the test result was used to assist treatment decisions. The primary outcome was antibiotic use within 14 days of follow-up. All analyses were prespecifi ed in the protocol and the statistical analysis plan. All analyses were done on the intention-totreat population and the analysis of the primary endpoint was repeated in the per-protocol population. This trial is registered under number NCT01918579. Findings Between March 17, 2014, and July 3, 2015, 2037 patients (1028 children and 1009 adults) were enrolled and randomised. One adult patient withdrew immediately after randomisation. 1017 patients were assigned to receive C-reactive protein point-of-care testing, and 1019 patients were assigned to receive routine care. 115 patients in the C-reactive protein point-of-care group and 72 patients in the routine care group were excluded in the intention-to-treat analysis due to missing primary endpoint. The number of patients who used antibiotics within 14 days was 581 (64%) of 902 patients in the C-reactive protein group versus 738 (78%) of 947 patients in the control group (odds ratio [OR] 0·49, 95% CI 0·40–0·61; p<0·0001). Highly signifi cant diff erences were seen in both children and adults, with substantial heterogeneity of the intervention eff ect across the 10 sites (I²=84%, 95% CI 66–96). 140 patients in the C-reactive protein group and 137 patients in the routine care group missed the urine test on day 3, 4, or 5. Antibiotic activity in urine on day 3, 4, or 5 was found in 267 (30%) of 877 patients in the C-reactive protein group versus 314 (36%) of 882 patients in the routine treatment group (OR 0·78, 95% CI 0·63–0·95; p=0·015). Time to resolution of symptoms was similar in both groups. Adverse events were rare, with no deaths and a total of 14 hospital admissions (six in the C-reactive protein group and eight in the control group). Interpretation C-reactive protein point-of-care testing reduced antibiotic use for non-severe acute respiratory tract infection without compromising patients’ recovery in primary health care in Vietnam. Health-care providers might have become familiar with the clinical picture of low C-reactive protein, leading to reduction in antibiotic prescribing in both groups, but this would have led to a reduction in observed eff ect, rather than overestimation. Qualitative analysis is needed to address diff erences in context in order to implement this strategy to improve rational antibiotic use for patients with acute respiratory infection in low-income and middle-income countries

Associations of Underlying Health Conditions With Anxiety and Depression Among Outpatients: Modification Effects of Suspected COVID-19 Symptoms, Health-Related and Preventive Behaviors

Objectives: We explored the association of underlying health conditions (UHC) with depression and anxiety, and examined the modification effects of suspected COVID-19 symptoms (S-COVID-19-S), health-related behaviors (HB), and preventive behaviors (PB).Methods: A cross-sectional study was conducted on 8,291 outpatients aged 18–85 years, in 18 hospitals and health centers across Vietnam from 14th February to May 31, 2020. We collected the data regarding participant's characteristics, UHC, HB, PB, depression, and anxiety.Results: People with UHC had higher odds of depression (OR = 2.11; p &lt; 0.001) and anxiety (OR = 2.86; p &lt; 0.001) than those without UHC. The odds of depression and anxiety were significantly higher for those with UHC and S-COVID-19-S (p &lt; 0.001); and were significantly lower for those had UHC and interacted with “unchanged/more” physical activity (p &lt; 0.001), or “unchanged/more” drinking (p &lt; 0.001 for only anxiety), or “unchanged/healthier” eating (p &lt; 0.001), and high PB score (p &lt; 0.001), as compared to those without UHC and without S-COVID-19-S, “never/stopped/less” physical activity, drinking, “less healthy” eating, and low PB score, respectively.Conclusion: S-COVID-19-S worsen psychological health in patients with UHC. Physical activity, drinking, healthier eating, and high PB score were protective factors

The Sudden Dominance of blaCTX–M Harbouring Plasmids in Shigella spp. Circulating in Southern Vietnam

Shigellosis is a disease caused by bacteria belonging to Shigella spp. and is a leading cause of bacterial gastrointestinal infections in infants in unindustrialized countries. The Shigellae are dynamic and capable of rapid change when placed under selective pressure in a human population. Extended spectrum beta lactamases (ESBLs) are enzymes capable of degrading cephalosporins (a group of antimicrobial agents) and the genes that encode them are common in pathogenic E. coli and other related organisms in industrialized countries. In southern Vietnam, we have isolated multiple cephalosporin-resistant Shigella that express ESBLs. Furthermore, over two years these strains have replaced strains isolated from patients with shigellosis that cannot express ESBLs. Our work describes the genes responsible for this characteristic and we investigate one of the elements carrying one of these genes. These finding have implications for treatment of shigellosis and support the growing necessity for vaccine development. Our findings also may be pertinent for other countries undergoing a similar economic transition to Vietnam's and the corresponding effect on bacterial populations

Micronutrient Deficits Are Still Public Health Issues among Women and Young Children in Vietnam

Background: The 2000 Vietnamese National Nutrition Survey showed that the population’s dietary intake had improved since 1987. However, inequalities were found in food consumption between socioeconomic groups. As no national data exist on the prevalence of micronutrient deficiencies, a survey was conducted in 2010 to assess the micronutrient status of randomly selected 1526 women of reproductive age and 586 children aged 6–75 mo. Principal Findings: In women, according to international thresholds, prevalence of zinc deficiency (ZnD, 67.262.6%) and vitamin B12 deficiency (11.761.7%) represented public health problems, whereas prevalence of anemia (11.661.0%) and iron deficiency (ID, 13.761.1%) were considered low, and folate (,3%) and vitamin A (VAD,,2%) deficiencies were considered negligible. However, many women had marginal folate (25.1%) and vitamin A status (13.6%). Moreover, overweight (BMI$23 kg/m 2 for Asian population) or underweight occurred in 20 % of women respectively highlighting the double burden of malnutrition. In children, a similar pattern was observed for ZnD (51.963.5%), anemia (9.161.4%) and ID (12.961.5%) whereas prevalence of marginal vitamin A status was also high (47.362.2%). There was a significant effect of age on anemia and ID prevalence, with the youngest age group (6–17 mo) having the highest risk for anemia, ID, ZnD and marginal vitamin A status as compared to other groups. Moreover, the poorest groups of population had a higher risk for zinc, anemia and ID

Viral Etiology of Encephalitis in Children in Southern Vietnam: Results of a One-Year Prospective Descriptive Study

Viral encephalitis is associated with high morbidity and mortality in Vietnam. However little is known about the causes of the disease due to a lack of diagnostic facilities in this relatively resource-poor setting. Knowledge about the etiologies and clinical outcome of viral encephalitis is necessary for future design of intervention studies targeted at improvement of clinical management, treatment and prevention of the disease. We report the viral agents, clinical outcome and prognostic factors of mortality of encephalitis in children admitted to a referral hospital for children in southern Vietnam. We show that about one third of the enrolled patients die acutely, and that mortality is independently associated with patient age and Glasgow Coma Scale on admission. Japanese encephalitis, dengue virus and enterovirus (including enterovirus 71) are the major viruses detected in our patients. However, more than half of the patients remain undiagnosed, while mortality in this group is as high as in the diagnosed group. This study will benefit clinicians and public health in terms of clinical management and prevention of childhood encephalitis in Vietnam

Dual Electron Spectrometer for Magnetospheric Multiscale Mission: Results of the Comprehensive Tests of the Engineering Test Unit

The Magnetospheric Multiscale mission (MMS) is designed to study fundamental phenomena in space plasma physics such as a magnetic reconnection. The mission consists of four spacecraft, equipped with identical scientific payloads, allowing for the first measurements of fast dynamics in the critical electron diffusion region where magnetic reconnection occurs and charged particles are demagnetized. The MMS orbit is optimized to ensure the spacecraft spend extended periods of time in locations where reconnection is known to occur: at the dayside magnetopause and in the magnetotail. In order to resolve fine structures of the three dimensional electron distributions in the diffusion region (reconnection site), the Fast Plasma Investigation's (FPI) Dual Electron Spectrometer (DES) is designed to measure three dimensional electron velocity distributions with an extremely high time resolution of 30 ms. In order to achieve this unprecedented sampling rate, four dual spectrometers, each sampling 180 x 45 degree sections of the sky, are installed on each spacecraft. We present results of the comprehensive tests performed on the DES Engineering & Test Unit (ETU). This includes main parameters of the spectrometer such as energy resolution, angular acceptance, and geometric factor along with their variations over the 16 pixels spanning the 180-degree tophat Electro Static Analyzer (ESA) field of view and over the energy of the test beam. A newly developed method for precisely defining the operational space of the instrument is presented as well. This allows optimization of the trade-off between pixel to pixel crosstalk and uniformity of the main spectrometer parameters