Objective: To document the evolution and optimization of the Zika virus (ZIKV) disease surveillance system in southern Viet Nam in 2016 and to describe the characteristics of the identified ZIKV-positive cases. Methods: We established a sentinel surveillance system to monitor ZIKV transmission in eight sites in eight provinces and expanded the system to 71 sites in 20 provinces in southern Viet Nam in 2016. Blood and urine samples from patients who met the case definition at the sentinel sites were tested for ZIKV using real-time reverse transcription polymerase chain reaction at the Pasteur Institute in Ho Chi Minh City (PI-HCMC). We conducted descriptive analysis and mapped the ZIKV-positive cases. Results: In 2016, 2190 specimens from 20 provinces in southern Viet Nam were tested for ZIKV at PI-HCMC; 626 (28.6%), 484 (22.1%), 35 (1.6%) and 1045 (47.7%) tests were conducted in the first, second, third and fourth quarters of the year, respectively. Of these tested specimens, 214 (9.8%) were ZIKV positive with 212 (99.1%) identified in the fourth quarter. In the fourth quarter, the highest positivity rate was those in age groups 30–39 years (30.0%) and 40–59 years (31.6%). Of the 214 ZIKV-positive patients, 210 (98.1%) presented with rash, 194 (90.7%) with fever, 149 (69.6%) with muscle pain, 123 (57.5%) with joint pain and 66 (30.8%) with conjunctivitis. Discussion The surveillance system for ZIKV disease underwent several phases of optimization in 2016, guided by the most up-to-date local data. Here we demonstrate an adaptable surveillance system that detected ZIKV-positive cases in southern Viet Nam.

In this report we describe a new approach in HIV sentinel surveillance that was piloted in Viet Nam in 2009 and is currently being rolled out in all provinces. It comprises a brief behavioural questionnaire added to the HIV sentinel surveillance surveys conducted routinely among people who inject drugs, female sex workers and men who have sex with men. Timely reporting of data from this system has resulted in improvements to HIV prevention efforts for most at-risk populations.

Background: Recently Japanese Encephalitis (JE) virus type 1 has surfaced and is co-circulated with JE virus type 3 in the northern areas of Viet Nam, so a sensitivity of JE viral antigen genotype 3 to detect IgM is required. Objectives: To compare the sensitivity of JE viral antigen genotype 1 and 3 to detect IgM against the JE virus. Materials and method: 783 cerebrospinal fluid and serum samples from viral encephalitis cases from 1999-2005 were collected and examined by MAC-ELISA for JE viral antigen genotype 1 and 3. Results: The agreement on the diagnosis of these kinds of antigen was 99.7% and the sensitivity of JE viral antigen genotype 3 was higher than that of genotype 1. Thus, JE viral antigen genotype 3 could be considered as the selected antigen for JE diagnosis in Viet Nam. IgM titer determined by JE viral antigen genotype 1 was higher than that of genotype 3 in 2003 and 2005 and lower in 1999, 2000, 2001, 2002 and 2004. Conclusion: The dominant phenomenon of JE viral genotypes differing over the years might be due to the interaction of the virus and its vectors. Further study is required to clarify this observation.
Japanese Encephalitis ; antigen

Background: Mosquitoes and pigs play important roles in maintaining and increasing the Japanese Encephalitis (JE) virus in nature and which is then transmitted to humans. Thus, surveillance of the JE infection frequency in the pig population may predict the human JE cases. \r\n', u'Objectives: The study aimed to determine IgG antibody against the JE virus in the pig population in Hanam province \r\n', u'Subjects and methods: The study included 1791 pig serum samples collected from 3 districts of Hanam province from Apr 2006 to Mar 2007. GAC-ELISA technique was used to determine the JE virus infection in the swine population.\r\n', u'Results: The average positive rate in pig population was 34.9 % (626/1791); with the highest frequency occurring in the summer (37.7%- 84.0 %), co-incident with the JE season in Northern Vietnam. On the contrary, in winter JE case are rare, frequency of IgG antibody against JE virus in the swine population was low, ranging from 9.2% to 22.0.%. \r\n', u'Conclusions: These results have shown the ecologically close relationship between the amplification of the JE virus in the swine population, vector and JE cases in northern Vietnam. \r\n', u'
Japanese encephalitis ; pig population ; GAC-ELISA.

Background: Japanese Encephalitis (JE) virus is a leading cause of encephalitis in children with high mortality and complication. JE is a dangerous infectious disease via Culex mosquitoes. Objective: To identify the density of some mosquitoes and vectors that transmit JE virus in Ha Nam province. Subject and Method:There were 30.333 mosquitoes including 05 genera and 15 species which were collected at night from April 2006 to March 2007 in the following communes: Tanson (midland area) Hungcong (plain area) and Liemchinh (suburban area). Results: A total of 06 Culex species, the highest rate is Culex tritaeniohychus (41.20%); Culex annulus (15.56%); other Culex species occupied around 0.15% -2.49%. In these communes, the density of Culex tritaeniohychus was higher than Culex annulus. They were found to be active all year round, but the highest density of Culex tritaeniohychus and Culex annulus is 5.86 and 2.15, respectively in April and fall to 4.35% and 1.71% in July. The collected mosquitoes during April, May, June and July includes 133 and 28 Culex tritaeniohychus and Culex annulus pools, respectively; all were to be processed for the isolation of Japanese Encephalitis (JE) virus. There were 12 Culex tritaeniohychus and 2 Culex annulus pools which were collected in Tanson commune yielding positive. Conclusion: The results were confirmed that Culex tritaenioohychus and Culex annulus are the major vectors that transmit JE virus in Ha Nam, 2006 - 2007. All 14 JE virus strains were isolated from collected mosquito pools during April, May and June; whereas JE virus strain was not yet isolated from collected mosquito pool in July. Thus, in order to control JE disease, it is necessary to control JE vectors in April, May and June.
Vector ; Culex tritaenioohychus ; Japanese encephalitis ; Ha Nam

Background: Japanese Encephalitis (JE) is common in the plains and mountainous areas in Asia \u2013 Pacific. Japanese encephalitis vaccine shows effectiveness in protecting children from JE in some countries such as Japan and Korea. Objective: To evaluate the efficacy of Japanese Encephalitis (JE) vaccination in Thai Binh province during 2003-2007. Subject and Method: Prospective, retrospective and sero-epidemiological methods were carried out on 329 samples collected from viral encephalitis patients and tested by JE MAC-ELISA, the positive average was 41.6% (137/329). Result: It had dramatically dropped from 85.2% in 2003 to 8.5 % in 2007 related to the rate of JE vaccination for children from 1 to 5 years old increasing from 49 % in 2003 to 77 % in 2007. Most of JE confirmed cases were un-vaccinated. Conclusion: JE etiology cause viral encephalitis in children in Thai Binh province was reduced thanks to JE vaccination in EPI program for 1 to 5 year old children. But more than 96% (131/136) of viral encephalitis in 15 years old upward was unknown etiology, the need for further study of the etiology cause viral encephalitis in adults.
Japanese encephalitis ; virus encephalitis ; MAC-ELISA ; Vaccine

Background: IgM antibody capture ELISA (MAC-ELISA) technique has been widely applied for Japanese Encephalitis Virus (JEV) diagnosis. So far rare internationally commercial kits are available. Thus, the international evaluation of the kit is required as per the recommendation of the WHO. Objectives: To evaluate the quality of the IgM antibody capture ELISA diagnostic kit for JEV produced by the Vietnam National Institute of Hygiene and Epidemiology (NIHE). Subjects and method: In this study, NIID kit was used as control to check the kit from NIHE. Both NIHE and NIID kits were used to detect JEV IgM among 38 serum and 6 CFS samples, which belongs to 5 sample groups (JE patients group, dengue patients group, other viral encephalitis patients group, Tick Born Encephalitis (TBE) patient group and healthy JE vaccinated donors group). Results: The detection of JEV IgM by NIHE kit was concurrent with the NIID kit. There is no positive with the JE in the groups of Dengue patients, TBE, other virus encephalitis patients and JE vaccinated donors. Conclusion: MAC-ELISA kit of NIHE can be used for different diagnosis of JEV and Dengue virus (both viruses are in Flavivirus genus), as well as other viruses caused by encephalitis.
IgM antibody ; ELISA diagnostic kit ; Japanese encephalitis virus

Background: In recent year, Japanese Encephalitis Virus (JEV) genotype 1 has been detected among isolates from mosquitoes and pig\u2019s blood samples in northern Viet Nam, but there has been no information on the presence of this genotype in the Central, Southern and Highland regions. Objectives: This study aims to detect the Japanese encephalitis genotype 1 in various different geographic regions of Viet Nam. Material and method: Sequence analysis\u2019s of whole E gene of 18 strains isolated from human, mosquitoes and pig\u2019s blood during 2001-2007. Results: 7 strains isolated from pig\u2019s blood and mosquito samples in the Northern, Central, Southern and Highland fell into genotype 1, but 11 others isolated from humans in the Northern and Central regions belonged to genotype 3. Conclusion: This is the first time that JEV genotype 1 was detected in the central, northern, highland Viet Nam and further studies on genotype 1 causing human diseases needs to be carried out.\r\n', u'\r\n', u'
Virus ; Japanese Encephalitis ; genotype 1 ; E gene.

Background: Viet Nam is located in the epidemiological region of Japanese Encephalitis (JE). JE vaccine manufactured in Viet Nam has been used in the national vaccination program since 2003, but there has been no scientific study on the effectiveness of this program in Ha Nam province. Objectives: To investigate the epidemiology of JE and effectiveness of vaccinations in Ha Nam province from 2001-2006. Subjects and method: All residents in Ha Nam province, with the key focus group being JE cases. The retrospective and prospective epidemiological descriptive method was used. Results: The records of 148 cases of JE were collected. Among them, 42.5% (63 cases) were confirmed as JE by MAC-ELISA. The incidence and mortality rate were 1.29/100,000 and 0.12/100,000, respectively. Confirmed JE cases were found annually in all districts of Ha Nam province. However, it has been in decline, especially since the vaccination program was implemented for 1-5 year old children. The disease occurred in the summer with the peak in May and June (80.9% of total cases). Most of the cases were children under 15 years old (98.4%). The highest incidence rate was 6.4/100,000; 5.5/100,000 and 5.3/100,000 in the children aged 5-9, 1-4 and under 1 year old, respectively. Conclusion: The vaccination program appeared effective in reducing the mortality and morbidity of JE among children in Ha Nam province.
Japanese Encephalitis ; epidemiology

Background: Massive blood transfusion is common in surgery: trauma, complicated surgery, organ implantation. Stored blood contains much lactate, ammonia, products of metabolism. These products have negative effects on patient\u2019s metabolic function which may be a cause of death. Objective: To study the change of blood biochemical indexes in surgical patients with massive blood transfusion at Viet Duc hospital. Subjects and method: A prospective study was conducted in the adult patients who had emergency and operation at Viet Duc hospital, from December/2004 to August/2006. All of them were transfused over 3000 ml of blood within 24 hours (pre-operation, intra-operation and post-operation). Results: During the period of study, there were 70 surgical patients with massive blood transfusion: men were more than woman (64%) and the mean age: 38\xb117. The survival rate was significantly improved (57%). The average transfused blood per patient per 24 hours was 3995ml\xb11067ml. There was a decrease in the value of pH, acid-base and HCO3 (the average pH value 7.218\xb10.181, lowest value 6.7). The average value of pH and HCO3\xac was higher in the survival patients than died patients (p<0.05). The mean level of K+ was 3.8\xb10.96mml/l. The increase in the level of K+ had a positive association with the amount of transfused blood. The mean level of Ca++ \xac\xacdecreased under the normal level (0.98mml). Conclusion: It should monitor blood gas and electrolytes continuously in surgical patients with massive blood transfusion in order to identify disorders soon for timely treatment.
Blood Transfusion